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Structural Heart Disease Intervention in Bhubaneswar

Structural Heart Disease Intervention

Structural Heart Disease Intervention in Bhubaneswar

The term "structural heart disease" describes difficulties with the heart's tissues or valves, which are crucial for maintaining appropriate blood flow. The heart is made up of four tissue-flapped valves that open and close in time with each beating. The heart must work harder to pump blood when these valves don't open completely or let blood flow backwards, which can have serious health consequences. 

These disorders may be congenital (existing from birth) or emerge later in life as a result of infections, myocardial infarctions, or myocardial attacks. In some cases, there may not be any symptoms and, therefore, no need for treatment. However, other cases may require medical attention from a doctor. Chest pain, breathlessness, exhaustion, an irregular pulse, high blood pressure, leg cramps, headaches, and strokes are typical symptoms. Heart valve disease, congenital heart disease, and cardiomyopathy are among the ailments that fall under the category of structural heart diseases. 

These diseases can be treated through various interventions, such as Transaortic Valve Implantation, Left Atrial Appendage Closure, Balloon Mitral Valvotomy and Balloon Pulmonary Valvotomy. These are minimally invasive techniques that provide better treatment outcomes and enhanced recovery. Manipal Hospitals has a team of experienced cardiologists skilled in treating and managing structural heart diseases using advanced surgical techniques in structural heart disease intervention in Bhubaneswar. Even when urgent treatment is not required, regular monitoring by a cardiologist is essential to successfully managing and preventing any problems. 

 

FAQ's

Structural irregularities can affect the heart's valves, chambers, walls, muscles, and main arteries. The important ones are:

  • Heart valve disease: Associated with the aortic, mitral, tricuspid, and pulmonary valves.

  • Regurgitation: The backward flow of blood due to a "leaky" valve

  • Stenosis: A valve narrowing that limits blood flow

  • Atrial Septal Defect (ASD): A hole between the upper chambers is one type of septal defect.

  • Ventriculoseptal defect (VSD): A gap between the lower chambers 

  • Aortic coarctation: Refers to the aorta's narrowing, which lowers blood flow to the organs.

  • Hypertrophic Obstructive Cardiomyopathy: Reduced blood flow due to thicker heart muscle 

 

The following are the prevalent forms of structural heart disease:

  • Diseases of the aortic valve
  • Congenital cardiac conditions like ventricular and atrial septal defects
  • Hypertrophic cardiomyopathy
  • Diseases of the mitral valve
  • Pulmonary and tricuspid valve diseases
     

The following are signs of structural heart problems and valvular disease:

  • Chest ache

  • Feeling dizzy

  • During a physical examination, doctors may hear a whooshing sound called a cardiac murmur when listening to your heart.

  • Disorders of the heart's rhythm (arrhythmias)

  • Breathlessness

  • Swelling in your feet, ankles, lungs, or abdomen

  • Unusual exhaustion 

Numerous tests might be performed to confirm a diagnosis if your doctor suspects structural heart disease. These could include: 

  • A chest X-ray to examine the anatomy of the heart  
  • An electrocardiogram to evaluate the heart's rhythm
  • An echocardiogram or magnetic resonance imaging (MRI) of the heart
     

Advantages of TAVR or TAVI: You should feel better immediately. This can be attributed to the proper functioning of your heart valve. It could take longer for some people to recover. Often, patients benefit in the following manner:

  • Having more energy
  • Regulating breathing 
  • Experiencing less pain
  • Experiencing fewer symptoms
  • Reduced anxiety

Following the surgery, the majority of patients are better able to take care of themselves and resume their regular activities. 
 

There are several ways to identify structural heart disease:

  • Foetal Echocardiogram: This pregnancy test uses sound waves to scan the heart of the foetus.

  • Heart murmur detection: Detected using a stethoscope, leading to a cardiologist's referral

  • Cardiac catheterization: To test heart chamber pressures and obtain up-close pictures, a tube is placed into the groyne artery.

  • Coronary Angiogram: An X-ray is used to see ‌blood flow after a dye is injected via a catheter.

  • Echocardiogram: Sound waves produce pictures of the valves and chambers of the heart.

  • Electrocardiogram (ECG/EKG): Assesses the heart's electrical activity

  • Exercise Stress Test: Heart monitors while treadmilling, walking, or jogging.

  • Holter Monitor: Captures 24-48 hours of electrical activity from the heart

  • Imaging tests: CT scan, heart MRI, or chest X-ray for structural problems

The two most popular tests are echocardiograms and ECGs.

The treatment and management of structural heart disease have progressed from open heart surgery to minimally invasive methods. These are crucial and offer various benefits like reduced recovery time, less scarring and pain, and fewer side effects. Important therapies consist of:

  • Transaortic Valve Implantation (TAVI/TAVR): This procedure treats aortic valve stenosis, a structural issue where the aortic valve is narrowed.

  • Transcatheter Mitral Valve Replacement (TMVR): Used to replace a damaged mitral valve, typically in patients with severe mitral regurgitation or stenosis.

