 Namaste. I am Dr. Rajesh Bhattiyu, Interventional Cardiologist and Associate Professor in Cardiology working in KMCO Hospital, Mangalore. Whenever one hears the term heart disease, it is usually coronary heart disease which leads to heart attack and other consequences. But structural heart diseases are those diseases encompass non-coronary heart diseases which are present in a patient. The structural heart disease may be from congenital in origin that is by birth or acquired later in life. Congenital heart diseases are those which shunt lesions or normally called as holes in the heart. Acquired heart diseases are those which are acquired and usually are valvular pathologies such as aortic stenosis, mitral stenosis or mitral regurgitation. Earlier, the surgery was only the standard of care for this kind of structural heart diseases. Unfortunately, many patients have risk factors make them high risk for the surgeries or ineligible for the surgeries. Those people had to suffer in silence till their end. But now, the newer structural heart disease interventions are branch of interventional cardiology which tries to correct these deformities without the surgical option. Earlier, they were conceptualized to treat the patients who are for high risk surgical interventions. But now, with improved hardware, improved in the operator's preparedness and improved imaging techniques, this has replaced most of the standard surgical cure for the patients. Earlier, when the surgery has been high risk, this were used all the time. In fact, now with the improved hardware, improved imaging techniques and the operator preparedness and training, most of the surgeries has been eclipsed by this structural heart disease intervention which can cure most of the heart diseases with minimal blood loss, with low anaesthetic complications and good postoperative pain and improvement. The structural heart diseases were there earlier like the ASD closure and the PDA closure which was done for the congenital heart diseases, which were for decades. In past few decades, the VSD closure has come into practice and we do it in our institute also. The newer structural heart disease intervention include TAVR, that is Trans-Cathedral Iotic Wall Replacement, or Mitra Clip for Mitral Regestration, LA Appendage Closure to prevent the complications of stroke in atrial fibrillation or the most recent is wall-beam wall techniques for the degenerated surgical wall implants. But the structural heart disease intervention, most probably the patient selection is important. One has to use the imaging techniques to select the proper patient. It is a teamwork consisting of interventional cardiologist, cardiac imaging specialist, anesthetist and even cardiac surgery. It might require a hybrid cath lab in which if need arises, the procedure is turned to a cardiac surgery. Most of the time, it is the continuous training and knowledge of the person who does it is important and knowledge of hardware or the devices which is to be updated. As I said earlier, this was kept only for high-risk patients for surgery. But now increase the training of the cardiologist and the newer hardware, it has been used even for low-risk patients. But as with the advances of artificial intelligence in decision-making, hardware improvement and the operator preparedness, most of this structural heart disease intervention probably will replace surgery for most of the cardiac ailments.