SUMMARY
Mayra Guerrero, M.D., develops and evaluates transcatheter treatments for complex structural heart disease. She focuses on mitral valve disease in patients who have limited surgical options. Her research has helped establish transcatheter mitral valve replacement for severe mitral annular calcification and for failed surgical bioprosthetic valves and failed annuloplasty rings. She has led international registries and prospective multicenter trials to define procedural techniques, patient selection and long-term outcomes.
Dr. Guerrero also studies complications of transcatheter mitral valve replacement, particularly left ventricular outflow tract obstruction. Her work combines clinical trials, multicenter registries, CT-based procedural planning and technique development to identify predictors of adverse outcomes and test strategies for prevention and treatment. These studies have contributed to the refinement and broader clinical use of transseptal mitral valve interventions.
Focus areas
- Transcatheter mitral valve replacement. Dr. Guerrero investigates transcatheter mitral valve replacement for patients with severe mitral annular calcification, failed surgical bioprosthetic valves and failed annuloplasty rings. She leads multicenter studies that evaluate procedural safety, effectiveness and long-term outcomes in patients who may have few or no conventional surgical options.
- Mitral annular calcification. Dr. Guerrero studies the diagnosis, classification and treatment of severe mitral annular calcification. She established an international registry to characterize early transcatheter experience and has contributed to consensus guidance intended to improve patient selection, procedural planning and management of this complex form of mitral valve disease.
- Preventing procedural complications. Dr. Guerrero examines left ventricular outflow tract obstruction, a serious complication of transcatheter mitral valve replacement. Her collaborative studies have identified predictors of this complication, validated computerized tomography-based prediction methods and evaluated strategies such as septal ablation to reduce obstruction risk or manage an obstruction when it occurs.
- Structural heart clinical trials. Dr. Guerrero leads and participates in multicenter studies of transcatheter mitral valve repair and replacement technologies. Her research includes physician-sponsored and pivotal trials designed to refine procedural techniques, evaluate new devices and generate evidence needed to determine which patients are most likely to benefit from catheter-based structural heart interventions.
- Procedural technique development. Dr. Guerrero develops and standardizes transseptal approaches for mitral valve-in-valve, valve-in-ring and valve-in-mitral annular calcification procedures. She has published step-by-step procedural guidance and uses clinical experience, imaging and outcomes data to improve reproducibility and reduce complications associated with technically demanding interventions.
Significance to patient care
Some people with severe mitral valve disease cannot safely undergo standard open-heart surgery, or they may have limited options after a previous valve operation fails. Dr. Guerrero's research evaluates catheter-based procedures that may offer treatment options to these patients without another open operation. Her studies also help healthcare professionals identify patients most likely to benefit from these procedures, anticipate serious complications and plan procedures more precisely. By refining transcatheter mitral valve techniques and studying their long-term outcomes, her work may expand treatment options and improve the safety and effectiveness of care for patients with complex structural heart disease.