Symptoms | Diagnosis | Conditions | Treatment | For More Information
Structural heart disease is a fairly common condition that refers to abnormalities of the heart’s structure, including its valves, walls or muscle. It can encompass a wide range of conditions and can be congenital or acquired later in life.
The heart contains valves that work together to ensure proper blood flow in and out of this vital organ. Valvular heart disease—one of the most common types of structural heart disease—occurs when one of these one way valves malfunctions or interrupts normal blood flow due to a blocked or narrowed valve (stenosis) or a leaking valve (regurgitation). Some individuals may have a valve abnormality from birth while others may develop a heart valve problem due to infection and inflammation. In most cases, valvular heart disease is acquired and develops over time. Patients most at risk for this type of heart disorder are usually over 70 years of age.
At NorthShore Cardiovascular Institute, our Structural Heart Disease Program has assembled one of the best multidisciplinary teams in the nation to evaluate, treat and provide coordinated care for patients with heart valve problems and all types of structural heart disease. We have been leaders in the development of innovative minimally invasive treatments for complex valvular heart disease and other structural heart conditions for many years. And, our team also participates in innovative research to develop new, less invasive treatment options. As a result of our participation in these important clinical trials, we are able to provide our patients with new, leading edge technologies to better treat their structural heart disease.
Our experienced cardiologists, interventional cardiologists, cardiovascular surgeons and cardiac rehabilitation specialists work as a team to provide collaborative, seamless cardiovascular care. We are committed to developing individualized treatment plans to treat a myriad of structural heart conditions.
Structural Heart Disease Symptoms
It is important to identify and treat structural heart disease in as timely manner as possible. If left untreated it can lead to heart failure and other serious complications.
Symptoms of heart valve problems can vary by individual and may or may not always be identifiable. In many cases, symptoms may worsen over time. For some, this gradual worsening of symptoms makes it hard to identify a specific issue. Other individuals may not experience symptoms at all.
The most common symptoms of structural heart disease include:
- Shortness of breath
- Swelling of feet and ankles
- Chest pain
- Dizziness or lightheadedness
Dizziness or lightheadedness, if progressive, may put a patient at risk for passing out and serious harm.
In addition to these telltale symptoms of heart valve problems, a physician might suspect structural heart disease if a murmur is detected during a routine physical exam and cardiac imaging test. A heart murmur produces an abnormal sound caused by irregular blood flow as a result of a malfunctioning valve or a hole in the heart.
Diagnosis of Structural Heart Disease
At the NorthShore Cardiovascular Institute, we take an integrated multispecialty approach to your care. Patients usually undergo an initial evaluation by one of our knowledgeable cardiologists. We will ask you about your medical history and conduct a physical exam. Most patients undergo non-invasive tests, including EKGs and echocardiograms (ultrasound exams). Additional imaging may also be recommended such as cardiac computed tomography scan (CT scan) or cardiac magnetic resonance imaging (MRI). We also often employ exercise stress testing as another tool to evaluate the severity of a heart condition.
Sometimes additional and more invasive testing to complete an evaluation may be required, including transesophageal echocardiography and cardiac catheterization.
Through a team approach, we are able to streamline your heart diagnosis to get you treated and back to health as efficiently as possible. Our structural heart disease experts collaborate on your care with a vast team of experts—from cardiac imaging specialists, cardiovascular surgeons, interventional cardiologists to advanced practice nurses and more.
Structural Heart Disease Conditions
Our Structural Heart Disease Program at NorthShore has both the experience and expertise to treat a wide range of structural heart conditions, including:
Our team of experts also treats patients with conditions relating to failing surgical valves or rings with stenosis or regurgitation as well as offers stroke prevention procedures in patients with atrial fibrillation.
Structural Heart Disease Treatment Options
Depending on your heart condition and its severity, our team works to develop a customized treatment plan. This plan may involve medical therapies, standard open heart surgery or new minimally invasive procedures.
Initial treatment of structural heart disease often begins with managing the condition with medications. Maintenance care involves:
- Minimizing symptoms of structural heart disease
- Protecting and slowing the deterioration of valve function
- Optimally determining the timing of more aggressive treatment, such as a minimally invasive procedure or open heart surgery
Traditional open heart surgery is the standard of care for the repair or replacement of heart valves in patients with a low risk of having surgical complications. Our highly skilled cardiothoracic surgeons have vast experience repairing and/or replacing aortic and mitral valves. They work closely with our cardiologists to determine the best course of action for your particular heart valve problem.
For patients who are too sick or at high risk for open heart surgery, the NorthShore Cardiovascular Institute offers innovative minimally invasive catheter-based techniques that are at the forefront of valve care. These minimally invasive techniques can either repair or replace heart valves, or correct other structural heart disease conditions.
