Percutaneous valve interventions: where we are and where we are headed

Boundaries between the specialties of cardiology and cardiovascular surgery are becoming less distinct, as cardiologists and cardiac surgeons alike strive to decrease invasiveness of procedures and improve patient results. For surgeons, new tools and techniques have allowed innovative, minimally invasive techniques to be performed successfully with smaller incisions and faster recovery. With the introduction of novel catheter technology, aortic valve prostheses can be placed percutaneously or, more recently, transapically without cardiopulmonary bypass. Furthermore, the field of percutaneous mitral valve repair is rapidly expanding with multiple novel off-pump percutaneous devices designed to reduce or eliminate mitral regurgitation, including devices that perform edge-to-edge leaflet repair and percutaneous mitral annuloplasty. The explosive growth of new ideas and new procedures to decrease invasiveness of valve procedures will continue to evolve over the next 5 years, and surgeons must remain nimble to become part of this process.