Image Gallery From the TCT 2019 Meeting

The is a comparison showing the before and after images using HeartFlow's new software tool called the HeartFlow Planner. It is a a noninvasive, real-time virtual modeling tool for coronary artery disease (CAD) intervention. It enables interventional cardiologists to virtually model clinical scenarios vessel-by-vessel, explore treatment strategies for patients with CAD before each procedure, review cases with colleagues and ensure everyone has a clear picture of the initial treatment plan. The user choses a vessel segment to open to the fullest extent of the native vessel lumen and it recalculates the FFR-CT values.

This is a realistic cath lab simulator training set up shown by Mentice. The patient has respiratory chest motion, eyes blink and it allows for radial or femoral catheterization. The simulator allows for PCI training. When not used for cath training, the patient simulator can be used by other hospital staff training or EMS training.

This was a really interesting a href="https://www.dicardiology.com/content/echopixel-introduces-3-d-holographic-intraoperative-software"> new technology shown by EchoPixel at TCT 2019 creates live holograms in the cath lab for procedural guidance. It takes live transesophageal echo (TEE) in the cath lab and projects the image as true 3-D holograms. The special display screen does not require the user to wear 3-D glasses. The interventional cardiologist can use hand movements and a foot switch to move the image around without breaking the sterile field. It allows the operator the ability to see catheters or devices being moved in real time in a 3-D format. The system is intuitive to use so anyone can learn it in a couple minutes. It was submitted for FDA review in September 2019.

The U.S. Food and Drug Administration (FDA) town hall meeting at the 2019 Transcatheter Cardiovascular Therapeutics (TCT) conference focused on the possible safety Issues with paclitaxel-eluting stents and balloons, and what should be included in future trials for new transcatheter valves.

Andrew Farb, M.D., from the FDA discusses ideas with a panel of experts during the town hall meeting at the TCT 2019.

GE Healthcare showed how it is using virtual reality to help customers visualize how a new cath lab buildout will look. It allows equipment to be moved around in a virtual environment to see how everything fits. The Dream Suite software can configure a room based on real measurements and will include equipment the hospital wants, such has the specific angiography system being considered, overhead booms or lights and displays, prep tables, supply cabinets, etc. The customer can wear a virtual reality head set to then see and interact with the room, with the ability to swivel booms and the C-arm around to see if it may collide with other equipment.

Use of virtual reality to show how optical coherence imaging (OCT) can help in coronary interventions at the Abbott booth.

This is the Abbott Perclose, ProGlide vascular closure device. It mentioned in sessions about vascular closure for large bore TAVR, EVAR and hemodynamic support devices for its ability to mimic a surgical suture. For large devices two of these devices can be used.

Abbott's Resting Full-cycle Ration (RFR) modality to measure hemodynamic FFR flow past coronary lesions to determine if they need to be stented. The newer RFR technology allows for pressure readings without the need for adenosine, which adds cost, procedure time and discomfort to the patient. The system uses a pressure wire with a wireless connection to the console to reduce the number of wires and catheters. The wire also can be left in place and used as a guide wire for devices. The console allows for use of both standard FFR or RFR. The screen shows the pressure wire pull back and where the drops in blood pressure occur so they can be correlated with the lesions seen on the angiography.

Abbott's Resting Full-cycle Ration (RFR) modality to measure hemodynamic FFR flow past coronary lesions to determine if they need to be stented. The newer RFR technology allows for pressure readings without the need for adenosine, which adds cost, procedure time and discomfort to the patient. The system uses a pressure wire with a wireless connection to the console to reduce the number of wires and catheters. The wire also can be left in place and used as a guide wire for devices. The console allows for use of both standard FFR or RFR. The screen shows the pressure wire pull back and where the drops in blood pressure occur so they can be correlated with the lesions seen on the angiography.

A 3-D printed heart from a patient CT scan used for structural heart procedure planning and education displayed by Materialise.

A 3-D printed heart valve from a patient CT scan used for structural heart procedure planning and education displayed by Materialise.

An overview of the main hallway and entrance into both the expo floor and the main arena at TCT 2019.

Right, Ajay Kirtane, MD, director of the cardiac cath lab, NewYork Presbyterian/Columbia Medical Center, took time to discuss the late-breaking EVOLVE Short DAPT Trial with DAIC Editor Dave Fornell. Watch the VIDEO: Early Discontinuation of DAPT in High Bleeding Risk Patients With the Synergy Stent.

A new type of EP electo-mapping catheter with multiple arms being developed by Biosense Webster and manufactured by the OEM company Quasar.

