Welcome to our annual issue in which we cover the current access and closure–related conversation as it evolves within the field of interventional cardiology. We have selected experts to discuss a range of pertinent topics that will hopefully synthesize the current data so that we can make more informed decisions for our patients—from beginning to end.

Because vessel access is the foundation for all percutaneous interventions, it seems to be a logical place to begin this issue as well. Ian C. Gilchrist, MD, kicks off the discussion by explaining how a well-planned radial access technique can ensure a successful procedure, along with the fact that optimal radial hemostasis is fundamental in maintaining the long-term function of the radial artery for any interventions that may be needed at a later date.

Next, as the pool of potential candidates for transcatheter aortic valve repair (TAVR) continues to expand, it is more important than ever to minimize access and closure complications to ensure an overall favorable result. Alice A. Perlowski, MD; Justin P. Levisay, MD; Michael H. Salinger, MD; and I describe an approach that we believe will improve the accuracy and safety of transfemoral TAVR access by using fluoroscopic guidance and the micropuncture technique. Creighton Don, MD, and Elizabeth M. Holper, MD, then discuss the future directions of percutaneous transfemoral access for TAVR, the procedural details of suture-mediated closure, and the current data that we have on these topics to date.

Another area of growing interest is the use of vascular closure devices to further decrease the risk of vascular complications compared with manual compression in appropriately chosen patients. M. Nicholas Burke, MD, compares the available data on the two types of vascular closure devices—extravascular and intravascular—but notes that further studies will be required that are larger and have longer follow-up. We conclude our cover focus with a review of femoral and apical closure devices for TAVR by Jonathon White, MD, and Mathew Williams, MD.

In addition to our access and closure coverage, Mary Shields, MD; Maria Baldasare, MD; David Goldberg, MD; Awail Sadiq, MD; and Sheldon Goldberg, MD, present a comprehensive overview on the pathophysiology and current options for surveilling and treating atrial septal defects. Also, Konstantinos Marmagkiolis, MD; Massoud Leesar, MD; and Mehmet Cilingiroglu, MD, update us on the expanded use of FFR, OCT, and IVUS imaging modalities and the value they can offer to interventional cardiology practices.

Finally, we close with an interview with Herbert D. Aronow, MD, MPH, in which we pick his brain about potential uses and applications of social media and smartphone technology in our field, as well as his role in the multisociety Emerging Leader Mentorship Program. As is always our goal, we hope you find Cardiac Interventions Today a useful way to digest and keep up with the interventional cardiology literature. Let us know if there are other topics you would like to read about.

Ted E. Feldman, MD, MSCAI, FACC, FESC

Chief Medical Editor

citeditorial@bmctoday.com