  • Left Atrial Appendage Closure (LAAC): It is used to prevent stroke in patients with atrial fibrillation, which is associated with the structural anatomy of the heart, particularly the left atrial appendage.

  • Balloon Pulmonary Valvotomy: Used to treat pulmonary valve stenosis, another structural abnormality affecting the heart's function.

  • Balloon Mitral Valvotomy: Performed to correct mitral stenosis, a structural defect of the mitral valve.

  • Alcohol Septal Ablation: This procedure thins the heart muscle to treat hypertrophic obstructive cardiomyopathy.

  • Amplatzer Septal Occluder: Seals adult and paediatric atrial septal defects.

Transcatheter Aortic Valve Replacement (TAVR) may carry the following risks:

  • Bleeding
  • Complications with blood vessels
  • Challenges with the replacement valve, including leaks or falling out of position
  • A stroke
  • Pacemaker requirements and issues with cardiac rhythm
  • Renal disease
  • Heart attack
  • Infection
  • Death
     

The length of your recovery after surgery will depend on several factors, including the type of operation you undergo, your age, your overall health, and your lifestyle. If your surgery does not require general anaesthesia, you will likely be able to return home the same day. However, recovery from open-heart surgery may take several months. Rehabilitation may be beneficial in helping you regain your strength and resume activities such as driving, working, and participating in sports. Medical specialists such as physiotherapists, nutritionists, and exercise physiologists can provide guidance and support to help you heal and develop heart-healthy habits. Talk to your heart specialist to get a better understanding of the expected recovery timeline after your surgery.

Stroke due to atrial fibrillation (AFib) can be reduced when treated with LAA. However, it does not address AFib directly. People with atrial fibrillation who require cardiac surgery may benefit from Left Atrial Appendage Closure. Additionally, the technique is beneficial to people who elect to undergo a Maze operation for atrial fibrillation but do not have any other conditions requiring cardiac surgery.
 

Most structural heart diseases are congenital, meaning you are born with them and cannot prevent them. However, some can develop after birth. Some things that can help prevent structural heart disorders include:

  • To prevent atherosclerosis or the clogging of your arteries, make some healthy lifestyle changes, such as eating a balanced diet and exercising regularly.

  • If you have high blood pressure, keep it under control by limiting your sodium intake and taking your medication as prescribed.

  • Limit your alcohol intake and avoid using drugs.

The following issues could arise from the LAA closure:

  • A malfunction with the device itself
  • An adverse response to anaesthesia
  • Bleeding from the site
  • Pain in the chest
  • Cardiac arrest
  • Irregular heartbeat
  • Infection
  • Pericardial fluid buildup
     

The prognosis for structural heart disease depends on several factors:

  • For how long have you had this condition?

  • The severity of the condition

  • The specific condition you have

  • Your other health issues

Many people with structural heart disease live long, full lives. However, you may be at higher risk for heart infections, such as endocarditis. Talk to your doctor about taking antibiotics during dental or surgical procedures to reduce your risk. 



 

Several consequences arise when the mitral valve shrinks to a size less than 1.5 square centimetres. A brain stroke is also possible if mitral stenosis is present. Individuals who are considering becoming pregnant but currently have mitral stenosis should proceed with caution. Breathlessness, a consequence of valve constriction, is the most important sign that requires attention. Moreover, echocardiography that reveals pulmonary hypertension, i.e., high blood pressure in the lungs, indicates a condition that requires analysis by a healthcare provider. 
 

During the valvotomy procedure, the medical professional will:

  • Pierces a blood vessel in the shoulder, arm, or groyne to insert a sheath—a small hollow tube
  • Pierce the sheath with a catheter while holding a deflated balloon
  • Utilise contrast dye injections and X-rays to direct the catheter to the heart valve
  • It inflates the balloon to release the restricted heart valve
  • After the catheter is removed, seal the insertion site with small sutures or a specialised surgical glue
     

Children who have pulmonary stenosis congenitally, that is, who are born with the defect, are more likely to develop it. Adults may get this illness later in life as a result of: 

 

  • Rheumatic heart disease
  • Non-thrombotic bacterial endocarditis 
  • Radiation to the chest
  • Carcinoid syndrome is a type of gastric cancer 
     

There is an immediate to five-year success rate with pulmonary valvotomy. Because Pulmonary Balloon Valvotomy is a minimally invasive procedure, it offers several advantages over additional treatment methods. The length of the hospital stay is minimal, and the expense is significantly lower. There are no side effects from general anaesthesia, and healing happens more quickly. There will no longer be any danger of organ failure, heart attacks, strokes, or death associated with major open-heart surgery. However, there is evidence that a very small percentage of patients may eventually experience restenosis of the valve, and the treatment can be simply repeated on them. 
 

A Mitral Valvuloplasty may have side effects that persist for at least two years. Although the surgery increases blood flow and provides short-term symptom relief, mitral valve disease cannot be cured; it must be controlled with routine exams, medication, and healthy lifestyle choices.

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