Structural Heart Disease & Treatment

Defects that interrupt the flow of blood through the valves and chambers within the heart are considered structural heart disease. These conditions range from congenital (present at birth) to those that have developed over time due to disease. High blood pressure, buildup of plaque in the coronary arteries, infection of the heart, rheumatic fever, certain medications and aging can impact the structural heart.

At WakeMed, we offer a team of cardiologists who are specially trained in the newest, most advanced interventions for structural heart conditions, including valve issues and closing holes between chambers in the heart. Specific areas of expertise include:

Valvular heart disease occurs when your heart’s valves do not work correctly, characterized by either damage or a defect in one of the four heart valves or supporting structures. Although many times, valve conditions can be watched and treated medically. If the condition negatively affects your quality of life, our structural heart specialists can help.

  • Aortic Valve Obstruction: The narrowing of the valve linking the heart and aorta can prevent the valve from opening and closing correctly. This condition is called Aortic
  • Valve Stenosis: When a valve does not close correctly, there is a backflow of blood from the aorta into the left chamber of the heart and results in poor blood flow to your organs and the rest of your body and can be treated using Transcatheter Aortic Valve Replacement or TAVR.
  • Damaged Mitral Valve: The mitral valve is in between the two right chambers of the heart. When the mitral valve has been damaged by disease, blood can leak backward into the lower chamber of the heart. This condition is known as Mitral Valve Regurgitation and can result in poor blood flow to your organs and the rest of your body and can be treated using a new procedure called a MitraClip (in copy under Cardiac Surgery).

Atrial Fibrillation

In normal hearts, the heart contracts with each heartbeat, and the blood in the left atrium and Left Atrial Appendage (LAA) is squeezed out of the left atrium into the left ventricle. When a patient has an irregular heart rhythm called atrial fibrillation, the electrical impulses that control the heartbeat do not travel in an orderly fashion through the heart. Instead, many impulses begin at the same time and spread through the atria. The fast and chaotic impulses do not give the atria time to contract and effectively squeeze blood into the ventricles.

Because the LAA is a little sac, blood collects there and can form clots. When blood clots are pumped out of the heart, they can cause a stroke. People with atrial fibrillation are 5 to 7 times more likely to have a stroke than the general population. These patients are often prescribed a blood thinner to prevent clotting; however these drugs cannot be tolerated by all patients and may be candidates for the Lariat and Watchman devices which are designed to seal the opening of the left atrial appendage delivered through a catheter to prevent clot migration.

Septal Defects

Sometimes there is a hole between two chambers of the heart. This is called a septal defect. Structural heart specialists can use a special catheter-based procedure to deploy an umbrella-type device to close the hole between the chambers. This method can be used for holes between the Ventricles (lower chambers of the heart) or the Atria (the upper chambers of the heart).