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

Predictors of 1-year mortality after TAVR are significantly different among men and women

Atrial fibrillation and peripheral artery disease, for example, are both predictors of mortality among women, but not men. 

A team of cardiologists and cardiac surgeons in Hong Kong has performed the first successful undermining iatrogenic coronary obstruction with radiofrequency needle procedure—or UNICORN for short—on a high-risk valve-in-valve transcatheter aortic valve replacement (TAVR) patient. The group wrote about their experience in Circulation: Cardiovascular Interventions, a journal launched and distributed by the American Heart Association.

Cardiologists make history, perform first UNICORN procedure during valve-in-valve TAVR

BASILICA was considered for the 67-year-old female patient, but UNICORN was seen as an overall better option. The full case study was published in Circulation: Cardiovascular Interventions.

TEER reduces mitral regurgitation, boosts survival among cardiogenic shock patients

Researchers tracked outcomes data and imaging results from nearly 4,000 TEER patients, sharing their findings in the Journal of the American College of Cardiology.

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Albuminuria linked to worse TAVR outcomes, including a higher risk of death

“Because patients with aortic stenosis are old and commonly have chronic kidney disease, it is essential to evaluate the renal function before TAVR," the study's authors wrote. “Albuminuria indicates glomerular injury and is an important factor in the assessment of renal function or diagnosis of chronic kidney disease."

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LAAO equally effective for men and women, new long-term study confirms

In-hospital complications are more common among women who undergo LAAO than men. However, according to a new study in JACC: Cardiovascular Interventions, men and women have similar long-term outcomes.

mixed reality LAAO Chase Western Reserve MRI

Researchers receive $3.7M to attempt robotic heart surgery inside MRI scanner

The group—which includes engineers, cardiologist, radiologists and other specialists—will attempt to perform a robotic-controlled left atrial appendage occlusion (LAAO) on a patient inside an MRI scanner.

transcarotid TAVR TAVI transcatheter aortic valve replacement

Transcarotid TAVR a safe alternative when femoral access is not an option

The conventional transfemoral approach is not always possible during TAVR procedures, leaving care teams with an important decision to make. 

An updated look at how cognitive impairment affects TAVR outcomes

The connection between cognitive impairment and postoperative delirium among TAVR patients stood out as a definite concern to the study's authors.

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.