It is important that trainees be experienced not only in caring for patients with coronary artery disease, but also in the evaluation and treatment of intrinsic valvular disease. Cardiac valvuloplasty is an important, relatively infrequently performed procedure—but not a core technique. Valvuloplasty is rarely emergent and thus should be regionalized. Not all interventional cardiologists need master it, and accordingly, not all interventional cardiology training programs need offer training in it. However, an interventional cardiologist must understand the hemodynamics and pathophysiology of valvular disease as well as the efficacy of, and the selection criteria for, cardiac valvuloplasty procedures. In order to provide this experience, a program should perform diagnostic catheterizations on at least 100 patients per year with intrinsic valvular heart disease.