Background: Percutaneous structural cardiac interventions have transformed the treatment landscape for congenital and acquired structural heart diseases. While short-term procedural success has been extensively documented, long-term outcomes remain a critical determinant of therapeutic efficacy. This study evaluates long-term clinical, echocardiographic, and functional outcomes following percutaneous structural cardiac interventions. Methods: A retrospective cohort study was conducted involving 412 patients who underwent percutaneous structural cardiac interventions between 2014 and 2022. Procedures included atrial septal defect (ASD) closure, ventricular septal defect (VSD) closure, patent foramen ovale (PFO) closure, transcatheter aortic valve implantation (TAVI), and transcatheter mitral interventions. Patients were followed for a median duration of 6.8 years. Results: Procedural success was achieved in 98.1% of cases. Long-term survival at 8 years was 94.6%. Significant improvements in New York Heart Association (NYHA) functional class, ventricular dimensions, and quality-of-life measures were observed. Device-related complications were rare, occurring in only 2.9% of patients. Freedom from reintervention was 96.3%. Conclusion: Long-term follow-up demonstrates excellent durability, safety, and sustained clinical benefits following percutaneous structural cardiac interventions. Careful patient selection and structured surveillance remain essential for optimizing outcomes.