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Structural heart disease refers to heart defects you were either born with (congenital) or developed later in life due to aging. Heart valve disease is a type of structural heart disease that occurs when your heart's valves aren't working correctly. This is caused by valves becoming too narrow (valvular stenosis) or not closing completely (valvular insufficiency) and leads to blood flow problems.

At Atrium Health Sanger Heart & Vascular Institute, we provide expert care for any condition affecting your heart's valves or chambers. Using the latest treatments available, including minimally invasive techniques, we treat structural heart disease with advanced, customized and complete care.

According to U.S. News & World Report, Sanger is the region’s top-rated heart program and is rated in the top 10% nationally for transcatheter aortic valve replacement (TAVR) and aortic valve surgery –making the level of care we provide unmatched in the region.

To schedule an appointment with our expert team, call 704-373-0212.

Learn more about structural heart disease from Dr. Rinaldi

"Structural heart really centers around valve disease, but it also includes things like holes in the heart and areas where blood clots can form,” says Michael Rinaldi, MD, director of Sanger's structural & valvular heart disease program. “We manage all the structural anatomic components of the heart outside of blocked vessels and the electricity of the heart."

Watch the video to learn more

Why choose us for structural & valvular heart disease care?

  • Nationally recognized: We're recognized by U.S. News & World Report as high performing in aortic valve surgery and transcatheter aortic valve replacement (TAVR) and are rated in the top 10% nationally for these procedures. And we’re 1 of only 3 centers in the Carolinas to receive this designation. We also received a 3-star rating for TAVR from The Society of Thoracic Surgeons. This is the highest designation for high-quality outcomes and places us in the nation’s top 10% for TAVR.
  • Better outcomes: As one of the nation's highest-volume heart valve disease treatment centers, handling the region's most complex cases, we consistently demonstrate better survival rates than the national average.
  • More options: We lead and enroll patients in a variety of clinical trials, meaning you get access to leading-edge treatments well before they're available elsewhere.
  • Expert team: When you come to us, you receive care from an experienced team of structural and valve experts, plus access to Sanger's entire team of diverse heart specialists.

Team approach

We're a team of nationally recognized physicians who put our experience and expertise to work for you. As leaders in our field, we work together to deliver the most effective structural heart treatments.

Our team includes:

  • Interventional cardiologists
  • Heart failure physicians
  • Advanced cardiac imaging physicians
  • Cardiothoracic surgeons
  • Electrophysiologists

Your first appointment

Whether you need help managing a congenital heart condition or treatment for a leaky valve, we offer advanced and tailored care to meet your unique needs. Here's what you can expect before, during and after your first appointment.

  • Before your appointment: We’ll ask your referring provider to send your medical records, including your medical history, test results and images (like an echocardiogram). We’ll also reach out to give you information about your care plan, upcoming appointments and itinerary.
  • During your appointment: Our structural cardiologists will evaluate your condition, determine which diagnostic care and tests are needed, and answer any questions you may have.
  • After your appointment: Once your tests and diagnostics are complete, we’ll determine if a procedure is necessary. If it is, you’ll meet with your surgeon, and your care team will arrange any additional testing and schedule your surgery. This team will also support you after your procedure.

Make an appointment

To schedule an appointment with one of our specialists, call 704-373-0212 or request one online.

Conditions treated

We evaluate and treat a variety of structural heart diseases, including:

  • Complication or failure of surgical valves:
    • Bioprosthetic aortic valve stenosis
    • Prosthetic paravalvular leaks
  • Congenital heart conditions causing a hole in the heart:
    • Atrial septal defect (ASD)
    • Patent foramen ovale (PFO)
  • Improper closure of the mitral valve:
    • Mitral valve prolapse
  • Leaky valves:
    • Aortic valve regurgitation
    • Mitral valve regurgitation
    • Tricuspid valve regurgitation
  • Narrowed valves:
    • Aortic valve stenosis
    • Mitral valve stenosis


We treat every type of structural heart disease using a full range of innovative options. And most of the time we can treat your condition minimally invasively (through the skin, a body cavity or an opening in the body), resulting in a quicker recovery and less risk of complications than traditional open heart surgery. We offer:

  • Transcatheter aortic valve replacement (TAVR) is a minimally invasive alternative to open heart surgery designed to treat aortic valve stenosis (narrowed valve). We replace the thickened valve with an artificial valve to restore blood flow.
  • Transcatheter mitral valve replacement (TMVR) is a minimally invasive procedure designed to replace a mitral valve that isn't working correctly, like when severe mitral valve stenosis (narrowed valve) occurs. We're also leading clinical trials involving new transcatheter mitral valve replacement technologies.
  • Transcatheter edge-to-edge repair (TEER) treats mitral or tricuspid valve regurgitation (leaky valve) and is a less invasive alternative to open heart surgery.
  • Valve-in-valve, valve-in-ring and valve-in-MAC therapies are performed on high-risk surgical patients, such as when there are complications with prior surgical valve replacements or repairs.
  • Transcatheter left atrial appendage occlusion (LAAO) is used to reduce the risk of stroke in patients with atrial fibrillation (irregular heartbeat). The device opens the left atrium, where blood clots can form. We currently perform this procedure using both the WATCHMAN FLX™ and Amulet™ devices. We also utilize Atriclip™ technology in patients when needed.
  • Closure of atrial septal defects (ASD) and patent foramen ovale (PFO). We use catheter-based approaches whenever possible, resulting in fewer risks and a faster recovery. And when there are additional complexities to your condition like heart failure or a higher stroke risk, we work hand in hand with other dedicated specialists to give you the comprehensive expertise you need.
  • Balloon mitral valvuloplasty is used to widen the narrowed heart valve using a catheter. This advanced technique replaces older procedures and can delay the need for surgery in certain patients.
  • Catheter-based repair of prosthetic paravalvular leaks is done using different techniques and devices tailored to your valve anatomy. As one of only a few centers in the country with expertise in this procedure, we’re your region’s treatment destination.
  • Complex valve surgery to repair or replace the aortic, mitral, tricuspid or pulmonary valve. We offer minimally invasive surgery, giving you a quicker recovery and a shorter hospital stay. And Sanger is a high-performing hospital for aortic valve surgery, according to U.S. News & World Report, which is the highest rating awarded for this procedure.

