In this expert discussion from 'Nail It With Nadira: The Next Chapter in AV Replacement', the faculty looking beyond the headlines to unpack the nuance of contemporary trial results and their implications for valve durability. 🔗 ow.ly/lBKJ50ZRwIw Hear Dr Nadira Hamid, Dr John Forrest, Prof Giuseppe Tarantini and Dr Tsuyoshi Kaneko explore the evidence shaping contemporary AVR practice – the full webinar is now available on demand. This webinar is supported by an unrestricted educational grant from Edwards Lifesciences. #StructuralHeart #TAVR #AorticStenosis #InterventionalCardiology #Cardiology

In this case-based presentation, Dr Firas Zahr demonstrates how real-time 3D intracardiac echocardiography (ICE) supports transcatheter tricuspid valve replacement (TTVR) with the EVOQUE valve. During this stage of the procedure, Dr Firas Zahr and the imaging team use 3D ICE to assess leaflet position, optimise device orientation and confirm the trajectory for leaflet capture. The clip highlights the importance of precise anatomical visualisation, including assessment of the septal leaflet, anterior–septal orientation and device positioning before final deployment. By using multiplanar imaging and targeted adjustments, the team evaluates leaflet interaction and confirms an optimal position for valve expansion. A practical example of how advanced imaging can support accurate device positioning during complex tricuspid interventions. #TTVR #TricuspidRegurgitation #StructuralHeart #ICE #EVOQUE #InterventionalCardiology

Prof Ole De Backer explores how cardiac CT can support assessment in low-flow, low-gradient aortic stenosis, alongside earlier intervention and more efficient patient pathways. 🔗 Watch the full interview for key learnings from ESC 2026: ow.ly/E5t250ZRsEb This symposium is supported by Medtronic. #TAVI #CardiacImaging #StructuralHeart

In Nail It With Nadira: The Next Wave of Tricuspid Valve Replacement, Dr Firas Zahr discusses the evolution of the Intrepid transcatheter tricuspid valve replacement (TTVR) system and the lessons learned throughout its development. Dr Firas Zahr explains how the early experience with Intrepid began with the first-generation transfemoral mitral platform, including the use of a large delivery system with multidirectional steering and a deployment strategy adapted from mitral intervention. He highlights how the same core principles and procedural techniques have been applied to tricuspid valve replacement, including single-stage deployment from atrial to ventricular position. The discussion provides insight into how early feasibility experience has shaped the ongoing evolution of TTVR technology and procedural approaches. A practical look at the engineering and clinical journey behind next-generation tricuspid valve replacement. #TTVR #TricuspidRegurgitation #StructuralHeart #HeartTeam #InterventionalCardiology

In this clip, Dr Matthew Sherwood highlights the importance of recognising and referring patients with mitral regurgitation earlier in their disease course. Dr Matthew Sherwood discusses a case where the patient was referred with moderate-to-severe MR, rather than at a later stage with advanced disease or end-stage cardiomyopathy. He emphasises the value of collaboration between heart failure specialists and interventional cardiologists to improve referral pathways and identify patients before clinical deterioration occurs. Earlier evaluation can provide an opportunity to optimise guideline-directed medical therapy, assess intervention options and support more informed patient management. A practical perspective on how multidisciplinary collaboration can help close the gap in MR care. #MitralRegurgitation #TEER #HeartFailure #StructuralHeart #InterventionalCardiology #Cardiology

In The Future of TAVR: 3-Year SMART Trial Results, Prof Howard Herrmann discusses three-year outcomes from the SMART Trial, including differences in bioprosthetic valve dysfunction between TAVR platforms. Prof Howard Herrmann highlights that disabling stroke or heart failure rehospitalisation outcomes were similar between platforms at three years. He then reviews the composite bioprosthetic valve dysfunction endpoint, incorporating haemodynamic and non-structural valve dysfunction, thrombosis, endocarditis and aortic valve reintervention. Using a definition based on European guideline criteria, the analysis showed differences between Evolut and SAPIEN in this composite endpoint. A closer look at how longer-term outcomes are helping inform discussions around valve performance and lifetime TAVR strategies. #TAVR #TAVI #StructuralHeart #AorticStenosis #ValveReplacement #InterventionalCardiology

