Welcome to our annual Learn the Technique issue in which we enlist expert commentary on the tips and tricks that we hope will help advance your practice and stimulate your mind. We begin our Learn the Technique coverage with a look at balloon aortic valvuloplasty through radial access. Carlo Tumscitz, MD, walks us through how, in properly screened patients, this technique may discriminate between effective and futile procedures in the frailest population with severe aortic stenosis.

Iatrogenic occlusive coronary dissection (IOCD) is a well-known complication of percutaneous coronary intervention and represents the main causes of abrupt vessel closure. Gabriele L. Gasparini, MD, and Dario Bongiovanni, MD, explore how to overcome a vessel that is dissected but cannot be wired in the case of IOCD.

Giorgio A. Medranda, MD; Adam B. Greenbaum, MD; and Toby Rogers, MD, then describe the novel and innovative transcaval technique for transcatheter aortic valve replacement (TAVR), including how to manage transcaval-specific complications. In an overview of the circle method, Jörg Kempfert, MD, and Melissa Fusari, MD, detail a screening technique for sizing, position, and complications before balloon-expandable TAVR in the bicuspid aortic valve, while Tanja K. Rudolph, MD, advises how to plan for and perform deployment and address complications during implantation of a self-expandable valve using the cusp overlap technique.

In another novel approach to TAVR, Won-Keun Kim, MD, teaches us how to manage an embolized TAVR with the stent-in-valve technique, which addresses malpositioning or malexpansion of a transcatheter heart valve and involves placement of a bare-metal stent into the inflow portion of the first valve prosthesis.

Next, Jaffar M. Khan, BM BCh, PhD; Adam B. Greenbaum, MD; Toby Rogers, MD; Christopher G. Bruce, MBChB; Vasilis C. Babaliaros, MD; and Robert J. Lederman, MD, provide a review of the tip-to-base laceration of the anterior mitral leaflet to prevent outflow obstruction (LAMPOON) technique to prevent left ventricular outflow tract obstruction resulting from transcatheter mitral valve replacement.

Evandro Martins Filho, MD, teaches us how to perform the reverse wire technique (and its new variations) for angulated side branches, including anatomic considerations and potential complications.

Closing out our Techniques articles, Hannah I. Chaudry, MD, and J. Dawn Abbott, MD, introduce us to dual lumen catheters and when and how to use them.

Any discussion of the year 2020 will likely begin and end with the impact of the global COVID-19 pandemic. Nearly halting all nonemergent medical services (including cardiovascular) beginning in March and extending for months in certain geographies, cardiology production nearly halved. This was the major story stemming from MedAxiom’s 2021 Cardiovascular Provider Compensation & Production Survey report and is the subject of our Today’s Practice article by Joel Sauer, MBA.

We close our issue by interviewing Simon R. Redwood, MD, who shares his thoughts on public reporting and outcomes data, insight on the ACTIVATION and ARREST trials, areas of growth in percutaneous mitral valve interventions, keys to a successful live case, and more.

We hope that you find this issue of Cardiac Interventions Today to be of value to your practice and teams.

Azeem Latib, MD
Chief Medical Editor

Antonio Mangieri, MD
Guest Chief Medical Editor