Heart Valve & Structural Heart Intervention
Damaged heart valves resulting in the incomplete opening (stenosis) or closing (regurgitation) can lead to the lack of blood flowing out of the heart or leakage of blood backward into the preceding chamber. This can lead to abnormal enlargement of the heart chambers or heart failure over time.
Traditionally, these conditions are often treated with open-heart surgery. However, there may be concomitant medical conditions (such as advanced age, kidney failure, previous open-heart surgeries) that may increase the risk of open-heart surgery. These patients can consider minimally invasive Heart Valve Interventions available at our practice.
At The Heart & Vascular Centre, we also provide minimally invasive Structural Heart Interventions to treat conditions such as “hole in the heart” (Atrial septal defects or Patent Foramen Ovale) and left atrial appendage closure device implantation for the treatment of Atrial Fibrillation.
The minimally invasive Heart Valve and Structural Heart Interventions available at The Heart & Vascular Centre include:
Transcatheter Aortic Valve Replacement (TAVR or TAVI)
- Transcatheter Aortic Valve Implantation (TAVI) is a technique where a severely narrowed aortic valve of the heart is replaced without open-heart surgery by a minimally invasive procedure. This results in a much quicker recovery and less post-procedure pain and discomfort.
- TAVI/ TAVR is most commonly performed through a small puncture hole in the groin. TAVI/ TAVR has been shown to be life-saving in patients who cannot undergo open-heart surgery and is equivalent or better than open-heart surgery in most patients.
The TricValve Transcatheter Bicaval Valves is a new technology that was recently launched in Singapore. It offers high-risk patients with heart failure due to severe tricuspid valve regurgitation (leakage) a minimally invasive treatment option. Patients with severe tricuspid valve regurgitation often experience shortness of breath, leg swelling, abdominal bloating, and loss of appetite. Involving a brief hospital stay, TricValve is a minimally invasive procedure that implants 2 specially designed self-expanding valves, via a leg vein, close to the chambers in the right side of the heart. These valves expand in place to eliminate the abnormal backflow of blood into the liver, kidney, head, and neck veins. This new therapy has been shown to improve quality of life and has the potential to benefit patients who currently have no suitable treatment options.
Mitral valvuloplasty is a minimally invasive procedure performed via a groin puncture, where a balloon is used to dilate a narrowed mitral valve of the heart (mitral stenosis). This technique is now the treatment of choice for patients with severe mitral valve narrowing, providing excellent results and symptom relief.
Percutaneous Valvular Leak Closure
Patients with previous surgical heart valve replacements may sometimes develop leakage at the edges of the implanted valves. Percutaneous paravalvular leak closure is a minimally invasive method to treat these leakages without the need for a repeat open-heart surgery, minimizing the risks and discomfort for patients.
- Patients with atrial fibrillation (chaotic heart rhythm) are at increased risk for stroke and clot formation, therefore they require anti-coagulation therapy using potent blood thinners. This in turn increases the risk of bleeding events (including bleeding in the brain) which could be life-threatening.
- The Watchman LAA closure therapy is where an umbrella-like device is placed percutaneously (minimally invasively) in a left heart chamber to reduce clot formation thus reducing the risk of stroke. It has been shown to be an alternative to treatment with lifelong potent blood thinners.
Find out more in this article: What is Watchman LAA Device Closure
Patent Foramen Ovale Closure
It has been found that a Patent Foramen Ovale (PFO) is a risk factor for stroke in young patients where no other causes can be found. Device closure of the PFO can lead to a reduction in the recurrence of stroke in these patients.
Find out more in this article: Percutaneous Minimally Invasive PFO Device Closure
Mitraclip is a minimally invasive treatment option for severe leakage of the mitral valve. A clip is delivered from the groin and is implanted to hold part of the valve leaflets together, reducing the leakage. This method is a safer option compared to open-heart mitral valve repair, especially for patients who are at increased surgical risk.