International Circulation: Some doctors are talking about the trend that treatment of patients with CHD by angioplasty is decreasing due to the better care provided by statins and drug eluting stents， while treatment of valvular heart diseases in the cath lab is increasing. Do you think it is a real life scenario? What’s you opinion about this change in interventional cardiology? 

Gerhard Schuler:   I can go along with the notion that the treatment rate of structural heart disease is increasing definitely.  More valves are being implanted and other valve disorders like mitral valve insufficiency will be treated more with interventional treatment.  We will see more use of the occlusion devices for the left atrial appendage.  We will close ASDs， PFOs， and ventricular septal defects interventionally.  There are a number of treatment options for structural heart disease and this number of interventions will increase in the future.  I do not foresee a decrease in PCI because the decrease in the incidence of coronary artery disease will be counteracted by the development and rise of diabetes and by the increase of age of these patients.  In our experience in Germany PCI is not on the decrease.