Transcatheter aortic valve implantation (TAVI), a procedure often performed under local anaesthetic with a 2–3 day length of stay, has the capacity to transform lives for the better with dramatic improvements in exercise tolerance and quality of life. Complication rates are low, but stroke – particularly disabling stroke – remains a feared outcome for patients and operators alike. As such, it is a focus of ongoing research and in this issue of Interventional Cardiology Review I am pleased to present three articles addressing the available evidence on how best to minimise the risk of stroke. Articles by Herbert G Kroon and Nicolas MDA Van Mieghem, and Martin G Radvany, relate exclusively to embolic protection devices; an article from Thomas Walther’s group reviews stroke prevention in general.
There are two further articles relating to TAVI in this issue of the journal: Ren Jie Yao, Matheus Simonato and Danny Dvir provide an excellent review of how haemodynamics can be optimised after valve-in-valve procedures, while Crochan J O’Sullivan1 and Peter Wenaweser predict which patients will be undergoing TAVI in 2020.
Tricuspid valve anatomy is a challenging environment for engineers and developing transcatheter devices for tricuspid valve interventions has taken much longer than it has for the aortic valve. In the past 2–3 years, however, real progress has been made and Francesco Maisano’s group – very much in the vanguard as researchers and operators – provides a timely review of the role of transcatheter interventions in the management of tricuspid regurgitation.
Developments in transcatheter interventions are always made in the context of surgical therapies. In addition, as cardiologists, it is incumbent on us to know all the treatments that are available for our patients. Thus, I would hope the final article in this issue’s Structural Section, about novel surgical techniques for treating aortic dissection, will be both informative and stimulating.
Novel devices and procedures provide new and exciting ways to treat our patients and one of the aims of this journal is to keep cardiologists up to date with developments in coronary and structural intervention. It is, however, also important that common procedures are undertaken safely and that patients derive maximum benefit from them. To this end, Kully Sandhu, Robert Butler and James Nolan, and Giovanni Luigi De Maria and Adrian Paul Banning, both provide excellent reviews of transradial coronary artery procedures and intravascular ultrasound imaging of the left main stem respectively. I commend them to you.