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(Circulation. 2006;113:774-775.)
© 2006 American Heart Association, Inc.

Editorial

Percutaneous Valve Intervention

A Surgeon’s Perspective

Richard J. Shemin, MD

From the Department of Cardiothoracic Surgery, Boston University School of Medicine, Boston, Mass.

Correspondence to Richard J. Shemin, MD, Department of Cardiothoracic Surgery, Boston University School of Medicine, 88 E Newton St, B-402, Boston, MA 02118. E-mail richard.shemin@bmc.org

Key Words: Editorials • aorta • arteries

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

Two articles^1,2 in this issue of Circulation present small series of patients who had either a percutaneous mitral annuloplasty performed via the coronary sinus or a percutaneous aortic valve replacement via a retrograde femoral artery approach. The main thrust of each article was to demonstrate the technical approach, complications, and short-term results of these techniques. It is clear that this technology is in its infancy. The technical challenges, reliability, and ability to achieve consistent results (not to mention appropriate patient selection) will be an area of active research and development over the foreseeable future.

Articles pp 842 and 851

The magnitude of investment by major medical device companies and startup companies and the degree of venture capital investment will clearly drive this technology forward rapidly. Nevertheless, our role as cardiologists and cardiac surgeons is to provide guidance, perform the trials honestly with minimal bias, and work collaboratively as providers of cardiovascular care to perfect the techniques to reliably and appropriately treat the specific valve lesion.³ We must perform the science rigorously to ensure patient safety and learn how to advise patients about the variety of options that will ultimately be available. The model of "bail-out" cardiac surgery after failed percutaneous coronary intervention for coronary artery disease will not be easily transferred to percutaneous approaches to a variety of valve lesions.^4–6

The specific approaches to mitral valve pathology are either focused on the leaflet with the use of edge-to-edge fixation or the dilated annulus often present in ischemic and functional mitral . . . [Full Text of this Article]

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