Overview of Guidelines and Philosophical Medical Implications of Percutaneous Valve Technology (pp. 1-8)
Authors: (David Liff, Vasilis Babaliaros, and Peter Block)
Abstract: Valvular heart disease is a serious public health problem. In 2009, more than 24,000 aortic valve replacements and nearly 7,000 mitral valve repairs were performed in the United States . As the population ages, the number of patients affected will increase. Surgery has been the only treatment proven to improve quality of life and survival for patients suffering from most forms of valvular disease.
Percutaneous therapy for stenotic lesions of the pulmonic, aortic, and mitral valves has been available to patients for years; however, the proliferation of novel percutaneous therapies for structural heart disease in the last decade has been unprecedented. Since the first-in-man report of transcatheter aortic valve replacement (TAVR) in 2002 , more than 20,000 TAVR have been performed worldwide. In that time, a multi-disciplinary effort, led by cardiologists, cardiothoracic surgeons, and imaging specialists has dramatically improved rates of procedural success, complications, and outcomes.
More percutaneous devices aimed at valvular disorders are developed every year, blurring traditional distinctions between cardiologist and cardiothoracic surgeons. It is yet unclear how to best investigate these devices, what patients should be included in trials, and who ought to be performing these procedures.
Though several professional societies have begun to address these topics through position statements, formal guidelines do not yet exist.