Comprehensive care for valve disorders

The Ohio State University Heart and Vascular Center’s Structural Heart Disease Program is a leader in providing patients with heart valve disease access to the newest and most advanced treatments.

Ohio State is one of only a handful of centers in Ohio offering transcatheter aortic valve replacement (TAVR) for aortic valve regurgitation or aortic valve stenosis. We are currently participating in a variety of clinical trials, evaluating groundbreaking therapies in patients with structural heart disease.

Our dedicated program for structural heart disease offers you access to the most advanced treatments and options for every condition. We have assembled a team of experts including interventional cardiologists, cardiac surgeons, dedicated nursing staff and other specialists, to ensure you receive the most comprehensive care available.

Our team can evaluate your condition and provide treatment options for you – whether this is your initial consultation or you are looking for a second opinion. Our advanced treatment options are giving new hope to patients who previously were not considered candidates for treatment due to advanced age or condition.

Advancing Care for Structural Heart Disease at Ohio State

Aortic Valve Replacement at Ohio State

Ohio State's approaches to aortic valve replacement from co-director of the Structural Heart Disease program, Barry George, MD

Life-Saving Valve Replacement

Learn how Ohio State's team saved Veneta's life with a transcatheter aortic valve replacement procedure.

How the TAVR Procedure Works

This video shows how the Transcatheter Aortic Valve Replacement (TAVR) procedure is performed

Structural Heart Diseases

Structural heart disease refers to conditions that interrupt the natural flow of blood through the chambers and valves of the heart. Structural heart disease can be the result of a birth defect or can develop later in life. The most common conditions related to structural heart disease include:

Aortic Valve Regurgitation or Insufficiency

A narrowing of the valve between the heart and aorta that prevents it from opening or closing properly.

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Aortic Valve Stenosis

A condition in which the aortic valve does not close properly, creating a backflow of blood from the aorta into the left chamber of the heart.

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Atrial Septal Defect

A hole between the heart’s two upper chambers.

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Complex Congenital Heart Defects

A congenital heart defect is a condition that occurs when the heart – or blood vessels near the heart – does not develop normally before birth.

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Hypertrophic Obstructive Cardiomyopathy

A thickening of the heart walls.

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Mitral Valve Regurgitation

A weakening or stretching of the valve between the heart’s upper and lower left chambers that prevents it from closing properly.

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Mitral Valve Stenosis

A stiffening of the valve between the heart’s upper and lower left chambers that prevents it from opening properly.

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Pulmonary Valve Regurgitation

The pulmonary valve is not strong enough to prevent backflow to the right ventricle.

Tricuspid Valve Regurgitation or Insufficiency

The tricuspid valve doesn't close properly, allowing some reverse flow of blood.

Ventricular Septal Defect

A hole between the heart’s two lower chambers.

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Our Treatments

As a leading regional academic medical center, Ohio State offers several options to treat valve and structural heart disease. Ohio State is one of only a handful of centers in Ohio able to replace the aortic valve through a catheter approach called transcatheter aortic valve replacement, or TAVR. TAVR is a closed-chest, catheter-based valve replacement procedure that is an alternative to traditional open heart surgery. If you have been diagnosed with severe aortic stenosis, you may be a candidate for this procedure.

Advanced age should not be a factor in determining not to have aortic valve replacement for aortic stenosis. Patients in their 80s and even 90s often benefit dramatically from aortic valve replacement for severe aortic stenosis.

Our treatment options include:

Balloon Aortic Valvuloplasty

In balloon valvuloplasty, a small catheter (thin, flexible tube) with a small, uninflated balloon attached to the tip is threaded through a blood vessel in the groin area. Once the catheter reaches the damaged valve, the balloon is inflated to stretch the valve opening and allow more blood to flow through it. The balloon is then deflated and guided back through the vessel and removed. The patient is generally awake during this procedure, and the recovery time is considerably shorter than with traditional surgery.

Many patients with degenerative valve disease are ineligible for surgery or for transcatheter aortic valve replacement (TAVR) because of their high-risk status due to advanced age, multiple co-morbidities or end-stage disease. For these patients, balloon valvuloplasty may help to improve symptoms of congestive heart failure.

Balloon valvuloplasty can relieve the symptoms of valve disorders, but is not a permanent solution and may need to be repeated at a later date. In certain situations, some patients may not be candidates for surgery or transcatheter aortic valve replacement due to a momentary decline in their heart functioning or overall health status. For these patients, balloon valvuloplasty may help improve symptoms of congestive heart failure and allow patient’s health status to improve so that they can eventually undergo surgery or TAVR.

Conventional Open or Minimally Invasive Aortic Valve Replacement Surgery

Open heart surgery to replace the diseased aortic valve has been around for many years and is a safe and effective treatment. Conventional aortic valve replacement uses an open heart surgery procedure to allow the surgeons to replace the valve through the chest plate.

