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This year has seen a fundamental shift in the balance between transcatheter aortic valve implantation (TAVI) and aortic valve replacement surgery for the treatment of aortic stenosis. This has come about as a result of the publication of the Placement of Aortic Transcatheter Valves (PARTNER) 3 trial in 2019, followed shortly afterwards by Mick Jagger undergoing what looks to have been a successful and uncomplicated TAVI.
The 2017 European Society of Cardiology guidelines for the management of valvular heart disease suggested that TAVI should be considered for anyone over the age of 75 years. These new developments have effectively pushed this cut off to 70 years, and I think this will be translated quickly into important shifts in patient flows with knock-on effects on cardiac surgical departments. The one major concern about TAVI is prosthesis durability and this has been analysed in detail in this issue of the journal by Marco Barbanti et al.
The other structural paper is provided by Azeem Latib et al., who have concisely summarised the current available options for transcatheter treatment of tricuspid regurgitation. An excellent review of the Randomized Comparison of Ultrasound Versus Radiofrequency Denervation in Patients With Therapy Resistant Hypertension (RADIOSOUND-HTN) trial of renal denervation by Phillip Lurz et al. completes the non-coronary papers.
Angela Hoye et al. have provided an excellent review and analysis of the differences in outcomes following percutaneous coronary intervention for men and women. Fizzah Choudhury et al. review the available data on thrombus embolisation during primary angioplasty – an event inevitably associated with a poor prognosis.
The remaining three papers are reviews of conditions routinely encountered by interventional cardiologists and as such will, I hope, be of direct use. The management of angina with unobstructed coronary arteries is reviewed by Tom Ford et al.; Christoph Gräni et al. review the assessment and management of anomalous coronary arteries; and Arjun Ghosh et al. provide a comprehensive review of 5-fluorouracil cardiotoxicity.