Toby Rogers discusses how advances in electrosurgery techniques in structural heart helped thousands of patients

Thousands of patients who once had no viable transcatheter options for severe heart valve disease are now receiving life-saving transcatheter valve therapies thanks to the growing adoption of innovative electrosurgical techniques.

Toby Rogers, MD, PhD, associate professor of medicine at Georgetown University and interventional cardiologist at MedStar Heart and Vascular Institute’s Structural Heart Disease Program, discussed the advances during the Electrosurgery Summit at the CRT 2025 meeting earlier this year, also speaking with Cardiovascular Business on these innovations.

“These procedures started with individual patients who weren’t eligible for standard therapy or surgery because of age, anatomy, or comorbidities,” Rogers explained. “They were left with the stark choice of doing nothing or palliative care. Electrosurgery opened the door to making many of these patients eligible for transcatheter treatment.”

The techniques, including transcaval access, BASILICA, LAMPOON, and SESAME, all use targeted electrosurgery to solve anatomical barriers that would otherwise disqualify patients from transcatheter aortic or mitral valve replacement. Each uses a modified surgical electrocautery wire to cut native valve leaflets to shave off excess cardiac tissue or bore an access between the venous and arterial vessels to enable unobstructed aortic valve access.