Gilbert H Tang, MD

Hi, my name is Gilbert Tang and I am the Surgical and Academic Director of the Structural Heart Program, System Director of Mitral and Tricuspid Structural Intervention at the Mount Sinai Health System, and a Professor and Vice Chair of Innovations in the Department of Cardiovascular Surgery at the Icahn School of Medicine at Mount Sinai. I have performed over 4000 cases of transcatheter aortic valve replacement (TAVR), transcatheter mitral valve repair (transcatheter edge-to-edge repair) (TEER with MitraClip), transcatheter tricuspid valve repair (TriClip), and transcatheter mitral and tricuspid valve replacement procedures with excellent outcomes, on par with some of the top programs in the country. With our Structural Heart Team and Dr. David Adams’ mitral team at our Reference Valve Center, I work with a multidisciplinary group of cardiac surgeons, interventional cardiologists, imaging specialists, vascular surgeons and interprofessional staff to offer comprehensive, holistic care in patients with complex valve disease. Whether it is surgical reconstruction, transcatheter intervention or a hybrid approach, our team has the expertise and experience to deliver top-notched care to you and your family. Our TAVR program has recently earned the top 3-star rating in outcomes in the US ACC/STS TVT Registry for 3 consecutive years, one of the few in the Tri-State area and in the country.

During my career, I have achieved many “first” successes in the region and United States, including transcatheter mitral and tricuspid valve replacement and tricuspid valve repair with MitraClip, all performed via the groin without open surgery. We performed the first newly FDA approved TriClip tricuspid repair procedure for primary regurgitation and second overall in the US. Prior to Mount Sinai, We are also one of the very first centers in the world to routinely use 3D ICE (intracardiac echo) to guide complex transcatheter tricuspid valve interventions. Prior to joining Mount Sinai, I was the Director of the Valve Disease Center at Westchester Medical Center, playing a pivotal role in the launch of its Transcatheter Heart Program. My 24/7 “concierge” model of care has been well received and recognized in the New York area.

As a regularly invited faculty and guest lecturer at national and international conferences, I am leading a number of innovative research projects in TAVR and transcatheter mitral and tricuspid valve therapies. I pioneered the concept of commissural alignment to better orient a transcatheter heart valve during TAVR to make it easier to reaccess the coronary arteries and repeat TAVR, and am leading several international registries in structural heart disease (EXPLANT-TAVR, CUTTING-EDGE, EXPLANTORREDO TAVR). Our collaborative research efforts and clinical results have been published in many top peer-reviewed medical journals and presented at many international conferences. Ialso had the fortune of training many physicians and heart teams to perform transcatheter valve procedures around the world. Currently, I am involved in several multicenter studies with leading institutions in the US and globally, and on the screening or steering committee in a number of innovative clinical trials in aortic, mitral and tricuspid valve disease.

In terms of my educational background, I received my bachelor's degree at Harvard University and MD at the University of Toronto, where I completed my residency in cardiac surgery as the Chief Resident at the Toronto General Hospital. I also completed a Master of Science in tissue engineering at the University of Toronto and an MBA at the Harvard Business School. Subsequently, I pursued specialized training at Mount Sinai Medical Center in New York focusing on complex mitral valve repair and TAVR, while also underwent advanced training in TAVR at the Leipzig Heart Center in Germany and the University of Pennsylvania. I am a Diplomat and Fellow of the Royal College of Physicians and Surgeons of Canada (FRCSC), Fellow of the American College of Cardiology (FACC), and one of the very few surgeons to be a Fellow of the Society for Cardiovascular Angiography and Interventions (FSCAI). I am also the Editor-in-Chief for the Journal of American College of Cardiology (JACC) Case Reports.

I look forward to the privilege of caring for you, your family and your loved ones. Thank you very much for the honor and the opportunity.

You can follow me online on Twitter and LinkedIn, and watch my invited lectures on Youtube.

