Aortic paravalvular leak closure
Paravalvular leak (PVL) occurs in 5% to 17% of patients after valve replacement surgery. Although the majority of PVLs are subclinical, some patients develop symptoms of heart failure, hemolysis, or…
Aortic valve-in-valve TAVR
Transcatheter aortic valve-in-valve (VIV) is an established treatment of degenerative surgical bioprostheses in patients at high operative risk and was approved by the US Food and Drug Administration in 2015….
Transcatheter aortic valve replacement using self-expanding valve
Self-expanding transcatheter aortic valve replacement: The medtronic corevalve system Currently in the United States, the most widely used self-expanding transcatheter aortic valve is the Medtronic CoreValve system. This transcatheter valve…
Balloon expandable transcatheter aortic valve replacement
Introduction The only balloon-expandable valve currently on the market is the Edward Sapien Heart valve manufactured by Edwards Life Sciences. This chapter will focus on the procedural techniques involved in…
Balloon aortic valvuloplasty
Background Aortic stenosis (AS) is common in the elderly population, with a prevalence of approximately 3% in patients over 75 years old. The prognosis of symptomatic severe AS is poor,…
Transcatheter aortic valve implantation: Work up and indications for intervention
Background Aortic stenosis is the most common valvular heart disease in the elderly population, with a prevalence of approximately 3% in patients over 75 years old. The prognosis of symptomatic…
Techniques of transseptal puncture
Transseptal catherization was first described by Ross, Braunwald, and Morrow in 1959 as a feasible method to obtain direct left atrial (LA) pressure measurements. Although the use of transseptal puncture…
Imaging for SHD interventions
Introduction The field of transcatheter structural heart interventions has grown tremendously in recent years. Because operators are not able to directly visualize the cardiac anatomy during percutaneous procedures, live imaging…
Hemodynamics for the structural interventionalist
Introduction Invasive hemodynamic assessment is a critical part of structural intervention. Imaging and hemodynamics are complementary, and both need to be mastered for effectiveness in structural heart disease (SHD) interventions….
Building blocks of structural intervention: An approach for procedural training
Structural heart disease (SHD) intervention is the fastest-growing area in cardiology and cardiac surgery. The number of transcatheter procedures has increased from approximately 5000 procedures in 2012 to over 60,000…