Electrophysiology ablation balloon catheter made my the OEM company Quasar for Biosense Webster. The irrigated balloon ablation catheter was one of the hottest technologies at the Heart Rhythm Society (HRS) meeting this year. Read more about the Heliostar Multi-electrode RF Balloon Ablation Catheter.

A new type of EP electo-mapping catheter with multiple arms being developed by Biosense Webster and manufactured by the OEM company Quasar.

An interesting feature on some newer angiography systems is a CPR button, which can be used during an emergency to immedately lower the table toward the floor to make it easier for staff to perform CPR on the patient if they go into cardiac arrest. This is on the new Siemens Artis Icono angiography system.

Chad Kliger, M.D., Lenox Hill Heart and Vascular Institute, performs a transcatheter left atrial appendage (LAA) occlusion on a simulator in the Siemens booth. He said performing simulations in the cath lab environment can help make things more realistic.

Sunil Rao, MD, chief of cardiology, Durham VA Health System, and Professor at Duke Univerity, met with DAIC Editor Dave Fornell at TCT 2019 today to discuss the latest trends in radial access. He said radial adoption is now about 47 percent or higher for PCI.

The Golden Gate Bridge at sunset during TCT 2019.

Gregg W. Stone, M.D., explains what will be needed included in any future FDA trials for bioresorbable stents. They spoke in a session on bioresorbable stents. He is the co-director of medical research and education at the Cardiovascular Research Foundation (CRF) and professor of medicine at the Icahn School of Medicine at Mount Sinai. Despite the Abbott Absorb are being taken off the market because of poorer outcomes than standard metallic drug eluting stents (DES), a lot of interest remains. The main issue with Absorb was its very thick struts, compared to much thinner DES struts. Newer generation bioresorbable stents in development by several companies offer much thinner struts.

The HeartFlow FFR-CT booth at TCT 2019.

Right, John Carroll, M.D., director of interventional cardiology, Univerity of Colorado, met with DAIC Editor Dave Fornell between sessions at TCT 2019 this week. Carroll is one of the experts on structural heart at the conference. Here is an interview with Carroll about his program VIDEO: Overview of University of Colorado Structural Heart Program.

An example of Philips' vascular roadmapping technology, which fuses a CT or a rotational angiography 3-D coronbary tree model to live fluoro to help guide wires and devices without the need to use more contrast.

A new X-ray radiation protection system for the cath lab that uses movable lead drapes and windows to see the patient. It was being displayed by Imaging Diagnostics Inc. and it was discussed in sessions concerning how to lower staff dose in the cath lab.

A new X-ray radiation protection system for the cath lab that uses movable lead drapes and windows to see the patient. It was being displayed by Imaging Diagnostics Inc. and it was discussed in sessions concerning how to lower staff dose in the cath lab.

This is the Biotel remote telemetry cardiac monitor. The simple adhesive patch sticks to the patient's chest and the patient carries a cell phone device that relays the data in real-time. An algorithm monitors the data and issues alerts to physicians if measures fall outside set parameters. The monitor was featured in a University of Colorado study presented at TCT where it was used to remotely monitor TAVR patients who did not have a pacemaker. The monitor shown here has been worn for several days, including in several showers.

The new MitraClip G4 transcatheter mitral leaflet clipping system to treat mitral regurgitation. The new clip allows each gripper to be engaged independently and it has a larger size not previously available. Abbott was demonstrating the system on the expo floor at TCT.

The new MitraClip G4 transcatheter mitral leaflet clipping system to treat mitral regurgitation. The new clip allows each gripper to be engaged independently and it has a larger size not previously available. Abbott was demonstrating the system on the expo floor at TCT.

This is an example of the Medis QFR system that offers an FFR blood flow measure in the coronary vessels based on angiography imaging alone. The FDA-cleared product uses two angiography images with contrast, shot from different angles are used to create a 3-D model of the vessel segment and calculate FFR flow past a lesion. The model also can help plan for stenting.

This is an example of the Medis QFR system that offers an FFR blood flow measure in the coronary vessels based on angiography imaging alone. The FDA-cleared product uses two angiography images with contrast, shot from different angles are used to create a 3-D model of the vessel segment and calculate FFR flow past a lesion. The model also can help plan for stenting.

American Heart Association (AHA) President Robert Harrington, M.D., interventional cardiologist and chairman of the Department of Medicine at Stanford University, explains the reasons for shorter duration dual-antiplatelet therapy (DAPT) in high-risk bleeding patients when using newer generation stents. Watch an interview with him at TCT 2019.