Recent News:

Cardiovascular Business: Tricuspid TEER shows clinical efficacy for first time in newest TRILUMINATE data 11/11/24 By Dave Fornell

“In the expanded cohort, all three primary efficacy endpoints for hospitalization, heart failure, mortality, and need for tricuspid surgery, showed improvement,” Tang said. “This is significant because, previously, two out of the three outcomes had shown equivalency.” 

TCTMD: TRILUMINATE: More Patient Data Reassure on TEER’s Benefits for Severe TR 10/29/24 By Michael O'Riordan

"To TCTMD, Tang said the lead analysis is reassuring. “With certain anatomies, you can get a good reduction in TR and good functional improvement [with TEER],” he said. While TTVR does carry risks of jailed leads and resulting heart block, the upside is that it eliminates TR, he said."

TCTMD: EARLY TAVR Breaks New Ground for Preemptive Treatment of Asymptomatic AS 10/28/24 By L.A. McKeown

"Also commenting for TCTMD, Gilbert Tang, MD (Mount Sinai Health, New York, NY), said a key takeaway of EARLY TAVR is that asymptomatic severe AS is not a benign condition. “Even if you’re asymptomatic you should be monitored very closely for onset of symptoms or progression of insidious symptoms  . . . so timely intervention can be done,” he said."

TCTMD: ACE-PROTAVI Data Solidify Protamine’s Role in Aortic Interventions 8/16/24 By Caitlin E. Cox

Gilbert Tang, MD (Mount Sinai Health, New York, NY), said that protamine is already widespread in TAVI—and for good reason. “The more minor vascular issues are not benign,” he commented to TCTMD. “These patients have [better] mobilization and especially if they’re at low surgical risk, they want to be recovering faster.”

TCTMD: Initial US Commercial TriClip Cases Offer Hope, but Reimbursement Still a Big Question 8/9/24 By L.A. McKeown

“I think it depends on several factors with potential trade-offs,” he noted. “T-TEER is extremely safe, needs no anticoagulation, and [the] patient can go home next day but often at the expense of residual TR. TTVR usually eliminates TR but requires a CT scan to evaluate anatomic feasibility and carries risks of acute RV dysfunction, pacemaker implantation, and bleeding from anticoagulation plus unknown durability/valve thrombosis risk, based on the TRISCEND II trial.”

TCTMD: Knowns and Unknowns in Subclinical Aortic Valve Thrombosis 6/21/24 By Caitlin E. Cox

Gilbert Tang, MD (Mount Sinai Health, New York, NY), said that the “no one knows” how much subclinical valve thrombosis truly matters. Even in low-risk patients, these cases “come and go,” he said. “The rate is definitely higher than what we probably should be seeing—it’s over 20%—[but] some disappear, and some appear. So we just don’t know what kind of conditions, whether it’s patient, anatomic, device-related, or procedure factors, we can pinpoint to better prevent this from happening.”

TCTMD: Essentials for 3D-ICE in Structural Interventions Explored in Position Statement 6/6/24 By Caitlin E. Cox

“Both structural interventions as a whole and 3D-ICE itself have evolved in recent years, said Gilbert H.L. Tang, MD (Mount Sinai Health System, New York, NY), so the time was right to pull together a document that summarizes key topics related to indications, training, and future needs.”

TCTMD: Concomitant AF Procedures During Non-Mitral Surgery Less Likely in Women 5/9/24 By Yael L. Maxwell

"In general, Tang said, there needs to be increased awareness that the AF burden in all patients, “not just minorities and women, is not benign.” Doing so can empower patients to ask about receiving these concomitant procedures when planning their cardiac surgeries."

Mount Sinai Today: Team at Mount Sinai Fuster Heart Hospital Performs Milestone Procedure With Newly FDA-Approved Therapy

“Having a first transcatheter repair device approved for patients with tricuspid regurgitation is a game changer,” says Dr. Tang. “We have already performed several procedures since FDA approval and their recoveries have truly been remarkable.”

