The HonorHealth study shows a major breakthrough in the treatment of structural shock

The HonorHealth study shows a major breakthrough in the treatment of structural shock

A clinical trial from the 8-year-old HonorHealth Research Institute using nonsurgical techniques showed that 86% of patients with a type of fatal low blood pressure known as "structural shock" survived at least 3 months, while 73% survived at least 6 months.

This is a spectacular improvement. This appears to be a monumental step forward. “

David G. Rizik, MD, chief of cardiovascular research at the Ariz.

Dr. Rizik presented the results of the study todayNew York Valves 2025: The Peak of the Structural HeartAt New York's Jacob K. Javits Convention Center. In just his second year,New York Valvesis already the world's leading meeting of structural heart disease, which refers to diseases that affect the heart's valves, walls, chambers and muscles.

While ultra-low blood pressure or cardiogenic shock due to a heart attack is often caused by blockages in the arteries that feed the heart muscle, there is growing recognition that this condition is also caused by structural shock, which usually damages two main heart valves:

• Die Mitralklappe, die den sauerstoffhaltigen Blutfluss von der Lunge bis zum linken Ventrikel des Herzens kontrolliert, dem größten und mächtigsten der vier Kammern des Herzens;
• Das Aortenventil, das den Blutfluss vom linken Ventrikel zum Kreislaufsystem des Körpers steuert.

"Most of these patients are not surgical candidates. These are patients who come to our emergency rooms in what is referred to as 'cardiogenic shock.' These patients are generally too sick to have surgery (surgery) to replace the mitral valve," said Dr. Rizik, lead author of a paper.Mitral transcatheter repair and mandatory mechanical circulatory support in patients with structural shock(doi: 10.1016/j.jscai.2025.102626) published in theJournal of the Society for Cardiovascular Angiography and Interventions(JSCAI).

Techniques pioneered at HonorHealth

Instead, structural shock patients at HonorHealth were diverted to the institute's cardiovascular catheterization lab, where specialists - who used devices passed through major blood vessels to get into the heart - performed two procedures:

• Die Mitralventile der Patienten wurden mit einer Art Clip nicht-chirurgisch repariert, wodurch das Blut oder wieder auferlegte, zurück in die Lunge;
• Die Patienten wurden nicht-chirurgisch mit einem motorisierten Laufrad implantiert, das Blut aus dem linken Ventrikel saugte und es durch die Aorta, die Zentralarterie des Körpers, in den Körper nach vorne schob.

Dr. Rizik said that on average, more than 90 percent of patients with cardiogenic shock do not survive.

“This is a brand new area of ​​clinical investigation,” he said, adding that the success of HonorHealth’s clinical trial resulted from an unprecedented collaboration among heart specialists at the institute, including cardiologists, cardiovascular surgeons and specialists in imaging, critical care and intensive care.

“This is one of the largest prospective, single-center experiences examining transcatheter edge-to-edge repair in this high-risk population,” said the paper published in JSCAI.

Looking for a larger clinical study

Dr. Rizik plans to build on the initial study of 30 cases by collaborating with other medical centers to refine non-surgical techniques in a larger clinical trial involving hundreds of patients.

Structural shock may be caused by genetic susceptibility in younger patients and by progressively deteriorating valves and chronic damage to the heart muscle in older patients.

New York Valves 2025provides live case demonstrations, interactive debates and hands-on training for on-site professionals including interventional cardiologists, cardiac surgeons, clinical cardiologists, cardiac imaging, heart failure specialists, catheter lab professionals and nurses.

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