The Structural Heart Fellowship at the University of Minnesota was established in 2013, with our inaugural fellow starting in July 2014. Since then, we have trained 12 structural fellows through a robust, high-volume program.Fellows rotate through three hospitals: a University Hospital, a high-volume private hospital, and the VA, gaining broad clinical exposure across diverse practice settings. During the fellowship year, trainees participate in approximately 300 TAVR procedures, 100 left atrial appendage occlusions (LAAO), and 60 mitral and tricuspid valve procedures. In addition, fellows perform numerous ASD and PFO closures, as well as other miscellaneous structural heart