This month, we review the current status of some of the new structural and valve interventions. The issue is timely in the wake of the recent US Food and Drug Administration panel recommendation for approval of the Edwards Sapien aortic valve system (Edwards Lifesciences, Irvine, CA).

We begin with an update on the PARTNER trial by Jean-Michel Paradis, MD, and Susheel Kodali, MD, who analyze the latest data from cohorts A and B, as well as the future direction of additional studies on transcatheter aortic valve replacement (TAVR). Carlos E. Ruiz, MD, PhD, provides his insights on the CoreValve program (Medtronic, Inc., Minneapolis, MN).

Next, Rafal Dworakowski, MD, PhD, and Olaf Wendler, MD, PhD, FRCS, discuss transapical access for TAVR, including the reported outcomes and new ways that the transapical approach may be applied.

Ehrin J. Armstrong, MD, MSc, and Jason H. Rogers, MD, provide an overview of some of the next-generation TAVR devices and the ways each of them have the potential to advance the technology and improve clinical outcomes.

Shifting gears to mitral valve repair, Alice Perlowski, MD, and I have prepared an article on the EVEREST trials, which is evaluating the MitraClip system (Abbott Vascular, Santa Clara, CA) for safety and effectiveness in treating mitral regurgitation. We hope that with time, these studies will reveal which patients are the best candidates to undergo treatment with this device. Then, Christian Frerker, MD; Ulrich Schaefer, MD; and Karl- Heinz Kuck, MD, review the various direct and indirect percutaneous mitral valve annuloplasty devices that are currently undergoing clinical investigation.

This issue also includes a focus on structural closure, comprising two fascinating articles. In the first article, Ismael Gonzalez, MD, and Zahid Amin, MD, FAAP, FSCAI, FACC, describe the techniques used in transcatheter closure for postinfarction ventricular septal defect, a rare but quite challenging presentation to treat. Also, Yolandee Bell-Cheddar, MD, and Zahid Amin, MD, FAAP, FSCAI, FACC, discuss how to reduce the procedural risks associated with device closure for atrial septal defects by conducting a thorough preprocedure evaluation and improving device knowledge and operator experience.

In our Ask the OCT Imaging Expert column, Gabriel Maluenda, MD, and Augusto Pichard, MD, FACC, demonstrate how optical coherence tomography can uniquely discover severely calcified lesions and guide percutaneous coronary intervention.

We also have a Today's Practice article in which Adhir Shroff, MD, MPH, explains the potential economic benefits associated with transradial access for imaging and intervention, including lower procedural costs and decreased patient complications.

To close this issue, we interview Martyn Thomas, MD, a cardiologist from the United Kingdom, who was recently involved in the US Food and Drug Administration Circulatory System Devices Panel meeting to review the evidence for the Edwards Sapien transcatheter heart valve. He discusses his experience with valvular replacement devices and the ongoing approval process for TAVR in the United States.

As always, I hope the synthesis of recent information we provide helps you digest the ever-expanding pile of journals we all find on our desks.

Ted E. Feldman, MD, FSCAI
Chief Medical Editor
citeditorial@bmctoday.com