STRUCTURAL HEART INTERVENTIONS

Structural heart disease includes malformations of blood vessels in the heart, problems with heart valves, structural defects of the heart muscle walls, and abnormal connections between the heart and the blood vessels that carry blood to and from the heart. The physicians at Lenox Hill Heart and Vascular Institute (LHHVI) are skilled in treating structural heart disorders, including:

• Septal defects, an opening in the septum, or wall that separates the heart chambers, such as Atrial Septal Defects (ASDS) secundum-type, Ventricular Septal Defects (VSDS), either post-traumatic, post-heart attack (post N.I-VSD), and some congenital VSDS, as well as residual shunts and post surgical patch/closure of VSD;



• Patent foramen ovale, a form of septal opening between the right and left atrium that has been linked to migraine headaches and strokes;



• Coarctation of the aorta, a narrowing of the aorta that causes severe hypertension and may induce formation of aneurysm of the brain vessels that can rupture and cause extensive hemorrhagic strokes;



• Congenital or acquired valve defects, which can include valves that are narrow (aortic stenosis, mitral stenosis, pulmonary stenosis, and tricuspid stenosis). Most of the time these can be initially treated with percutaneous balloon valvuloplasty. Dr. Ruiz has been a pioneer in a new investigational alternative therapy for elderly patients with severe aortic valve stenosis who are at very high surgical risk. It consists of the percutaneous implantation of an aortic valve prosthesis, which is very similar to the prosthetic valves that are implanted surgically, but is implanted percutaneously via a catheter in the femoral artery. Dr. Ruiz is the principal investigator for the CoreValve Revalving Percutaeous Aortic Valve implantation trial that will soon be initiated in the United States after approval by the FDA.
  
  Furthermore, the structural heart disease team at Lenox Hill Heart and Vascular Institute has ample experience in percutaneously closing prosthetic paravalvulas leaks that occur after surgical implantation, of both aortic and mitral valve prostheses, which are very difficult to resolve surgically. In addition, our team will soon be involved in the percutaneous therapy of mitral regurgitation in collaboration with Dr. Subramanian.



• Patent ductus arteriosus (PDA), a congenital pediatric condition in which a blood vessel between the aorta and the pulmonary artery fails to close after birth, can result in severe pulmonary hypertension. This anomaly can be safely closed with percutaneous devices, avoiding the need for surgical intervention. In addition, there are other congenital anomalies such as anomalous aorto-pulmonary collaterals, (which are frequently seen in patients with tetrallogy of fallot or pulmonary atresia, large pulmonary arterial-venous malformations, and coronary artery fistulas), that are preferably closed with transcatheter occlusive devices rather than surgically.

Until recently, conditions like these required open surgery to repair, often with the patient on heart-lung bypass machines -- major surgeries that caused the patient a great deal of discomfort and required lengthy recovery time. The advent of new techniques allows physicians at LHHVI to perform many minimally invasive versions of the procedures to repair structural heart disorders using tiny instruments and devices delivered through catheters. That means less discomfort and a faster recovery time for you. Drs. Ruiz, Cohen, and Soffer lead the Structural Heart Interventions team, a staff of highly trained and experienced physicians and nurses who specialize in nonsurgical, minimally invasive treatments for structural heart disorders in both adult and pediatric interventions. Some of these techniques were pioneered by Dr. Ruiz, who was the first surgeon to perform double-balloon valvuloplasty for narrowed heart valves. In this procedure, a surgeon guides a balloon-tipped catheter through the blood vessels to the narrowed valve. Then the balloon is inflated to widen the narrowed valve, allowing more blood to flow through it. Dr. Ruiz also has led the way in percutaneous aortic valve replacement, which is an alternative to open-heart surgery. In addition, the physicians at Lenox Hill have developed techniques to repair defective valves instead of replacing them with synthetic valves, which helps patients avoid having to take anticlotting medication for the rest of their lives.

The Structural Interventions team takes a comprehensive approach to your care, meeting with you before your procedure, keeping you and your family fully informed about your condition and the procedure, and providing the most advanced treatment available. The team combines decades of training and experience, the latest in medical techniques, facilities, and technologies, and an environment that is patient- and family-friendly to ensure the best possible outcome for you.

To learn more about all the physicians with this area of expertise, please click here .

Lenox Hill Hospital
130 East 77th Street,
9th floor
New York, NY 10021
Phone: (212) 434-2606
Fax: (212) 434-2610
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