Transcatheter Advances in the Treatment of Adult and Congenital Valvular Heart Disease.

Transcatheter valve therapies represent the newest frontier in interventional cardiology. At present, transcatheter aortic valve replacement and mitral valve edge-to-edge repair are currently approved by the US FDA in appropriately selected patients. These transcatheter therapies are typically employed in patients of advanced age with comorbid conditions. However, many younger adults with congenital heart disease are of comparable surgical risk due to multiple previous open heart surgeries. An array of percutaneous options currently exists for either temporizing or treating such patients (e.g., balloon septostomy, valvuloplasty, coiling of patent ductus arteriosus), but evidence-based treatment options for degenerative valve disease in this population are currently lacking. The most significant advance in this area to date has been the development and validation of transcatheter pulmonic valve implantation. Similarly, catheter-based approaches for the treatment of other valve lesions in patients with congenital valve disease are gaining interest, based in large part on promising evidence from studies of patients with acquired adult valvular heart disease.