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.

Types of heart valve problems

Your heart's job is to pump blood through your body. Inside your heart, blood passes through a series of "one-way gates" called valves. If a valve works poorly, not enough blood moves forward.

A heart valve problem may consist of one or both of these issues:

• Problems opening (stenosis)—When a valve doesn't open all the way, blood has to flow through a smaller opening. As a result, the heart muscle has to work harder to push the blood through the valve.
• Problems closing (regurgitation)—When a valve doesn't close tightly enough, some blood leaks through the valve back into the chamber. As a result, the heart has to work harder by moving that blood twice.

Common causes of valve problems

Men and women of any age can have heart valve trouble. You may have been born with a problem valve, or a valve may have worn out as you've aged. It may not be possible to pinpoint what caused your valve problem, but common causes include:

• Buildup of calcium or scar tissue on a valve
• High blood pressure
• Rheumatic fever and certain other infections and diseases
• Other heart problems, such as coronary artery disease

Symptoms of heart valve problems

You can have a problem heart valve for decades without having any symptoms. If you do have symptoms, they may come on so slowly that you barely notice them. In other cases, symptoms appear suddenly.

Some symptoms may include:

• Fast, pounding, fluttering or irregular heartbeat
• Feeling dizzy, faint or lightheaded
• Pain, pressure, tightness or numbness in your chest, neck, back or arms (angina)
• Problems breathing when you lie down, exert yourself or feel emotionally distressed
• Tiredness, especially with activity or as the day goes on
• Swollen ankles or feet
• Waking up at night coughing or short of breath

If you have chest pain or other signs of a heart attack, call 911.

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.