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J Thorac Cardiovasc Surg 2006;132:1258-1261
© 2006 The American Association for Thoracic Surgery

Editorial

Emerging opportunities for cardiac surgeons within structural heart disease

Oern Stuge, MD*, John Liddicoat, MD

Medtronic Cardiac Surgery, Minneapolis, Minn.

Received for publication July 11, 2006; accepted for publication August 25, 2006.

* Address for reprints: Oern Stuge, MD, Medtronic World Headquarters, Medtronic, Inc, 710 Medtronic Parkway, Minneapolis, MN 55432-5604 (Email: Oern.stuge@medtronic.com).

The first 20% of the full text of this article appears below.

Technological advancements, such as the heart-lung machine, prosthetic valves, intravascular catheters, and stents, have increased treatment options for patients and have created exceptional growth for hospitals and cardiac specialists. Although cardiac surgeons have led much of this innovation, the delivery of these therapies has often been led by other medical specialties as the procedures have become less invasive (Table 1).


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  		TABLE 1. Less-invasive cardiovascular procedures
 
In 1990, coronary artery bypass grafting (CABG) and percutaneous coronary interventions were performed in approximately equal numbers. Since then, percutaneous coronary intervention volumes have grown considerably, whereas CABG volumes have not (Figure 1). 1Go Although cardiac surgeons have adapted by focusing on surgical repair and replacement of valves, emerging technologies will force further changes.


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  		Figure 1. Unbounded business for cardiac providers: Historical profile.

 
There is a natural trend to decrease procedural invasiveness to mitigate risks and increase acceptance. The ongoing efforts to treat many cardiovascular diseases less invasively include catheter-based approaches. In fact, catheter-based endoaortic grafting and valve repair techniques are in clinical evaluation and might soon become clinical realities. Cardiac surgeons should take a leading position in the development and delivery of these procedures.

Emerging Technologies Will Increase Procedural Demand

In the future, treatment options for patients with cardiovascular disease will include open surgical procedures, minimally invasive surgical intervention, and percutaneous approaches (Figure 2). Patients contraindicated for surgical intervention might be candidates for less-invasive treatments, and less . . . [Full Text of this Article]




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