My Picks for Fellows Attending TCT 2017

TCT 2017 kicks off this weekend in a new location: Denver, CO. A platform for the global interventional cardiology community, the conference brings together practitioners with different levels of experience and varying opinions. It also serves as a great opportunity for exchanging techniques and idea, debating data, and disseminating cutting-edge science. I vividly remember my 2016 TCT experience in Washington, DC, where I saw the EXCEL, NOBLE, and ILUMIEN III trials presented and learned about the initial patient experience with transcaval TAVR and the balloon lithotripsy technique for calcified vessels. I’ll also forever be able to say I saw firsthand some of the field’s stalwarts debate interventional topics clad in costume in the middle of a boxing ring, some reciting poetry!

If you’ve taken a look at this year’s TCT agenda, you know that it is jam-packed. Trying to decide which sessions to attend can be mind-boggling for new attendees and fellows, especially since lots of events occur simultaneously. To help, I’ve highlighted a few agenda items that I’ll definitely be making an effort to check out.

1.  Headline-Making Research: The PIs for several major trials are preparing to present their results next week during Late-Breaking Clinical Trial (LBCT) sessions each day in the Main Arena. If you’ve never attended a session like this—with a seemingly endless sea of attendees crowded into one of the largest auditoriums you’ve ever seen—I highly recommend going. In particular, go to the opening LBCT session on Monday, October 30, 2017, at 11 AM; it includes the randomized CULPRIT-SHOCK trial of multivessel PCI in cardiogenic shock patients and DKCRUSH-V, which randomized patients with distal left main bifurcation lesions to either double kissing crush or provisional stenting. Both of these studies will have immense implications for interventional cardiologists as they challenge current standards of practice. If you want to head back to the Main Arena later in the week, I’d recommend checking out both the DAPT STEMI presentation on Wednesday, November 1, 2017, comparing 6- versus 12-month DAPT after STEMI and the sham-controlled ORBITA trial of PCI on Thursday, November 2, 2017. The latter has already generated lot of interest on Twitter since the whole field will likely be adversely impacted if it does not show a significant decrease in symptoms for stable angina—the main reason for PCI in this population.

2.  BVS Updates: Last year was a bad one for bioresorbable scaffolds (BRS), with first-generation devices being pulled off cath-lab shelves due to high rates of stent thrombosis and MACE. But the main rationale for using BRS originally was that their stent struts dissolved by 2-3 years, which is when their benefit over traditional DES would supposedly start to become apparent. During the First Report Investigations session on Tuesday, October 31, 2017, at 12 PM in the Main Arena, the 4-year data from ABSORB II will finally be presented and I am looking forward to learning if the Absorb BVS (Abbott Vascular) cohort had any decrease in MACE after 3 years. That could breathe new life into BRS research. Three-year ABSORB III data as well as 30-day outcomes from ABSORB IV will also be presented during Tuesday’s LBCT session beginning at 11 AM in the Main Arena. These trials have incorporated the newer “PSP” strategy along with rigorous vessel selection criteria and in the near future will help us determine if results are now noninferior to DES.

3.  Go International: Since this meeting draws experts from literally all over the world, it’s a good idea to take advantage and learn from these people in person. There are several interesting sessions taking place Sunday, October 29, 2017, in association with international interventional societies. One that I’m intrigued by is the “Evolution in CTO Recanalization” session at 2 PM in Room 705/707 with several Japanese experts, as I think they have led this field for a long time. For structurally inclined fellows, there is partnership session with Bangla Interventional Therapeutics (BIT), also in Room 705/707, at 5 PM that will break down the components of complex interventions including TAVR and LAA closure.

4.  Learn at Lunch: There are a whopping 15 “Learn the Technique” lunch sessions on Monday at noon, and reading through the list each one looks more interesting than the next. The one I’ll probably end up at is called “Interventional ‘Rich Emotional Experiences’ (AKA Complications)” in Room 605. Learning about complications that others have dealt with is one of the most practical things you can do as a fellow, as you could never make all the possible mistakes in interventional cardiology yourself. The case presentations in this session include complications related to both femoral and radial access, TAVR, and TMVR. If I could be in two places at once, I’d probably also check out the lunch session on venous interventions in Room 603 that highlights an area in which most fellows are not trained.

5.  Bring on the Sharks: The TCT meeting introduced a unique component a few years ago by hosting a Shark Tank-style competition for healthcare tech startups. The half-day session taking place Tuesday morning is chock full of entries chosen for addressing an area of unmet clinical need. All of the presenters have already filed preliminary patent applications and submitted preclinical or early human clinical data. I’d recommend stepping into the Four Seasons Ballroom 4 any time between 8 AM and noon to view at least a few of these presentations, as they provide a vision for the future. You will also observe how new ideas are conceived and best pitched to an expert panel, so you can learn how to evaluate new business ideas when they come to you.

Outside of attending sessions, I’d highly recommend taking the time to network both with your peers and your superiors. A good place to do the former would be at the fellows reception on Monday evening at 6:30 PM outside of Room 708/710. There will likely be tasty snacks and beverages, and you can meet Fellows Forum editor Yael Maxwell who will also be filming on-camera interviews for the site. So make sure to dress sharply! For more on what the TCT organizers recommend for fellows, click here.

Lastly, if you’re a social media addict like me, check out the Hot Topic Lunch session on Wednesday, November 1, 2017, in Room 501. You’ll get to hear tips and tricks directly from some of the most engaged cardiologists and thought-makers on Twitter. Of course, you’re also not going to want to miss the special evening with Tom Hanks on Monday at 8:15 PM in the Main Arena. To me, Hanks is one of the most interesting actors of all time and I’m looking forward to hearing him speak in person.

If you do get time after your busy days, be sure to check out the sights and sounds of Denver. I hear it’s a vibrant city with great restaurants, museums, and not so far away hiking trails to be explored.