Other defects commonly treated by transcatheter approaches include patent foramen ovale, atrial septal defects, patent ductus arteriosus, and ventricular septal defects, as well as pulmonary valve stenosis.
We specialize in sophisticated diagnostic techniques to assess complex cardiovascular conditions, particularly in patients with heart failure, pulmonary hypertension, or unclear diagnoses. Invasive exercise testing involves catheter-based measurements of cardiac output, pulmonary pressures, and other hemodynamic parameters during physical exertion, revealing abnormalities that may not appear at rest. Cardiopulmonary exercise testing (CPET) combines exercise with respiratory gas analysis, measuring oxygen consumption to assess the integrated function of the heart and lungs. Vasoreactivity testing is used to evaluate how pulmonary arteries respond to vasodilator medications. These diagnostic tools can be valuable for patients with complex or overlapping conditions, where standard diagnostics may not provide sufficient clarity, and can help to address the underlying causes of symptoms like shortness of breath, fatigue, or exercise intolerance.
Our Chronic Total Occlusion (CTO) specialists focus on treating coronary arteries that have been completely blocked for weeks, months, or even years, presenting some of the most technically challenging cases. These blockages, often filled with dense scar tissue or plaque, can lead to persistent chest pain, reduced heart function, or limitations in physical activity. Our specialists are highly skilled in navigating these occlusions using advanced percutaneous techniques. The antegrade approach involves carefully advancing guidewires and catheters through the blockage to create a pathway, followed by balloon angioplasty and stenting to restore blood flow. In more complex cases, the retrograde approach is employed, accessing the occlusion through collateral vessels that have formed naturally to bypass the blockage. CTO procedures require meticulous planning, specialized equipment, and a deep understanding of coronary anatomy, as the occluded segments often lack clear pathways. By reopening these long-blocked arteries, we can address symptoms that can significantly impact patients’ daily lives, offering solutions for those who may have been previously managed with medications alone or considered for more invasive surgical options.
Complex percutaneous coronary artery interventions address severe cases of coronary artery disease, where blockages or calcifications in the heart’s arteries pose significant challenges. Our physicians employ a range of cutting-edge, minimally invasive techniques to restore blood flow and improve heart function. Specialists perform coronary angioplasty and stenting, a procedure that involves dilating narrowed arteries to widen the vessel. For patients with heavily calcified arteries, orbital and rotational atherectomy, as well as laser atherectomy can be used. These are advanced techniques that use high-speed rotating or orbiting devices to break down hardened plaque, allowing for successful balloon expansion and stent placement. Our center also employs intravascular lithotripsy, a technology that delivers targeted ultrasound shockwaves to fracture calcium deposits within the artery walls, making them more pliable for treatment. These advanced techniques are particularly valuable for elderly patients or those with complex anatomies, where traditional methods may be less effective. Our center utilizes advanced mechanical endovascular support devices if needed to support patients during percutaneous coronary intervention. The center’s expertise ensures that even high-risk patients, such as those with multivessel disease and advanced heart failure, receive tailored interventions to address their conditions using state-of-the-art tools.
We use state-of-the-art imaging technologies to guide cardiovascular interventions: Intravascular Ultrasound (IVUS) uses a catheter with an ultrasound probe to create detailed images of the vessel walls, revealing plaque composition, vessel dimensions, and stent placement accuracy. Optical coherence tomography (OCT) uses near-infrared light to produce microstructural images of the arteries. These imaging technologies are critical for complex coronary and peripheral interventions, allowing cardiologists to assess the extent of disease and optimize treatment strategies in real-time.
Our center offers alcohol septal ablation, a minimally invasive procedure used to treat hypertrophic cardiomyopathy by reducing the thickened heart muscle. This treatment, performed by expert cardiologists, can help relieve symptoms such as shortness of breath and chest pain, improving overall heart function.
Symptoms of microvascular disease occur due to dysfunction in the heart’s small blood vessels. This condition, often seen in women or patients with risk factors like diabetes or hypertension, is challenging to diagnose due to the limitations of standard angiography. Our center employs specialized diagnostic techniques, such as coronary flow reserve testing, which uses a catheter-based approach to measure blood flow in the microvasculature, identifying abnormalities that may contribute to angina or shortness of breath. Treatment strategies are highly individualized, often combining multiple medical therapies to relax blood vessels and improve microvascular function. Advanced diagnostic tools, such as stress testing and functional assessments, are used to monitor treatment progress and adjust therapies as needed.
