Despite the recent downturn in the national economy, Ireland's medical device community is on the verge of a major growth spurt. A lot of the credit goes to strong government support, particularly in the form of Enterprise Ireland, which serves as a major investor in medtech start-ups. Even with such support, Ireland's medtech start-up community faces many of the challenges that any start-up community faces. But the sector has high hopes and great ambitions. The second of a two-part series.

Over the last three decades, Ireland has built a robust medical device community serving large multi-national device companies, built on favorable tax policies and a strong manufacturing and engineering base. But now Ireland is trying to incubate a robust start-up community as well, focused on R&D and innovation, hoping to create the next Medtroniic or Covidien rather than simply serving the current ones.

While there is no question that heart valve repair and replacement is moving toward minimally invasive techniques and devices, there is a big difference between a minimally invasive surgical approach and a truly percutaneous, incisionless procedure. The challenges of reaching the latter goal are substantial, but apparently not insurmountable., In fact, recent progress in this field provides hope that in the not too distant future, percutaneous valve replacement and repair will become an accepted part of the treatment armamentarium, greatly expanding the number of patients who can be offered these potentially life-saving procedures.