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Complex Cardiac Care

Advanced Evaluation and Treatment of Structural Heart Disease and Complex Cardiac Conditions

Comprehensive specialist assessment of heart valve disease, structural cardiac abnormalities, and unexplained cardiac symptoms, supported by advanced cardiac imaging and catheterization-based haemodynamic evaluation. The focus is on identifying the true anatomical and physiological basis of each patient’s condition, accurately defining disease severity, and guiding the most appropriate treatment pathway, whether medical optimization, catheter-based intervention, or surgical referral.
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What Is Structural Heart Disease?

Structural heart disease refers to abnormalities in the heart’s physical architecture, including its valves, chambers, walls, and major vessels. These conditions may be present at birth or develop over time due to ageing, hypertension, infection, or progressive degenerative changes.

Unlike coronary artery disease, which restricts blood flow through narrowed vessels, structural heart disease affects the heart’s mechanical ability to pump blood. Symptoms do not always indicate the true severity of the underlying condition. Patients may remain relatively well for extended periods despite progressive structural deterioration. Others may experience severe symptoms even when standard imaging suggests only moderate disease. Accurate assessment involves integrating imaging findings with the patient’s clinical status and exercise capacity. In selected cases, it also requires direct hemodynamic measurements obtained through cardiac catheterisation.

Other Services

Coronary Artery Disease

Cardiovascular Care in Diabetes

Heart Rhythm Disorders

Pulmonary & Resistant Hypertension

How do imaging techniques help in diagnosing heart blockages?

Conditions Treated

Aortic Valve Disease

Progressive narrowing of the aortic valve that increases strain on the left ventricle and requires careful assessment to determine the right time for intervention.

Tricuspid Valve Disease

Tricuspid regurgitation and stenosis affect right heart function and are often underdiagnosed, making careful haemodynamic assessment essential for effective management.

Unexplained Breathlessness with Suspected Cardiac Cause

Unexplained breathlessness may result from elevated heart filling pressures or diastolic dysfunction, which invasive haemodynamic assessment can detect when non-invasive tests are inconclusive.

Pre-Operative Cardiac Assessment

Specialist evaluation of cardiac risk, haemodynamic status, and functional reserve before major non-cardiac surgery, particularly in patients with known or suspected structural heart disease.

Mitral Valve Disease

Mitral stenosis and regurgitation affect heart and lung pressures, requiring integrated imaging and haemodynamic assessment to guide treatment.

Cardiac Chamber Abnormalities

Enlargement, thickening, or dysfunction of the heart chambers caused by valve disease, pressure overload, or ischaemia, often presenting with breathlessness, reduced exercise tolerance, or arrhythmia.

Heart Murmurs

Incidentally detected or symptomatic murmurs requiring specialist evaluation to exclude haemodynamically significant valvular pathology

Advanced Diagnostic Assessment

Echocardiographic Analysis

Detailed specialist interpretation of transthoracic and transoesophageal echocardiographic studies, assessing valve morphology, stenosis severity, regurgitant fraction, chamber dimensions, and systolic and diastolic function. Echocardiography forms the primary imaging foundation of structural heart disease evaluation.

Right Heart Catheterisation

The gold standard for direct haemodynamic assessment, performed in the catheterisation laboratory via venous access. It provides direct measurement of pressures throughout the right heart and pulmonary circulation, as well as cardiac output. These measurements are essential in complex valve disease, unexplained breathlessness, and pre-operative risk assessment. Over 200 right heart catheterisations have been performed at Level 3 independent competence.

Coronary Angiography as Part of Structural Assessment

Coronary artery disease frequently coexists with structural heart disease and must be assessed before any valve intervention is planned. Coronary angiography is integrated into the pre-intervention assessment pathway where clinically appropriate.

Haemodynamic Exercise Assessment

In selected patients, resting measurements do not fully reflect the physiological burden of structural disease during activity. Exercise haemodynamic assessment can reveal elevated filling pressures and abnormal pulmonary responses that are absent at rest, refining the indication for intervention.

Procedures and Interventions

Right Heart Catheterisation

This procedure is performed under local anesthesia through venous access to directly measure pressures within the right heart and pulmonary arteries and calculate cardiac output. It takes 30 to 60 minutes to complete and does not require general anesthesia or an overnight hospital stay.

Coronary Angiography

Performed as part of pre-intervention structural assessment to characterise the coronary circulation and determine whether revascularisation is required alongside structural intervention.

Structural Intervention Assessment and Referral

Patients requiring valve repair or replacement receive comprehensive pre-procedural assessment and detailed treatment planning, with coordinated referral to the appropriate specialist through a multidisciplinary team.

WHY CHOOSE DR. YASIR PARVIZ

International Expertise. Precision Cardiovascular Care.

Dr. Yasir Parviz provides specialist assessment for heart valve disease, structural abnormalities, and unexplained cardiac symptoms. He combines advanced cardiac imaging with direct haemodynamic assessment to accurately determine disease severity and guide medical treatment, intervention, or surgical referral.
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200+ Right Heart Catheterisations

Advanced Haemodynamic Assessment

Specialist Valve Disease Evaluation

Pre-Operative Cardiac Assessment

Frequently Asked Questions

1. What is structural heart disease?
Structural heart disease refers to conditions affecting the physical architecture of the heart, including its valves, chambers, and walls. It is distinct from coronary artery disease, which affects the blood supply to the heart through narrowed arteries. Both conditions can coexist and are frequently assessed together.
2. When does valve disease require treatment?
Valve disease requires treatment when it causes significant symptoms, when imaging or haemodynamic testing shows it is causing progressive damage to ventricular function or the pulmonary circulation, or when the risk of further delay outweighs the risk of intervention. These thresholds are defined by international guidelines and require specialist assessment to apply correctly to each individual patient.
3. Is breathlessness always a cardiac problem?
No. Breathlessness has cardiac, pulmonary, and mixed causes. Specialist evaluation including echocardiography and, where necessary, invasive haemodynamic testing is required to determine the precise physiological mechanism and guide appropriate treatment.
4. What is right heart catheterisation and why is it needed?
Right heart catheterisation is a minimally invasive procedure performed via a vein in the neck or groin that directly measures pressures within the right side of the heart and the pulmonary arteries. It provides haemodynamic information that echocardiography alone cannot reliably quantify and is the gold standard for evaluating pulmonary hypertension, complex valve disease, and unexplained cardiac symptoms.
5. Does every valve problem require surgery?
No. Many patients with valve disease are managed with medication and regular monitoring. Intervention is recommended only when objective criteria are met, based on symptom status, imaging findings, and haemodynamic assessment. The goal is always to intervene at the right time, not prematurely and not too late.
6. What happens during a pre-operative cardiac assessment?
A pre-operative cardiac assessment involves a detailed clinical review, interpretation of existing investigations, and where necessary, additional testing including echocardiography or cardiac catheterisation. The aim is to quantify cardiac risk, identify any conditions that require treatment before surgery proceeds, and provide clear guidance to the surgical and anaesthetic team.