Our team of experts continues to be leaders in structural heart interventions and offers a wide variety of innovative, cutting edge treatments and clinical trials for structural heart disease, including:
- Transcatheter aortic valve replacement (TAVR) – Patients with severe aortic stenosis can benefit from this procedure. Depending on a patient’s risk, our team can assess which TAVR treatment option will be best suited for his or her individual case. Our experts are involved in a variety of different clinical trials to treat low, intermediate and high risk patients. We are also able to offer transcaval access for valve replacement in patients who do not have a good aortic access option.
- Transcatheter mitral valve replacement (TMVR) – NorthShore is one of only a handful of centers in the world performing transcatheter mitral valve replacement (TMVR) to treat patients with mitral valve disorders who cannot have standard valve replacement surgery due to extremely high surgical risk.. This is a revolutionary, minimally invasive procedure that replaces mitral valves without open heart surgery. NorthShore is one of a few centers in the country to have more than one clinical trial for TMVR. The MITRAL trial is evaluating the safety of TMVR in patients with calcific mitral stenosis and failing surgical rings who cannot have standard open heart surgery. NorthShore’s Dr. Mayra Guerrero is the National Prinicipal investigator and sponsor of this clinical trial. The Tendyne trial is available to patients with mitral regurgitation in native valves. Our experts also offer transcatheter valve-in-valve procedures to treat patients with failing surgical bioprosthesis who cannot have standard surgery.
- Transcatheter mitral valve repair (MitraClip) - Our internationally renowned interventional cardiology team has pioneered this new treatment for patients with mitral regurgitation or leaky heart valves. The procedure involves inserting via catheter a device known as the MitraClip to repair the valve. Recently approved by the Food and Drug Administration, this novel device therapy has proven successful and offers much promise for patients who otherwise have few valvular heart disease treatment options. In 2003, NorthShore was the first medical center in the country to perform mitral valve repair using the MitraClip. This treatment option is commercially available for degenerative mitral regurgitation and for functional mitral regurgitation through a clinical trial.
- Percutaneous Paravalvular Leak Closure (aortic, mitral) – This minimally invasive technique is done to repair a leak caused after a surgical or transcatheter aortic or mitral valve replacement. While a paravalvular leak (PVL) is a rather uncommon complication of a previous surgery, if left untreated it can lead to heart failure and anemia.Our cardiac experts take great care to ensure the closure is properly performed.
- Percutaneous Left Atrial Appendage Closure – NorthShore offers device procedure options—including the WATCHMAN device—to close the left atrial appendage in patients who are at risk of developing blood clots or have an increased risk of stroke. A closure procedure may be especially helpful in patients with atrial fibrillation.
- Alcohol Septal Ablation – This procedure is done to treat patients with hypertrophic cardiomyopathy by removing excess heart tissue via an alcohol injection.This procedure can help improve a patient’s symptoms, which may include long-term breathing difficulties.
- Balloon valvuloplasty (aortic, mitral, pulmonic, tricuspid) – Our team of experts has broad experience with this technique to help widen heart valves with stenosis. This treatment allows our cardiovascular team to inflate a balloon catheter to open up the valves. Once opened, the deflated balloon and catheter can be removed.
- Closure procedures for congenital heart defects – When someone is born with a hole in his or her heart and it does not properly close on its own over time, minimally-invasive interventions may be needed to close it. At NorthShore, we offer advanced closure procedures and surgical repair options for various congenital conditions, including atrial septal defect (ASD), ventricular septal defect (VSD) and patent foramen ovale.
- Interventions for Heart Failure – Through our advanced research, our team offers innovative procedures that can help heart failure patients. We are involved in two clinical trials that utilize leading edge devices—Corvia and parachute device—to aid those with heart failure. The Corvia device works to decrease the build up of pressure in left upper chamber, while the Parachute device is intended to restore the shape of a dilated heart so it can work more efficiently during each heart beat.
Our experts are involved with innovative clinical trials to develop additional structural heart disease treatment options that allow us to be at the forefront of new technologies and procedures. NorthShore is the only organization in Illinois participating in two transcatheter mitral valve replacement trials, one for narrowed valves and one for leaking valves. If a patient suffers from a narrowed or leaking mitral valve, and cannot have standard open heart surgery, it is very likely that our team may be able to offer a minimally invasive procedure with one of these very important trials.
Our cardiologists and cardiac surgeons also regularly contribute to various scientific publications to further discuss innovations and updates to the field of structural heart disease.
For More Information
Please call 847.570.2250 for more information on structural heart disease or to schedule an appointment with one of our specialists.