Our valve subspecialists in interventional cardiology, cardiothoracic surgery and advanced cardiovascular imaging work as an integrated team to offer the full spectrum of traditional and pioneering valve therapies. The valve team meets weekly to discuss complex and high-risk patients and determine the most appropriate therapy, including options for leading-edge interventions.
Valve subspecialists and valve nurse coordinators are available to answer referring physicians’ questions regarding traditional valve therapies as well as patient eligibility for investigational percutaneous trials. Minneapolis Heart Institute® at Abbott Northwestern Hospital is a regional valve center of excellence with a hybrid operating room designed for transcatheter and minimally invasive surgical valve procedures. These high tech rooms have the advanced imaging systems necessary for repairing and implanting valves often through very small incisions necessitating indirect visualization.
Transcatheter Treatments for Valvular Heart Disease
Aortic balloon valvuloplasty is a percutaneous procedure for symptom palliation and enhanced quality of life in appropriately selected patients who are not candidates for surgical or transcatheter aortic valve replacement. Further, it can be a useful bridge for select patients to undergo subsequent surgical or percutaneous aortic valve replacement. Minneapolis Heart Institute® is a recognized world leader in establishing and performing this therapy and is one of the highest volume centers in the country.
The team also has extensive experience in mitral and pulmonic balloon valvuloplasty, which unlike aortic valvuloplasty, are treatments of first choice for mitral and pulmonic stenosis. Minneapolis Heart Institute® Aortic Balloon Valvuloplasty Database has shown that among patients who have had the procedure:
- More than 90 percent achieve >30 percent improvement in aortic valve area
- More than 90 percent achieve New York Heart Association functional class of ≤ 2 with sustained benefit for 0.5-1.5 years
- Less than 3 percent experience complications
Valve Center physicians’ published studies have shown that the procedure can be safely performed:
- In patients over 90 years of age
- In combination with coronary stenting
- In patients with severe left ventricular dysfunction (including LVEF <20 percent)
Transcatheter aortic valve replacement (TAVR) is a revolutionary percutaneous therapy for aortic valve replacement. At present, however, this therapy can be offered only to patients who are nonoperative or high risk for traditional open heart surgery. The Valve Center currently performs TAVR using transfemoral or transapical approaches, both of which are now approved by the Food and Drug Administration (FDA).
Transcatheter (percutaneous) mitral valve repair is an investigational option for the treatment of high surgical risk patients with severe mitral regurgitation. The Valve Center is currently evaluating the MitraClip system in these patients. In this video, Dr. Paul Sorajja talks about the latest advances in treating heart failure or leaky valves with MitraClip.
Percutaneous repair of periprosthetic valve leaks addresses perivalvular leaks that can be severe in 1 to 2 percent of patients following surgical valve replacement. This option avoids the need for a second open heart surgery, but it is a technically demanding procedure performed at only a few centers in the U.S.
Surgical Replacement and Repair
Minneapolis Heart Institute®‘s cardiothoracic surgeons offer surgical valve replacement and repair using conventional and minimally invasive approaches to best meet patients’ needs. Surgical replacement or repair is the recognized gold standard for treatment of valvular disease.
Treatments for Other Structural Diseases
The atrial septal defect (ASD)-patent foramen ovale (PFO) percutaneous closure program is well established. Since 2003, Minneapolis Heart Institute® has done more than 300 procedures with a minimal complication rate. Careful patient selection, advanced CT and TEE imaging, including 3D TEE and intra-cardiac echo, help make this possible. Newer guidelines, based on recent clinical trials, and American Heart Association and American College of Cardiology position statements currently favor a more conservative approach in patients with PFO and stroke. Our physicians incorporate these newer guidelines into their practice, which is tailored to each individual patient to provide the best possible care.