Conditions We Treat

The multidisciplinary team of specialists at Mount Sinai’s Structural Heart Program treats a variety of cardiovascular diseases and conditions affecting the heart itself, including the following conditions:

• Aortic valve disease
• Atrial septal defect
• Hypertrophic cardiomyopathy
• Leaky valves
• Mitral valve disease
• Narrowing of aorta
• Narrowing of aortic valves
• Paravalvular leaks
• Patent ductus arteriosus, or PDA
• Patent foramen ovale, or PFO
• Pulmonary valve disease
• Tricuspid valve disease
• Ventricular septal defect

Aortic Valve Disease

Aortic valve disease is a heart problem affecting the valve that controls blood flow where the aorta connects to the heart. The aorta is the largest artery, carrying oxygenated blood from the heart to the entire body. When patients have aortic valve disease, the valve does not work properly, and blood can back up into the left ventricle (bottom heart chamber). When the aortic valve is leaky, this disease is called aortic regurgitation. Stenosis is another type of aortic valve disease that occurs when the aortic valve becomes stiff and narrow, which can limit the amount of blood that flows to the body, leaving patients feeling tired. At Mount Sinai, we treat aortic valve disease with a minimally invasive procedure called transcatheter aortic valve replacement (TAVR), also known as transcatheter aortic valve implantation (TAVI). The TAVR procedure is also very effective in treating patients with previous aortic valve surgery with bioprosthetic surgical valves that may have narrowed or are leaking.

Atrial Septal Defect

Atrial Septal Defect is a birth defect that happens when babies are born with a hole in the wall, or septum, between the two upper heart chambers. It can cause too much blood flow to the lungs, and a large atrial septal defect, or one that goes untreated for a long time, may damage the lungs or heart. At Mount Sinai, we often treat atrial septal defects by implanting a catheter-based septal occluder that “fills in” the hole.

Hypertrophic Cardiomyopathy

Hypertrophic cardiomyopathy is a type of heart disease that happens when the actual muscle of the heart becomes too thick and stiff. At Mount Sinai, we often treat hypertrophic cardiomyopathy with a procedure called alcohol septal ablation, which eliminates some of the heart tissue by delivering alcohol to the affected part of the heart through a catheter (typically in the wall of the heart that separates the bottom left and right heart chambers).

Mitral Valve Disease

The mitral valve controls the blood flow between the top and bottom chambers on the left side of the heart. Mitral valve regurgitation happens when the valve does not close correctly, and blood backs up into the top chamber, the left atrium. Mitral valve stenosis occurs when the mitral valve flaps get stuck together, which limits blood flow from the left atrium to the left ventricle. With both types of mitral valve disease, patients don’t get enough good blood flow to their bodies. At Mount Sinai, we often treat mitral valve disease by implanting a device called a MitraClip. Also, we use a catheter-based procedure called mitral valvuloplasty for patients whose mitral valve has become too narrow. The transcatheter placement of a balloon-mounted valve procedure is also very effective in treating patients with previous mitral valve surgery with bioprosthetic surgical valves that may have narrowed or are leaking.

Narrowing of Aorta

The aorta is the largest artery, carrying oxygenated blood from the heart to the entire body. The part of the aorta that connects to the heart can become narrowed – often from a birth defect – making it more difficult for blood to flow through the aorta to other body parts. Balloon dilation of the narrowing and, in some cases, placement of a catheter-delivered stent is often a very effective method of treating such narrowing.

Paravalvular Leaks

Paravalvular leak, also called paravalvular regurgitation, is a leak that develops around natural heart tissue and a valve replacement. These leaks – a rare complication resulting from transcatheter or surgical replacement of a mitral or aortic valve – can be closed using catheter-delivered plugs in appropriate cases.

Patent Ductus Arteriosus (Pda)

Patent ductus arteriosus, or PDA, happens when the aorta, the largest artery that carries oxygenated blood to the entire body, becomes connected to the pulmonary artery. When this happens, blood can flow between the two arteries. PDA usually happens to babies in the womb, and the opening closes at birth. But sometimes, it does not close, and Mount Sinai structural heart experts must close the connection.

Patent Foramen Ovale (Pfo)

Patent foramen ovale, or PFO, occurs when a connection forms between the two upper heart chambers, the left and right atria. It is quite common, and often treatment is not required. However, it can occasionally increase the risk of stroke. If a patient requires treatment, the physicians at the Mount Sinai Structural Heart Program can fix the hole by implanting a catheter-based septal occluder that “fills in” the hole.

Pulmonary Valve Disease

Pulmonary valve disease affects the valve that controls the blood flow between the right ventricle (lower, right chamber) and the pulmonary artery, which sends blood from the heart to the lungs. When the valve does not work properly, the lungs don’t receive enough blood. Like many valve diseases, pulmonary valve disease can occur as regurgitation, when the valve does not close properly and blood backs up into the heart chamber; stenosis, when the valve opening narrows, preventing blood from flowing freely; and atresia, which is a birth defect where there’s no valve at all. In the case of atresia, tissue blocks the blood flow and prevents blood from reaching the lungs. In appropriate cases, Mount Sinai’s Structural Heart Program physicians can expertly repair these valve issues with catheter-based techniques.

Tricuspid Valve Disease

Tricuspid valve disease affects the valve that controls blood flow between the two right chambers of the heart: the right atrium (top chamber) and the right ventricle (bottom chamber). Tricuspid valve disease can take several forms:

• Regurgitation: This occurs when the valve does not close correctly, and blood leaks out.
• Stenosis: This occurs when the valve opening narrows, limiting blood flow to the body.
• Atresia: This is a birth defect in which the valve is not present. In place of the valve, tissue blocks blood flow from the right chambers of the heart and prevents blood from reaching the lungs.
• Ebstein anomaly: This rare birth defect occurs when a valve is in the incorrect location and is misshapen, which allows blood to leak out.

For leaky tricuspid valves, catheter-based techniques can be used to place a clip to bring the leaky leaflets together to mitigate regurgitation. The transcatheter placement of a balloon-mounted valve procedure is also very effective in treating patients with previous tricuspid valve surgery using bioprosthetic surgical valves that are leaking or narrow.

Ventricular Septal Defect

A ventricular septal defect is a type of birth defect in which a hole forms in the wall, or septum, between the two lower heart chambers: the right and left ventricle. The physicians at Mount Sinai’s Structural Heart Program work with heart specialists at Nicklaus Children’s Hospital to address ventricular septal defects in newborn babies. In addition, for adults who have had a ventricular septal defect repaired during childhood, those that may have been missed as a child, or those that can develop following a heart attack or heart surgery, our adult congenital heart defect experts can repair such defects with catheter-based techniques.