The rapid and widespread adoption of transcatheter valve technology has overshadowed progress in other areas of management of patients with valvular heart disease.

Imagine a hospital system with a 50% utilization rate for an effective therapy for a deadly cancer, and among those patients not treated, only one-third were referred to an oncologist for evaluation; or, imagine in the cardiovascular arena, only 50% of patients presenting with an ST-segment elevation myocardial infarction receiving treatment with percutaneous coronary intervention.

Hypertrophic cardiomyopathy (HCM) is a disorder in which derangements in cardiomyocyte architecture result in asymmetric left ventricular hypertrophy, myocardial fibrosis, and ultimately heart failure and sudden cardiac death.

In the 1980s, inpatient mortality among patients with acute myocardial infarction (MI) was >10%, which enabled mortality to be used as a practical, solitary endpoint for clinical trials. With the introduction of prompt reperfusion approaches over the next decade, mortality declined.

Patients with advanced chronic kidney disease (CKD) arguably represent one of the highest risk populations in contemporary ambulatory practice.