Author + information
- David J. Moliterno, MD, FACC, Editor-in-Chief, JACC: Cardiovascular Interventions∗ ()
- ↵∗Address for correspondence:
Dr. David J. Moliterno, Department of Internal Medicine, University of Kentucky, 900 S. Limestone Avenue, 329 Wethington Building, Lexington, Kentucky 40536-0200.
There was a time when cardiologists kept print copies of journals for years or even decades. Some fancied having their journals bound like those in the medical library, and the gold-letter-engraved covers could be seen in the background of headshot photos or behind them during office-based video interviews. I remember as a fellow and later as a young faculty member having shelves filled with journals (unbound ones in my case since it was rather costly to get them bound). They provided a treasure-trove of information and a bit of comfort knowing they contained the results of many scientific investigations and practice guidelines, and that they were always an arm's-reach away. Every few years I would purge the collection because the bookshelves would reach maximum capacity and the piles on the floor would become a make-shift obstacle course. Throwing away the older journal issues was like parting with good friends or important heirlooms. One of the problems with print journals in the pre-Internet era was finding an article in a prior issue. If I wanted to find a paper I recollected reading a short time ago, it seems I would usually find it (after a lot of looking) in an issue from many months or years ago—the challenge of judging time when life runs at high speed. Not uncommonly, like a kid with attention deficit-hyperactivity disorder, I would come across other good articles during my page-flipping search, get distracted, and end up rereading those articles—sometimes never finding the initially sought-after paper. I guess that was part of the fun of having older issues on the shelf.
A saving grace would come at the end of a journal volume or at the end of the year when publishers would produce an index. Some journals would also publish special issues once a year, and these too were viewed as a key resource and prized until the next year’s specialty issue was published. For example, I can remember when JACC would publish the information about cardiology fellowship programs in the United States. If one aspired to become a cardiologist and wanted to learn details about available training programs, such as the number of fellows accepted, the affiliated hospitals, and to find the name and addresses of the program director, that annual issue was priceless!
Fast forward to the present and consider the very extensive research and published reports being generated in cardiovascular medicine. Where there once might have been a focus issue on interventional cardiology, now there are many periodicals dedicated to the topic. So, too, JACC: Cardiovascular Interventions commonly divides new research papers and corresponding editorials into the dedicated categories of coronary, structural, and peripheral interventions. And each of these categories can contain an array of subject areas. We are fortunate that the journal has a strong inflow of high-quality papers, such that from time to time we will aggregate papers with common themes such as chronic total occlusions, or bifurcation lesions, or end-stage renal disease. Likewise, the inflow of papers about structural heart disease interventions is now brisk enough that we may have a section that focuses exclusively on patients with atrial appendage occlusions, or mitral valve interventions, or specific procedures for pediatric patients. Our goal is to include enough variety to interest all readers, yet present the papers in such a focused way as to create synergy among them when possible. The general impression or feedback we have received is that the readership has enjoyed having an occasional focus issue or focused area.
In this issue of JACC: Cardiovascular Interventions, we put together several papers in the structural intervention category that have a common theme and hence the “aortic valve focus.” In the first paper, Möllmann et al. (1) present the 30-day outcomes from the Portico transcatheter aortic valve line-up. This novel system contains a reshapable valve that can be retrieved into the delivery sheath and redeployed in a new position if needed. In roughly one-third of 220 cases, the operator repositioned the valve, and all attempts to retrieve and relocate the valve were successful. Three-fourths of patients had at least 1 functional class level improvement, and serious adverse events were reasonably low. The following paper by Stundl et al. (2) reports that among 756 consecutive patients undergoing transcatheter aortic valve replacement, the majority had biomarker evidence of periprocedural myocardial injury, and this injury (15× upper rate limit high-sensitivity troponin I or 5× creatine kinase-myocardial band) was related to the valve type, but fortunately was not associated with 30-day or 1-year mortality. In the third paper, Auffret et al. (3) considered 3,527 transcatheter aortic valve replacement patients and found that nearly 1 in 10 had right bundle branch block on their baseline electrocardiogram, and this was associated with a short-term need for permanent pacemaker implantation and a relatively higher long-term mortality. In the last paper of the focus area, Mooney et al. (4) reviewed patient-prosthesis mismatch from the PARTNER II (Placement of Aortic Transcatheter Valves) trial according to computed tomography–defined criteria versus transthoracic echocardiograph (TTE)-defined criteria. They found that as compared with conventional TTE-defined severe mismatch, that computed tomography–based severe mismatch occurred with lower frequency. With neither methodology did severe patient-prosthesis mismatch predict 1-year mortality, though TTE-based severe mismatch was associated with lack of left ventricular mass regression.
This focused section is a nice example of aggregating specific papers. I find it interesting that even with a seemingly narrow focus, these papers evidence the depth and breadth of our field. The papers cover many aspects of cardiology—anatomy and the mechanics of a new valve system, laboratory science and procedure-related evidence of myocardial injury, electrophysiology and the impact of underlying conduction system abnormalities, and hybrid imaging modalities to assess valve prosthesis effective orifice area relative to body surface area. And each of these studies is bound by a unifying theme, patient outcomes. So in an era when we are regularly reminded in health care delivery that we should focus on value, there are good reasons to see there is value in focus.
- 2017 American College of Cardiology Foundation
- Möllmann H.,
- Linke A.,
- Holzhey D.M.,
- et al.
- Stundl A.,
- Schulte R.,
- Lucht H.,
- et al.
- Auffret V.,
- Webb J.G.,
- Eltchaninoff H.,
- et al.
- Mooney J.,
- Sellers S.L.,
- Blanke P.,
- et al.