Foreword

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Abstract

I am delighted to have the opportunity to contribute to this informative and comprehensive review of Interventional Cardiology. It is difficult and unfair to attribute the birth of this speciality to the work of only a small number of pioneers; nevertheless, I feel this exercise is valid. I would like to recognise a few key players: Mason Sones (coronary arteriography), Andreas Gruentzig (coronary angioplasty) and Jeffrey Hartzler (primary angioplasty and complex interventions). Building on the foundations set by these three brave leaders, many others have contributed to the progression of the field with further landmark steps: Julio Palmatz and Ulrich Sigwart (coronary stents), Gary Roubin (carotid angioplasty), Jouan Parodi (percutaneous treatment of abdominal aortic aneurysms) and Alain Cribier (percutaneous aortic valve implantation). Indeed, it is amazing to imagine what Mason Sones and Andreas Gruentzig would think if they were around today to witness the achievements and ongoing progress in our field over the last 30 years.

Since the mid-1970s we have seen many frontiers conquered and new land discovered. Perhaps the biggest milestone was the advent of coronary stents, which almost eliminated the need for emergency surgery during coronary intervention and lowered restenosis rates. Following on from this, drug-eluting stents made restenosis a single-digit occurrence. The most recent novel and promising development in intervention is the establishment of percutaneous treatment for structural heart disease.

This issue of Interventional Cardiology is aimed at updating our knowledge of the latest innovations in these areas. Second-generation drug-eluting stents appear to be safer and more efficacious, and the percutaneous treatment of left main disease is now a reality. The Synergy between PCI with Taxus and Cardiac Surgery (SYNTAX) trial gave us a wealth of new information, and the SYNTAX score can be utilised to improve patient selection, allowing us to provide safer, more efficacious and more cost-effective treatment. Elsewhere, there is an article on the current guidelines for management of patients with coronary disease who need non-cardiac surgery.

The field of peripheral interventions is also addressed, with an article covering the still controversial field of percutaneous treatment of abdominal aortic aneurysms. There is also a section on closure devices, which are bound to become more relevant with the expansion of procedures of the aortic valve.

Notably, significant space is devoted to percutaneous treatment of aortic valve disease. This information is extremely topical and is bound to enlarge exponentially over the coming years.

While this edition attempts to be comprehensive, it cannot entirely exhaust all aspects of intervention. As we try to decorate a room or set up a museum, we are always forced to leave out important works that fully deserve to be present in order to leave room for new books and new editions that will fill in the missing gaps. The most important point to note is that all the authors are experts who have lived through these topics with hands-on experience and knowledge. My best thanks and congratulations go to the Editor, Jonathan McKenna, for having brought together so many informative articles.