This year’s two major European interventional cardiology conferences have highlighted the different stages of development of three different aspects of interventional cardiology.
Coronary intervention is a mature subspeciality and presentations at the EuroPCR meeting (Paris, 17–20 May 2016) focussed on highly complex (chronic total occlusions) and high-risk (ST-elevation myocardial infarction) interventions as well as pharmacological and mechanical adjuncts such as antiplatelet agents and support devices for cardiogenic shock. Live cases were of complex interventions and discussion touched on all aspects of the case – reflecting the experience of operators and moderators.
Aortic valve intervention is at an intermediate stage of development with presentations at both EuroPCR and PCR London Valves (London, 18–20 September 2016) largely documenting outcomes of first and second generation devices. Live cases were reasonably straight forward with discussion often focussing on device selection and the basics of the procedure.
Mitral and tricuspid interventions, however, remain very much in the early stages of development, particularly for the tricuspid valve. At PCR London Valves, Professor Vinayak Bapat (St. Thomas’ Hospital, London) stated that – to his knowledge – no single operator had performed more than 50 transcatheter mitral valve replacement procedures, of any description, in total. This contrasts with aortic valve interventions where most operators will be performing more than this number of procedures annually, and more sharply still with coronary interventions where the highest volume operators will be approaching this number of procedues every month. Presentations concentrated on case selection and hard outcome data where interventions in man have been undertaken. Other presentations related to devices still in development.
These are exciting times for valvular interventions but it is important to remember that in many countries there will be individual centres performing more coronary intervention procedures each year than valvular interventions will be performed in the whole country. This issue of Interventional Cardiology Review reflects the overwhelming primacy of coronary artery disease management in the work of the interventional cardiologist and I commend it to you.