Expanding the Boundaries of Interventional Cardiology

The boundaries of interventional cardiology continue to expand. In this issue of the Journal of Invasive Cardiology, there are several articles describing cutting-edge techniques for coronary, peripheral, and structural intervention. One article describes the results of closure of patent foramen ovale with atrial septal aneurysm and documented paradoxical emboli using different devices. Another article describes the use of bare-metal stents and drug-coated balloons to treat coronary artery lesions. A provocative analysis of coronary chronic total occlusions (CTOs) suggests that we may need to be doing more for female patients with CTOs. A nice review article summarizes the data regarding left ventricular support devices for high-risk percutaneous coronary intervention. An original research article describes the use of the renal resistive index to help identify which patients are most likely to benefit from renal artery stenting.

This issue of the Journal of Invasive Cardiology continues our focus on transcatheter aortic valve replacement (TAVR). The German TAVI Registry Investigators present data from their large, ongoing national multicenter study. Their thoughtful paper examines outcomes with TAVR across different age groups. They find similarly high procedural success rates, irrespective of age. Also, the rates of 30-day mortality were similar in the age groups. These data are very important in helping decide who might benefit from TAVR.

Quite exciting, in this issue we launch a new section, Plaque Composition and Dynamics. The Section Editor will be Dr Lloyd Klein. The goal of the new section of the journal is to bring to the attention of interventional and invasive cardiologists the significance of new findings from various basic science and clinical fields in the area of plaque composition and dynamics. In particular, the emerging roles of invasive and non-invasive imaging in the detection of thin cap fibroatheromas in patients at high risk of acute coronary syndromes will be emphasized. Additionally, the synergistic value of biomarkers and clinical measures of risk in identifying patients most likely to benefit from these imaging modalities will be addressed. Finally, how these features may determine appropriate device based and pharmacologic therapies will be considered. The first paper in the section is from the group at Emory University in Atlanta. They evaluate the effect of intensive statin therapy on plaque progression and composition, as well as on arterial remodeling and microvascular function. This is exactly the sort of careful science for which this new section is designed.

These are just some of the really interesting articles in print or online in this issue of the Journal of Invasive Cardiology.