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(Circulation. 2006;113:771-773.)
© 2006 American Heart Association, Inc.

Editorial

Percutaneous Valve Repair and Replacement

Challenges Encountered, Challenges Met, Challenges Ahead

Ted Feldman, MD

From the Cardiology Division, Evanston Hospital, Evanston, Ill.

Correspondence to Ted Feldman, MD, Cardiology Division, Burch 300, Evanston Hospital, 2650 Ridge Ave, Evanston, IL 60201. E-mail tfeldman@enh.org

Key Words: Editorials • mitral repair • valve replacement • valves

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	Introduction

 
This issue of Circulation contains reports on the acute results of 2 approaches for percutaneous heart valve treatment.^1,2 The introduction of nonsurgical, catheter-based approaches to the management of valvular heart disease is in a phase of rapid development. These 2 reports highlight both challenges and successes in phase I experience with these innovative therapies.

Articles pp 842 and 851

Percutaneous valve therapy developed initially with aortic valve replacement, described by Andersen et al³ in 1992 in a swine model. These investigators fabricated a stent-mounted bioprosthetic valve and demonstrated that percutaneous implantation is feasible. Bonhoeffer et al⁴ reported the use of a stent-mounted bioprosthesis for pulmonic valve replacement in 2000. This achievement clearly marked the beginning of the era of percutaneous valve replacement therapy in patients. Pulmonic valve replacement with this percutaneous approach has been remarkably successful. To date, >100 patients have been treated, with only a single procedure-related mortality and good results in a population of pediatric patients with congenital heart disease who otherwise would face third or fourth open heart procedures. Percutaneous aortic valve replacement with a stent-mounted bioprosthetic valve device was initially reported by Cribier et al^5,6 in 2002, with a growing experience since then.

	Challenges Encountered

 
Numerous technical and clinical challenges have been encountered during phase I procedures for percutaneous heart valve therapy. The patient population for aortic valve replacement has been a group of patients considered high risk for surgery or nonsurgical candidates with numerous comorbid conditions. These patients have come to the cardiac catheterization laboratory with hypotension . . . [Full Text of this Article]

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