Frazier Healthcare Ventures has never been one to faddishly follow the flow of money in or out of medical device investing, maintaining its commitment to invest in this space. Indeed, the firm recently shifted its focus to concentrate on more early-stage medical device deals, a strategy that appears to be paying off.

Not many healthcare product executives have resumes that can boast of having run both drug and device businesses the way Ron Mstricaria did at Eli Lilly. Not content with his success at Lilly, Matricaria took early retirement to embark on the challenge of directing St. Jude Medical's transition from a successful single-product firm to a major, multi-platform device company. At both companies, Matricaria endured tough times and critics questioning his strategies, but was ultimately vindicated through the success of each company. Matricaria is the recipient of this year's Phoenix Lifetime Achievement award and spoke with IN VIVO about his career and the current state of the medical device industry.

Despite studies that show that patient in earlier stages of mitral regurgitation experience better rates of mortality and long term survival following valve repair surgeries, clinicians reserve the invasive procedures for the more seriously ill congestive heart failure patients.

Innovative device companies have always had to contend with the Sword of Damocles of unexpected technological obsolescence, but for would-be developers of interventional devices for the prevention of restenosis, the sword is dangling perilously close. In the RAVEL trial, a 238-patient clinical trial on a drug eluting stent, treated patients experienced 0% restenosis compared to 26% in the control group. Now, device developers with alternatives to stents reposition themselves to sustain businesses in the face of potentially shrinking target markets. Many argue that they will serve certain applications better than stents; others hope to work with drug-coated stents to enhance performance, many believe that economics will leave room for alternative approaches, and still others are getting out of the coronary business entirely.