Dallas, TX - One of the authors on a new American Heart Association (AHA) Scientific Statement on percutaneous and minimally invasive valve procedures says patients needing valve surgery are already requesting a less invasive form of treatment—despite the fact that the devices and treatments in the pipeline likely won't be commercially available for years [1].

According to Dr Robert O Bonow (Northwestern University, Chicago, IL), who participated in the AHA writing group, the aim of the statement is to educate physicians about the fast-evolving field.

"Many doctors and particularly many patients are already aware of these developments," Bonow told heartwire. "And those of us who see patients with valve disease are seeing people who need heart-valve surgery who are saying, I heard you can do this now with catheters, why can't I have that done instead? So we thought it would be worthwhile to put out a scientific statement for healthcare providers just to kind of get them up to speed with what is going on."

The statement by Dr Todd K Rosengart (State University of New York—Stony Brook) et al was released online March 10, 2008.

The document reviews the current state of valve surgery, noting that surgical advances have set a high benchmark that will need to be met by newer, less invasive valve replacement or repair procedures. But it also points out that, according to surveys, as many as one-third of all patients requiring aortic- or mitral-valve surgeries currently are deemed too high risk to actually get them.

The statement reviews the types and approaches of minimally invasive surgical procedures as well as fully percutaneous procedures for both aortic-valve and mitral-valve regurgitation—the two most active areas of research, which also represent the greatest public need. Rosengart et al also describe the status of the clinical trials currently under way and explore the challenges to device improvements, clinical-trial design, and standardization of study results and reporting. A theme throughout the statement is the increasing degree of collaboration between surgeons and interventionalists, something Bonow told heartwire will only become more important over time, not just in the clinical trials, but at institutions hoping to offer percutaneous valve procedures and indeed many of the minimally invasive procedures in the future.

According to Bonow, the statement should help physicians get a better sense of the different developments in the field and prepare them for the types of things they will see in the not-too-distant future.

"Physicians should be aware that the field is evolving very quickly," he said. "On the aortic side, for example, about 1200 patients have now been treated percutaneously—roughly 600 with the Edwards device and roughly 600 with the CoreValve procedure. And some of these devices are now approved in Europe. So we're going to be seeing more and more patients who have been treated with these devices."

He continued: "We thought it would be worthwhile to get people up to speed as to what's new and what the state of things is right now."