This structural heart channel includes news, videos, podcasts and other content related to diagnosis and treatment of structural heart disease. Topics covered include heart valve repair and replacement, transcatheter aortic valve replacement (TAVR), transcatheter mitral valve replacement (TMVR), transcatheter tricuspid valve replacement (TTVR), left atrial appendage (LAA) occlusion, heart failure interventional device therapies, and closing holes in the heart using, including occlusion of atrial septal defects (ASDs), ventricular septal defects (VSDs) and patent foramen ovales (PFOs).
An illustration of the BASILICA procedure showing the leaflet of the original bioprosthetic valve sliced open to allow coronary blood flow after implantation of a TAVR valve. The new TAVR valve can push the leaflets of the bioprosthetic valve upwards, blocking the coronary arteries. During the BASILICA procedure, a catheter directs an electrified guidewire through the base of the left aortic cusp into a snare in the left ventricular outflow tract (LVOT). After snare retrieval, the mid-shaft of the guidewire is electrified to lacerate the leaflet, and the the leaflet splays after TAVR permitting coronary flow.
Left, an illustration of the beginning of deployment for a CoreValve Evolut self-expanding transcatheter aortic replacement (TAVR) valve. Right, an illustration of the final balloon expansion of an Edwards Lifesciences Sapien 3 TAVR valve. Both valves received simultaneous FDA clearance for use in low-risk surgical patients. Clearing this last hurdle now allows wide-spread use of minimally invasive TAVR in all patients who otherwise would need an open-heart surgical valve replacement.
This image shows a left-ventricular outflow tract (LVOT) obstructed by an Edwards Sapien TAVR valve used for a valve-in-valve procedure. The arrow points to the small, crescent shaped dark area of the neo-LVOT, which did not allow enough blood to flow from the left ventricle into the aorta and the rest of the body. To prevent this issue, the procedure used by Henry Ford ablates (kills) some of the tissue in the cardiac septum to allow these valves to fit better and allow for an enlarged neo-LVOT for patients who otherwise could not receive this therapy.