The growth of structural heart disease interventions and their prominence in the field of interventional cardiology is but one example of the technological advances dividing our speciality. In this issue of the journal, there are three meta-analyses of the most pressing question about aortic stenosis management. What should be done for low-surgical-risk patients? One meta-analysis looks at three studies, one at four, and one at five. But unlike the blind men feeling the elephant and coming up with three different opinions of what it is, these three papers come to the same conclusion: transcatheter aortic valve replacement (TAVR) is a reasonable treatment for aortic stenosis even in low-surgical-risk patients. For prospective authors, I think reading all three will be helpful to judge the methodology used and to examine the strengths and weaknesses of each. There is no question that structural heart disease interventions are on the rise with papers on these subjects flooding into editorial offices of all the journals. The remarkable success of TAVR for aortic stenosis and the hope for success in other types of structural heart disease has been disruptive for interventional cardiology. Not only the technology, but the expertise to operate it and the training required, is resulting in fragmentation of the speciality.