Abstract
The history of interventional therapeutic cardiology can be regarded as a set of overlapping eras initiated by a flurry of innovation, followed by rapid diffusion of new technologies and procedures. Such eras include the development of balloon angioplasty, the treatment of acute myocardial infarction, the advent of coronary stents, particularly drug-eluting stents, and more recently the development of procedures designed to treat macro-cardiac structures. Going to work in the heart, cardiologists took their knowledge and enthusiasm for balloon technology and applied it to aortic and mitral valve disease. While success in the aortic position was limited, percutaneous balloon mitral valvuloplasty rapidly became standard of care for carefully selected patients with rheumatic mitral stenosis. The development of transcutaneous heart valve technology for the treatment of calcific aortic stenosis resulted in a permanent transformation of the treatment of cardiac patients. Despite initial continued significant resistance, transcutaneous aortic valve replacement (TAVR) is now commonplace and the preferred treatment for many patient subsets. The development of TAVR followed the familiar timeline: An innovation initially regarded not feasible and perhaps not safe (“crazy”) became fully developed through innovation funded by medical device companies, validated in prospective studies, and applied worldwide. Now, rather than being considered bizarre or inappropriate, we wonder “why didn’t we think of that?” Perhaps the answer lies in ex arca or out-of-the-box thinking when approaching patient problems. Innovation in structural heart interventions continues rapidly, and now encompasses all four heart valves, with the development of procedures using off-the-shelf technology, as well as innovative novel valve designs. Pioneers, who often do not know what lays over the horizon, industry partners, skilled operators, and clinical researchers are all necessary to make this ecosystem work. The future is bright, and we expect patients with structural heart disease to look forward to more minimally invasive and hybrid technologies brought to bear to their problems.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Similar content being viewed by others
References
Ross J, Braunwald E, Morrow AG. Transseptal left atrial puncture: new technique for the measurement of left atrial pressure in man. Am J Cardiol. 1959;3(5):653–5.
Ross J. Transseptal left heart catheterization. J Am Coll Cardiol. 2008;51(22):2107–15.
Inoue K, Owaki T, Nakamura T, Kitamura F, Miyamoto N. Clinical application of transvenous mitral commissurotomy by a new balloon catheter. J Thorac Cardiovasc Surg. 1984;87(3):394–402.
Cribier A, Rath PC, Letac B. Percutaneous mitral valvotomy with a metal dilatator. Lancet. 1997;349(9066):1667.
Rihal CS, Nishimura RA, Holmes DR Jr. Percutaneous balloon mitral valvuloplasty: the learning curve. Am Heart J. 1991;122(6):1750–6.
Abascal VM, Wilkins GT, O'Shea JP, Choong CY, Palacios IF, Thomas JD, et al. Prediction of successful outcome in 130 patients undergoing percutaneous balloon mitral valvotomy. Circulation. 1990;82(2):448–56.
Wilkins GT, Weyman AE, Abascal VM, Block PC, Palacios IF. Percutaneous balloon dilatation of the mitral valve: an analysis of echocardiographic variables related to outcome and the mechanism of dilatation. Heart. 1988;60(4):299–308.
Nishimura RA, Otto CM, Bonow RO, Carabello BA, Erwin JP 3rd, Guyton RA, et al. AHA/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2014;63(22):e57–185.
Cannan CR, Nishimura RA, Reeder GS, Ilstrup DR, Larson DR, Holmes DR, et al. Echocardiographic assessment of commissural calcium: a simple predictor of outcome after percutaneous mitral balloon valvotomy. J Am Coll Cardiol. 1997;29(1):175–80.
Ommen SR, Nishimura RA, Grill DE, Holmes DR Jr, Rihal CS. Comparison of long-term results of percutaneous mitral balloon valvotomy with closed transventricular mitral commissurotomy at a single north American institution. Am J Cardiol. 1999;84(5):575–7.
Turi ZG, Reyes VP, Raju BS, Raju AR, Kumar DN, Rajagopal P, et al. Percutaneous balloon versus surgical closed commissurotomy for mitral stenosis. A prospective, randomized trial. Circulation. 1991;83(4):1179–85.
Reyes VP, Raju BS, Wynne J, Stephenson LW, Raju R, Fromm BS, et al. Percutaneous balloon valvuloplasty compared with open surgical commissurotomy for mitral stenosis. N Engl J Med. 1994;331(15):961–7.
