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Heart Valve Center

If you have heart failure, your heart is not strong enough to pump blood effectively to the rest of your body. As your heart struggles to work harder, it may become enlarged. You may feel shortness of breath and feel tired when you exert yourself. 

The Heart Valve Center at NewYork-Presbyterian Queens is dedicated to developing and evaluating new and less-invasive techniques for repairing and replacing damaged mitral, aortic, and pulmonary valves. Our experts have played a leading role in clinical trials assessing the latest percutaneous valve replacement approaches, giving our Center greater experience than most in these emerging new techniques.

Our program’s success has been built upon the commitment of the heart team across the continuum of patient care. Together, the team assesses each patient using state-of-the-art diagnostic tools and recommends appropriate treatment solutions, including interventional and surgical options and medical therapy based on what is in the best interest of the patient.

Aortic Valve Treatment

If it is decided that the heart valve disease requires treatment, our clinical team will review treatment options; however, at this time, drug therapy does not exist to treat aortic valve disease. There are some medicines that can improve how the patient feels, but only in the short-term.

Surgery – The gold standard for treating significant aortic valve disease is heart surgery, a safe and highly effective treatment for most patients. The aortic valve is repaired or replaced with a bioprosthetic (tissue) or mechanical valve.

Transcatheter Aortic Valve Replacement (TAVR) – Approximately 300,000 people in the United States have aortic stenosis, and about one third of these patients are too sick or too old to undergo surgical replacement. A minimally invasive technique, called Transcatheter Aortic Valve Replacement (TAVR), is available for these patients. A prosthetic valve is delivered to the heart with a catheter guided by a special type of x-ray. The prosthetic valve is carefully positioned inside the patient’s own valve and expanded. The diseased leaflets are pushed aside and replaced with the new valve which will immediately begin to function.

The replacement valve may be advanced to the heart through the femoral artery or transapically, which is a minimally invasive technique designed for people whose femoral vessels are not appropriate for transfemoral access. In order to perform the procedure, a small incision is made under the left chest and the valve is advanced from just below the heart. The Transaortic Approach involves direct access to the aorta via a mini-sternotomy directly above the breast bone. This approach is appropriate for patients who have inaccessible femoral arteries and are unsuitable for the transapical approach, often because of poor respiratory function.

Mitral Valve Treatment

If the mitral valve disease is mild, medicine will be prescribed to treat the symptoms. If the disease is more severe, one of the following treatments will be recommended.

Surgery – The current preferred treatment is a surgical repair of the patient’s valve. The surgeon accesses the heart through a sternotomy (opening of the chest bone) and excises or repositions the diseased valve leaflets. In instances where the valve is severely diseased, a surgeon will perform a valve replacement using a mechanical or bioprosthetic valve. For some patients, a minimally invasive surgical option is available where a mini or partial sternotomy is performed involving a smaller incision on the chest. The mitral valve is accessed between the ribs, therefore not requiring the breastbone to be spread. The advantage to surgery includes an improved quality of life and expanded life expectancy, as the flow to the heart becomes regulated.

MitraClip – MitraClip, a catheter-based treatment, is available for patients with significant symptomatic degenerative mitral regurgitation who are too high risk for surgery. In this procedure, a metal clip is advanced on a catheter delivery system, most often through the femoral vein in the groin, and guided by a special type of x-ray into the mitral valve. The MitraClip device then clips the leaflets of the valve together to reduce the amount of blood that flows back into the left atrium.

 

Contact

Phone: 718-670-2485