Gregg W. Stone, MD, co-director of the division of medical research and education at the Cardiovascular Research Foundation and a professor at Columbia University College of Physicians and Surgeons, both in New York City, discussed the upcoming Transcatheter Cardiovascular Therapeutics (TCT) conference with Cardiovascular Business. Now in its 25th year, the event is scheduled to take place Oct. 27-Nov. 1 in San Francisco.

Here is part one of a two-part Q&A.

What decisions made 25 years ago led to where the TCT is now?

Twenty-five years ago it was never envisioned that TCT would evolve as it has. It was envisioned at that time as a relatively small boutique meeting to discuss the implementation of new device angioplasty, beyond balloon angioplasty.

At the first TCT, stents were mentioned as an afterthought. The excitement was about atherectomy and laser and hot balloons and other areas.

Over the years, TCT has evolved into a meeting that is not only about the future but about the present; not only the United States but the world. It is about how to practice, make treatment decisions to decide who is appropriate for revascularization procedures and where the gaps are in our abilities to take care of patients, where the clinical needs are.

At the same time, of course, it emphasizes innovation and new device development. The whole field has [grown] simultaneously with the evolution of TCT to address not only coronary intervention but endovascular intervention, including carotid intervention, and now the explosive growth of structural heart disease intervention.

The field, where we educate, the integral nature of live case transmissions in the TCT format, the number of sessions, the late-breaking trials [and] the original research as reflected in abstracts [have all evolved.] The meeting is 99.5 percent different from what it was 25 years ago.

What lesson did you learn from the last TCT that you are applying to this year’s program?

There is one major change that came out of last year’s TCT that will be in direct evidence this year. It became more and more clear to us that people who attend meetings for the most part are passive recipients of information. They sit in chairs while a group of lecturers or a podium of people in roundtable discussions describe concepts.

There is limited time for discussion and many people are shy about going up to the microphone and having a discussion. Many of the rooms are large and don’t lend themselves to having a discussion. We have been struggling for years with how to increase audience participation to make them feel they are an active part of the meeting.

With this in mind, our major initiative this year is TCT Goes Tablet. We will provide a free tablet computer to all [paid] attendees of the meeting. Not only will that replace all of the paper in the meeting but all of the major sessions—even moderate-size sessions—will have a new chat room environment. When people are sitting in the session they will have their tablet computer open and they will enter a chat room. There will be a virtual conversation ongoing with all the people in the audience with a digital monitor about the topic, the specific lectures, the live cases being viewed, etc.

If you were watching a live case, this could range from questions [such as], ‘Why did he or she choose that device or do that? That is not what I would have done.’ Or if a speaker gives a certain opinion someone might say, ‘I don’t agree and this is why.’ There can be a healthy conversation ongoing about some controversial topics by people who would not normally engage in conversation.

We are hoping this really redefines the conference experience by having everybody much more engaged and having an active discussion and interaction.

Stay tuned for part two, which will focus on the late-breaking clinical trials and other aspects of the program.