Our center is dedicated to treating vascular disease in the arteries outside the heart, particularly those in the legs, arms, kidneys and carotids. Peripheral artery disease (PAD) usually results from atherosclerosis, leading to narrowed or blocked vessels that cause symptoms like leg pain during walking, numbness, or, in severe cases, tissue damage or non-healing wounds. Our physicians employ a range of minimally invasive endovascular techniques to restore circulation. Angioplasty is a key procedure, using balloon catheters to open narrowed segments of arteries, such as the iliac, femoral, or tibial vessels, often followed by the placement of stents to maintain vessel patency. For arteries occluded with plaque, atherectomy procedures are utilized, employing directional, rotational, or laser-based devices to physically remove or vaporize the plaque, creating a clearer pathway for blood flow. In cases of acute occlusion caused by blood clots, the center performs thrombectomy, a procedure that uses specialized catheters to extract clots and restore circulation quickly. These interventions are tailored to the patient’s specific vascular anatomy and disease severity, often guided by advanced imaging to ensure precision. The center’s focus on minimally invasive approaches allows for quicker recovery compared to traditional surgical methods, making it an ideal option for patients with comorbidities or those seeking less invasive treatments. Similarly, varicose veins, chronic deep vein thrombosis and other vein disorders can be treated with a broad range of interventional therapies. The team collaborates closely with vascular surgical specialists to provide comprehensive care.
Our structural heart center specializes in treating aortic valve stenosis, a condition where the aortic valve narrows, restricting blood flow from the heart to the body and causing symptoms like shortness of breath, chest pain, or fainting. Transcatheter aortic valve replacement (TAVR) offers a minimally invasive alternative to open-heart surgery, particularly for patients at higher surgical risk due to age or comorbidities. Our center performs TAVR using multiple access routes to accommodate diverse patient anatomies. The femoral approach, delivered through the femoral artery in the groin, is the most common, involving the insertion of a collapsible prosthetic valve that is guided to the heart and expanded within the diseased valve. For patients with unsuitable femoral arteries, alternative approaches include subclavian (via the artery under the collarbone), carotid (via the neck artery), transaortic (directly through the chest), or transcaval (via a vein in the abdomen). Each procedure is meticulously planned using imaging technologies like CT scans and echocardiography to ensure precise valve placement. The TAVR procedures are performed by a skilled team of interventional cardiologists, cardiac surgeons, imaging specialists, and anesthesiologists.
For the treatment of mitral regurgitation or mitral stenosis our center offers two minimally invasive procedures: Transcatheter Edge-to-Edge Repair (TEER) and Transcatheter Mitral Valve Replacement (TMVR). TEER, involves placing a small clip to secure the mitral valve leaflets, reducing leakage and improving heart function. This procedure is ideal for patients with primary (structural) or secondary (functional) mitral regurgitation, guided by real-time echocardiography to ensure precise clip placement. In select cases of prosthetic valve or calcific mitral stenosis, TMVR replaces the mitral valve with a prosthetic valve, delivered via a catheter through the femoral vein or other access points. These procedures are highly technical, requiring advanced imaging and a coordinated team to navigate the mitral valve’s complex anatomy. The center’s work is tailored to patients with high surgical risk, such as those with advanced heart failure or multiple comorbidities, offering a minimally invasive solution that avoids the challenges of open-heart surgery.
Tricuspid valve dysfunction, often regurgitation (leakage), is commonly associated with right-sided heart failure, leading to symptoms like swelling, liver dysfunction, and fatigue. Our center employs innovative, minimally invasive techniques to repair or replace the tricuspid valve. Repair procedures use devices to enhance leaflet coaptation to reduce leakage. These procedures are guided by advanced imaging, such as transesophageal echocardiography or intracardiac ultrasound, to ensure accuracy. In some cases, transcatheter tricuspid valve replacement is performed, deploying a prosthetic valve via catheter to restore normal function.