An ACC highlight & why it matters

Here is what I am looking forward to at the American College of Cardiology’s confab next weekend—besides warm weather and sunshine.

It is hard to believe that we are at the five-year mark for the PARTNER trial. The use of transcatheter aortic valve replacement (TAVR) in the U.S., first in trials and now with FDA-approved valves from Edwards Lifesciences and Medtronic, has been a sizzler of a hot topic for years. This is not only because of the innovation of using this less invasive approach for treating inoperable and high-risk patients who have severe aortic stenosis.

TAVR has opened pathways for innovation in practice and surveillance as well. The heart team concept may not have originated with TAVR but it gained prominence with hospitals’ embrace of TAVR centers. Physicians and administrators have championed the benefits of having different subspecialists working together, not just in hybrid operating rooms but cath labs and other settings as well.

TAVR also inspired the birth of the TVT Registry, named for transcatheter valve therapy, which is proving to be a valuable resource for tracking TAVR outcomes. The American College of Cardiology and the Society of Thoracic Surgeons partnered on the database portion of the registry, and the FDA and Centers for Medicare & Medicaid Services collaborated on the program. Other societies and industry also had some say.  

Europe, which typically gets a step or two ahead of the U.S. in adopting new technologies, has made inroads with TAVR and lower risk patient populations as well as with other devices that soon could enter the U.S. market. Expect more on that at the scientific sessions, along with a late-breaking clinical trial session with two-year results from the CoreValve trial that enrolled high-risk patients.   

Back to PARTNER: To miss the session on the five-year results would be like attending a series of live performances by your favorite ensemble (Emerson, in my case) playing all of the Beethoven string quartets—only to be AWOL for the Grosse Fuge. There are so many long-term findings of interest: Are the valves durable? Do patients not only live but live well? Who might be better served without this therapy? After all, the therapy is expensive and the procedure is not without some risk.

That is only one of many presentations, displays and keynotes that will keep me inside a convention center in sunny Southern California. I know it will be worthwhile, though.

Candace Stuart

Editor, Cardiovascular Business