February is Heart Month

Advanced Treatment Options are Saving Lives at Montefiore

By Dr. Edwin Ho, co-director, Heart Valve/Structural Heart Center, Montefiore Einstein Center for Heart & Vascular Care, February 9, 2020

HEALTH- Diseases of the heart valves are common and tend to affect more people as they get older. This can include valve narrowing, leaking, or a combination of both.

Individuals develop these conditions either because they were born with an abnormal heart valve or because of wear and tear that happens slowly over time.

While symptoms of a heart valve problem are variable, the most common reported symptoms are related to those that limit exertion, including shortness of breath, fatigue, lightheadedness and chest pain.

Heart valve disease is always followed by a care team specializing in cardiovascular medicine and is treated with medicines if needed.

In the past, if medicines were not enough to treat these valve problems, the only additional option was open heart surgery. This is when a surgeon will open the chest to directly repair or replace a heart valve.

In the last decade, many advances in technology have allowed doctors to now fix many common valve problems using minimally invasive techniques. These are often referred to as “transcatheter” options and are generally able to avoid opening the chest. Many are performed through a blood vessel in the groin area instead. Special devices can be brought to the heart through these blood vessels and allow doctors to repair or replace valves.

Advances in structural heart imaging, in particular, are allowing more procedures to be developed and performed to solve certain valve conditions that previously had limited treatment strategies.

Patients who might benefit from these treatments are those with valve problems that need more than medicines, but may be at increased risk for conventional open surgery or who do not want open surgery after a discussion with their cardiac care team. Specific advantages and disadvantages of different treatment options are evaluated on a case by case basis, because many factors need to be considered.

One example of a commonly performed minimally invasive valve treatment in the United States is called transcatheter aortic valve replacement, or “TAVR.” This is performed to treat a dangerously narrowed aortic valve, which is the last of the four main valves of the heart that blood will travel through before exiting the heart and entering the rest of the body. A specially developed artificial heart valve is compressed and brought to the heart through a blood vessel (usually from the leg) and implanted inside the existing narrowed valve.

Montefiore Health System is able to offer a wide variety of options for treating heart valve disease, including both conventional open surgery as well as newer transcatheter technologies. Some of these are well established techniques used every day all around the world, while others are more novel and offer options to patients who previously had very few or none at all.

The Montefiore Heart Valve specialty team is based out of the Structural Heart Clinic (located at the Montefiore Hutchinson Campus) and is run by doctors and nurse practitioners with expertise in the treatment of heart valve disease. This includes doctors with subspecialized training in interventional cardiology, cardiac surgery and cardiac imaging, all key components in evaluating patients so that the best treatment options for each individual person can be recommended and performed.

Our team has extensive international experience with some of the newest technologies that expand the potential treatment options for our patients right here in the Bronx and surrounding areas.

Care from the clinic is not meant to replace the role of a person’s usual cardiac care team, but rather serves a complementary role in the treatment of heart valve problems.

To get in touch with the Structural Heart Clinic, please call: 718-904-3442.