Commemorating the 15-year anniversary of TAVI: insights into the early stages of development, from concept to human application, and perspectives
A. Cribier. shares his experience of cardiac catheterisation in the early 1970s and follow the fascinating evolution of the technology over the past 40 years.
For all of us, the crucial milestone has been the invention of percutaneous transluminal balloon angioplasty by Andreas Grüntzig, and the first coronary angioplasty performed by him in September 1977, of which we are celebrating the 40th anniversary. We can be profoundly indebted to him, not only for having introduced such a revolutionary creative approach for the treatment of coronary artery disease, initiating at the same time the specialty of “interventional cardiology”, but also for having been such a great source of inspiration for many others. If he was still among us, Andreas Grüntzig would probably be amazed and proud to see that his invention catalysed the incredible expansion of transcatheter interventions in cardiology to a wide range of congenital and acquired heart diseases, far beyond angioplasty and stent implantation.
In the field of “structural heart diseases”, a term introduced by Martin Leon at the Transcatheter Cardiovascular Therapeutics meeting of 1999 to cover all non-coronary heart diseases and their dedicated interventional techniques, valve replacement and repair have been the fastest developing areas. Following in the footsteps of transcatheter treatment of congenital pulmonic (1979)1 and aortic valvular stenosis (1983)2, mitral valvuloplasty (1984)3 and aortic valvuloplasty in adults (1985)4, then pulmonic valve replacement in degenerated conduits (2000)5, the technique of transcatheter aortic valve implantation (TAVI)6 emerged in 2002 to alter the landscape of cardiovascular medicine profoundly. In its turn, TAVI became a strong source of inspiration for the development of new interventional techniques aimed at treating other valvular diseases, such as mitral valve repair and, more recently, mitral valve replacement. With the increased prevalence of valvular diseases with age, over the next decade one can expect a 30% growth of interventional cardiology in this field. Find out more ...