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.

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.

Medtronic's Evolut Pro TAVR valve treating aortic stenosis

Medtronic TAVR valves at heart of key studies presented during PCR London Valves 2024

One study presented during the three-day conference focused on the potential benefits of an optimized TAVR pathway. Another study, meanwhile, tracked changes in paravalvular leak severity over time.

Newsweek ranked the 50 best heart hospitals in the world

Prosthesis-patient mismatch after TAVR: 5 key findings related to patients with small annuli

PPM is still relatively common after TAVR, especially among patients with a small aortic annulus. What can be done to minimize the risk of PPM? Does valve type play a role? Researchers explored those questions, and many others.

Gilbert H. Tang, MD, professor in the Department of Cardiovascular Surgery at the Icahn School of Medicine and surgical director of the Structural Heart Program at the Mount Sinai Health System, explains how to overcome the limited imaging windows of the tricupid valve using a TEE and intracardiac echo (ICE) at TCT 2024.

How to overcome imaging challenges during tricuspid valve procedures

Gilbert Tang, MD, surgical director of the structural heart program at the Mount Sinai Health System, discussed a key challenge care teams often encounter during tricuspid valve procedures. 

Cardiologist Azeem Latib

First patients treated with Abbott’s new balloon-expandable TAVR valve

Abbott already has an FDA-approved self-expanding TAVR valve, the Navitor system, on the market. The company is now evaluating the safety and effectiveness of a new balloon-expandable device that could potentially be implanted using software guidance. 

Sapien 3 Ultra Resilia TAVR valves

Newest TAVR valve from Edwards linked to better 1-year outcomes than its predecessors

The Sapien 3 Ultra Resilia TAVR valve from Edwards Lifesciences is associated with a significantly higher survival rate after one year than the company's previous balloon-expandable valves. Researchers identified other key benefits as well, sharing their findings in JACC: Cardiovascular Interventions.

Around the web

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

Eleven medical societies have signed on to a consensus statement aimed at standardizing imaging for suspected cardiovascular infections.