EuroPCR 2016: Mitral Innovations, LAA Closure, and ‘TAVI, TAVI, TAVI’

PARIS, France—EuroPCR kicks off Tuesday here with a range of “hotline” trials, live cases, debates, innovation sessions, and a beefed up selection of oral abstracts including the rapid-fire “PCR’s Got Talent” sessions that pit trainees against one another in a sudden-death knockout format that sees only select abstracts move forward to the next round.

According to EuroPCR Course Director William Wijns, MD, PhD (Cardiovascular Center Aalst, Belgium), the major late breakers designated as “immediately clinically relevant” are grouped in Tuesday’s hotline session, immediately following the opening ceremony and inaugural live case. These include an ACS substudy from the LEADERS FREE  trial; a comparison of IVUS and optical frequency domain imaging in PCI; global registry findings from a study of full transcatheter mitral valve replacement; a durability study of TAVR out to 10 years; and registry data from Europe looking at 3-month outcomes following left atrial appendage closure.

Other late-breaking abstracts, however, are dotted throughout the program. An entire Tuesday afternoon session is devoted to bioresorbable stents, while a concurrent session offers new data on various renal and peripheral interventions, including updates on renal denervation. Mid-afternoon on Tuesday, a separate group of late-breaking abstracts focused on advances in ACS tackles everything from bioresorbable stents and polymers to effective platelet inhibition strategies. A simultaneous session looks at new data from transcatheter aortic valve replacement (TAVR) registries, including an update from the international valve-in-valve registry for degenerative surgical aortic valves. Indeed, said Wijns, the sheer number of abstract submissions related to transcatheter aortic valve implantation suggests that interventionalists are increasingly excited about what he called “TAVI, TAVI, TAVI.”

Wednesday highlights include a hotline session with studies addressing the use of direct thrombin inhibitors and protection devices to reduce cerebral emboli during TAVR.

On Thursday, an important hotline session highlighted by Wijns deals with fractional flow reserve and instantaneous wave-free ratio in the setting of coronary artery disease, including new data from the DEFINE-REAL and FAVOR studies.

Debate, Discuss, Digest

This 2016 program includes a full 920 abstracts. Trying something new this year, program directors gave researchers the chance to specify whether they wanted to present their data in an oral format, as a poster, or as part of the “PCR’s Got Talent” session. The latter gives presenters just 3 minutes to pitch their studies—without the benefit of slides—and receive feedback on their delivery, with only a minority moving through to the next round in which they’re given just 5 minutes. Of this second round, only eight abstracts out of more than 120 at the outset are selected to move through to the final round, held on Friday. The intent of the PCR’s Got Talent session is to help junior trainees improve their speaking skills, but to the amusement of Wijns and his fellow reviewers, several more senior academics submitted their abstracts in this category (although opted to be reassigned after the format was explained).

The “great debate” at this year’s meeting—the topic not only of a dedicated session Tuesday but also supported by additional talks and a live case—tackles the use of TAVR in low-risk patients. For this, said Wijns, the program chairs invited three cardiovascular surgeons and three interventional cardiologists to debate the topic. “The surgeons are extremely, extremely cautious, to put it politely,” Wijns said, “and the cardiologists are very much pushing in the opposite direction.”

New this year, the Main Arena will be 100% live-case sessions, although three additional theatres will also have live feeds. Live cases at EuroPCR are being broadcast from 12 centers in Europe, Asia, and the Middle East and have been the focus of a multi-year initiative known as ViTAL-Live, aimed at improving the educational quality of the broadcasts by having all operators adhere to a standardized set of principles. “We hope it will translate into added value for the participants,” both the operators themselves and the audience in the auditorium, Wijns said.

While there is no formal lietmotif to EuroPCR this year, Wijns described what he believes to be the underlying theme of the meeting—namely the need to marry evidence with daily practice. The overarching aim of the congress, said Wijns, is to help physicians match theoretical knowledge, guidelines, and clinical trial data to an individual patient in any given situation. Most of the time, he continued, “there is no one-size-fits-all solution.” While EuroPCR has always been known for highlighting innovation and new tips and tricks, the shift has increasingly been towards creating space for reflection and discussion about a single patient’s problems and “trying to pull together everything we know to decide what is best for that patient,” Wijns said.

TCTMD reporters Caitlin Cox, Michael O’Riordan, Yael Maxwell, and myself are in Paris for EuroPCR 2016.

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