TY - CHAP M1 - Book, Section TI - Valvular and Ischemic Heart Disease A1 - Accola, Kevin D. A1 - Burnett, Clay M. A2 - Cohn, Lawrence H. A2 - Adams, David H. PY - 2017 T2 - Cardiac Surgery in the Adult, 5e AB - Recently, there have been exciting developments involving new technologies for the surgical treatment of valvular heart disease associated with coronary artery disease (CAD). Interventional therapies for coronary artery obstruction have been extended to multivessel disease with hybrid procedures (targeted percutaneous interventions staged with limited access surgical coronary bypass surgery) and continues to change the number and nature of patients referred for surgery.1 Similarly, the surgical treatment of structural valvular heart disease has continued to expand with advances in techniques for repair, as well as total valve replacement and valve-sparing repair options for both aortic and mitral valve abnormalities.2 Most recently, bioprosthetic valve manufacturing advances in regard to calcium mitigation, tissue processing, and hemodynamically superior prosthetic valve stent designs have improved prosthetic valve durability, thereby broadening the valve replacement options for young and old alike.3 The advent of transcatheter valve replacement (TAVR procedures) has also quickly become a commercial reality and has proven to be safe and efficacious in numerous studies. The stunning early success of the TAVR approach has allowed this remarkable new option to become commonplace in many institutions in hospitals around the world.4 Most importantly, perhaps, is that transcatheter valvular interventions have provided very high-risk patients, such as the elderly or those with a myriad of threatening comorbidities, a viable new option to consider. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/29 UR - accesssurgery.mhmedical.com/content.aspx?aid=1144166046 ER -