Research and innovations

Clinical trials 

We conduct a variety of clinical trials to bring you the latest treatment options – which often are only available here. For instance, while there are no commercially available therapies for tricuspid interventions at this time, we are making significant progress in the clinical trial space.

Our latest clinical trials include: 

  • Acurate:Transfemoral aortic valve replacement for severe native (natural) aortic valve stenosis
  • AltaValve: Alta valve treatment for severe mitral valve regurgitation when open heart surgery is too high risk
  • Cephea: A mitral valve replacement system for symptomatic mitral valve regurgitation when transcatheter therapy is a better option than open heart surgery
  • CLASP:Transcatheter valve repair for degenerative mitral valve regurgitation
  • Early TAVR:Transcatheter aortic valve replacement for symptomless severe aortic valve stenosis
  • Expand G4: MitraClip™EXPAND G4 used for mitral valve regurgitation treatment
  • MVRS: Transcatheter mitral repair with CardioMech NeoChord technology for severe symptomatic degenerative mitral regurgitation
  • SUMMIT: Tendyne mitral valve system for severe mitral valve regurgitation
  • Triluminate:Tri-clip device for severe tricuspid valve regurgitation
  • Triscend II:Use of the EVOQUE tricuspid valve replacement system for severe tricuspid valve regurgitation

Interested in participating in a clinical trial?

Talk to your doctor or call us at 704-355-4794. You can also find more information on our cardiology research page. Search for the trial you're interested in by name.

Innovative care at Sanger’s Valve Center

Our multidisciplinary team at Atrium Health Sanger Heart & Vascular Institute Valve Center has redesigned care delivery for heart valve disease patients. Our new care model reduces the time it takes for you to see your doctors and complete all your testing. Regardless of your diagnosis, care pathway and treatment plan, we ensure you’ll receive most of your evaluations and consultations with your cardiologist and surgeon in about 2 visits. This results in timely, high-quality, patient-centered care.

For more information about Sanger’s Valve Center, call 704-373-0212.

Make a referral

When you refer a patient to us, we keep you involved and up to date until your patient can be transitioned back to your care.

Make a referral

Our nationally renowned team provides the latest structural heart treatment options.

Pioneering work and publications

We're an international training site for other structural & valvular heart disease programs that want to integrate new technologies into their clinical practice. We also frequently write about our innovative work to improve patient care.

Here are some of our recent presentations and publications.

Meet the team

We're renowned experts in our field who provide the latest treatments in the least invasive way possible to achieve the best long-term outcomes. We look forward to meeting and caring for you.

Frequently asked questions

Structural heart disease refers to defects of the heart that you were either born with (congenital) or developed later in life due to aging. There are many kinds of structural heart disease, including:

  • Aortic valve stenosis is when the aortic valve has become narrow and cannot open properly
  • Atrial septal defect (ASD) and patent foramen ovale (PFO) are conditions characterized by a hole in the heart that can disturb the heart's ability to function
  • Cardiomyopathy involves changes in the heart muscle, like becoming stiff or enlarged
  • Left ventricular hypertrophy is when the muscle of the left ventricular thickens
  • Aortic insufficiency is when the aortic valve no longer functions adequately to control the flow of blood
  • Mitral valve regurgitation occurs when the mitral valve doesn't close properly, allowing blood to leak backward

The most common signs and symptoms of structural heart disease include:

  • Chest pain
  • Fainting and fatigue
  • High blood pressure
  • Irregular heartbeats
  • Lightheadedness
  • Shortness of breath
  • Swelling in the abdomen and legs
  • Weight gain

Treatments for structural heart disease can help reduce these signs and symptoms and improve quality of life.

Heart valve disease can significantly reduce your quality of life, leaving you exhausted and unable to do many things you're used to. It can also be life-threatening. Fortunately, there are surgical and transcatheter treatment options to treat a number of heart valve diseases, like mitral valve regurgitation and aortic valve stenosis.

We are interventional cardiologists and cardiothoracic surgeons specializing in repairing or replacing heart valves and other abnormalities. Collaborating with other experts on our structural heart team, like advanced cardiac imaging physicians, we find the best treatment option for each patient's unique condition.

A transcatheter aortic valve replacement is a procedure where a new valve is placed in the heart through a small tube (called a catheter), typically in the leg.

A surgical aortic valve replacement is an open heart surgery where a new valve is placed in the heart directly, replacing the old valve. This is an option for patients without other severe health problems.

An echocardiogram can provide a lot of information about your heart. Your doctor will look at specific measurements to assess how your leaky valve is progressing and how it’s affecting your heart. For example, an ejection fraction (a type of measurement) tells us how well your heart is pumping blood to the rest of your body.

Mitral valve regurgitation occurs when one of the valves in the heart – called the mitral valve – doesn’t close properly. Instead, the valve leaks, allowing some blood to flow back into the heart. When this happens, your body may not get the oxygen it needs. Some people are born with a problem in their mitral valve. For others, it develops due to wear and tear or damage from a heart attack, old age or heart failure.