Procedures
Left Atrial Appendage Occlusion
Atrial fibrillation is a heart condition where the upper chambers of the heart (atria) beat too fast and with a chaotic rhythm (atrial fibrillation). This condition can cause blood to pool and form clots in an area of the heart called the left atrial appendage. If a blood clot forms, it can travel through an artery to the brain and cause a stroke.
Blood thinners, or anticoagulants, are very effective at reducing the risk of stroke in people with atrial fibrillation, and most people can take them for years without serious side effects. However, because blood thinners help prevent clots by thinning the blood, they also increase the risk of bleeding.
For those patients that have reason to seek an alternative to blood thinners due to a high risk of bleeding or due to life-style that makes being on life-long blood thinners less attractive, the WATCHMAN Left Atrial Appendage Closure Implant is a one-time procedure alternative to blood thinners that can help reduce stroke risk and bleeding worry for life.
The WATCHMAN device is implanted in the left atrial appendage of the heart to permanently close off this small pouch and keep harmful blood clots from entering the bloodstream. The device is inserted through the vein of the leg using a minimally invasive small incision and a catheter, which then comes out. By closing off the left atrial appendage, the source of more than 90% of stroke-causing blood clots that come from the heart in people with non-valvular atrial fibrillation, the risk of stroke may be reduced and, over time, patients are able to stop taking blood thinners. In a clinical trial with WATCHMAN, 96% of people were able to stop using blood thinners after 45 days.
Left atrial appendage occlusion (WATCHMAN device)
Atrial fibrillation is a heart condition where the upper chambers of the heart (atria) beat too fast and with a chaotic rhythm (atrial fibrillation). This condition can cause blood to pool and form clots in an area of the heart called the left atrial appendage. If a blood clot forms, it can travel through an artery to the brain and cause a stroke.
Blood thinners, or anticoagulants, are very effective at reducing the risk of stroke in people with atrial fibrillation, and most people can take them for years without serious side effects. However, because blood thinners help prevent clots by thinning the blood, they also increase the risk of bleeding.
For those patients that have reason to seek an alternative to blood thinners due to a high risk of bleeding or or due to a lifestyle that makes being on lifelong blood thinners less attractive, the WATCHMAN Left Atrial Appendage Closure Implant is a one-time procedure alternative to blood thinners that can help reduce stroke risk and bleeding worry for life.
The WATCHMAN device is implanted in the left atrial appendage of the heart to permanently close off this small pouch and keep harmful blood clots from entering the bloodstream. The device is inserted through the vein of the leg using a minimally invasive small incision and a catheter, which then comes out. By closing off the left atrial appendage, the source of more than 90% of stroke-causing blood clots that come from the heart in people with non-valvular atrial fibrillation, the risk of stroke may be reduced and, over time, patients are able to stop taking blood thinners. In a clinical trial with WATCHMAN, 96% of people were able to stop using blood thinners after 45 days.
Mitral Valve Repair and MitraClip Implantation
The mitral valve controls blood flow to the left side of the heart. However, blood can regurgitate or flow backward when the mitral valve doesn’t work properly. Mitral valve problems, which are quite common, can be congenital (from birth) or result from infections and diseases. They can also happen with age due to “wear and tear” on the heart valve.
At Mount Sinai, our cardiac surgeons use minimally invasive techniques whenever possible to repair or replace the mitral valve for patients requiring this intervention. In fact, Mount Sinai has performed more valve surgeries than any hospital in South Florida, and our cardiac surgeons have far-reaching expertise with complex cases, using the most advanced surgical techniques available.
Our experts often perform mitral valve repair (used to treat mitral valve disease) using catheter-based techniques rather than heart surgery. During this process, one of our doctors inserts a catheter into a blood vessel, to the heart, to then fix the abnormal valve.
MitraClip implantation uses a catheter to insert a clip into the leaky valve to ensure the valve closes correctly. Inserting the catheter into the groin area, your Mount Sinai physician will guide the tube into the heart, crossing the septum to access the left chambers. The MitraClip is attached to the valve and protects the heart from further leakage of blood.
Septal Ablation (with alcohol)
For patients with hypertrophic cardiomyopathy, a thickening of the wall between the heart chambers called the septum, Mount Sinai physicians may recommend septal ablation. To reduce this thickening, your doctor will insert a catheter into a blood vessel, find the septum between the heart’s ventricles, and release alcohol into the wall. This alcohol causes some of the cells in the septum to die or reduce in size, relieving stress on the heart muscle.
Septal Occluder Implantation
In this process, your Mount Sinai physician will use a catheter to insert an occluder (a mesh and polyester disc) into the atrial septum, which is the wall separating the heart’s upper chambers. The occluder closes, or blocks, the hole in the septum to prevent blood from flowing between the two chambers.
Transcatheter Aortic Valve Replacement (TAVR)/Transcatheter Aortic Valve Implantation (TAVI)
For patients with aortic valve disease, such as stenosis, or failed previously placed bio-prosthetic aortic or mitral valves, transcatheter aortic valve replacement/implantation offers a less invasive approach than open heart surgery to replace the aortic valve or failing bioprosthetic aortic/mitral valves. During this procedure, your physician will insert a replacement valve through a catheter, or thin hollow tube, by making an incision in your groin. Then the physician will thread the catheter to the heart and “pop” a new valve into place. The new valve pushes the old valve away as it expands.
