The worldwide spread of transcatheter aortic valve implantation (TAVI) has suggested the paradigm shift in the strategy of treatment for structural heart diseases (SHD). Generally, an indication of a treatment changes based on the device advancement and physicians’ experience: it is limited initially to a very sick patient but soon will be expanded, sometimes over-indicated, and finally will be settled in a reasonable range. TAVI, for example, is a treatment for patients with symptomatic severe aortic stenosis that is inoperable, or where they are at high risk from surgery. However, trials with an indication for low risk patients are now ongoing. Other catheter interventions for SHD such as mitral regurgitation, left atrial appendage occlusion, perivalvular leak closure, tricuspid regurgitation etc. will be introduced in Japan very soon. These less-invasive treatments are suitable in aged patients and will be prevailed in Japan where society is aging. Advancement of device expands indications of treatments and finds new limitations. In the present symposium, advancement and limitations of device treatments for SHD will be discussed.