JACC: Gilbert H. L. Tang, MD, MSc, MBA, FACC, Named New Editor-in-Chief of JACC: Case Reports

"I am both honored and humbled to be a cardiac surgeon among the Editor-in-Chiefs in the JACC family of journals," Tang said. "It is going to be an exciting time for JACC: Case Reports to build on a team of multidisciplinary cardiovascular practitioners with diverse backgrounds and experiences, and at different stages of their professional careers, to enhance the journal's academic and educational impact globally."

ACC: ACC Honors 2023 Recipients of the Simon Dack Award for Outstanding Scholarship and Elite Reviewers 4/5/24 By Julie Boyland

The Simon Dack Award is named after the founding editor of JACC and recognizes outstanding peer reviewers for their contributions and achievements. The recipients’ efforts help JACC achieve its mission to publish new and important clinical information.

TCTMD: Ross Procedure Offers ‘Excellent Survival’ 25 Years Out 11/15/23 By Caitlin E. Cox

"Gilbert Tang, MD (Mount Sinai Health System, New York, NY), who commented on the findings for TCTMD, said: “There are no surprises, and I think it’s encouraging that the Ross procedure continues to perform well [decades later].”

TCTMD: Some Surprises in Low-Risk TAVI Follow-up: PARTNER 3 and Evolut Trials 10/24/23 By Michael O'Riordan

"Gilbert Tang, MD, MBA (Mount Sinai Health System, New York, NY), echoed that sentiment. The difference in mortality, he commented to TCTMD, is a signal that doesn’t warrant clinical concern “right now,” but close monitoring in longer-term follow-up, as well as a deeper dive into the causes of death, will be important."

TCTMD: SAVR 5-Year Survival Tops 92% in Low-Risk Patients: STS Registry 10/20/23 By Yael L. Maxwell

“This is at best a good reference point for isolated AVR outcomes in the United States, which have come a long way,” Tang said. “Beyond that, everything else is purely conjectural and I don't think can be a fair comparison.”

TCTMD: Many Young Patients With AR Do Not Achieve LV Normalization With Surgery 9/26/23 By L.A. McKeown

"The data are a “call to arms” to diagnose and treat earlier, with the possibility of TAVI on the horizon, says Gilbert Tang."

“This needs to be picked up more broadly by educating pediatricians and primary care physicians, he added. “Some of these younger patients don’t have a primary care doctor and present first to an urgent care. So, I think we need to have a bit of a campaign to educate the whole medical community to diagnose these patients earlier rather than later.”

Cath Lab Digest: How Important is Commissural Alignment? 6/11/23

CLD talks with Gilbert Tang, MD, MSc, MBA, Surgical Director, Structural Heart Program, Mount Sinai Health System; Professor, Cardiovascular Surgery, Icahn School of Medicine at Mount Sinai, New York, New York.

Cath Lab Digest: Feasibility of Coronary Re-Access and Repeat TAVR After Sapien 3 TAVR Stratified By Implant Depth: A CT Simulation Study 6/11/23
"We need to look at the CT scan, look at the patient, and determine ahead of time what target implant type to aim for to potentially get the best of all worlds, which means avoiding a pacemaker and avoiding left bundle branch block, but at the same time being able to facilitate anatomically TAVR-in-TAVR in the future."

Cath Lab Digest: Fluoroscopic “Lucent Line” Deployment in Sapien 3 TAVR Using Conventional View is Non-Reproducible With No Impact on Short-Term Outcomes 6/11/23

"Our message is that visualizing the lucent line is not necessary to achieve a high Sapien 3 implantation because, number one, it is not always visible and, number two, there are other factors involved that affect the final implant depth. The good thing is that there is no impact on procedural outcome or in-hospital outcomes."

