Carlos E. Ruiz - Böcker

Transcatheter Valve Repair discusses all aspects related to percutaneous and established valve repair methods. The book is divided into few major sections covering all four valves and other topics. Each section contains several chapters discussing everything related to that valve. Beginning with the pulmonary valve, since it was the first valve to be tackled in the catheterization laboratory, and then moving to the aortic, then the mitral and then finally end with the tricuspid valve. 1.5M US citizens alone have some degree of aortic valve stenosis, with half (750K) requiring aortic valve replacement. Aortic valve replacement, on the whole, is performed by surgeons, requiring bypass machines and technicians, as well as the usual operating team. The operation is expensive and occupies a considerable amount of operating room time. Mostly, the aortic valve is calcified and the usual option available to patients is valve replacement with a variety of choices, ranging from porcine valves to synthetic, for which there are many manufacturers. It should be noted that the aortic valve is the most problematic of valves. Percutaneous procedures are the answer.The bottom line is that given the growing elderly population, many more patients will require valve repair, thus increasing health care costs with not only surgical operations but also hospitalisation. Percutanous valve repair, whilst requiring a cath lab team, does not involve bypass machines nor extended hospitalisation. Like percutaneous transluminal coronary artery interventions (PTCA) has replaced coronary artery bypass grafts (once the golden standard), and now stenting having replaced PTCA and its balloons. We now see drug eluting stents replacing ordinary stents (though at a much higher cost. There will be a huge movement toward percutanous valve repair, which should presumably cut costs but also morbidity and mortality.