In a small number of patients who have had a heart valve replaced, a space may open up between the valve replacement and the patient’s natural heart tissue. This is called a paravalvular leak (PVL) and forces the heart to work harder than it should to pump blood to the body. Symptoms of PVL may include shortness of breath, unexplained weight gain and swelling in the legs and feet. Without treatment, severe paravalvular leaking may lead to heart failure.
Scripps interventional cardiologists use minimally invasive surgery to place a device around a paravalvular leak that blocks or plugs the leak. The device is placed using a long, thin tube called a catheter. Once the device has closed the leak, the catheter is removed.
Several rare or unusual structural heart conditions are difficult or impossible to treat with surgery and can only be taken care of with catheter-based techniques. These conditions include:
A pseudoaneurysm or “false aneurysm” happens when the wall of a blood vessel is injured and the blood becomes trapped in the tissues. A pseudoaneurysm may be a complication of a heart attack or a cardiac catheterization procedure.
Pseudoaneurysms often heal on their own. However, some may require treatment to prevent hemorrhage or other complications. If your physician suspects you have a pseudoaneurysm, you may need an ultrasound exam to evaluate it and determine the best course of treatment. Most pseudoaneurysms can be treated with a minimally invasive catheter-based procedure.
An arteriovenous fistula is a rare condition in which the connection between one of the coronary arteries and a chamber of the heart or a blood vessel is abnormal. Babies may be born with it; in adults, it can be caused by an infection, an injury to the heart or a complication of heart surgery.
Fistulas may be evaluated with an X-ray, ultrasound, MRI or cardiac catheterization, and many do not require treatment. Those that do can be treated with a minimally invasive catheter-based procedure that blocks the abnormal opening.
Hypertrophic cardiomyopathy occurs when the cells of the heart muscle enlarge and cause the walls of the ventricles to become thicker. If this blocks the flow of blood through the ventricle, the condition becomes obstructive hypertrophic cardiomyopathy. This condition can lead to elevated blood pressure levels, arrhythmia (irregular heartbeat) and, in rare cases, sudden cardiac arrest during vigorous physical activity.
If treatment is needed and medication does not control the condition, Scripps interventional cardiologists can perform minimally invasive, catheter-based procedures including:
Transcatheter alcohol septal ablation
The physician injects a type of alcohol called ethanol through a tube into the artery that supplies blood to the thickened cells. The alcohol kills the cells, and the thickened tissue shrinks, allowing blood to flow more freely.