Percutaneous heart valve replacement and repair

The new millennium, with its rapid technical and technological developments, inevitably brought a new era in the field of interventional cardiac treatment, that of percutaneous heart valve replacement and repair. According to the traditional surgical technique of valve replacement, the damaged valve is removed and a new bioprosthetic graft planted in its place. This method, despite its high index of efficiency, credibility and long term survival still excludes a number of patients because of their co-morbidities which do not allow them undergo an interventional procedure of this nature, with its possible complications. The term percutaneous valve implantation defines the development of a foldable heart valve that can be mounted on an expandable stent, delivered percutaneously via standard catheter-based techniques and implanted within a diseased valve annulus. In the case of non-imperative need for valve replacement, the valved stent is substituted by an intra luminary repair device that is put into action in situ. The advantages of minimally invasive techniques such as percutaneous valve replacement and repair are obvious, but, in spite of their impressive results, there are still a number of faults and deficiencies that limit their wide application in clinical practice. It is imperative that more clinical trials are carried out so as to make the new method sufficiently competitive with the surgical technique that is already well established. At the dawn of a new era for surgical treatment, a patient undergoing heart valve replacement and leaving the hospital only a few hours later no longer seems a science fiction scenario.