Peripheral vs Structural Training

[Myostatin]

For those who are recently out of fellowship or finishing up fellowship and looking for jobs, any thoughts on what is more valuable - training in periperhal interventions including EVAR/TEVAR, carotids, etc., or structral training i.e. TAVR.

I've always planned on doing valves but I don't see any jobs specifically for structurally trained interventionalists, while there seem to be many jobs for those with peripheral skills.

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[Benton]

I was in your shoes a year ago. I decided to do an addition year of peripheral interventions as opposed to structural training. I felt that I would have more job options and locations available to me with peripheral training. For now structural is in its beginnings and there are somewhat more restrictions on where you could go to practice. It takes a lot of more infrastructure (i.e. hybrid lab, heart team etc.) to be doing complex structural heart disease interventions. I can do virtually any peripheral intervention except TEVAR and EVAR by myself in any standard cath lab. At my institution, I do work together with surgery for EVAR/TEVAR. I also think there is substantially more peripheral vascular disease out there than there is structural heart disease that can be treated with catheter based intervention right now. As technology improves I am sure structural training will be more and more ubiquitous in the community and you will see many more jobs wanting this training. Just my 2 cents.