Structural Heart

Structural Heart Care

Comprehensive Care for Structural Heart Disease

Monument Health’s Structural Heart program is a collaborative effort between cardiothoracic surgery and interventional cardiology. Board-certified cardiologists specialize in treating conditions and diseases using minimally invasive catheter-based therapies.

Find a Provider Find A Location Make An Appointment

What is structural heart disease?

Your heart depends on healthy valves, chambers and electrical signals working together to keep blood moving the way it should. When any part of the heart’s structure is affected — whether it’s a valve, a wall or the rhythm that keeps everything in sync — it’s known as structural heart disease.

Structural Heart Care

What We Treat

Monument Health’s Structural Heart team treats a range of conditions, including:

Atrial septal defect (ASD)
Damaged or diseased heart valves, such as aortic valve disease
Heart rhythm problems
Patent foramen ovale (PFO)
Ventricular septal defect (VSD)

Structural Heart Care

Treatments, Devices and Procedures

Treatment is tailored to your specific condition and can range from ongoing monitoring and lifestyle changes to minimally invasive or surgical procedures. Our team works with you every step of the way to find the right approach for your heart health.

Procedures include:

- Left atrial appendage occlusion (LAAO) [Watchman and Amulet]
- Transcatheter aortic valve replacement (TAVR)
- Transcatheter edge-to-edge repair (TEER) [MitraClip and PASCAL]
- Transcatheter mitral valve replacement (TMVR)
- Tricuspid valve repair (TriClip)

Heart and Vascular Institute

Experts in Structural Heart Care

Experience matters when it comes to structural heart care — and Monument Health’s Heart and Vascular Institute has it in depth. As a high-volume center, our team performs a significant number of structural heart procedures each year, giving patients access to a level of expertise that comes only through repetition and specialization.

That expertise extends beyond our own patients. Physicians from across the country come to Monument Health to train alongside our team, learning techniques and approaches from one of the nation’s recognized centers for structural heart disease. Medical device and pharmaceutical representatives also train here, a reflection of the advanced procedures and technologies our team works with regularly.

Monument Health’s Heart and Vascular Institute also participates in pivotal clinical trials, giving patients in the Black Hills region access to emerging treatments and technologies often available only at major academic medical centers. Monument Health has been part of this community for generations — and today, that same commitment means bringing national-level structural heart expertise close to home.

Schedule An Appointment

Find a Provider

At Monument Health, you’ll receive expert care from a comprehensive team of healthcare providers and specialists. Our providers diagnose, treat and manage a wide range of health conditions and concerns. Find a provider who can help you understand your options and build a care plan around your individual needs.

Find A Provider

Take Control of Your Health with MyChart

View test results, message your care team, schedule appointments, refill prescriptions, and access your records in one secure place.

Sign up today to manage your health anytime, anywhere.

More From Monument Health

Monument Health Heart and Vascular Institute Welcomes Three New Physicians, Continuing Decades of Growth in Heart Care Close to Home

August 28, 2026

Monument Health recognized for advancing rural stroke care

August 25, 2026

Monument Health Opens Region's First Epilepsy Monitoring Unit at Rapid City Hospital

August 20, 2026

Advanced Heart Failure

Advanced Heart Failure Treatment

Monument Health Heart & Vascular Institute

Advanced heart failure is the most severe stage of heart failure, when the heart cannot pump enough blood to meet the body’s needs and symptoms may occur even at rest. While it is a chronic condition, specialized care can help manage symptoms and improve quality of life.

The Monument Health Heart & Vascular Institute provides advanced heart failure care for patients across western South Dakota and the surrounding region, using medications, cardiac devices, remote monitoring, and other advanced therapies when needed.

Find a Provider Make An Appointment

Nationally Recognized as a Leader in the Care of Heart Failure

What is advanced heart failure?

Advanced heart failure is the most severe stage of heart failure, sometimes called Stage D heart failure. At this stage, the heart cannot pump blood efficiently enough to supply the body with oxygen and nutrients.

People with advanced heart failure often continue to experience symptoms even after receiving standard treatments such as medications and lifestyle changes. Specialized care may be needed to manage symptoms, reduce hospitalizations, and evaluate advanced treatment options.

Heart failure does not mean the heart has stopped working. Instead, it means the heart cannot pump blood as effectively as it should.

Symptoms of Advanced Heart Failure

Symptoms occur when the heart cannot pump blood effectively and fluid begins to build up in the lungs and body.

Common symptoms include:

shortness of breath during activity or while resting
swelling in the legs, ankles, feet, or abdomen
fatigue and weakness
rapid weight gain caused by fluid retention
difficulty lying flat due to breathing problems
persistent cough or wheezing
Because symptoms can change over time, monitoring them carefully is an important part of managing heart failure.

Explore Signs & Symptoms

Treatment Options for Advanced Heart Failure

Treatment for advanced heart failure focuses on improving heart function, reducing symptoms, and preventing hospitalizations. Many patients benefit from a combination of medications, lifestyle changes, and specialized therapies.

