Percutaneous valve repair and replacement: the frontier of valve disease treatment.

The percutaneous treatment of mitral stenosis using balloon valvuloplasty is a reality. However, in Western countries there is only a low incidence of rheumatic valvular disease. Thus, attention is now focused on percutaneous, transcatheter approaches that will allow wider ranging treatment of pulmonic, aortic and mitral valve disease. These new approaches should result in percutaneous technologies that will allow replacement of pulmonic and aortic valves for both stenosis and regurgitation, repair of mitral regurgitation, and possibly even replacement of the mitral valve. Pulmonic and aortic valve replacement are already being studied in safety and efficacy trials in Europe. Investigators using percutaneous mitral valve repair will soon complete a Phase I US trial and the technology will be studied in a Phase II randomized trial. Patient care options for valvular heart disease are rapidly changing. 'Potential percutaneous replacement of the mitral valve still faces many practical hurdles, but sooner or later they will be overcome.'