TCTMD: Surgical Outcomes After Failed TEER: More Insights, Red Flags From CUTTING-EDGE 6/8/23 By Shelley Wood

“We know that with surgical mitral valve repair, if you [achieve] a near-perfect result with mild or better MR, [then] you actually restore the patient's life expectancy, whereas the problem with TEER is that if you don't get that, and you’re left with moderate or worse MR, we now have some data showing that it does not restore the patient's life expectancy and, in fact, it impacts mortality.”

TCTMD: Beware High-Risk TAVI in Patients With Low-Lying Coronaries 5/11/23 By Michael O'Riordan

“In young, low-risk patients, physicians should strongly consider a low-risk SAVR over a high-risk TAVI,” said Gilbert Tang, MD, MSc, MBA (Mount Sinai Health System, New York), who has highlighted the importance of commissural alignment to facilitate future coronary access.

TCTMD: TAVI Explantation Remains a Risky Proposition, Two New Studies Show 4/27/23 By Michael O'Riordan

“With younger patients undergoing TAVR, we have to start thinking more seriously about, number one, what is the ideal first valve intervention in theseyounger patients, and number two, when the valve fails, what are the options that can be done safely and be potentially durable,” Gilbert Tang, MD, MSc, MBA (Mount Sinai Health System, New York, NY), lead author of the EXPLANTORREDO-TAVR analysis, told TCTMD.

TCTMD: Real-world Primary MR TEER Outcomes Carry a Reminder: Do Better 3/10/23 By Shelley Wood

"Commenting on the registry findings for TCTMD, Gilbert Tang, MD (Icahn School of Medicine at Mount Sinai, New York), said he found the data somewhat “concerning,” noting that a surgeon would never deem residual MR of 2+ or less “successful,” particularly since studies have documented the clear link between residual MR and mortality, a finding affirmed in these data."

Healio - Cardiology Today: Next-generation TAVR system approved to treat patients with severe aortic stenosis 1/17/23 By Erik Swain

“Once the new Navitor valve rolls out, we have to see what the procedural performance looks like. If it is competitive in terms of usability, then we will have a viable third competitor in the market. If it is not, then we will not."

Healio - Cardiology Today: Next-gen self-expanding valve improves alignment, implant depth in TAVR 12/2/22 By Regina Schaffer

“We are reporting on the first, initial experiences with this system, particularly because there are a number of new designs over the Evolut Pro+ platform,” Tang told Healio. “The previous Pro+ had two spines in the delivery system; now, they have simplified to one spine, enabling better trackability, which is especially useful for those with challenging anatomy."

TCTMD: Real-World TEER Outcomes in Primary MR Make Gains, but Questions Remain 12/1/22 By Shelley Wood

“The study also confirms what we’ve seen in surgical mitral repair in primary MR, where more residual MR is associated with higher mortality, as shown in this study with patients left with 2+ or greater MR,” he noted. “We should therefore strive to achieve ≤ 1+ MR in TEER in primary MR when feasible, especially in lower risk patients.”

Cardiovascular Business: Medtronic’s newest self-expanding TAVR system linked to improved performance 11/29/22 By Michael Walter

“These features resulting in better procedural predictability and consistency in TAVR may be critical in low-risk patients and broaden the adoption of TAVR to a wider population. By looking closely at data across multiple centers, we’re able to demonstrate the procedural improvements of the FX system over its predecessors.”

TCTMD: Surgical Explant or Redo for TAVI Failures? Some Registry Insights 6/10/22 By Michael O'Riordan

“It’s why I think we see the differences,” he said. “It also explains some of the early mortality differences because a good percentage of these [explant] patients had concomitant surgery."

TCTMD: Non-COAPT-Like Patients Fare Well With MitraClip, EXPAND Suggests 6/9/22 By Michael O'Riordan

"It was a sustained reduction in the COAPT-like patients, which is encouraging because these patients are supposed to be similar to the COAPT trial patients, as well as in the other [non-COAPT-like] patients."

