SAN FRANCISCO The 2013 edition of Transcatheter Cardiovascular Therapeutics is underway, and the weather in the City by the Bay is remarkably clear, but one thing is not clear regarding transcatheter aortic valve replacements; how their manufacturers will grown their geographic markets in the near term. David Cohen, MD, of the Mid America Heart Institute (Kansas City, Missouri), told attendees that where TAVR is concerned, "the economic issues are paramount," and that at least some research clearly indicates that the technology is as yet too costly for most societies, even many of those in the West.