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.

TricValve Transcatheter Bicaval Valves System Cleveland Clinic

Interventional cardiologists complete first heart procedure of its kind in North America

While the system used during the procedure has not yet gained full FDA approval, this patient was treated under a compassionate-use clearance from the agency.

A view showing the close relationship between the mitral and aortic valves and how the overhang of a longer TAVR valve can interfere with the left ventricular outflow tract (LVOT). Image from a mitral echo assessment using Siemens eSie Valves software at ACC22.

The latest data on mitral valve infective endocarditis after TAVR

Self-expanding heart valves and the presence of significant PVL were both linked to a heightened risk of mitral valve infective endocarditis after TAVR. 

The American College of Cardiology (ACC) annual meeting is the premier source for the latest cardiac science. #ACC22

Links to the ACC.22 late-breaking clinical trials

Learn more about the late-breaking studies presented at ACC.22 in Washington, D.C. 

VIDEO: TAVR durability outperforms surgical valves

Michael J. Reardon, MD, professor of cardiothoracic surgery and Allison Family Distinguished chair of cardiovascular research at Houston Methodist DeBakey Heart and Vascular Center, presented pooled data at ACC.22 from the CoreValve SURTAVI trials that found transcatheter aortic valve replacement (TAVR) was more durable than surgical aortic valve replacement (SAVR) devices.

How the continued rise of TAVR has impacted SAVR outcomes

Did SAVR outcomes suffer due to the rapid rise of TAVR? A team of researchers aimed to find out with a brand new analysis. 

Adam Greenbaum, MD, Emory, explains the CLASP TR trial of the Pascal clip device for transcatheter repair, which was a late-breaking ACC22 study.

VIDEO: Pascal effective in transcatheter repair of tricuspid valve regurgitation

Adam Greenbaum, MD, co-director of the Structural Heart and Valve Center at Emory University Hospital Midtown in Atlanta, explains details from the late-breaking CLASP TR trial at ACC.22.

Several ACC 2022 late-breaking trials may have impacts on clinical practice for interventional cardiology and structural heart. One trial compared FFR vs. IVUS guided PCI for intermediate coronary lesions. Photos by Dave Fornell

Key interventional cardiology takeaways from ACC.22

Several late-breaking clinical trials at ACC.22 will likely impact clinical practice. Below are summaries of a few key trials and their takeaways for interventional cardiology and structural heart interventions. 

MitraClip vs mitral valve edge to edge repair (TEER).

VIDEO: MitraClip vs. surgical mitral valve replacement

Joanna Chikwe, MD, founding chair of the department of cardiac surgery at Cedars-Sinai Hospital, compares transcatheter edge-to-edge repair (TEER) to mitral valve surgery for primary mitral regurgitation.