In this clip, Dr Matthew Sherwood reviews real-world outcomes from the EXPAND G4 study, evaluating contemporary MitraClip G4 technologies in patients with mitral regurgitation. The prospective, multicentre, single-arm study included more than 1,100 patients across multiple regions and assessed outcomes including mortality, heart failure hospitalisation and procedural complications. Dr Matthew Sherwood highlights that even among patients with complex anatomies or those outside traditional anatomical criteria, MitraClip G4 was associated with substantial MR reduction, with more than 90% of patients achieving MR ≤1+ at follow-up. He also discusses the low rates of major complications at one year, including mitral valve surgery, single leaflet device attachment and leaflet damage. A practical review of contemporary real-world evidence supporting the safety and effectiveness of TEER in clinical practice. #MitralRegurgitation #TEER #MitraClip #HeartFailure #StructuralHeart #InterventionalCardiology

In Collaborative Management of HF Patients with MR: Bridging Evidence and Practice, Dr Matthew Sherwood discusses the growing burden of significant mitral regurgitation and the need for closer collaboration across heart failure and interventional teams. Dr Matthew Sherwood highlights that moderate-to-severe valvular disease becomes increasingly common with age, with mitral regurgitation representing a major contributor to the burden of valve disease in older populations. Despite the prevalence of significant MR, many patients who may benefit from intervention remain untreated. He emphasises the importance of earlier recognition, referral and multidisciplinary decision-making to help address this treatment gap. A collaborative approach between heart failure specialists and interventional cardiologists can support timely assessment and identify patients who may benefit from transcatheter edge-to-edge repair (TEER). #MitralRegurgitation #TEER #HeartFailure #StructuralHeart #InterventionalCardiology #Cardiology

In this clip, Dr David Meier discusses the progressive nature of bioprosthetic valve thrombosis and how early leaflet changes may evolve over time. Dr David Meier presents an example of a SAPIEN valve in a valve-in-valve position with elevated gradients caused by leaflet thrombosis. Histological assessment demonstrates the difference between freely moving leaflets and those affected by thrombus formation. He highlights how early leaflet thrombosis is often characterised by acute fibrin-rich thrombus, which may respond to anticoagulation or resolve spontaneously. However, over time, thrombus can become organised with fibrotic transformation, reducing the likelihood of response to anticoagulation. Understanding this progression is essential when assessing bioprosthetic valve dysfunction and planning appropriate management strategies. A practical insight into the importance of recognising the timing and nature of leaflet thrombosis in lifetime valve care. #TAVI #TAVR #StructuralHeart #ValveInValve #BioprostheticValve #InterventionalCardiology

In this clip, Prof Andrew Cook explores how previous surgical valve design and implantation position can influence future transcatheter interventions. Prof Andrew Cook reviews a Hancock II surgical bioprosthetic valve and highlights key anatomical considerations, including its supra-annular position and the relationship between the prosthetic frame and surrounding conduction tissue. Although this valve remains functioning well and does not require intervention, the case demonstrates why understanding the original surgical valve design is essential when planning lifetime valve management. The interaction between prosthetic valves, the aortic root anatomy and the conduction system remains an important consideration when evaluating future TAVI strategies. A practical insight into how early valve decisions can shape future treatment options. #TAVI #TAVR #StructuralHeart #ValveInValve #HeartTeam #InterventionalCardiology

In this clip, Dr Douglas Wright discusses how detailed echocardiographic assessment supports anatomical evaluation and procedural planning for transcatheter edge-to-edge repair. Dr Douglas Wright highlights the importance of optimising transoesophageal echocardiography (TEE) views to improve visualisation of the tricuspid valve, using different imaging planes to assess leaflet anatomy, coaptation and regurgitant jets. He demonstrates how adjusting the imaging perspective can help reduce interference from surrounding structures and provide clearer assessment of the tricuspid valve, including the relationship between leaflets and adjacent devices or anatomical features. The session emphasises the value of complementary imaging views, including biplane and long-axis assessment, to support accurate procedural planning and decision-making in tricuspid TEER. A practical approach to using advanced echocardiography for anatomy-driven tricuspid intervention. #TEER #TricuspidRegurgitation #StructuralHeart #Echocardiography #InterventionalCardiology #Cardiology

