STRUCTURAL INTERVENTIONS

Why is there a need for structural interventions?

Most surgical interventional strategies address a range of cardiac conditions, including valvular conditions, whether acquired or congenital. Apart from genetics, structural heart disease may occur as a result of infection, injury or age.

The most prevalent types of structural heart disease include valvular heart disease and certain types of congenital heart lesions.

What structural interventional strategies are available, and how are they performed?

Modern medicine has opened the doors to numerous possibilities, including the option of undergoing minimally invasive surgery to correct structural abnormalities of the heart and recover much sooner than expected. In addition, there are implantable surgical devices such as a cardioverter-defibrillator (ICD) and a pacemaker to treat life-threatening arrhythmias.

You may experience heart arrhythmia or atrial fibrillation, which increases your risk of stroke. Blood clots can develop in the heart's left atrial appendage, which can dislodge and migrate to the brain, causing a stroke. Typically, blood-thinners are taken to dissolve blood clots. However, in some cases, when a patient is put on long-term anticoagulant medication, this is not a favourable option. As a result, an umbrella-like device, referred to as the "Watchman", obstructs the left atrial appendage to prevent the formation of clots. A device of this kind is inserted through a vein in the leg and positioned in the heart.

A cardioverter-defibrillator (ICD) and a pacemaker may seem the same, but both have different functions. A pacemaker is a miniature device inserted underneath the skin in the chest to correct slow heart rhythms, also known as heart block. An implantable cardioverter-defibrillator is placed beneath the skin and carries a built-in computer that measures your heart rate. The ICD detects life-threatening arrhythmia and delivers an electrical shock.

Following a diagnosis of high blood pressure, monitoring the condition is of high priority at the time of the findings. Resistant hypertension, a condition resulting in high blood pressure even after taking blood pressure-lowering medication and a diuretic, is a particular concern. Renal denervation is a less invasive technique that utilises radiofrequency ablation to cauterise the kidneys’ arterial nerves to minimise activity and reduce blood pressure.

What are the results of structural interventions?

Structural heart interventional surgeries are considered a success in restoring the heart's function, making it easier for you to return to what you enjoy doing most. However, it may take a few weeks to recover from surgery, depending on the procedure undergone and your current health status.

FAQ

What causes a hole in the heart?

A structural abnormality of this nature occurs during development in pregnancy. While a baby’s heart is in the process of forming fully, there remain gaps in the wall of the heart’s top chambers. When an opening does not close, a hole forms. This is a condition we refer to as an atrial septal defect. Usually, surgery or the use of a device closure is the only way of repairing an atrial septal defect. Sometimes a hole may develop in the bottom chamber, also known as a ventricular septal defect.

Can a pacemaker move its position?

Yes, a pacemaker can move out of position, but this only happens with time. However, within a year of having the pacemaker inserted, a capsule similar to a protective bubble forms around the device, preventing it from moving further.

Is a cardiac defibrillator the same as a pacemaker?

A pacemaker protects against slow heart rhythms, also known as heart blocks, to allow the heart to function when its own electrical system fails. An implantable cardiac defibrillator provides an electrical shock when one suffers from fast heart rhythms which can result in cardiac arrest.

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