Newer minimally invasive procedures for aortic valve replacement are being used with patients including mini-sternotomy and mini-thoracotomy. These newer less-invasive procedures for aortic valve replacement are designed to reduce the trauma to the body (sternum, rib cage) and accelerate patient recovery.

Transcatheter Aortic Valve Replacment

Transcatheter aortic valve replacement (TAVR) is a minimally invasive procedure that allows the aortic valve to be replaced through a catheter approach rather than through a traditional open heart surgery.

First, a balloon valvuloplasty is performed. Balloon valvuloplasty involves a small incision typically made in the groin area. A catheter (thin, flexible tube) with a small, uninflated balloon attached to the tip is threaded through the opening into a blood vessel. Once the catheter reaches the damaged valve, the balloon is inflated to stretch the valve opening and allow more blood to flow through it. The balloon is then deflated and guided back through the vessel and removed.

A new catheter containing the heart valve is then reinserted into the blood vessel. The new heart valve is threaded through the blood vessels to the heart and into the damaged heart valve where it is released. The new heart valve will take the place of the damaged one, allowing the blood to flow normally out of the heart and through the body.

This procedure is less invasive than open heart surgery, offering quicker recovery times and a shorter hospital stay.

Patient Referral

The Valve and Structural Heart Disease Program at The Ohio State University Heart and Vascular Center has a reputation for excellence in the diagnosis, treatment and management of complex cardiac conditions. Our multidisciplinary heart valve clinic allows patients to be evaluated by a cardiologist, cardiac surgeon or an interventional cardiologist in one appointment. In many cases, additional tests may also be performed during the same visit.

A variety of treatment options are available for patients with valve or structural heart disease, including conventional open-heart surgery, minimally invasive heart surgery or transcatheter procedures, depending on our expert assessment of the patient’s specific needs. We are currently participating in a variety of clinical trials evaluating groundbreaking therapies for patients with structural heart disease.

Physician referrals are required. Patients should request a referral from their regular healthcare providers. Healthcare professionals wishing to make referrals, or consumers with questions about the referral process can contact Ohio State’s Valve and Structural Heart Disease Clinic at 614-293-8866.

Patients can be referred for:

Transcatheter Aortic Valve Replacement (TAVR)

In order to be evaluated for transcatheter aortic valve replacement (TAVR), patients must have severe symptomatic aortic stenosis. Currently, TAVR is approved for use in patients who are considered high risk or not candidates for traditional aortic valve replacement surgery. We are also evaluating lower surgical risk patients and patients with prosthetic aortic valve stenosis or insufficiency in the context of a clinical trial. In many patients, coronary artery disease may be treated at the same time as TAVR.

There are many requirements patients must meet in order to be eligible for TAVR. An extensive multidisciplinary evaluation must be performed as a part of this eligibility process, including assessment of the aortic valve annulus and peripheral vasculature. It is anticipated that the majority of patients will meet these requirements. Patients who do not meet requirements for TAVR may be candidates for conventional aortic valve replacement surgery or for palliative procedures such as balloon aortic valvuloplasty.

Surgical Aortic Valve Repair or Valve Replacement

Surgical aortic valve repair or replacement can be done as a minimally invasive procedure through a small chest incision or through a traditional chest incision. Most patients with no other heart problems can have minimally invasive aortic valve surgery.

Surgical Mitral Valve Repair or Replacement

Surgical mitral valve repair or replacement for a leaky mitral valve (regurgitant/insufficient) can be done as a minimally invasive procedure through a small chest incision or through a traditional chest incision. Most patients with no other heart problems can have minimally invasive mitral valve surgery. The majority of patients with leaky mitral valve (regurgitant/insufficient) disease benefit from mitral valve repair. Our surgeons are experts in mitral valve repair techniques. Patients with narrowed mitral valve (stenosis) may benefit from mitral balloon valvuloplasty or from surgical mitral valve replacement.

Closure Procedures

Our team offers atrial and ventricular septal defect closures, and patent foramen ovale (PFO) closures, performed by transcatheter or surgical technique when clinically indicated. Novel transcatheter closure techniques are also available for treatment of prosthetic perivalvular insufficiency.

Our Leaders

Our leaders

Barry George, MD

Barry George, MD, FACC, FSCAI, FACP

Director, Advanced Interventional Cardiovascular Medicine and Structural Heart Disease

Dr. George is an interventional cardiologist and an associate professor of Clinical Internal Medicine, and director of Advanced Cardiovascular Catheter-based Therapies at The Ohio State University Wexner Medical Center.

Dr. George has been named one of the "Best Doctors in America." He is board-certified in internal medicine, cardiovascular disease and interventional cardiology.

Jaun Crestanello, MD

Juan Crestanello, MD

Director, Cardiac Surgery; Co-Director, Structural Heart Disease Program

Dr. Crestanello is the section director of Ohio State's Cardiac Surgery program. He focuses on the treatment and evaluation of patients with heart valve disease and adult congenital pathologies. His research interests include minimally invasive valve surgery, valvular heart disease, hybrid coronary revascularization, and the effect of hyponatremia on cardiac surgery outcomes. 

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