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.

AHA: Is ECMO the wave of the future?

NEWTON, Mass.Everyone who receives ECMO [extracorporeal membrane oxygenation] does not die, said Joshua N. Baker, MD, a cardiovascular surgeon at Massachusetts General Hospital (MGH) in Boston, during a presentation April 26 at the American Heart Association's 22nd Annual Cardiovascular Nursing Conference. While ECMO is still sparsely used in the U.S., there may be ground for more widespread acceptance despite the costs, he told Cardiovascular Business.

Astra CEO to retire

AstraZenecas CEO and board member, David Brennan, has decided to retire and relinquish his board responsibilities as of June 1. He has served as CEO since Jan. 1, 2006, but the company has experienced a few difficult, consecutive financial quarters, to which many analysts attribute his departure.

A busy time for TAVR

The clock is ticking. With its deadline looming, the Centers for Medicare & Medicaid Services (CMS) is exploring issues related to transcatheter aortic valve replacement (TAVR) as the agency completes its national coverage determination. The final decision, originally scheduled for June 26, may be released as early as May.

FDA slaps warning on using aliskiren with ACEIs, ARBs

The FDA is warning of possible risks when using blood pressure medicines containing aliskiren (Tekturna, Novartis Pharmaceuticals) with ACE inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) in patients with diabetes or renal impairment. These drug combinations should not be used (are contraindicated) in patients with diabetes.

Circ: Beneficiaries in donut hole more likely to drop CV drugs

Medicare Part D beneficiaries with no financial assistance who fall in the coverage gap known as the donut hole are 57 percent more likely to discontinue cardiovascular (CV) medications, according to a study published online April 17 in Circulation: Cardiovascular Quality and Outcomes. The researchers added that it was unclear whether these lapses affected long-term outcomes.

AJMC: Simplifying dosing regimens may improve medication adherence

A once-daily dosing regimen was related to greater adherence versus a twice-daily regimen with prescription medications used by patients with cardiovascular disease, according to a large analysis in the March issue of the American Journal of Managed Care.

JAMA: HF patients given high-dose losartan not at increased risk of death

Counter to some findings, a large prospective study of two angiotensin II receptor blockers found no increased risk of death in heart failure (HF) patients taking a high dose of losartan compared with higher doses of candesartan. Low doses of losartan, though, were associated with increased mortality. The study was published in the April 11 issue of the Journal of the American Medical Association.

AIM: Dialysis patients might not derive same benefit from ACEIs, ARBs

Compared with patients with normal kidney function, chronic dialysis patients may not derive the same cardiovascular benefit from angiotensin-converting enzyme inhibitor (ACEI) and angiotensin receptor blocker (ARB) use, based on a study published April 9 in the Archives of Internal Medicine.

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.