EIRMC has a very robust cardiac program with physicians who specialize in structural heart procedures. Our Heart Team will conduct a comprehensive evaluation to determine whether these procedures are an appropriate therapeutic option for patients with valve disease or other structural heart defects. In certain cases, these procedures may not be an option because of coexisting medical conditions or disease processes that would prevent the patient from benefitting as expected or because the risks outweigh the benefits. The risks and benefits of the desired procedure are carefully assessed by the Heart Team physicians, and then discussed with the patient so he or she can make an informed decision about the treatment plan.

TAVR (Transcatheter Aortic Valve Replacement)

TAVR is a minimally invasive catheter procedure that is used to replace the aortic valve in patients with severe aortic stenosis (narrowing of the heart’s aortic valve). Common symptoms include symptoms like shortness of breath, syncope (passing out), chest pain, and fatigue.

A team of heart surgeons and interventional cardiologists work together to place an artificial valve into the heart via a catheter through an artery. Before TAVR, replacing the valve was done through open heart surgery. The TAVR procedure has been proven to significantly improve the quality of life and survival rates for these patients, and allows for a faster recovery.

This procedure is available for consideration for any patient with severe aortic stenosis, including those who may be considered inoperable, after thorough workup and Heart Team evaluation.

  • Procedure time: about 1.5-2 hours
  • Hospital Stay: 1-2 nights
  • Follow-up Care: 30 day echocardiogram and visit with implanting physician, routine cardiology visits, and one year echocardiogram and visit with implanting physician.

Facts about EIRMC’s TAVR program:

  • EIRMC TAVR program started in November of 2015.
  • EIRMC has performed well over 150 TAVRs to date.
  • EIRMC uses moderate sedation for most patients.

Transcatheter Mitral Valve Repair (TMVr)

EIRMC is the first hospital in Eastern Idaho to offer a less invasive treatment for severe mitral valve regurgitation as a cutting edge alternative to open-heart valve surgery. It is often recommended to patients with symptomatic mitral valve regurgitation who are considered to be elevated risk for traditional surgery.

TMVr is performed through a small puncture in the groin where a catheter is inserted into the femoral vein. The steerable, guided catheter is advanced into the left atrium. The clip or clips are attached to the leaflets of the valve, reducing mitral regurgitation.

  • Procedure time: about 2-3 hours
  • Hospital Stay: 1-2 nights
  • Follow-up Care: 30 day echocardiogram and visit with implanting physician, routine cardiology visits, and one year echocardiogram and visit with implanting physician.

Transcatheter Mitral Valve Replacement (TMVR)

TMVR is a less invasive treatment for severe mitral valve regurgitation or mitral stenosis. Especially in the setting of prior mitral valve replacement, using a catheter from the femoral vein the new valve is able to be deployed to replace the poorly functioning mitral valve as an alternative to traditional surgery.

  • Procedure time: about 2-3 hours
  • Hospital Stay: 1-2 nights
  • Follow-up Care: 30 day echocardiogram and visit with implanting physician, routine cardiology visits, and one year echocardiogram and visit with implanting physician.

Left Atrial Appendage Occlusion (LAAO)

LAAO is a treatment offered to patients with atrial fibrillation (irregular heartbeat) that have been treated with anticoagulants to reduce risk of stroke but no longer are a good candidate for the blood thinner. The LAA is a small sac-like appendage in the upper left chamber of the heart. During an LAA closure procedure, the atrial appendage is sealed with a catheter procedure using the femoral vein in the groin while under general anesthesia. This reduces the risk of stroke without the need for blood thinners long term.

  • Procedure time: about 1 hour
  • Hospital Stay: Overnight for monitoring
  • Follow-up Care: You will need to take warfarin and aspirin for about 45 days or until the left LAA is sealed (the lining of the heart grows over it). This will be confirmed by a transesophageal echocardiogram around 45 days post-procedure.

Atrial Septal Defect (ASD) Closure

An ASD is a hole in the wall that divides the two upper chambers of the heart. An ASD causes blood to flow through the defect, which causes more blood than usual to pass into the right chamber, called a left-to-right shunt. Overtime, this puts pressure on the right heart and pulmonary arteries. Treatment of an ASD depends upon the type and size of the defect or presence of any other congenital heart defects. ASD repair or closure may often be performed through a catheter procedure.

  • Procedure time: Approximately 1 hour
  • Hospital Stay: Same-day discharge or possibly overnight
  • Follow-up Care: Echocardiogram at six months and yearly thereafter

Patent Foramen Ovale (PFO) Closure

A patent foramen ovale (PFO) is a hole between the upper chambers of the heart that didn't close after birth as it most often does. If this causes an issue, a catheter procedure can be performed to plug this hole. The catheter is inserted into a vein in the groin and guides the device into place with the imaging assistance of an echocardiogram. This can be performed with conscious sedation or general anesthesia.

  • Procedure time: about 1 hour
  • Hospital Stay: Same-day discharge or possibly overnight
  • Follow-up Care: Echocardiogram at six months and yearly thereafter.

Paravalvular leak (PVL) Closure

A paravalvular leak (PVL) is a hole next to a previous valve replacement that causes leaking. When significant, a catheter procedure can be performed to plug this hole. The catheter is inserted into a artery or vein in the groin and guides the device into place with the imaging assistance of an echocardiogram. This is performed using general anesthesia.

  • Procedure time: about 1 hour
  • Hospital Stay: Same-day discharge or possibly overnight
  • Follow-up Care: Echocardiogram at one month and as needed thereafter.

Complex Coronary Intervention

Using tools such as athrectomy (“roto-rooting”) and specialized equipment, complex coronary (heart artery) interventions can be performed using catheters, when appropriate, to avoid open heart surgery. This includes chronic total occlusion (CTO) interventions.

  • Procedure time: variable
  • Hospital Stay: Usually overnight