Cardiovascular News: TVT 2022: EXPAND registry shows benefit of MitraClip in patients outside of COAPT trial criteria 6/9/22

"The real-world findings from this study show that excellent MR reduction and one-year outcomes were achieved by MitraClip not only in COAPT-like patients but also in a wider group of patients outside the COAPT criteria, meaning physicians may be able to help even more people with secondary MR."

TCTMD: As TAVI Turns 20, How Has the Heart Team Evolved?  5/04/22 By Yael L. Maxwell

"[Dr.] Tang urged more focus on patients’ individual circumstances in deciding what’s the best option for care. Family support and socioeconomics need to be considered, he said, when the Heart Team makes their recommendations."

TCTMD: Surgery for IE After TAVI No Better Than Antibiotics in High-Risk Patients 2/25/22 By Michael O’Riordan

“Gilbert Tang, MD (Mount Sinai Medical Center, New York, NY), who wasn’t involved in the study, said the take-home message is that you shouldn’t take such sick patients to surgery, because it’s not going to help. He noted that heart failure and stroke were common complications in this cohort of IE patients, affecting 42% and 10%, respectively. Also, more than a quarter of patients developed septic shock.”

TCTMD: With Some Adjustments, Commissural Alignment Possible With TAVI 9/16/21 By Michael O'Riordan

Gilbert Tang, MD, MBA (Mount Sinai Health System, New York, NY), who has investigated how to optimally align THVs with native aortic valve commissures, praised the investigators for their “provocative” study, saying it suggests it is possible to modify existing implantation techniques to optimize valve alignment. “It’s very elegant and nicely illustrated,” said Tang, “but it’s a small, proof-of-concept study that will require a larger number of patients to see if it can be broadly adaptable.”

MedTech Outlook: Perspectives on the Current Landscape of Transcatheter Therapies for Aortic and Mitral Valve Disease 2021 By Gilbert H. L. Tang

As our understanding of valvular heart disease continues to evolve, newer transcatheter technologies will undoubtedly emerge, including updated designs from currently-approved systems. With a plethora of percutaneous therapies available on the market, interventional surgeons have to be well-versed with the various patient-, anatomy-, and device-specific factors that ultimatley lead to device selection.

TCTMD: Timing of Mitral Surgery After Failed TEER Influences Outcomes 7/21/21 By Todd Neale

“Even though the TEER profile is safe based on the data out there, it’s important to avoid procedural complications and doing procedures on patients with right-sided heart failure and tricuspid regurgitation, because if it fails that leads to a higher mortality,” Tang told TCTMD.

Mount Sinai Newsroom: Mount Sinai Cardiovascular Doctors to Receive Honors During American College of Cardiology 70th Annual Scientific Session 5/15/21

William Whang, MD, Associate Professor of Medicine (Cardiology), and Gilbert Tang, MD, MSc, MBA, Associate Professor of Cardiovascular Surgery at the Icahn School of Medicine at Mount Sinai, are receiving the 2021 Simon Dack Awards for their exceptional contributions to the Journal of the American College of Cardiology (JACC) for their peer reviews. This journal ranks among the top cardiovascular journals in the world for its scientific impact.

TCTMD: Dedicated Structural Heart Training Pathway in the Works for Surgeons 2/4/20 By Yael L. Maxwell

To TCTMD, panelist and surgeon Gilbert Tang, MD (Mount Sinai Health System, New York, NY), said he has been part of the ABTS steering committee with Fullerton. “We really strongly believe that surgical trainees who are interested in valvular heart disease should equip themselves with the skill set and knowledge to treat patients with all modalities possible, including medical therapy,” he said. “But not to have that knowledge and skill set to be able to do that presents an inherent bias, just like cardiologists. That's where the heart team comes in.”

