Valve in valve procedure and paravalvular leaks

Valve in valve procedure and paravalvular leaks Bioprosthetic heart valves, despite best attempts at tissue treatment will suffer from degeneration. The can occur due to structural deterioration of the valve leaflets ( eg calcium accumulation and scar formation leading to immobile and obstructive to blood flow or perforation and tears leading to severe leakage). Occasionally, deterioration can occur when holes, gaps or slits occur outside the surgical valve due to disruption of previously placed sutures The traditional option was to … Continued

Tricuspid valve regurgitation

The tricuspid valve is a valve located between the right upper and right lower chambers of the heart. This valve controls the flow of blood in a single direction Tricuspid regurgitation occurs when the valve do not close well. In essence the valve cannot seal tightly enough resulting in a backflow of blood in the opposite direction. This results in a significant amount of blood volume re-entering the right atrium and raises the pressures in the chamber. When this happen … Continued

Right heart catheterization

This is a procedure that is used to assess pressure and oxygen levels in the heart. A very small flexible catheter with a balloon tipped flotation catheter is introduced via the vein the right thigh. This balloon floats and travels with blood flow and together with some control externally would arrive at the various chambers on the heart. This is monitored using X -ray (fluoroscopy). This procedure is indicated for a variety of situations: Studying the function of the heart … Continued

Left atrial appendage closure

The left atrial appendage is a structure in the left upper chamber of the heart. When some patients develop atrial fibrillation (an irregular heart beat), blood flow within the left heart chamber and especially that in the LAA becomes sluggish. This can lead to an increased risks of clot formation within the LAA. Occasionally, these clots can migrate and travel via the blood stream and lodge themselves into blood vessels causing disastrous consequences. If the blood vessel obstructed is in … Continued

Device closure of Patent Foramen ovale

About a quarter of people have this. The foramen ovale is an important structure during fetal life but most close after birth. When this tissue flap fails to close we call it patent foramen ovale. This small opening in the heart can, in some cases, allow blood clot to pass from the right to the left side of the heart and then travel via one of the blood vessels to the brain, obstructing this vessel and causing a stroke. The … Continued

Balloon pulmonary angioplasty (For CTEPH)

Some patients may have repeated episodes of blood clots travel to the lungs and develop severe lung artery abnormalities. These results in elevated lung pressures. WE call this chronic thromboembolic pulmonary hypertension or CTEPH. Patients have to undergo a right heart catheterization study, a pulmonary angiogram (contrast injection of the arteries) as well as a ventilation perfusion scan ( radioisotope scan) for the diagnosis to be confirmed. Some patients may benefit from surgery. In those who have smaller, distal vessel … Continued

Adult Congenital Heart Disease Catheter Assessment and Interventions

Adult patients with congenital heart disease often require follow up and assessment. These include physical examination or cardiac imaging with transthoracic echocardiograms or advanced imaging with cardiac computed tomography or cardiac magnetic resonance imaging. Some patients will also benefit from cardiopulmonary exercise testing to objectively assess their symptoms and progress. When hemodynamics become affected, patient may require treatment. These may be cardiac surgery or transcatheter interventions. The percutaneous therapies available include atrial septal defect and ventricular septal closure as well … Continued

Mitral Valve Intervention

MITRACLIP for mitral valve regurgitation and heart failure Historically, the only option for patients with mitral regurgitation (a condition where the valve is leaking) is open heart surgery. There is now a much less invasive option to treat this condition. Mitraclip mitral valve repair is a catheter based treatment that we provide for patients with severe mitral valve regurgitation (leakage) at high risk for open heart surgery. This has shown to improve survival as well as reduce heart failure hospitalizations. … Continued

Transcatheter aortic valve implantation (TAVI)

Transcatheter aortic valve implantation (TAVI) is the least invasive method to treat patients with severe symptomatic aortic valve stenosis (narrowing). TAVI has been shown to be effective at prolonging life, reducing heart failure and significantly improving patients’ quality of life. We have a comprehensive programme (advanced imaging) to evaluate every patient. This allows us to provide patients bespoke valve treatment. This service also helps those who have had previous valve surgery and who need further cardiac optimization and treatment. Find … Continued

EP Study & Catheter Ablation

An electrophysiology study, or EP study, is a test to see if there is a problem with your heartbeat (heart rhythm) and to find out how to fix it. In this test, the doctor inserts one or more flexible tubes, called catheters, into a vein, typically in the groin or neck. Then he or she threads these catheters into the heart. At the tip of these catheters are electrodes, which are small pieces of metal that conduct electricity. The electrodes … Continued