Cardiologist Q&A: Transcatheter Innovations for Congenital Heart Valve Disease

Video Transcript:

Adam Pick: Hi everybody, it's Adam with HeartValveSurgery.com and we're in Los Angeles, California at Cedars Sinai Medical Center. I'm thrilled to be joined by Dr. Steve Nageotte, who is a leading interventional cardiologist at the Guerin Family Congenital Heart Program here at Cedars Dr. Nageotte, it is great to see you again and thanks for being with me today.

Dr. Stephen Nageotte: Great to see you. Thank you so much for having me.

Adam Pick: We are talking about one of my favorite topics, which is innovation. Can you share with all the folks in our community, the patients and the parents of the patients, what do you see as the most exciting innovation in congenital heart valve disease?

Dr. Stephen Nageotte: It's a really exciting time right now to be a congenital interventional cardiologist because the types of procedures and the types of devices that we now have access to has really taken off, particularly over the last five to 10 years, where traditionally we didn't have access to many different options.

There's really been a boom in terms of research and innovation in in valves that are made. Directly for congenital patients, specifically looking at self-expanding pulmonary valve replacement. There's a lot of research and development going into that technology. Such that the amount of patients that we can now treat with a self-expanding valve is drastically more than prior when we were just dealing with the traditional valves that we had.

Adam Pick: We talked about the pulmonary, any other new devices or strategies or techniques for the aortic, mitral, or tricuspid?

Dr. Stephen Nageotte: In the congenital space, the vast majority of the lesions we're dealing with are tricuspid and pulmonary valve. So, there is definitely innovation in the tricuspid valve realm with the structural heart teams.

I think that's one of the reasons it's important to associate yourself with a complete heart team so that you have access to all the different valves that may be available to aortic, mitral, tricuspid, or pulmonary. There's been even more development in the young patients such that there's now devices that are coming out that will be studied thad may be put in in much earlier kids -- even three to four years of age.

Adam Pick: That was going be my next question. How old were these patients that were receiving these transcatheter techniques? That's really young. And so ultimately do you plan for the lifetime management of that patient with that valve?

Dr. Stephen Nageotte: Yeah. I think the most important thing that you can do is the right thing off the bat.

So setting the patient up for success. When I was mentioning those patients that are much younger, that is still the exception to the rule. More often than not, we're performing these first interventions when the patients are in their early adolescent or teenage years. Uh, in terms of a valve replacement.

It is critical though when you make that first decision that you're making a decision that will set the patient up for a lifetime of success with valve-in-valve interventions and not trying to force a patient down a pathway that may or may not be right for that particular patient and really strategizing what's the best route for that patient in particular.

Adam Pick: Well, Dr. Nageotte, I love how you're tying together not just the innovation. But the lifetime management of the disease for that patient. So on behalf of those patients and the parents out there, thanks to you for everything you and your team are doing here at the Guerin Family Congenital Heart Program at Cedars.

Dr. Stephen Nageotte: Thank you so much. It's really a pleasure.