Treatment plans are personalized and may include:

heart failure medications
implantable cardiac devices
remote monitoring technologies
advanced therapies when necessary

Discover Treatment Options

Medications Used to Treat Heart Failure

Several types of medications help the heart pump more effectively and reduce fluid buildup in the body. These medications work together to improve heart function and reduce strain on the heart.

Common medication groups include:

ARNI, ACE inhibitors, ARB
beta blockers
aldosterone blockers
SGLT2 inhibitors
diuretics (water pills)
vasodilators

Taking medications exactly as prescribed is one of the most important parts of heart failure treatment.

Explore Medication Options

Heart Failure Devices and Monitoring

Some patients with advanced heart failure benefit from specialized medical devices that help the heart function more effectively or allow doctors to monitor their condition more closely.

These technologies may include:

Implantable Cardioverter Defibrillators (ICDs) — Devices that continuously monitor heart rhythm and deliver treatment if dangerous rhythms occur.
Cardiac Resynchronization Therapy (CRT) — Devices that help the right and left sides of the heart pump together more efficiently.
CardioMEMS™ Heart Failure Monitoring System — A small implanted sensor that allows doctors to remotely monitor pressure in the heart and detect fluid buildup before symptoms worsen.

These technologies can help reduce hospitalizations and support more proactive, long-term heart failure management.

Explore Devices & Monitoring

Schedule an Appointment

If you or a loved one has been diagnosed with advanced heart failure, the Monument Health Heart & Vascular Institute can help.

Schedule an appointment with our heart failure specialists to discuss your symptoms, treatment options, and personalized care plan.

Schedule An Appointment

Download the Heart Failure Patient Education Guide

For more detailed information about heart failure symptoms, medications, lifestyle management, and monitoring, download our Heart Failure Patient Education Guide.

This guide includes practical tips for managing heart failure and working with your healthcare team.

Download Guide (PDF)

Find a Provider

Find A Provider

Frequently Asked Questions

Q: What is heart failure?

A: Heart failure doesn’t mean your heart has failed. It means that your heart can’t pump properly, so it cannot meet your body’s need for blood and oxygen. Your heart is failing to meet your body’s needs for blood and oxygen. Heart failure is not the same as having a heart attack. However, a heart attack can be a cause of heart failure.

Q: What are the common symptoms of heart failure?

A: Common symptoms include:

shortness of breath during activity or while resting
swelling in the legs, ankles, feet, or abdomen
fatigue and weakness
rapid weight gain caused by fluid retention
difficulty lying flat due to breathing problems
persistent cough or wheezing
Because symptoms can change over time, monitoring them carefully is an important part of managing heart failure.

Q: When should I see a doctor about heart failure symptoms?

A: These signs mean heart failure is worsening, and you need to call your physician or 911:

Frequent dry, hacking cough
Worsening shortness of breath with activity or rest
Increase discomfort or swelling in the lower body
Sudden weight gain or more than 2-3 lbs. in a 24-hour period (or 5 lbs. in a week)
New or worsening dizziness, confusion, sadness or depression
Loss of appetite
Discomfort or swelling in the abdomen
Increase trouble sleeping; cannot lie flat

Q: How is heart failure diagnosed?

A: Heart failure is typically diagnosed through a combination of a physical exam, blood tests, an electrocardiogram (ECG) and an echocardiogram.

Q: How is heart failure treated?

A: Treatment for advanced heart failure focuses on improving heart function, reducing symptoms, and preventing hospitalizations. Many patients benefit from a combination of medications, lifestyle changes, and specialized therapies.

Treatment plans are personalized and may include:

heart failure medications
implantable cardiac devices
remote monitoring technologies
advanced therapies when necessary

Interventional Cardiology

Comprehensive Care for Heart Disease

Monument Health’s interventional cardiologists provide advanced and comprehensive treatment for a variety of cardiac issues including coronary artery disease, cardiomyopathies and heart valve diseases. Our interventional cardiologists provide diagnostic and interventional coronary angiograms as well as diagnostic heart catheterizations as needed to inform patient care.

Find A Provider Find A Location

Nationally Recognized in Heart and Vascular Care

U.S. News & World Report

High Performing Hospitals – Heart Attack

American College of Cardiology — NCDR

Platinum Performance Achievement Award – Chest Pain – MI Registry

WHAT WE TREAT

Coronary Artery Disease

A buildup of plaque in the heart’s arteries, potentially leading to a heart attack. Symptoms include chest pain, shortness of breath, or decreased exercise tolerance. Persistent chest pain, pressure, sweating, or nausea lasting over 20 minutes should be urgently evaluated.

Cardiomyopathy

A condition where the heart muscle weakens, leading to inefficient pumping, fluid retention, shortness of breath, and heart failure.

Valvular Stenosis

Narrowing and stiffening of heart valves, reducing blood flow. Symptoms include shortness of breath, fluid retention, chest pain, fainting, and exercise intolerance. Often detected as a heart murmur.

Valvular Regurgitation

Heart valves allow blood to flow backward, causing shortness of breath, fluid retention, and decreased exercise tolerance. Often detected as a heart murmur.

Find a Provider

Find A Provider