Percutaneous and minimally invasive valve procedures: a scientific statement from the American Heart Association Council on Cardiovascular Surgery and Anesthesia, Council on Clinical Cardiology, Functional Genomics and Translational Biology Interdisciplinary Working Group, and Quality of Care and Outcomes Research Interdisciplinary Working Group.
The incidence of valvular heart disease is expected to increase over the next several decades as a large proportion of the US demographic advances into the later decades of life. At the same time, the next several years can be anticipated to bring a broad transition of surgical therapy to minimally invasive (minithoracotomy and small port) access and the more gradual introduction of percutaneous approaches for the correction of valvular heart disease. Broad acceptance of these technologies will require careful and sometimes perplexing comparisons of the outcomes of these new technologies with existing standards of care. The validation of percutaneous techniques, in particular, will require the collaboration of cardiologists and cardiac surgeons in centers with excellent surgical and catheter experience and a commitment to trial participation. For the near term, percutaneous techniques will likely remain investigational and will be limited in use to patients considered to be high risk or to inoperable surgical candidates. Although current-generation devices and techniques require significant modification before widespread clinical use can be adopted, it must be expected that less invasive and even percutaneous valve therapies will likely have a major impact on the management of patients with valvular heart disease over the next several years.
Rosengart
Todd K
TK
State University of New York-Stony Brook, USA.
Feldman
Ted
T
Borger
Michael A
MA
Vassiliades
Thomas A
TA
Gillinov
A Marc
AM
Hoercher
Katherine J
KJ
Vahanian
Alec
A
Bonow
Robert O
RO
O'Neill
William
W
D000572:American Heart Association; D000758:Anesthesia / Q000379:methods / Q000592:standards*; D000818:Animals; D013504:Cardiovascular Surgical Procedures / Q000295:instrumentation / Q000379:methods / Q000592:standards; D023281:Genomics / Q000295:instrumentation / Q000379:methods / Q000592:standards*; D019918:Heart Valve Prosthesis Implantation / Q000295:instrumentation / Q000379:methods / Q000592:standards*; D006801:Humans; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation / Q000379:methods / Q000592:standards*; D014481:United States