Preface

The first edition of this textbook was published 10 years ago because Alan Yeung and I recognized that the field of interventional cardiology had matured enough to warrant a comprehensive exploration of the discipline. I was serving as chair of the writing group for the American Board of Internal Medicine Interventional Cardiology board at the time and was aware that the questions that we were asking needed a text that could provide answers from experts who were generating those answers. Alan succeeded me as chair of the board test writing group, and the job has increased greatly because of the expansion of the discipline.

To collate much of the current knowledge pertinent to interventional cardiology, we now have enlisted two of our colleagues, Habib Samady and Bill Fearon, who have become leaders in the specialty, to join us in updating or, more appropriately, redoing Interventional Cardiology. Of course, no textbook can provide the latest trial results, and in the age of information technology, some even question the value of textbooks. As an editor of JACC: Cardiovascular Interventions, I have often said that review papers should be different from book chapters. This is true but should not denigrate book chapters. A book chapter on a targeted subject forces authors to concisely focus attention to what they perceive to be the pertinent knowledge base about that subject. That base of knowledge is necessary if results of new findings are to be correctly interpreted and their influence on practice properly evaluated. History teaches us that we must know what went on before if we are to understand the present. This is the purpose of this book: to provide the current base of knowledge that is necessary but not completely sufficient to become an expert in interventional cardiovascular medicine. To become and remain an expert requires not only the current knowledge but also the continued learning from new evidence. To that end, this book will be accompanied by periodic updates that will be available electronically. We believe that new evidence in isolation, without the background, may often be misleading.

The book is organized into nine sections with chapters geared to the current needs thoughtfully chosen by the chapter authors. Each chapter is followed by a set of questions that focus on the main points of the topic addressed by the chapter. These questions are not intended to replace courses specifically targeted to the objective of preparing for examinations. Nonetheless, we believe that this method of asking what we have learned from a discussion is a helpful tool. Growth in interventional cardiology training and practice is perhaps best reflected in the largest section of the book, which deals with interventional procedures. In this section, 29 chapters in the first edition have increased to 38 chapters with expanded coverage of radial approach, chronic total occlusion intervention methods, and structural heart disease interventions. New chapters on the MitraClip procedure and atrial appendage occlusion, and three chapters covering patient selection and procedural techniques for transcatheter aortic valve implantation headline all the amazing advances that have occurred in the treatment of structural heart disease. Likewise, important advances in peripheral vascular interventions are emphasized. More than other digestible sources, this book also provides concise explanations of evolving concepts in intravascular physiology and imaging that inform current practice and underlie research and development efforts in stenting and bioabsorbable scaffold technology, as well as evolving pharmacological approaches to control thrombosis, restenosis, and neoatherosclerosis. There are other expanded chapters on healthcare economics and methods for achieving innovation.

This book is intended for all who are being trained in the discipline of interventional cardiology as well as those who practice this specialty and have trouble remembering all the background that relates to the patient whom they are currently treating. (Certainly true for many of us.) The perspectives of the carefully selected authors of these chapters will frequently be of value in making current judgments. In addition, any physician who wants to know the astonishing possibilities of, as well as the limitations of, interventional cardiology will benefit by referring to this volume for guidance.