Powell BD, Holmes DR, Nishimura RA, Rihal CS. Calcium embolism of the coronary arteries after percutaneous mitral balloon valvuloplasty. Mayo Clin Proc. 2001;76(7):753–7.
ROSS J, Braunwald E. Aortic stenosis. Circulation. 1968;38(1s5):V-61–V-7.
Passik CS, Ackermann DM, Pluth JR, Edwards WD. Temporal changes in the causes of aortic stenosis: a surgical pathologic study of 646 cases. Mayo Clin Proc. 1987;62(2):119–23.
O'Keefe JH Jr, Vlietstra RE, Bailey KR, Holmes DR Jr. Natural history of candidates for balloon aortic valvuloplasty. Mayo Clin Proc. 1987;62(11):986–91.
Cribier A, Savin T, Saoudi N, Rocha P, Berland J, Letac B. Percutaneous transluminal valvuloplasty of acquired aortic stenosis in elderly patients: an alternative to valve replacement? Lancet. 1986;1(8472):63–7.
Andersen HR, Knudsen LL, Hasenkam JM. Transluminal implantation of artificial heart valves. Description of a new expandable aortic valve and initial results with implantation by catheter technique in closed chest pigs. Eur Heart J. 1992;13(5):704–8.
Leon MB, Smith CR, Mack M, Miller DC, Moses JW, Svensson LG, et al. Transcatheter aortic-valve implantation for aortic stenosis in patients who cannot undergo surgery. N Engl J Med. 2010;363(17):1597–607.
Smith CR, Leon MB, Mack MJ, Miller DC, Moses JW, Svensson LG, et al. Transcatheter versus surgical aortic-valve replacement in high-risk patients. N Engl J Med. 2011;364(23):2187–98.
Adams DH, Popma JJ, Reardon MJ, Yakubov SJ, Coselli JS, Deeb GM, et al. Transcatheter aortic-valve replacement with a self-expanding prosthesis. N Engl J Med. 2014;370(19):1790–8.
Popma JJ, Adams DH, Reardon MJ, Yakubov SJ, Kleiman NS, Heimansohn D, et al. Transcatheter aortic valve replacement using a self-expanding bioprosthesis in patients with severe aortic stenosis at extreme risk for surgery. J Am Coll Cardiol. 2014;63(19):1972–81.
Meredith IT, Worthley SG, Whitbourn RJ, Antonis P, Montarello JK, Newcomb AE, et al. Transfemoral aortic valve replacement with the repositionable Lotus valve system in high surgical risk patients: the REPRISE I study. EuroIntervention. 2014;9(11):1264–70.
Leon MB, Smith CR, Mack MJ, Makkar RR, Svensson LG, Kodali SK, et al. Transcatheter or surgical aortic-valve replacement in intermediate-risk patients. N Engl J Med. 2016;374(17):1609–20.
Reardon MJ, Van Mieghem NM, Popma JJ, Kleiman NS, Søndergaard L, Mumtaz M, et al. Surgical or transcatheter aortic-valve replacement in intermediate-risk patients. N Engl J Med. 2017;376(14):1321–31.
Mack MJ, Leon MB, Thourani VH, Makkar R, Kodali SK, Russo M, et al. Transcatheter aortic-valve replacement with a balloon-expandable valve in low-risk patients. N Engl J Med. 2019;380(18):1695–705.
Popma JJ, Deeb GM, Yakubov SJ, Mumtaz M, Gada H, O’Hair D, et al. Transcatheter aortic-valve replacement with a self-expanding valve in low-risk patients. N Engl J Med. 2019;380(18):1706–15.
Schaff HV. Transcatheter aortic-valve implantation — at what price? N Engl J Med. 2011;364(23):2256–8.
Kapadia SR, Kodali S, Makkar R, Mehran R, Lazar RM, Zivadinov R, et al. Protection against cerebral embolism during transcatheter aortic valve replacement. J Am Coll Cardiol. 2017;69(4):367–77.
Søndergaard L, Ihlemann N, Capodanno D, Jørgensen TH, Nissen H, Kjeldsen BJ, et al. Durability of transcatheter and surgical bioprosthetic aortic valves in patients at lower surgical risk. J Am Coll Cardiol. 2019;73(5):546–53.
