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.

Video with JACC Editor Harlan Krumholtz offering an overview of key tricuspid and TAVR late-breakers at TCT24.

Progress in tricuspid valve care and TAVR on full display at TCT 2024

Harlan Krumholz, MD, editor-in-chief of the Journal of the American College of Cardiology, said tricuspid valve treatments are a popular topic among cardiologists right now. TAVR research, meanwhile, remains as important as ever.

Boston Scientific ACURATE neo2 aortic valve system self-expanding TAVR valve

Boston Scientific TAVR valve comes up short in comparison with Medtronic, Edwards devices

The Acurate neo2 TAVR valve has been used to treat severe aortic stenosis in other parts of the world for years. In the United States, however, the device has still not been approved for commercial use.  

TTVR with Evoque device linked to substantial benefits after 1 year

New late-breaking data presented at TCT confirmed that the first FDA-approved TTVR system for TR is associated with a much better quality of life than medical therapy alone after one year.

Didier Tchetche, MD, an interventional cardiologist and head of the structural heart disease program at Clinique Pasteur in Toulouse, France, and colleagues combined data from the RHEIA and PARTNER 3 trials into a single comparison of TAVR outcomes in female patients.

TAVR linked to better outcomes than surgery for women, pooled analysis confirms

New research presented at TCT combined data from the RHEIA and PARTNER 3 trials. “TAVR is a good option, and probably the best one, for an elderly woman," cardiologist Anna Sonia Petronio, MD, explained during the conference. 

EARLY TAVR investigator Philippe Généreux, MD, announced his team’s findings in front of a packed audience at TCT 2024.

Treating asymptomatic aortic stenosis with TAVR linked to significant benefits

Attendees cheered as lead investigator Philippe Généreux, MD, shared his team's findings at TCT 2024. “A major reset in our approach to severe asymptomatic AS is now warranted,” one veteran cardiologist said about the data. “The concept of watchful waiting is no longer appropriate."

Medtronic Evolut FX+ TAVR

Medtronic’s next-generation TAVR device receives CE mark approval

The Evolut FX+ TAVR system, which already received FDA approval in March, was designed with improved coronary access in mind. One cardiologist described the device as a "significant step forward" for patients with heart disease. 

A transcatheter aortic valve replacement (TAVR) procedure being performed at Intermountain Healthcare. Image from Intermountain Healthcare

TAVR survival is down in recent years, leaving cardiologists stumped

Researchers tracked recent TAVR data from the STS/ACC TVT Registry, highlighting a "concerning" finding they were unable to explain.

Massachusetts Institute of Technology won a $50,000 award to help commercialize its 3D printed, polymeric auxetic stent to treat pediatric aortic coarctation. It is bioresorbable so the patient can continue to grow without the need for as many reinterventions.

Pediatric cardiology device competition introduces world to new technologies

Most cardiac devices do not fit young children, making it especially important for growth in pediatric cardiology to continue. The FDA helped fund a contest aimed at identifying new devices that show a ton of potential. 

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.

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