The journey of transcatheter therapy for structural heart disease has been one of disruptive innovation and remarkable success. The velocity of advancement has been unprecedented. Structural heart intervention has redefined cardiovascular care and engendered the “heart team,” a team that now includes a broad cross-section of medical and surgical caregivers. Despite these remarkable achievements, many challenges and opportunities remain. Valve replacement and repair for tricuspid and mitral valve disease is far from solved; nonvalvular interventional therapies for congestive heart failure are in their early stages; and the transcatheter tools and management of stroke prevention have not been fully defined. Other challenges are not addressed by simply better technology and therapy and include issues of training pathways, reimbursement, best practices, and access to and disparities in care. This lecture will not only review the challenges ahead and current successes, but it will look forward to the boundless potential for transcatheter solutions to transform patient care and outcomes. This journey has been exciting, and it is far from over.
James B. Hermiller, MD, MSCAI
James B. Hermiller, MD, MSCAI, is an interventional cardiologist, researcher, and teacher. He is a graduate of the Ohio State University College of Medicine and completed his cardiology training at Duke University. Dr. Hermiller serves as director of the Interventional Cardiology Fellowship and the Structural Heart Program at St. Vincent Ascension Heart Center in Indianapolis, IN, and is an assistant clinical professor of medicine at Duke University. His expertise in structural heart disease includes transcatheter valve replacement, mitral and tricuspid repair, left atrial appendage, paravalvular leak, and atrial septal defect (ASD)/patent foramen ovale (PFO) closure. He has been an author, leading enroller, primary investigator, and steering committee member in many transcatheter therapy studies, including several pivotal trials of structural heart disease. He was recognized as a Master Interventional Cardiologist by SCAI. Dr. Hermiller was chair or co-chair of the SCAI scientific meetings from 2009 through 2013. His current SCAI committee service includes chairman of the Structural Heart Disease Council, co-chairman of the Industry Relations Committee, and member of the Board of Trustees.