TVS meets EuroPCR. (2007)

The origins of interventional cardiology are mostly credited to incomparable geniuses such as Charles Dotter and Melvin Judkins1, who introduced the concept of transluminal angioplasty in 1964, but actually it never took off until another genius innovator, Andreas Gruentzig, developed the basis for the current balloon angioplasty technology2. What perhaps we do not remember as often is that true interventional cardiology started far before this angioplasty concept – or for that matter, even the Rashkind balloon atrial septostomy3 – when Drs. Rubio and Limon-Lason in Mexico did the first balloon pulmonary valvuloplasty using a urethral catheter over a wire4. Again, it took Semb and associates twenty-five year to resurrect the concept of “balloon valvotomy”5 and nearly three years more for Jean Kan6 to actually begin the current era on transcatheter interventions for valvular heart disease. Indeed this new orientation in the management of valvular heart disease has helped to develop the logical next-step, transcatheter valve implantation, pioneered independently by two great innovators, Henning R Andersen7 with a stented biological valve, and Dusan Pavcnik8 with an all-mechanical valve in 1992. Bonhoeffer9, working on the same concept eight years later, brought it to fruition by doing the first-inman implantation in the pulmonary position. Cribier10 implanted the first transcatheter aortic valve in man two years later. On a warm and sunny afternoon on April 5th, 2003, sipping a “Ristretto” espresso at a hotel terrace in Milan, Philipp and I were talking about the success of Mario Carminati’s 4th International Workshop on Interventional Pediatric Cardiology that had just finished. Suddenly we both realised that given the exponential growth of technology and the advancements in this field, transcatheter valve interventions were going to be the next explosive interventional arena – Phillip had just presented the largest experience in percutaneous valve implantation in humans and I had presented the new idea of a remodelable biological tissue valve proof-of-concept11. Furthermore, it was obvious to us that the length of time between the invention of devices, proof-of-concept and its mass use by the population was diminishing and, therefore there could be a certain unfocussed or repetitive pervasiveness about this growth, unless a truly collaborative effort from all participants in the field, work and learn from each other. Thus, what better way to accomplish this goal than organising a very comprehensive conference about transcatheter valve technology which would include: basic scientists such as cell biologists; biomaterials specialists; mathematicians; physicists and computer scientists; of course – clinicians and valvular surgeons; imaging specialists; and finally, regulatory experts. The concept for the Transcatheter Valve Symposium (TVS) was born, but not at first without a large dose of scepticism on how we could expect to have a successful meeting over two full days just talking about transcatheter valve technologies; and what was worse, not allowing industry to have exhibits, and asking them for their – unrewarded – financial support. Well, the key to the TVS success was the tremendous enthusiasm vested not only by both of us, but by our strongest supporters and partners, Sir Magdi Yacoub and Carlos Duran, great innovators, superb valvular surgeons, unsurpassed connoisseurs of cardiac valves and great personal friends. In addition, we also had incredibly altruistic support from well established industry as well as small start-up companies that believed in our mission. From the very first TVS, we also were fortunate to count on the support and guidance from another pioneer and personal friend of ours, Patrick Serruys, with an incredible vision interventional cardiology’s future. At that point we were not aware we were dealing with a technology which would later be recognised as “disruptive”. It is in the nature of such technology that, it is misunderstood at the outset and the impact is profoundly underestimated. Every single aspect of valve technology as used by surgeons was put into question with