Tinkering with the Ticker
This article was originally published in Start Up
Established heart valve companies are putting out second and third generation devices, while start-ups are developing novel technologies to overcome the drawbacks associated with mechanical and tissue valves. The replacement valve market is essentially flat; future growth will come from macro factors such as an aging population or improving economies in third world countries, but companies continue to improve products to retain or capture market share from each other. Meanwhile, start-ups see a new market opening up for percutaneous technologies. Such technologies promise to offer a solution for patients who aren't candidates for surgery. Early intervention could also delay the need for valve replacement procedures. While new heart valves aren't readily adopted by conservative surgeons that already have a host of options that are proven to be safe, interventional cardiologists are eager for the new procedures that the percutaneous technologies promise.
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According to "European Markets for Heart Valve Repair and Replacement Products," Medtech Insight's recent report, in the coming years growth in the heart valve industry will be somewhat flat in Europe-with a compound annual growth rate in the overall number of procedures of 1.6% between now and 2013. However, that number reflects a drop in the number of mechanical valves used, and a rise in tissue valves, which are enjoying increased uptake with each generation of technological improvements.
Health Research International has just issued a report, "US Opportunities in Heart Valve Disease Management." According to the report, the market for valve replacement and repair products will grow from more than $500 million in 2004 to some $900 million in 2010, with the greatest growth occurring in percutaneous valve products.
In heart valves, the advent of new, less invasive procedures promises the usual advantages over open surgery and more; lower cost, reduced procedural morbidity, faster healing times, and also, a new kind of intermediate treatment option that could serve new patient groups. Most companies are still in development; two companies have begun clinical trials in a handful of patients. But despite the early stage of the field, it's incited a great deal of controversy, particularly afer heart surgery company Edwards Lifesciences acquired the leading percutaneous valve company for what many view as a surprisingly large chunk of money. Central to the debate is the continuing (and uncertain) role of cardiovascular surgeons, the heart valve experts, once the referring cardiologists get their hands on their own procedure.