The field of interventional cardiology began in the late 1970s and consisted primarily of balloon catheter angio plasty until the early 1990s. Although understanding of the process of coronary angioplasty has evolved signifi cantly, restenosis still remains the Achilles' heel of the interventional cardiologist. This article reviews the cur rent issues involved in interventional cardiology for coronary disease from patient selection, anticoagulant therapy, restenosis, current interventional devices (stent mania), and future devices (intracoronary radiation). Noncoronary interventional procedures, vaivuloplasty, and atrial septal defect closure are also reviewed to provide an overview of cardiac interventional proce dures for the anesthesiologist.