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.

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CT imaging showing the congenital heart defect of left heart hypoplastic syndrome.

VIDEO: Congenital heart imaging with cardiac CT

As the population of patients with adult congenital heart disease grows, they are presenting to adult cardiology clinics and being imaged with CT. Many also do not have access or cannot be imaged by MRI, said Renee Bullock-Palmer, MD.

The Medtronic Intrepid transcatheter mitral valve replacement (TMVR) system performed well in two studies presendted at TCT 2022. #TCT #TCT22 #TCT2022 #TMVR

Intrepid transcatheter mitral valve pilot study shows positive 3-year outcomes

New data on the Medtronic Intrepid transcatheter mitral valve replacement system from the Intrepid Pilot Study and Intermediate-Term Outcomes of the Intrepid Early Feasibility Study, were presented at the 2022 Transcatheter Cardiovascular Therapeutics (TCT) conference.

Impella Heart Pump Abiomed RECOVER IV RCT cardiogenic shock

Regulatory Roundup: FDA clears AI model for RV/LV ratios, approves calcium-blocking TAVR valve and much more

Read our review of some of the biggest FDA-related stories that have hit cardiology in the last month, including news from Viz.ai, Edwards Lifesciences, Abiomed and Medtronic. 

Medtronic launches Evolut FX TAVR system aortic stenosis

Medtronic launches Evolut FX TAVR system for severe aortic stenosis

This is the fourth device in Medtronic's Evolut TAVR platform. The self-expanding valve gained FDA approval in 2021 for the treatment of high- and low-risk patients presenting with symptomatic severe aortic stenosis.

The Pascal transcatheter mitral valve repair system. Similar to the latest version of the MitraClip, the Pascal can operate each leaflet independently to grasp the mitral valve leaflets. Results of the CLASP IID trial at #TCT2022.

Pascal transcatheter mitral repair device performs as well as MitraClip in late-breaking CLASP IID Trial 

Comparison between transcatheter edge-to-edge repair (TEER) devices found Pascal was non-inferior compared with MitraClip in the CLASP IID pivotal trial.

Sentinel Boston Scientific PROTECTED TAVR stroke disabling stroke

TAVR embolic protection devices fail to reduce stroke risk, but some cardiologists—and a leading vendor—remain encouraged

The PROTECTED TAVR results presented at TCT 2022 resulted in a mix of reactions. For some cardiologists, the slight reduction in the risk of a disabling stroke after TAVR is a positive result. For others, it was simply not enough. 

he U.S. Food and Drug Administration (FDA) granted market clearance ion September 2022 for the Edwards Lifesciences Corp. Pascal Precision transcatheter valve repair system for transcatheter edge-to-edge repair (TEER). It is indicated for the treatment of patients with degenerative mitral regurgitation (DMR).

FDA clears Edwards Pascal device for transcatheter mitral valve repair

This is the second FDA-cleared transcatheter repair device for the mitral valve. Data from pivotal trial comparing Pascal vs. MitraClip will be presented at TCT 2022.

Examples of structural heart transcatheter valve replacement procedure planning CT scans and post procedure followup for TMVR and TAVR.

VIDEO: CT imaging for TAVR and TMVR structural heart interventions

Joao Cavalcante, MD, director, cardiac MRI and structural CT labs, Minneapolis Heart Institute, discusses the use of cardiac CT imaging to plan and guide structural heart procedures. 

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