Structural Heart Disease Program

The Structural Heart Disease Program team at Brigham and Women’s Hospital (BWH) provides innovative multidisciplinary care for patients with advanced and complex structural heart disease. From evaluation to treatment, this unique program is designed to deliver the best possible outcomes for each and every patient.

Aortic valve replacement – Click on the image above to see an animated representation of how a slender catheter (tube) can be used to replace a diseased aortic valve with a synthetic aortic valve.

The program specializes in offering interventional (minimally invasive) treatments for patients who don’t qualify for the conventional open procedures offered by our Brigham Cardiac Valve Center. Although open-heart surgery continues to be the preferred method for treating structural heart disease, interventional cardiology provides a viable alternative for patients for whom conventional surgery is considered to be too risky – and offers the potential benefits of less scarring, less blood loss, less pain and a quicker recovery.

The core of the program is a multidisciplinary team of specialists, representing cardiology, interventional cardiology, cardiac surgery, cardiovascular imaging and cardiac anesthesia, all working together at our state-of-the-art Shapiro Cardiovascular Center. With this vast diversity of medical expertise under one roof, our team is able to efficiently perform a multidisciplinary evaluation, collaborate closely to develop a specialized treatment plan and continuously work together to provide patients with informed and effective cardiovascular care. This clinical expertise is further enhanced by the team’s access to the best in medical technology, including one of the most advanced hybrid operating rooms (ORs) in the country.

Structural Heart Disease Services

Specialists in the Structural Heart Disease Program offer care for patients with:

• Advanced structural and valvular heart disease.
• Patent foramen ovale (PFO) – a hole in the heart that didn’t close as it should after birth.
• Atrial and ventricular wall defects.
• Valve leaks.

In addition to evaluation and diagnosis, specialists in the Structural Heart Disease Program offer a range of advanced procedures, including:

• Percutaneous valve replacement – an alternative to open heart surgery that uses a catheter to replace a diseased aortic valve with a synthetic aortic valve
• Percutaneous aortic and mitral valvuloplasty – uses a balloon to expand abnormally narrow heart valves
• Minimally-invasive valve procedures – replacing/repairing a mitral valve or aortic valve through a chest incision that is much smaller (about 3 inches) than what is required for conventional open surgery (about 8 inches).
• Catheter-based closure of atrial and ventricular wall defects
• Alcohol septal ablation for hypertrophic cardiomyopathy – interventional procedure designed to reduce thickening of the heart muscle
• Catheter-based closure of valve leaks in high-risk or inoperable patients
• Hybrid approaches to combined coronary and valvular heart disease – combining a percutaneous (minimally invasive) coronary procedure with a surgical valve procedure

Structural Heart Disease Team

Meet our multidisciplinary team of structural heart disease specialists.

• R. Morton Bolman, III, MD - Chief, Cardiac Surgery
• Andrew Eisenhauer, MD - Director, Interventional Cardiovascular Medicine Service
• Frederick Welt, MD - Interventional Cardiologist
• Sary Aranki, MD - Cardiac Surgeon
• Frederick Chen, MD, PhD - Cardiac Surgeon
• Lawrence Cohn, MD - Cardiac Surgeon
• Gregory Couper, MD - Cardiac Surgeon
• Michael Davidson, MD - Cardiac Surgeon
• Prem Shekar, MD - Cardiac Surgeon

Structural Heart Disease Research

Our cardiac surgeons, cardiac anesthesiologists and interventional cardiologists collaborate to perform clinical trial procedures aimed at advancing treatment of patients with advanced valvular and structural heart disease, including:

• EVEREST II Trial - percutaneous mitral valve repair, an effective potential alternative to surgery for patients with chronic structural mitral regurgitation from mitral prolapse or other leaflet disorders. 
• COMPETENT Trial – for patients with functional mitral regurgitation.
• PARTNER (Placement of AoRTic TraNscathetER) Trial - a promising new treatment for patients with severe aortic stenosis (narrowing of the aorta) who are not ideal candidates for traditional open heart surgery.
• Surgical Interventions for Moderate Mitral Regurgitation - to determine whether repairing a mitral valve with moderate leakage at the time of planned coronary artery bypass graft (CABG) surgery will improve outcomes.
• Surgical Interventions for Severe Mitral Regurgitation - to determine whether it is better to repair or replace the mitral valve of patients with severe mitral valve leakage (regurgitation) from coronary artery disease.

Refer a Patient to the Structural Heart Disease Program

To refer a patient to the Structural Heart Disease Program, or for assistance with transfers or consultations, please call Cardiovascular Access Managers Lisa Downey, RN, BSN or Brian Laneau, RN, BSN at (617) 543-4170.