Lissa Sugeng, M.D., associate professor of medicine, director of echocardiography, Yale School of Medicine, and DAIC Editor Dave Fornell. She was a panelist at a session of Women In Structural Heart (WISH) evening session at TCT 2019. Watch a VIDEO interview with her of 3-D echo.

DAIC Editor Dave Fornell and Ashish Pershad, M.D., chief of interventional cardiology, Banner University Medical Center, Phoenix. Pershad explains the trend of using closure devices to seal larger vascular access sites from the use of TAVR, EVAR, TMVR and hemodynamic support devices in the VIDEO: Use of Large Bore Vascular Closure.

The new MitraClip G4 transcatheter mitral leaflet clipping system to treat mitral regurgitation. The new clip allows each gripper to be engaged independently and it has a larger size not previously available. Abbott was demonstrating the system on the expo floor at TCT.

Example of a laser cut stent on display by OEM manufacturer Norman Noble at TCT 2019. Numerous OEM companies display at TCT to discuss making devices for both established vendors and new start ups. #TCT19 #TCT2019

Philippe Genereux, M.D., (left) co-director of the structural heart program at the Gagnon Cardiovascular Institute at Morristown Medical Center, part of Atlantic Health System, with DAIC Editor Dave Fornell at TCT 2019. Among the sessions Genereux was involved in was how to close large bore access sites. Here is a VIDEO interview with him on that topic.

A live case presentation in the main arena at TCT 2019.

The Cardiovascular Research Foundation (CRF) heart at TCT 2019.

A virtual reality game at Medtronic's booth where users can virtually dissect a heart implanted with a CoreValve TAVR valve.

The TCT 2019 training pavilion had several classrooms where vendors had hands-on training with guidewires, hemodynamic support and TEE procedure guidance.

The new Siemens Artis Icono angiography system offers an imaging algorithm to automatically adjust to optimize radiation dose and image quality. It has a smaller footprint that most floor mounted systems and has an option to preset the display setup for each operator so they can press one button to have the system configure everything and save about 90 seconds for room set up. Doctors also can interface their iPads if they have specific advanced visualization software or apps they want to use on the lab.

The new Siemens Artis Icono angiography system offers an imaging algorithm to automatically adjust to optimize radiation dose and image quality. It has a smaller footprint that most floor mounted systems and has an option to preset the display setup for each operator so they can press one button to have the system configure everything and save about 90 seconds for room set up. Doctors also can interface their iPads if they have specific advanced visualization software or apps they want to use on the lab.

The new Siemens Artis Icono angiography system offers an imaging algorithm to automatically adjust to optimize radiation dose and image quality. It has a smaller footprint that most floor mounted systems and has an option to preset the display setup for each operator so they can press one button to have the system configure everything and save about 90 seconds for room set up. Doctors also can interface their iPads if they have specific advanced visualization software or apps they want to use on the lab.

One button press from a menu will swing the C-arm of the new Siemens Artis Icono angiography system into the proper position for standard angiographic views.

The TCTMD TV studio in operation with cardiologists Ajay Kirtane and Michael Gibson doing an interview on one of the late breaking trials Kirtane presented.

A motion activated, talking robot to help draw people into one of the booths on the expo floor.

Abbott's OCT intravascular imaging system on display at TCT19.

This is a realistic cath lab simulator training set up shown by Mentice. The patient has respiratory chest motion, eyes blink and it allows for radial or femoral catheterization. The simulator allows for PCI training. When not used for cath training, the patient simulator can be used by other hospital staff training or EMS training.

This is a realistic cath lab simulator training set up shown by Mentice. The patient has respiratory chest motion, eyes blink and it allows for radial or femoral catheterization. The simulator allows for PCI training. When not used for cath training, the patient simulator can be used by other hospital staff training or EMS training.

This is a realistic cath lab simulator training set up shown by Mentice. The patient has respiratory chest motion, eyes blink and it allows for radial or femoral catheterization. The simulator allows for PCI training. When not used for cath training, the patient simulator can be used by other hospital staff training or EMS training.

Roxana Mehran, M.D., professor Of medicine at Mt. Sinai, New York, commenting during a press conference on the late-breaking trials for short DAPT in patients at high-risk for bleeding. She presented data on the Platinum Diversity Trial that looked at short DAPT and the use of the Promus Element stent in minorities and women, and the the late-breaking TWILIGHT trial, which looked at Ticagrelor monotherapy used in high risk bleeding patients following PCI.

The beach at Fisherman's Wharf in San Francisco.