Beyond Blockages: Structural Heart Disease and the Rise of Minimally Invasive Solutions

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A common example of structural heart disease is aortic valve stenosis, especially in patients over 60 years old.
Heart disease is often associated with blocked arteries and heart attacks, but there's another lesser-known category of heart conditions that demands attention: structural heart disease. While coronary artery disease is defined by the narrowing or blockage of arteries that nourish the heart muscle, structural heart disease refers to abnormalities or defects in the heart's valves, walls, muscles, or chambers. These can be congenital—present from birth—or acquired over time due to aging, infections such as rheumatic fever, or degenerative changes.
A common example of structural heart disease is aortic valve stenosis, especially in patients over 60 years old. This occurs when calcium deposits restrict and stiffen the aortic valve, making it harder for the heart to pump blood efficiently. Another congenital condition is the bicuspid aortic valve, where the valve has only two cusps instead of the usual three, leading to accelerated wear and valve failure, often in younger adults.
Dr. Yugal Mishra, Chief of Clinical Services, Chairman of the Manipal Institute of Cardiac Sciences, and Chief Cardiovascular Surgeon at Manipal Hospital, Dwarka, New Delhi, shares everything you need to know:
New symptoms of structural heart disease can include difficulty breathing, fatigue during everyday activities, chest discomfort, irregular heartbeats, or swelling in the limbs or abdomen. These may signal that the heart's valves or chambers are not functioning properly and require immediate medical attention.
Surgical options such as valve repair or replacement remain effective, particularly in younger patients or those with minimal comorbidities. However, less invasive options have revolutionized care for older patients or those with additional kidney or lung complications.
One such procedure is TAVR (Transcatheter Aortic Valve Replacement), also known as TAVI. In this approach, a prosthetic valve is inserted via catheter through an artery, avoiding the need for open-heart surgery. This minimally invasive method is particularly beneficial for patients with severely compromised health, offering restored heart function, faster recovery, and improved quality of life.
Advanced therapies like TAVR offer renewed hope for living a healthier, more fulfilling life. If you or a loved one is experiencing recurring cardiac symptoms, it is advisable to consult a cardiologist. Early detection and timely intervention can make all the difference.
As highlighted by the World Health Organization, cardiovascular disease (CVD)—including heart attacks and strokes—remains the leading cause of death worldwide. Alarmingly, many of these deaths are premature, especially among individuals under 70. Aortic stenosis (AS) is a prime example of a condition that can progress silently until it becomes critical.
To further improve outcomes, the SMART trial evaluated various valve types used in TAVR procedures, enhancing treatment protocols, safety, and long-term success rates. For India to meet the growing burden of heart disease, a multi-faceted healthcare approach—combining early diagnostics and innovative treatments like TAVI—is essential to transform cardiac care and improve patient outcomes.
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