TCTMD: MitraClip in the US: As Coverage Update Looms, Some Questions for REPAIR MR 1/24/20 By Shelley Wood

Gilbert Tang, MD (Mount Sinai Health System, New York, NY), has previously highlighted the fact that quantitative echocardiography in MR is dynamic, making it all the more challenging for referring centers to decide whether a given patient is a suitable candidate.

The New York Times: Bernie Sanders Had Heart Attack, His Doctors Say as He Leaves Hospital 10/4/19 By Sydney Ember

A heart attack means that a portion of the heart muscle died, starved of blood when a vessel was blocked, Dr. Gilbert Tang, a heart surgeon at Mount Sinai Hospital in New York, said.

“The first question is, how serious was the heart attack? What muscle was damaged and how will that affect the heart’s function?” Dr. Tang said. “If it was a significant portion of the heart, will that affect the heart’s ability to pump?”

If only a small portion of heart muscle was damaged, he added, Mr. Sanders should make a full recovery — even at 78. These days recovery does not depend on age so much as other medical issues, like lung problems, he said.

That does not mean that Mr. Sanders can simply continue as if nothing happened, though. Doctors usually recommend a cardiac rehabilitation program, which is essentially an exercise program in which patients are closely monitored. Such a program, Dr. Tang said, “conditions the heart to work harder.”

Mr. Sanders would normally also take a cocktail of drugs to reduce his risk of another heart attack, including powerful anti-clotting medications that require close monitoring for a month, Dr. Tang said.

The New York Times: Bernie Sanders Is Hospitalized, Raising Questions About His Candidacy 10/2/19 By Sydney Ember and Jonathan Martin

Dr. Gilbert Tang, a heart surgeon at the Mount Sinai Hospital in New York, said that if Mr. Sanders’s heart was not damaged, he should make a full recovery. But he also sounded a note of caution, saying the risks depended on which artery was blocked: “We don’t know what the anatomy looks like and what kind of stent at what location,” he said.

TCTMD: Evolut Valves: Initial Positioning Can Be Optimized for Future Coronary Access  7/10/19

"The issue is that, unlike surgery where we actually remove the leaflets of the aortic valve and put the new valve in and then align the commissures properly, in TAVR nobody has been paying attention to how the valve aligns wiht the native anatomy," lead investigator Gilbert Tang, MD told TCTMD.

Health.com: Mick Jagger Had a Heart Valve Replacement -- Here's What That Means 4/5/19

"People need this procedure because they have aortic stenosis--the stiffening and narrowing of one of the heart valves," says Gilbert Tang, MD, surgical director of the Structural Heart Program at the Mount Sinai Health System in New York City.

The New York Times: Tens of Thousands of Heart Patients May Not Need Open-Heart Surgery 3/16/19

“If I were a patient, I would choose TAVR,” said Dr. Gilbert Tang, a heart surgeon at the Icahn School of Medicine at Mount Sinai in New York, who was not involved in the new research.

The New York Times: Tiny Device Is a “Huge Advance” for Treatment of Severe Heart Failure, 9/23/18

The results have left leading researchers unexpectedly optimistic. The trial sends “a very, very powerful message,” said Dr. Gilbert Tang, a heart surgeon at Mount Sinai Medical Center, which enrolled a patient in the trial.

TCTMD: Will Percutaneous Mitral Repair Catch Up or Surpass Surgery? Experts Make Their Predictions 6/22/18

Not so fast, said Gilbert Tang, MD (Mount Sinai Health System/Icahn School of Medicine, New York, NY), who took the stage after Feldman. Or at least, “not yet.”

Percutaneous procedures, at least for now, do not offer the variety of approaches that surgery can offer, he argued, pointing out that MR comes in myriad forms. Different MR etiology, mitral lesions, and patient risk profile all play an important role. And while transcatheter therapies have evolved to approximate edge-to-edge, annuloplasty, and chordal replacement procedures, no percutaneous therapy is able to perform resection and reconstruction, a common surgical technique, Tang said.

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