Structural heart

"Structural heart diseases" refers to the conditions and diseases of the heart's valves and chambers, including:

• Arrhythmia
• Atrial septal defects (ASDs)
• Heart attack
• Heart failure
• Heart valve disorders
• High blood pressure
• Pericardiocentesis
• Peripheral vascular disease
• Vascular disorders

Heart defects in children

There are four chambers in the heart. An ASD is a hole in the wall that divides the two upper chambers. This causes blood to flow through the defect, which, overtime, puts pressure on the pulmonary arteries.

An ASD is a congenital heart defect, meaning a person is born with the condition. In some cases, the ASD will close itself within the first years of a child’s life. However, if an ASD is left untreated, it can lead to permanent lung problems in adulthood.

Types of ASDs:

There are three main types of ASDs:

• Sinus venosus—a defect in the outer atrial septum
• Secundum—a defect in the middle atrial septum
• Primum—a defect next to the heart valves in the atrial septum

Symptoms of atrial septal defects

Some children with an ASD have no symptoms, but others may present symptoms such as:

• Frequent bouts of pneumonia
• Slow growth
• Tiring easily during exercise
• Trouble breathing

Diagnosing and treating ASDs

Your child’s pediatrician will perform a physical exam to check for a heart murmur—an extra noise in the heartbeat—and refer you to a pediatric cardiologist for further testing if needed.

Because some ASDs close on their own, your pediatric cardiologist may wish to monitor your child’s condition before suggesting an atrium septum closure. If surgery is needed, your child will need regular visits with a cardiologist but, with our experts' help, they will be as active as other children as they grow up.

Our doctors have access to advanced imaging technology, this allows them to accurately screen for, diagnose and develop a treatment plan for your condition. Some of the cardiac diagnostic techniques we use include:

• Ambulatory monitoring
• Cardiac magnetic resonance imaging (MRI)
• Coronary calcium scans
• Dobutamine echocardiograms
• Echocardiograms, with and without contrast
• Electrophysiology (EP) studies
• Exercise stress tests
• Intravascular ultrasounds
• Non-invasive testing for vascular disease
• Nuclear stress testing, including pharmacological nuclear stress testing
• Research studies
• Stress echocardiograms
• Transesophageal echocardiography (TEE)

Among our other complete cardiology services, our team provides the following procedures to treat structural heart issues:

• Angioplasty
• Atherosclerosis atherectomy
• Atherosclerosis endarterectomy
• Atrial septal closure
• Cardiac catheterization
• Cardiac closure devices for patent foramen ovale (PFO) and ASD
• Cardioverter defibrillator implantation
• Cardioversioning
• Carotid stenting
• Catheter ablation
• Convergent ablation
• Coumadin clinics
• Hybrid ablation
• Biventricular pacemaker and implantable cardioverter defibrillator (ICD-Bi-V) device therapy (for heart failure)
• Left atrial appendage closure (LAAC)
• Lead extraction
• Lipid (cholesterol) management
• Minimally invasive mitral valve repair (as an alternative to open-heart mitral valve replacement)
• Pacemaker implants

Transcatheter aortic valve replacement (TAVR)

TAVR is an innovative heart valve procedure, and the structural heart program at St. Mark’s Hospital was among the first to offer it in Utah. In fact, they are one of only 150 hospitals in the U.S. approved to perform this procedure.

TAVR is used to treat severe symptomatic aortic valve stenosis. It is useful for patients considered too high-risk for traditional heart valve replacement or patients who were previously considered inoperable.

Mitral valve repair

The mitral valve controls blood flow from the left upper chamber into the left lower chamber of the heart. If you are diagnosed with mitral regurgitation, this means blood can leak back into the heart when the valve contracts.

As an alternative to open-heart mitral valve replacement, we offer minimally invasive mitral valve repair. During this procedure, your doctor implants a tiny clip where the leak occurs in the mitral valve. The clip holds the leaflets in place. This corrects the leak and reduces the amount of blood that flows back into the heart.

Left atrial appendage closure (LAAC)

We offer the LAAC procedure to treat atrial fibrillation (AFib). AFib is a condition that causes the upper chambers of the heart to beat very quickly and out of rhythm. It can cause blood clots and put you at a higher risk for a stroke.

During an LAAC procedure, your doctor will implant a small device (about the size of a quarter) into your heart using a catheter. The device permanently closes off the left atrial appendage (a small sac of the heart) and prevents blood clots from entering the bloodstream.

Benefits of the LAAC procedure

LAAC helps significantly decrease stroke risk and, over time, you may be able to stop taking blood thinners. It also eliminates the need for open-heart surgery. Once the device is in place, it is permanently fixed in the heart.