How minimally invasive interventions make a big difference for heart health
Dr. Oguayo and Dr. Patel are interventional and structural cardiologists affiliated with Memorial Hermann, practicing at Memorial Hermann Northeast Hospital, Memorial Hermann Memorial City Medical Center and Memorial Hermann
The Woodlands Medical Center.
Heart disease is a killer.
It’s the leading cause of death for both men and women in the United States, claiming about 700,000 lives a year, according to the U.S. Centers for Disease Control and Prevention. But advances in preventing and treating heart disease are helping those at risk. At Memorial Hermann, physicians are using minimally invasive techniques to treat conditions including coronary artery disease, heart valve diseases and heart abnormalities, which once required traditional surgery. These innovative techniques can mean less pain, shorter hospitalizations and faster recoveries for patients. Memorial Hermann affiliated interventional and structural cardiologists Dr. Kevin Oguayo and Dr. Ruchir Patel discuss the latest treatment methods.
What is coronary artery disease, and how can it be treated?
Dr. Patel: Coronary artery disease is an accumulation of plaque that builds up in the walls of the coronary vessels that supply blood to the heart. It can be a factor of age and other risk factors, including hypertension, diabetes and obesity. It’s the most common form of heart disease, and it causes about half of all deaths from heart disease.
Dr. Oguayo: The goal for treatment is to restore blood flow to the heart, and there are multiple therapeutic options for that. One is medical management, which was historically the primary way to treat coronary artery disease before we had procedures that could treat it.
But now we can also identify and open blocked arteries through percutaneous interventions. A percutaneous intervention uses a less-invasive route through a blood vessel, usually via a small puncture in the wrist or the groin. Another option is a coronary artery bypass graft, which is a slightly more invasive procedure that can restore blood flow to a vessel that’s blocked.
What treatments are available for patients with heart valve problems?
Dr. Oguayo: Four heart valves — the aortic, mitral, tricuspid and pulmonary valves — move blood within the heart and throughout the body. In the past, the only way to replace or repair a valve was open heart surgery, but for many patients, that wasn’t an option because they were at high risk for complications. Today, most patients with aortic valve issues are treated with a transcatheter aortic valve replacement (TAVR), where the valve is replaced through one of the arteries — typically the femoral artery.
Dr. Patel: We now have percutaneous options to treat the mitral valve as well, although these options are not available in many medical centers. We are one of only a handful of institutions in the United States that can offer this treatment. At Memorial Hermann Memorial City , Dr. Oguayo and I recently did the first transcatheter mitral valve replacement (TMVR) in a patient whose surgically repaired valve had failed. The patient was out of the hospital the next day. The alternative would have been traditional open-heart surgery, which would have kept the patient in the hospital a lot longer, with a couple months of recovery time.
How have treatments for heart conditions evolved in recent years?
Dr. Patel: As interventional and structural cardiologists, we’re not opening the chest — most of our procedures are done through the blood vessels, often percutaneously, which involves almost no recovery time. Nine out of 10 patients who have percutaneous valve replacements are discharged the next day. Part of the motivation behind the minimally invasive approach is that it makes treatment more accessible to people with other underlying health issues. Traditionally, aortic valve replacements weren’t being performed on high-risk patients because of the concern that they wouldn’t recover well from a traditional surgery. Now we routinely perform valve replacements on patients in their 70s, 80s and even 90s, and they do very well.
Dr. Oguayo: The dominant idea behind the latest treatments has been: What can we do to minimize hospitalizations and get you back to where you were before — or even better? From our standpoint, the goal is to find procedures that can help people as they age with the least amount of risk, from transcatheter valve replacement to left atrial appendage closure to stenting coronary arteries. The future in treating heart disease is evolving right before our eyes, and it’s very exciting to see.
To learn more about minimally invasive treatments for heart disease at Memorial Hermann, or to schedule an appointment with a heart and vascular specialist, visit