Heart Valve Clinic
MidMichigan Health’s Heart Valve Clinic is based on best practices for treating patients with heart valve disease. The program is specifically designed to evaluate patients for advanced heart valve treatment, including a new minimally-invasive procedure called transcatheter aortic valve replacement (TAVR).
The Clinic was developed to focus on patients suffering from heart valve disease with special emphasis on aortic stenosis, a disease that narrows the heart’s aortic valve that is crucial for blood circulation. Though aortic stenosis has become the most common heart valve disease in the Western World, symptoms in milder cases often go overlooked or be mistaken for signs of aging (such as shortness of breath or dizziness).
Structural Heart Team
Clinic patients benefit from the expertise of a multidisciplinary team of experienced specialists. These include from left to right: Cardiologist/Advanced Cardiac Imaging Specialists Jeffrey Martindale, D.O., and Susan Sallach, M.D.; Cardiothoracic Surgeon Robert Jones, M.D.; Interventional Cardiologists Andrzej Boguszewski, M.D., and Maged Rizk, M.D., Ph.D.; Cardiovascular Surgeon Hassan Reda, M.D.; and Cardiologist/Advanced Cardiac Imaging Specialist Waleed Doghmi, M.D.
What is Aortic Stenosis?
Aortic Stenosis (AS) is a disease that narrows the opening of the heart’s aortic valve. Under this condition, the heart must work harder to pump blood to the aorta – the body’s main artery. The heart muscle eventually weakens with AS, which can affect your overall health. Severe AS, left untreated, increases the risk for heart failure and is a life-threatening condition, with a two-year mortality rate between 50 and 60 percent, and a three-year rate less than 30 percent.
It is important that this condition is diagnosed and monitored so that treatment can be prescribed as the disease progresses. Signs and symptoms of severe AS can include chest pain or tightness, feeling faint or fainting with activity, dizziness, fatigue, shortness of breath, irregular heart beat or an unusual sound during a heartbeat.
What causes Aortic Stenosis?
A healthy lifestyle cannot necessarily stop the onset of AS. It is usually not preventable, and may be related to the following:
- A buildup of calcium deposits that narrows the aortic valve
- A history of a bacterial infection of the heart (rheumatic fever)
- Increased fat in the blood vessels (high cholesterol)
- Radiation therapy
- How Aortic Stenosis is Treated
Treatment will depend on how far the AS has progressed. Medications are prescribed in mild cases to regulate the heartbeat and prevent blood clots. As the severity of AS increases, doctors will likely recommend replacement of the aortic valve. Aortic valve replacement (AVR) through open heart surgery, in which surgeons replace the diseased aortic valve with an artificial valve, is the most common method. But for patients who are too high-risk or too sick for surgery, TAVR might be an option.
What is TAVR?
TAVR is a procedure that is less invasive than surgery, as the artificial aortic valve is inserted through an artery in the neck, leg or between the ribs, and placed inside the diseased valve while the heart is still beating. The treatment is proven to consistently lengthen a patient’s life and improve his or her quality of life. While this one to two hour procedure could be a life-saving alternative for patients not suitable for surgery, it has its own associated risks and it not appropriate for all patients. The Heart Valve Clinic is equipped to determine whether replacement of the aortic valve is necessary, and whether a patient could safely undergo TAVR.
What Services are Provided Through the Heart Valve Clinic?
- Comprehensive education and counseling about AS and the management and treatment of the disease.
- Evaluation by multidisciplinary team of experienced heart specialists.
- Assistance in monitoring the signs and symptoms of severe AS to determine when treatment becomes necessary.
- A comprehensive analysis of a patient’s health and health history as it relates to AS and the suitability of a patient for AVR or TAVR.
- Care coordination with the patient’s cardiologist and primary care provider.
- Assistance with streamlined referrals to other centers for advanced treatment when necessary.
- Ongoing support for patients and their caregivers during all stages of AS, including transition from treatment to therapies and referrals.
- Evaluation for participation in clinical trials of experimental medications and procedures that may help with symptoms of AS, some of which are only available in a limited number of health centers in the country.
- Care coordination between multiple disciplines, including social work, pharmacy, cardiac rehabilitation, nutrition services, as well as primary care and specialty providers.
- Assistance with social and financial concerns.
- Monitoring and adjusting treatment to improve the overall quality of life for AS patients.