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J Thorac Cardiovasc Surg 2009;137:1315-1316
© 2009 The American Association for Thoracic Surgery

Editorial

Not if, but when

Mayo Clinic and Mayo Foundation, Rochester, Minn

Received for publication January 30, 2009; accepted for publication February 6, 2009.

^_* Address for reprints: Thoralf M. Sundt, MD, Mayo Clinic and Mayo Foundation, 200 First St, SW, Rochester, MN 55905. (Email: johnson.barbara4@mayo.edu).

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

See related article on page 1430.

 

In this issue of the Journal, Kapadia and colleagues¹ share their early experience with percutaneous aortic valve replacement (PAVR) as part of the "REVIVAL" trial, a moniker imaginatively derived from the proper title "Transcatheter EndoVascular Implantation of VALves." The aim of this report is to characterize those patients referred for the trial and the course of their care. There is an understandable focus on the number of patients eligible for the technology and the effectiveness of PAVR. The study, like others, shows what many of us once thought was not possible: (1) despite our protestations that we turn down few patients for surgery and there will be no appropriate place for a technology with unproven durability against a therapy that is tried and true, there are indeed patients turned down for open surgery even at a center of excellence such as theirs, and (2) a tissue valve mounted on an expandable stent can indeed be successfully implanted percutaneously without removing the calcified native valve, and with remarkably good results. Furthermore, judging by the enthusiasm of the public as well as clinical (not interventional) cardiologists, the results seem to be "good enough." Like it or not, the question is no longer if, but when. . . . [Full Text of this Article]

Related Article

Characterization and outcome of patients with severe symptomatic aortic stenosis referred for percutaneous aortic valve replacement

Samir R. Kapadia, Sachin S. Goel, Lars Svensson, Eric Roselli, Robert M. Savage, Lee Wallace, Srikanth Sola, Paul Schoenhagen, Mehdi H. Shishehbor, Ryan Christofferson, Carmel Halley, L. Leonardo Rodriguez, William Stewart, Vidyasagar Kalahasti, and E. Murat Tuzcu
J. Thorac. Cardiovasc. Surg. 2009 137: 1430-1435. [Abstract] [Full Text] [PDF]