Dave Fornell, DAIC Editor

Dave Fornell, editor of DAIC Magazine

Blog | Dave Fornell, DAIC Editor | September 26, 2014

Trends and New Data at TCT 2014

By Dave Fornell, editor of DAIC Magazine

The key take away messages from the 26th annual Transcatheter Cardiovascular Therapeutics (TCT) scientific symposium were bioresorable stents and transcatheter valve technologies will likely become primary interventional tools in the near future. These two areas were among the hottest topics of discussion in sessions, live case presentations, late-breaking trials and on the expo floor. The latest trial data for both technologies presented at TCT continue to show extremely positive trends in patient outcomes that are equal or better than current standards of therapy. 

Key news on bioresorbable stents at the meeting came from the ABSORB II Trial, which compared the Abbott Absorb BVS drug-eluting bioresorbable stent to the company's market-leading Xience metalic drug-eluting stent. At one year the clinical outcomes were the same, but the bioresorbable stent patients reported a significantly lower incidence of angina. This opens up an entirely new avenue of research into these devices and their potential benefits. This inspired changes in the upcoming ABSORB IV trial to examine angina outcomes specifically. Watch a video discussing these findings and the future of bioresorbable stents. 

There were several trial presentations of transcatheter aortic valve replacement (TAVR), including long-term outcomes and economic impact of using these devices (see news items below). One of the key issues with TAVR has been stroke rates higher than surgical valve replacements, and three start-up companies showed cerebral embolic protection devices at TCT. The biggest news in this area was from a trial involving the Claret device, which resulted in a lower stroke rate. Here is an article overview of the TAVR embolic protection devices in development

I attended one packed, standing-room-only session on transcatheter mitral valve replacement devices in development. This is definitely the next technology area to watch, as I suspect this will become the next major technology highlighted at future ACC and TCT meetings.

I highlighted the details of two technologies that may offer paradigm shifts in interventional cardiology in the next couple years in a video about intravascular imaging to detect vulnerable plaque, and a video about CT-FFR.

There were many cutting-edge technologies highlighted at TCT. I offer a roundup of these in my video "DAIC Editor's Choice of the Most Innovative New Technologies at TCT 2014."

 

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Raj Makkar, M.D., led a multicenter national study comparing outcomes for minimally invasive heart valve replacement to open-heart surgery. Photo by Cedars-Sinai. TAVR performs as well as surgery for aortic valve replacement.

Raj Makkar, M.D., led a multicenter national study comparing outcomes for minimally invasive TAVR heart valve replacement to open-heart surgery. The study showed the two methods have similar outcomes. Photo by Cedars-Sinai.

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Abbott Tendyne TMVR, TMVI system received European CE mark clearance in January 2020. The Abbott Tendyne transcatheter mitral valve replacement (TMVR) system uses an anchor attached to the apex of the heart with a whether line attached to the valve. This helps to keep the valve anchored in the mitral annulus and prevent embolization. This anchor system was used because, unlike the aortic valve, the mitral valve has a very thin landing zone to secure the valve. Prevents LVOT obstruction.

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This is the latest version of the MitraClip, the G4, which allows each side of the clip to be opened and closed independently to offer more flexibility when capturing the valve leaflets. The device is being used in the REPAIR MR clinical trial.

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The Wyss Translational Center in Zurich, Switzerland has developed the LifeMatrix platform to engineer tissues that can be implanted in patients and will grow with them. This technology is being developed for heart valves in younger patients to eliminate the need for repeat surgeries to implant larger prosthetic heart valves as the patient grows.

The Wyss Translational Center in Zurich, Switzerland has developed the LifeMatrix platform to engineer tissues that can be implanted in patients and will grow with them. This technology is being developed for heart valves in younger patients to eliminate the need for repeat surgeries to implant larger prosthetic heart valves as the patient grows.

 

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A sample of the transcatheter mitral valve replacement (TMVR) devices in development or clinical trials.

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 Retired National Football League (NFL) star Ed White, the former Chargers guard and four-time Pro Bowler, waited until the FDA approved TAVR for low-risk patients like himself to avoid open-heart surgery.

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