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Percutaneous aortic valve replacement (AVR) is a cutting-edge treatment being investigated for select patients with severe symptomatic aortic stenosis (narrowing of the aortic valve opening) who may not be candidates for convention valve replacement surgery. Several hospitals are currently evaluating a percutaneous(through the skin rather than an open chest incision) approach for implanting a prosthetic valve inside the diseased calcified aortic valve. This less invasive procedure is performed in the cardiac catheterization lab by an interventional cardiologist. See Video.

During the procedure a catheter is placed through the femoral artery (in the groin) and guided into the chambers of the heart. A compressed tissue heart valve is placed on the balloon-mounted catheter and is positioned directly over the diseased aortic valve. Once in position, the balloon is inflated to secure the valve in place. Edwards Life Sciences has introduced the Sapien Transcatheter Heart valve which is currently in the investigational stages in the US. In September of 07 it did recieve CE mark approval

Percutaneous valvotomy or valvuloplasty is a less invasive procedure performed in many patients to treat mitral valve and pulmonic valve stenosis (narrowing of the valve). Percutaneous valvotomy can also be performed in carefully selected patients to treat stenosis of the aortic valve. See video.

During mitral valvuloplasty, a specialized catheter is placed percutaneously through the femoral vein (in the groin) and guided into the chambers of the heart. The cardiologist then creates a tiny hole in the wall between the heart’s two upper chambers. This hole provides an opening for the cardiologist to access the left atrium with a special catheter that has a balloon at the tip.

The catheter is placed precisely so that the balloon tip is directly inside the narrowed mitral valve. The valve opening is widened (or dilated) by rapidly inflating and deflating the balloon. Once the interventional cardiologist has determined that the opening has been widened enough, the balloon is deflated and removed. The procedure is similar when performed in the aortic and pulmonic valves.

Percutaneous Mitral Valve Repair - a less invasive procedure for the treatment of severe mitral valve regurgitation. In 2008 Evalve recieved approval for the use of the Mitraclip for minimally invasive repair of the mitral valve. Read more.

MitraClip, a percutaneous, less invasive mitral valve repair system that is used by interventional cardiologists and is intended to reduce mitral regurgitation. A major benefit of this device is that it enables the interventional cardiologist to repair the mitral valve while the heart is beating, without cardiopulmonary bypass (CPB) and without the need for a thoracotomy or sternotomy.

Atrial Fibrillation affects almost 2.5 million people in the US alone, with 300,000 new cases diagnosed every year. 15% of all strokes that occur anually can be attributed to atrial fibrillation. There are numerous interventions available to help convert this rhythm to a more regular one, including medications, electrical cardioversion, atrial pacemakers, surgery or ablation. Less invasive techniques can now be employed to perform atrial fibrillation surgery or maze procedure.

Numerous robotically -assisted, less invasive cardiac procedures are currently being performed using the da Vinci ® robotic system. It has been reported the approximately 70- 90 hospitals in the United States are currently employing robotic assistance for certain less invasive cardiac surgeries. Not every patient is a candidate for this type of minimally invasive procedure, each case is evaluated on an individual basis. The da Vinci Surgical System is changing the practice of cardiac surgery as it's known today. Data suggests that recovery time, pain and trauma are reduced significantly through this less invasive approach.The da Vinci robotic system offers three-dimensional visualization and remarkable technical precision, which has assisted and improved a cardiac surgeons' ability to perform difficult procedures with greater accuracy. Intuitive surgical has received FDA clearance for the following less invasive robotic assisted cardiotomy procedures: mitral valve repair, endoscopic atrial septal defect closure, mammary to left anterior descending coronary artery anastomosis for cardiac revascularization with adjunctive mediastinotomy, and internal mammary artery mobilization and cardiac tissue ablation.

Many institutions have recently expanded the application of robotically-assisted MIDCAB to selected patients with multi- vessel disease. By combining coronary artery stenting and robotic MIDCAB, all territories may be revascularized through a minimally invasive approach. Robotics are currently being employed for the treatment of end- stage cardiomyopathy and congestive heart failure. Robotically assisted, less invasive placement of biventricular pacing wires has been effective treatment to minimize the symptoms (shortness of breath and fatique) associated with cardiomyopathy or congestive heart failure. Shrinking robots and growing processors are taking minimally invasive techniques where they have never gone before, read more...

Less invasive robotic-assisted Atrial Septal Defect (ASD) repair - if your cardiologist recommends surgical repair of your ASD, you may be an appropriate candidate for a less invasive surgical procedure called da Vinci ASD Repair. This surgery employs the state-of-the-art da Vinci robotic surgical system designed to assist your surgeon see critical anatomical structures more clearly and to perform a more accurate operation.

The most common interventional procedure is angioplasty or percutaneous coronary intervention. Performed by an interventional cardiologist, this procedure is done to view the coronary arteries to determine the extent of a patient’s disease, if any. Once access is gained to the patient’s vessels, specialized catheters are advanced to the heart. Once in the heart, under real-time imaging, the interventional cardiologist injects dye that can be seen under imaging through the coronary arteries. If a significant blockage or narrowing is seen, after balloon angioplasty is done, a stent can be deployed to keep the blockage open. Under certain circumstances, specialized catheters may need to be used to remove fresh clots from within the vessel. Click here for video information on cardiac catherization. Click here to read about the history of angioplasty ( http://www.sw.org ).

Statistics from the American Heart Association's website 2009 update: 1,314,000 angioplasties were done in the United States in 2006. Of these 1,313,000 were percutaneous coronary interventions (PCIs).
* 855,000 men and 459,000 women had angioplasties.
* 448,000 cardiac revascularizations (also known as coronary artery bypass graft or CABG operations) were done in the United States in 2006.
* CABG was performed on 323,000 men and 125,000 women.