Valvular heart disease, caused by tight or leaky valves between heart chambers, affects up to 10% of older adults and leads to more than 120,000 deaths globally each year. Traditional open-heart surgery can be life-saving, but many patients are too frail to undergo such invasive procedures, while others face long recoveries and significant risks. New clinical evidence now shows that less invasive catheter-based treatments can achieve comparable long-term outcomes, while making life-saving care accessible to far more patients.

The trials involved patients treated at Robert Wood Johnson University Hospital, part of Rutgers Health (New Brunswick, NJ, USA) and RWJBarnabas Health (West Orange, NJ, USA). The studies evaluated catheter-based valve procedures that are delivered through blood vessels, typically via a small puncture in the groin, rather than through open-chest surgery.

Across the trials, these transcatheter approaches were applied to multiple forms of valvular disease, including narrowed aortic valves and severely leaking aortic and mitral valves. The techniques are designed to reduce physical trauma, shorten hospital stays, and expand treatment options for patients previously considered ineligible for surgery.

One trial published in The New England Journal of Medicine followed 1,000 relatively healthy patients with severe aortic stenosis who were randomly assigned to either open-heart surgery or transcatheter aortic valve replacement. After seven years, rates of death, stroke, and valve-related rehospitalization were statistically equivalent between the two groups.

Two additional trials published in The Lancet evaluated catheter-based solutions for leaky aortic and mitral valves in high-risk patients. Both studies showed outcomes that significantly exceeded prespecified safety and performance targets, with low mortality rates, improved heart function, and better quality of life.

The findings confirm that catheter-based valve therapies can safely match surgical outcomes in selected low-risk patients and provide effective options for individuals who previously had no viable treatment. These approaches reduce recovery time and allow many more patients to receive timely intervention before heart failure develops.

Researchers expect similar stepwise progress for newer devices treating leaky aortic and mitral valves, potentially expanding their use from high-risk patients into broader populations. Ongoing trials are also extending catheter-based techniques to other valves, further strengthening minimally invasive care pathways.

“In most of these cases, we are looking at patients who are basically poor surgical candidates, so they could not undergo treatment,” said Mark J. Russo, professor of surgery and chief of cardiac surgery at Rutgers Robert Wood Johnson Medical School, and chief of cardiothoracic surgery at RWJUH. “By having less invasive therapies, those patients have options to treat their valve disease that they would probably otherwise die from.”

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