In The Future of TAVR: 3-Year SMART Trial Results, Dr Sanjay Mehrotra discusses the challenges of managing patients with small aortic annuli and the importance of evaluating post-procedural haemodynamics. Dr Sanjay Mehrotra highlights a key clinical decision point following valve-in-valve TAVR: when elevated gradients remain after implantation, should bioprosthetic valve fracture be considered? He discusses the importance of weighing potential haemodynamic benefits against the risk of additional procedural injury, particularly when an acceptable result has already been achieved without fracture. The case also highlights the importance of final procedural assessment, including femoral access evaluation, where achieving a good outcome with smaller access requirements remains an important consideration. A practical discussion on individualised decision-making in small annulus TAVR. #TAVR #TAVI #StructuralHeart #AorticStenosis #InterventionalCardiology #Cardiology

In this clip, Dr Zarina Sharalaya discusses the complex balance between thrombotic and bleeding risks in patients undergoing transcatheter aortic valve replacement. Dr Zarina Sharalaya highlights that the TAVR population often presents with multiple factors contributing to both thrombosis and bleeding risk. Advanced age, atrial fibrillation, chronic kidney disease and frailty can increase thrombotic risk, while factors such as gastrointestinal bleeding risk and intracranial haemorrhage risk complicate decisions around anticoagulation. She emphasises that many of the same clinical characteristics that increase thrombotic risk can also increase bleeding risk, making treatment decisions challenging. A personalised approach remains essential, with careful consideration of which patients are most likely to benefit from anticoagulation and which may be exposed to unnecessary harm. #TAVR #TAVI #StructuralHeart #Anticoagulation #InterventionalCardiology #Cardiology

The future of catheter-based PE intervention Prof Andrew Sharp reviews emerging pulmonary embolism trials, including STRIKE PE, PEERLESS I and II, and PERSEVERE, exploring how new evidence may shape thrombectomy and catheter-based treatment strategies. #PulmonaryEmbolism #PEManagement #InterventionalCardiology

Prof Francesco Saia, Prof Giuseppe Tarantini and Prof Tanja Rudolph highlight key takeaways across the discussion 👉 ow.ly/AOmx50ZlA3f Key messages include: • Redo TAVI is not a repeat procedure but a forward-looking strategy requiring planning from the index implant to enable safe future intervention • CT-based assessment is central for accurate sizing, positioning and preserving coronary access and redo feasibility • Across SAPIEN valve sizes and mechanisms of failure, invasive gradients remain consistently low, reinforcing procedural performance in redo TAVI #StructuralHeart #TAVI #AorticStenosis #RedoTAVI #InterventionalCardiology

Accessing Efficiency and Ergonomic Benefits of AI-Assisted Echocardiography. Join leading experts to explore the evidence behind AI-assisted acquisition and its impact on workflow efficiency, exam duration and sonographer well-being. 📅 17 September | 6pm EDT 👉 Reserve your seat: transcatheteracademy.com/web… This webinar is supported by Siemens Healthineers #Echocardiography #CardiacImaging #AIinHealthcare

Prof Erik Klok reviews the first large randomised trial comparing EKOS plus anticoagulation with anticoagulation alone in intermediate-high-risk PE. The trial showed reduced early PE-related complications, with no significant difference in major bleeding or intracranial haemorrhage. #PulmonaryEmbolism #PEManagement #InterventionalCardiology

Tricuspid imaging for intervention Dr Mehdi Eskandari discusses how modified TTE views and multimodality imaging support tricuspid valve assessment and procedural planning. #TricuspidTEER #TricuspidRegurgitation #StructuralHeart #Echocardiography

Tricuspid annular anatomy and TEER planning Prof Andrew Cook discusses how regional differences in annular support influence tricuspid valve dilatation and remodelling, shaping procedural strategy. #TricuspidTEER #TricuspidRegurgitation #StructuralHeart #InterventionalCardiology

🔴 Just 48 hours remain until 'Valve for Life: Anatomical, Procedural and Device Considerations for Future Re-Intervention'. Secure your place 🔗 ow.ly/72hz50ZvRrK Join co-chairs Prof Rafal Dworakowski and Prof Tony Walton alongside Prof Andrew Cook, Dr Stephanie Sellers, Prof Kent So and Dr Karl Poon. Hear expert perspectives, explore real-world considerations and submit your questions to the panel live! Don't miss practical insights into how initial valve selection influences durability, coronary access and future procedural options. 👋 See you there! #StructuralHeart #TAVI #ValveInValve #InterventionalCardiology #Cardiology