More than five million people are diagnosed with valvular heart disease each year, with more than 13 percent of adults over the age of 75 suffering from some form of the disease.
When confronted with a diagnosis of valvular heart disease, patients often ask: What caused this?
Valvular heart disease is a progressive condition in which any one of the valves in the heart is damaged or diseased. There are multiple forms of the disease, as well as a number of factors that can cause it.
As we age, calcium deposits form on the leaflets of our heart, causing them to thicken. Think of these leaflets as the doors that allow oxygen-rich blood to flow to your entire body. As calcium builds, it becomes harder for the “doors” to open and deliver blood flow to the body. This extra labor can lead to weakening of the heart muscle. For the patient, this can cause shortness of breath, increased fatigue, chest pressure, feeling dizzy or passing out. Oftentimes patients associate these symptoms with simply getting older when, in fact, they could be indicative of a problem with the heart valves.
Other causes can include congenital heart defects present at birth or rheumatic fever, an infection that can damage the heart valves.
An innovative, multidisciplinary approach to care
The Structural Heart Program at Tallahassee Memorial HealthCare (TMH) brings to the Big Bend region innovative techniques for treating life-threatening heart disorders – specifically those impacting the heart’s valves – available only at select hospitals across the country. Through a multidisciplinary approach in a clinic setting, the team is able to review patients’ cases and identify the best individual care plans for treating their valvular heart disease.
This collaborative approach to treatment offers patients more efficient care, with expert insight and guidance from cardiologists, interventional cardiologists, heart surgeons, anesthesiologists and other allied health professionals, including nurse practitioners, nurses, physician assistants, imaging specialists and anesthesia providers. Leading this team are Structural Heart Program Co-Chairs and interventional cardiologists, Thomas E. Noel, MD, FACC and Pablo A. Rengifo-Moreno, MD; cardiothoracic surgeons, Edward R. Ferguson, MD, Juan J. Gallegos, MD, C. Patrick Murrah, MD, FACS and David L. Saint, MD, FACS; and Structural Heart Program Manager, Catie Yarborough, BSN, RN.
Once a patient wraps their head around a diagnosis, the next question is usually: What happens now?
When you are diagnosed with heart valve disease, a series of diagnostic tests can help determine the severity of your disease, which will in turn guide the most appropriate treatment course.
One of the most common and serious valve diseases is aortic stenosis, which involves the narrowing of the heart’s aortic valve opening connecting the left ventricle and aorta. For eligible patients who present with severe and symptomatic aortic stenosis but are deemed intermediate or high risk for open chest surgery, the structural heart team at TMH offers a minimally invasive treatment with a quick recovery – transcatheter aortic valve replacement, or TAVR.
By delivering a small, stent-like valve to the heart through a catheter inserted via a small incision in the patient’s groin, this procedure allows our team to open the individual’s narrowed valve without ever having to open the chest. This procedure takes place in one of TMH’s four state-of-the-art Cath Labs. Patients typically feel immediate relief of symptoms, require just one overnight stay in the hospital and are only minimally limited for the first two weeks of recovery.
The Structural Heart Program also offers a minimally-invasive treatment option for patients suffering from mitral regurgitation (MR) – a condition in which the heart’s mitral valve leaflets do not close tightly, causing blood to flow backward from the heart’s left ventricle into the left atrium. This makes the heart work harder to push blood through the body. Patients with MR caused by a structural defect in the heart, who are experiencing symptoms and are deemed too high risk for surgery, may be candidates for the minimally invasive implantation of a device called MitraClip.
As with TAVR, this procedure is performed by Structural Heart Program leaders, Dr. Noel and Dr. Rengifo-Moreno, in the Cath Lab via a catheter-guided delivery system. The MitraClip procedure involves placing a small clip-like device that brings the separated valve leaflets together, reducing the backflow of blood, or regurgitation, into the left atrium. Patients often feel relief of symptoms, specifically shortness of breath, immediately following the procedure.
Our heart physicians at TMH perform more clinical research and advanced procedures than any other program in the North Florida and South Georgia region, meaning TMH frequently has the opportunity to participate in and offer eligible patients access to cardiac research trials. In fact, TMH is one of only a hand full of institutions chosen to participate in select valvular heart disease studies.
The next frontier of valvular medicine lies in treating tricuspid valve regurgitation – a condition in which the tricuspid valve, located between the heart’s right ventricle and right atrium, allows blood to leak into the right ventricle. Our physicians are currently involved in clinical trials to advance treatment options for patients with tricuspid valve regurgitation. If you think you may be a fit for these trials, please call Structural Heart Program Manager, Catie Yarborough, at 850-431-7397.