Page 39 - Journal of Structural Heart Disease - Volume 1 Issue 1

Commentary
Journal of Structural Heart Disease, May 2015, Volume 1, Issue 1: 33-35
DOI: http://dx.doi.org/10.12945/j.jshd.2015.00102-14
Received: April 11, 2015 Accepted: April 12, 2015 Published online: May 2015
Of Becoming a Structural Heart Disease Expert: Another Giant Leap?
Carlos E. Ruiz, MD, PhD, FACC, FESC, MSCAI*, Itzhak Kronzon, MD, Chad Kliger, MD Lenox Hill Hospital, Department of Cardiology, New York, New York, USA
Abstract
Over the last 10 years, Structural Heart Disease (SHD) has emerged as a distinct sub-specialty of interven- tional cardiology. However, to date there are no formal training guidelines or training programs. We believe as the population ages, over the next few years, this sub specialty will continue to mature and guidelines for training will become established.
Copyright © 2015 Science International Corp.
Key Words
Structural heart disease • Coronary angioplasty • Training in SHD
In July of 1969, how many children watched Neil Armstrong and Buzz Aldrin land the Apollo 11 on the surface of the moon, and take the first steps on its sur- face? Many of us remember Armstrong and more or less Aldrin; however, does anyone remember who kept the spaceship in orbit? Well, the pilot’s name was Mi- chael Collins and he was an Italian born American [1].
At that time, everyone was dreaming of becoming an astronaut. These were supermen: tough, smart, brave and dedicated professionals who operated the most complex, most advanced technology and equip- ment to fly to space and land on the moon. They had the satisfaction and the glory of being pioneers and discoverers. They were our heroes. They had earned the admiration of everyone, doing what nobody could have done before them. Their “one small step for man”...became a “one giant leap for mankind”...
Does this remind you of what is happening today
with Structural Heart Disease (SHD)? Cardiologists are very curious individuals, and I guess, this quality is in- herent in our profession. When Andreas Grüentzig first opened the door to what is now called interventional cardiology by performing and describing percuta- neous coronary angioplasty (PTCA), a large number of cardiology trainees wanted to become “interven- tionalists” [2]. Over the past 30 years, this sub-special- ty has matured, and there are now concise training requirements [3]. Nonetheless within the nearly last 10 years, the evolution of coronary interventions has reached a plateau. Conversely, the so-called Structur- al Heart Disease (SHD) interventions have emerged as the new kid on the block.
The name SHD is now reserved to those acquired or congenital cardiovascular pathologies that involve the major central cardiovascular structures outside the scope of acquired atherosclerotic coronary and peripheral vessels pathologies [4-5]. The origins of the SHD interventions initially arose within the pe- diatric cardiology arena. It started by creating atrial septal defects in newborns with transposition of the great arteries [6], followed by balloon valvuloplasty [7] of the pulmonic valves. It was later extended to the adult population with percutaneous balloon aortic as well as mitral valvuloplasties. From the late 1980’s to the early 2000’s, a handful of interventional pediatric cardiologists and few adult coronary interventionists performed these SHD interventions. With the advent of transcatheter valve replacement, the field has been revolutionized in a very dramatic way, generat- ing interest by both coronary interventionalists and
* Corresponding Author:
Carlos E. Ruiz MD, PhD, FACC, FESC, MSCAI
Structural and Congenital Heart Disease Program
Lenox Hill Hospital
188 E 78th Street – 8 Floor, New York, New York 10075, USA Tel. +1 212 434-2606, E-Mail: cruizmd@gmail.com
Fax +1 203 785 3346
E-Mail: jshd@scienceinternational.org http://structuralheartdisease.org/
© 2015 Journal of Structural Heart Disease Published by Science International Corp. ISSN 2326-4004
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http://structuralheartdisease.org/