Makkar RR, Fontana G, Jilaihawi H, Chakravarty T, Kofoed KF, De Backer O, et al. Possible subclinical leaflet thrombosis in bioprosthetic aortic valves. N Engl J Med. 2015;373(21):2015–24.
Généreux P, Head Stuart J, Hahn R, Daneault B, Kodali S, Williams Mathew R, et al. Paravalvular leak after transcatheter aortic valve replacement. J Am Coll Cardiol. 2013;61(11):1125–36.
Alkhouli M, Sarraf M, Maor E, Sanon S, Cabalka A, Eleid MF, et al. Techniques and outcomes of percutaneous aortic paravalvular leak closure. JACC Cardiovasc Interv. 2016;9(23):2416–26.
Eleid MF, Cabalka AK, Malouf JF, Sanon S, Hagler DJ, Rihal CS. Techniques and outcomes for the treatment of paravalvular leak. Circ Cardiovasc Interv. 2015;8(8):e001945.
Rihal CS, Sorajja P, Booker JD, Hagler DJ, Cabalka AK. Principles of percutaneous paravalvular leak closure. J Am Coll Cardiol Intv. 2012;5(2):121–30.
Gössl M, Rihal CS. Percutaneous treatment of aortic and mitral valve paravalvular regurgitation. Curr Cardiol Rep. 2013;15(8):388.
Lloyd JW, Rihal CS, Eleid MF. Hemodynamics rounds: hemodynamics of mitral valve interventions. Catheter Cardiovasc Interv. 2020;96(3):712–24.
Maor E, Raphael CE, Panaich SS, Reeder GS, Nishimura RA, Nkomo VT, et al. Acute changes in left atrial pressure after MitraClip are associated with improvement in 6-minute walk distance. Circ Cardiovasc Interv. 2017;10(4):e004856.
Stone GW, Lindenfeld J, Abraham WT, Kar S, Lim DS, Mishell JM, et al. Transcatheter mitral-valve repair in patients with heart failure. N Engl J Med. 2018;379(24):2307–18.
Pilote L, Hüttner I, Marpole D, Sniderman A. Stiff left atrial syndrome. Can J Cardiol. 1988;4(6):255–7.
Eleid MF, Reeder GS, Rihal CS. Comparison of left atrial pressure monitoring with dedicated catheter versus steerable guiding catheter during transcatheter mitral valve repair. Catheter Cardiovasc Interv. 2018;92(2):374–8.
Maor E, Raphael CE, Panaich SS, Alkhouli M, Cabalka A, Hagler DJ, et al. Left atrial pressure and predictors of survival after percutaneous mitral paravalvular leak closure. Catheter Cardiovasc Interv. 2017;90(5):861–9.
Gibson DN, Di Biase L, Mohanty P, Patel JD, Bai R, Sanchez J, et al. Stiff left atrial syndrome after catheter ablation for atrial fibrillation: clinical characterization, prevalence, and predictors. Heart Rhythm. 2011;8(9):1364–71.
Holmes DR Jr, Schwartz RS, Latus GG, Van Tassel RAA. History of left atrial appendage occlusion. Interv Cardiol Clin. 2018;7(2):143–50.
Holmes DR, Reddy VY, Turi ZG, Doshi SK, Sievert H, Buchbinder M, et al. Percutaneous closure of the left atrial appendage versus warfarin therapy for prevention of stroke in patients with atrial fibrillation: a randomised non-inferiority trial. Lancet. 2009;374(9689):534–42.
Raphael CE, Alkhouli M, Maor E, Panaich SS, Alli O, Coylewright M, et al. Building blocks of structural intervention. Catheter Cardiovasc Interv. 2017;10(10):e005686.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2021 Mayo Foundation for Medical Education and Research, under exclusive license to Springer Nature Switzerland AG
About this chapter
Cite this chapter
Rihal, C.S., Simard, T.J., Holmes, D.R. (2021). 2000s: Structural Heart Disease. In: Holmes Jr., D.R., Frye, R.L., Friedman, P.A., Hagler, D.J., Munger, T.M., Ritman, E.L. (eds) The Mayo Clinic Cardiac Catheterization Laboratory. Springer, Cham. https://doi.org/10.1007/978-3-030-79329-6_7
Download citation
DOI: https://doi.org/10.1007/978-3-030-79329-6_7
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-79328-9
Online ISBN: 978-3-030-79329-6
eBook Packages: MedicineMedicine (R0)