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Healthcare: Cardiovascular Medicine

Structural Heart Disease FAQs

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What Is Structural Heart Disease?

Structural heart disease can begin as a result of a birth defect or can develop later in life. Some conditions have no symptoms, while others can make it impossible to live normally.

What Are the Symptoms of Structural Heart Disease?

There are several different causes for structural heart disease that may cause symptoms ranging from lightheadedness, fatigue, shortness of breath, chest pain or heart palpitations.

What Is a Percutaneous Procedure?

Percutaneous pertains to any medical procedure where access to inner organs or other tissue is done via needle-puncture of the skin, rather than by using an "open" approach where inner organs or tissue are exposed. The percutaneous approach is commonly used in vascular procedures such as angioplasty and stenting. This involves a needle catheter getting access to a blood vessel, followed by the introduction of a wire through the lumen (pathway) of the needle. It is over this wire that other catheters can be placed into the blood vessel. This technique is known as the modified Seldinger technique.

What Devices Are Used in a Percutaneous Procedure?

Two different brands of closure devices are approved by the U.S. Food and Drug Administration for percutaneous ASD closure — Amplatzer® Septal Occluder and the GORE HELEX® Septal Occluder. The closure devices differ in design, but the placement method and their function are similar.

The device is attached to a catheter, which is inserted into a vein in the groin and advanced to the heart and through the defect, guided by X-ray and intracardiac echo. As the device slowly is pushed out of the catheter, it opens up to cover each edge of the defect, sealing it closed. Over time, tissue grows over the implant and it becomes part of the heart.

Before a percutaneous closure device procedure, the patient will have a cardiac catheterization to determine the size and location of the defect. Pressures inside the heart chambers also will be measured.

For at least the first six months after the repair, the patient will need to take an anticoagulant such as aspirin, clopidogrel or warfarin (Coumadin) to prevent clots from forming on the device.

What Are the Advantages of a Percutaneous Procedure?

Percutaneous procedures take less time, carry less risk, do not leave a large scar and cost less than traditional surgical procedures.