Structural Heart Disease

Structural heart diseases include any issues preventing normal cardiovascular function due to damage or alteration to the anatomical components of the heart. This is caused by aging, advanced atherosclerosis, calcification, tissue degeneration, congenital heart defects and heart failure. The most commonly treated areas are the heart valves, in particular the mitral and aortic valves. These can be replaced through open heart surgery or using cath lab-based transcatheter valves or repairs to eliminate regurgitation due to faulty valve leaflets. This includes transcatheter aortic valve replacement (TAVR). Other common procedures include left atrial appendage (LAA) occlusion and closing congenital holes in the heart, such as PFO and ASD. A growing area includes transcatheter mitral repair or replacement and transcatheter tricuspid valve repair and replacement.

A TAVR procedure being performed at Northwestern Medicine in Chicago. These structural heart procedures require a team approach.

Treating AFib patients with TAVR still linked to elevated risks

While the technology and techniques associated with TAVR have advanced over the years, treating patients who present with baseline atrial fibrillation is still associated with certain risks.

Back in October 2024, heart surgeons with the WVU Heart and Vascular Institute in Morgantown, West Virginia, performed the world’s first robotic aortic valve replacement and coronary artery bypass (RAVCAB) procedure. Now, the team behind that historic surgery has shared its full story for the first time, publishing an in-depth look at the procedure in The Annals of Thoracic Surgery, an official journal from the Society of Thoracic Surgeons.[1]

Heart surgeons detail world’s first robotic heart procedure of its kind

The care team behind the very first robotic aortic valve replacement and coronary artery bypass surgery has written about the experience in The Annals of Thoracic Surgery. The group discussed the development of the technique, how the patient was chosen for treatment and other key details.

Sapien 3 Ultra Resilia TAVR valves

Years of progress have made TAVR more effective when treating concomitant mitral stenosis

Newer balloon-expandable TAVR valves are associated with much better outcomes for patients presenting with both severe AS and severe MS than older models.

Cardiologist heart

TAVR/PCI bests SAVR/CABG when treating severe AS and complex CAD

Percutaneous treatment was linked to improved survival and fewer adverse events than surgery when patients presented with both symptomatic severe aortic stenosis and complex coronary artery disease. 

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TAVR survival less likely when patients are depressed

Screening TAVR patients for signs of depression prior to treatment could help providers adapt as necessary and deliver better patient care.

Robotic aortic valve replacement (RAVR) is a new minimally invasive treatment option for symptomatic severe aortic stenosis (AS) that uses advanced robotic surgical systems. It has already started gaining momentum as an alternative to both surgical aortic valve replacement (SAVR) and transcatheter aortic valve replacement (TAVR).

Q&A: Pioneer heart surgeon on the development and long-term potential of robotic aortic valve replacement

It's early for RAVR, but the minimally invasive technique has already started gaining momentum as an alternative to both SAVR and TAVR. We spoke to Vinay Badhwar, MD, one of the world’s leading voices in robotic heart surgery, to learn more.

Heart surgeons with the WVU Heart and Vascular Institute have made a bit of history, performing the world’s first combined robotic aortic valve replacement (AVR) and coronary artery bypass grafting (CABG) procedure—all through one small incision. Patients requiring these procedures typically undergo open-heart surgery.

Heart surgeons perform world’s first combined robotic AVR and CABG

The entire robotic procedure was performed through one small incision. Surgeons originally recommended the 73-year-old patient undergo open-heart surgery, but she requested a less invasive alternative. 

Off-label TAVR for native aortic regurgitation linked to worse outcomes

Targeting aortic regurgitation with TAVR valves built to treat aortic stenosis may be the only option a cardiologist has—but valves designed specifically to treat AR are linked to much better outcomes, according to a new meta-analysis. Edwards Lifesciences recently acquired the two companies at the center of this study, JenaValve and JC Medical.

Around the web

Several key trends were evident at the Radiological Society of North America 2024 meeting, including new CT and MR technology and evolving adoption of artificial intelligence.

Ron Blankstein, MD, professor of radiology, Harvard Medical School, explains the use of artificial intelligence to detect heart disease in non-cardiac CT exams.