Published on July 10, 2017

An inside job done right

Interventional cardiologists make repairs to the heart using innovative techniques

At St. Mary Medical Center, fixing a problem in the heart’s intricate structures doesn’t always require open-chest surgery.

Today that work is often done through slender tubes that deliver state-of-the-art medical devices, offering new options for people with heart problems. Highly qualified doctors wield those tools in a modern operating room.

If that sounds like care you’d expect at a large academic medical center, you’d be right. But it’s all right here—part of St. Mary’s Structural Heart Disease Program.

A minimal approach

Doctors at St. Mary have minimally invasive ways to correct narrowed heart valves and some other serious heart problems. Among them:

Transcatheter aortic valve replacement (TAVR)

Instead of surgically removing a defective aortic valve by opening the chest up, doctors use a catheter (a tube about the size of a pen) to put a new valve in its place. The catheter is inserted near the groin and guided to the heart.

TAVR also is used to implant a new valve into a previously replaced valve that has worn out—what’s called a valve-in-valve procedure.

“That would spare a patient a high-risk reoperation,” says George P. Heyrich, MD, FACC, FSCAI, an interventional cardiologist at St. Mary.

Other benefits of TAVR include a quick recovery, a hospital stay of just two to three days, and immediate symptom relief.

“It’s gratifying to help people feel better so quickly and to help them get back to normal activities, including spending time with family and friends,” Dr. Heyrich says.

Watchman procedure

St. Mary was one of the first hospitals in the region to perform Watchman implants for people who have an irregular heartbeat called atrial fibrillation (AF) and who can’t take medicines called blood thinners.

A blood thinner is typically prescribed to help reduce the risk of stroke. Blood can pool in the upper chambers of the heart in people with AF, causing a clot to form. If the clot breaks off and travels to the brain, it can cause a stroke.

Some AF patients can’t take a blood thinner, however, because they are at high risk for bleeding, a potential complication of the medicine.

To help protect against strokes in these people, the Watchman, a small parachute-like device, is placed in the heart to seal off an area where most clots form. Patients can go home the next day after the procedure.

Repairing holes in the heart

Surgeons at St. Mary also use special devices to seal off holes in the heart. Previously that involved open-heart surgery.

“Now we use a catheter-based procedure, and the patient can go home after an overnight stay,” Dr. Heyrich says.

These are just some of the many ways St. Mary is making advanced cardiac care available to the community.

“We strive to be on the leading edge when it comes to cardiac care,” says Holly Madara, Service Line Administrator for Cardiovascular Services. “We always have our eyes open for what’s the next best treatment. I think people want the best in their own backyard.”