To ablate or operate? that is the question!

In this modern era of management of various cardiovascular disorders, surgical therapy has virtually always preceded the development of percutaneous techniques. This has been the case with myocardial revascularization (aortocoronary bypass surgery vs. angioplasty), procedures for mitral stenosis (surgical commissurotomy vs. balloon valvuloplasty) as well as for the management of certain congenital heart defects such as patent ductus arteriosus or atrial septal defect (surgical closure vs. percutaneous device closure). In each instance, surgery has proven the value of these procedures; subsequently, the percutaneous techniques have attempted to match the surgical results. With all of these techniques, there is obviously a learning curve involved in both the surgical and interventional procedures.