Innovation in Minimally Invasive Cardiac Procedures

Alter­na­tive pro­ce­dures to open heart surgery

The growth seen in health­care tech­nol­o­gy is at an all-time high, specif­i­cal­ly for advanced imag­ing tech­niques which can help diag­nose health con­di­tions accu­rate­ly. When deal­ing with med­ical con­di­tions relat­ed to your car­diac sys­tem, it is impor­tant to have pre­cise test­ing that can iden­ti­fy your diag­no­sis ear­ly, as heart fail­ure and oth­er car­diac dis­eases con­tin­ue to lead the mor­tal­i­ty rate for both men and women in the Unit­ed States.

With pre­cise imag­ing, your car­di­ol­o­gist is able to cre­ate an informed treat­ment plan that best suits your con­di­tion. If your heart con­di­tion is chron­ic or you have heart fail­ure, open heart surgery or long-term med­ica­tion might be your next step. How­ev­er, many car­di­ol­o­gists now have the abil­i­ty to offer min­i­mal­ly inva­sive pro­ce­dures that can be just as effec­tive as open heart surgery, with­out the high­er risk.

Our struc­tur­al heart team offers the fol­low­ing min­i­mal­ly inva­sive pro­ce­dures that may be used as an alter­na­tive to open heart surgery.


Mitral regur­gi­ta­tion occurs when the mitral valve in your heart doesn’t close prop­er­ly, allow­ing back­ward blood flow. Some com­mon symp­toms may be per­sis­tent or wors­en­ing fatigue, short­ness of breath or swelling and flu­id buildup in your feet, ankles and lungs. If left untreat­ed, mitral regur­gi­ta­tion can lead to high blood pres­sure (pul­monary hyper­ten­sion). In the past, this con­di­tion has been treat­ed through open heart surgery, how­ev­er, our struc­tur­al heart team is now able to offer a less inva­sive pro­ce­dure called MitraClip®.

The Mitr­a­Clip® allows your car­di­ol­o­gist to repair the mal­func­tion in the mitral valve, with­out open­ing the chest, by access­ing the valve through a thin tube that is insert­ed in a vein to reach your heart. The Mitr­a­Clip® will then per­ma­nent­ly attach to the valve which will aid in regain­ing reg­u­lar blood flow to the heart. The pro­ce­dure time varies by case and you are typ­i­cal­ly released from the hos­pi­tal one to three days after your procedure.

Micra™ Wire­less Pacemaker

If you have chron­ic atri­al fib­ril­la­tion (AFib), heart fail­ure or a slow heart­beat or are tak­ing long-term med­ica­tions that may affect your heart, your doc­tor may rec­om­mend a pace­mak­er to mon­i­tor and pre­vent fur­ther car­diac complications.

The Micra™ device is one of the small­est pace­mak­ers in health­care and is insert­ed direct­ly into your heart through one min­i­mal­ly inva­sive attempt. The device is placed on a tube that is insert­ed through your vein and guid­ed to your heart, leav­ing you with no scar or bump. Once insert­ed, the Mir­ca™ pace­mak­er is able to adjust your heart rate auto­mat­i­cal­ly by sens­ing changes in your body and has a bat­tery life of twelve years. This is a sig­nif­i­cant advance­ment in heart mon­i­tor­ing as seen from pre­vi­ous pace­mak­ers, which are placed in your chest with leads run­ning to the heart and fre­quent main­te­nance visits.

Valve Clo­sures

Our struc­tur­al heart team can use tran­scatheter valve repair devices to address sev­er­al dif­fer­ent heart con­di­tions. In each of the fol­low­ing pro­ce­dures, a small inci­sion is made in your groin, leg, upper stom­ach or neck for inser­tion of a thin, flex­i­ble tube that will be guid­ed to your heart and used to place the plug or patch device in the prop­er area for valve closure.

Atri­al Sep­tal Defect Clo­sure (ASD)

ASD is a hole between the two upper cham­bers of the heart. Symp­toms may include decrease in exer­cise capa­bil­i­ty, fatigue, heart pal­pi­ta­tions and short­ness of breath. If left untreat­ed, ASD can put you at high­er risk for exces­sive blood flow to the right side of your heart and increased pres­sure in your pul­monary artery. ASD clo­sure is per­formed with a guid­ed catheter that places a patch over the hole between your heart cham­bers. The pro­ce­dure takes approx­i­mate­ly one to two hours and the length of the hos­pi­tal stay varies from patient to patient.

Patent Fora­men Ovale Clo­sure (PFO)

PFO is an intrac­ar­diac con­di­tion that occurs at birth when the heart doesn’t ful­ly close, result­ing in a hole. The most com­mon symp­toms are an irreg­u­lar heart­beat and short­ness of breath. If left untreat­ed, you may be at high­er risk of devel­op­ing a blood clot. PFO clo­sure takes approx­i­mate­ly two hours to com­plete and con­sists of a catheter and clo­sure device being insert­ed through a vein, where the device will be placed to strad­dle each side of the heart hole. From there, the device will per­ma­nent­ly remain in your heart to stop abnor­mal blood flow between the two atri­al cham­bers of your heart.

Tran­scatheter aor­tic valve replace­ment (TAVR)

Aor­tic steno­sis occurs when the aor­tic valve begins to nar­row, reduc­ing blood flow from your heart to the rest of your body, caus­ing chest pain, heart mur­murs and short­ness of breath. Aor­tic steno­sis weak­ens your heart over time putting you at high­er risk for fur­ther car­diac com­pli­ca­tions. In some cas­es, aor­tic valve replace­ment surgery is nec­es­sary, but in oth­ers, a less-inva­sive pro­ce­dure called TAVR is an option. Dur­ing this pro­ce­dure, a heart valve device is placed on your dis­eased or fail­ing valve to act as a replace­ment valve that will aid in prop­er blood flow. The pro­ce­dure is approx­i­mate­ly one to two hours long and you might spend up to two days in the hos­pi­tal, depend­ing on your condition.


Atri­al Fib­ril­la­tion (A‑FIB) is one of the most com­mon types of abnor­mal heart rhythms and may pro­duce a vari­ety of symp­toms includ­ing short­ness of breath, fatigue and chest pain. Long term, AFib can increase your risk of stroke or devel­op­ing addi­tion­al dis­or­ders that affect your heart’s rhythm.

If you have chron­ic A‑FIB, the WATCH­MAN™ pro­ce­dure pro­vides you with an alter­na­tive treat­ment option to long-term anti­co­ag­u­la­tion med­ica­tion, or blood thin­ners, through a one-time, min­i­mal­ly inva­sive pro­ce­dure. Dur­ing this hour-long pro­ce­dure, your car­di­ol­o­gist will implant the WATCH­MAN™ device through a catheter into the left atri­al appendage (LAA), the small ear-shaped sac in the mus­cle wall of the let atri­um of your heart. The WATCH­MAN™ clos­es the LAA to keep blood clots from form­ing in this area. Most patients return home the next day fol­low­ing the procedure.

As the car­di­ol­o­gy field con­tin­ues to advance in imag­ing, car­diac pro­ce­dures and research, more access is avail­able for informed deci­sion-mak­ing and pre­ven­tive heart health prac­tices. By using these meth­ods, we are able to ensure the high­est qual­i­ty images, bet­ter clin­i­cal answers and more effec­tive treat­ment plans for our patients.

Learn more about our Car­di­ol­o­gy care team and the lat­est in car­dio­vas­cu­lar technology >

Health Topics: