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.

Pre-procedure CT imaging benefits LAA occlusion in Henry Ford study

There is not agreement among the top structural heart experts if CT is required for left atrial appendage occlusion (LAAO), but a Henry Ford Hospital study shows it can improve outcomes.

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Cardiac surgeons gaining procedural volume despite TAVR making up 84% of cases

A decade ago, when TAVR was first cleared by the FDA, surgeons had concern about losing business. But unexpectedly, TAVR has helped also gain heart surgery cases. 

The Harmony pulmonary valve was among the devices involved with the FDA Breakthrough Device Designation program that gained more rapid market clearance. The FDA graph shows cardiovascular devices leading the types of devices involved in the program.

Cardiovascular devices lead FDA Breakthrough Device Designation program

The FDA said cardiovascular devices make up the largest number of technologies accepted into the Breakthrough Devices Program, and several are on the list of the first 50 in the program to gain market clearance.

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

VIDEO: How to build a collaborative heart team in structural heart

Brijeshwar Maini, MD, structural heart cardiologist, national and Florida medical director of cardiology, Tenant Health, explains what hospitals need to build a structural heart program and develop a heart-team care collaboration approach.

Mitral annular calcium (MAC) does not appear to have a negative effect on long-term transcatheter aortic valve replacement (TAVR) outcomes, according to new research published in the American Journal of Cardiology.

TAVR safe and effective for patients presenting with mitral annular calcium

Researchers from Cleveland Clinic reviewed data from more than 400 patients, presenting their findings in the American Journal of Cardiology.

Performing valve-in-valve transcatheter mitral valve replacement (ViV TMVR) with conscious sedation (CS) or monitored anesthesia care (MAC) instead of general anesthesia (GA) is safe and effective, according to new research published in JACC: Cardiovascular Interventions.

Using a TAVR-like minimalist approach for valve-in-valve TMVR is safe and effective, Cleveland Clinic study confirms

During valve-in-valve TMVR, patients are treated with conscious sedation or monitored anesthesia care instead of general anesthesia. This new analysis confirms that the change does not impact patient outcomes, but it was linked to a shorter length of stay.

Subclinical leaflet thrombosis after TAVR CT JAMA Cardiology OAC

Subclinical leaflet thrombosis after TAVR: What we know, and still need to learn, about a challenging complication

Treating subclinical leaflet thrombosis after TAVR has been an ongoing challenge for structural heart clinicians, but recent research has gone a long way toward improving our understanding of this important topic. 

A TAVR procedure being performed at Northwestern Medicine in Chicago. These structural heart procedures require a team approach.

TAVR outcomes take a hit when patients present with heart failure or hypertrophic cardiomyopathy

In-hospital mortality was especially high among TAVR patients presenting with hypertrophic cardiomyopathy, according to a new analysis.