Transcatheter Therapies for Structural Heart Disease

In the past 10–15 years, the invention and maturation of transcatheter aortic valve replacement (TAVR) and mitral transcatheter edge-to-edge repair (M-TEER) have change the way heart valve disease managed. The increasing adoption of transcatheter therapies has been fueled by their appeal to patients, given they represent a less invasive treatment modality, allowing shorter hospital stays and faster return to activities. During TAVR, a bioprosthetic valve is deployed inside the native aortic valve, pushing the native leaflets aside. Historically, TAVR was reserved for patients who were deemed to be of high or prohibitive risk with open surgery. However, as the use of TAVR has expanded to younger and healthier patients, the decision of which modality to offer patients has become more complex. The Sapien (balloon-expanding) and Corevalve Evolut (self-expanding) are the two most commonly used TAVR prostheses. In this chapter, we will discuss transcatheter therapies based on pathology with a specific focus on TAVR.