PHOTO GALLERY: Interventional cardiology technologies at TCT 2023

Virtual reality (VR) cath lab training demo in the Medtronic booth at TCT 2023. VR and augmented reality (AR) technology for training or as a cath lab procedural guidance tool was shown in at least five vendor booths on the expo floor.

CathWorks demonstration of its FFR-Angio vessel assessment technology fused with fluoroscopy to help interventional cardiologists in determining if a stent is needed and if so, provides information for the stent diameter and length. The technology works using a rotational angiography spin of the C-arm around the patient to create a 3D coronary segment that is color coded by FFR flow. This is then translated into the data fused with the image here.

Elena Amin, MBChB, a pediatric cardiologist with UCSF Health, shows off the HeartPoint Global IntelliStent to treat congenital pulmonary artery hypertension (PAH). The device won the TCT 2023 Shark Tank innovation competition. Read more in the article New pediatric interventional device for PAH wins ‘Shark Tank’ event at TCT 2023.

Martin Leon, MD, presents the PARTNER 3 low-risk transcatheter aortic valve replacement (TAVR) 5-year results, which was the most impactful late-breaking trial at TCT 2023. It was standing room only at this and the following presentation of the Evolut Low-Risk TAVR 4-year results. Both trials showed TAVR is low-surgical risk patients performed as well as surgical aortic replacement (SAVR), and in some data points TAVR was better than SAVR. These trials may pave the way for TAVR as a front-line procedure in most older patients in the years to come. Read more.

The coronary theater at TCT 2023.

A coronary computed tomography angiography (CCTA) hands-on training session for interventional cardiologists to learn how to create curved planar views and analyze soft plaques. The GE Healthcare session at TCT 2023 was designed to give interventional cardiologists a better understanding of how to use cardiac CT, since its use is rapidly rising and the image datasets have a lot of value for preplanning PCI procedures.

A closeup view of the JenaValve Trilogy transcatheter aortic valve replacement (TAVR) valve designed specifically to treat aortic regurgitation in non-stenotic valves. This device was discussed in the positive late-breaking trial ALIGN-AR at TCT 2023. The currently cleared TAVR valves are all designed for use in calcified native valves as a stable anchoring point. But in valves without heavy calcium, a TAVR valve needs to be anchored to the soft tissue to prevent embolization. The Trilogy has three nitinol clips that grasp the native leaflets during deployment to secure the device to the valve annulus. There was a lot of excitement about this new device at TCT, which will allow AR patients to be treated without open heart surgery. Read more.

View of a MitraClip after capture of both mitral valve leaflets using the HD Live surgical view imaging feature on the GE Vivid e95 echocardiography system. Read more on advances in structural heart echo imaging.

Biventricular Impella hemodynamic support using an Impella RP and an Impella. Demonstration model in the Abiomed booth at TCT 2023.

GE Healthcare's newest angiography system, the Allia IGS, on display at TCT 2023. Its laser-guided, free-rolling gantry can be parked out of the way and does not require any floor or ceiling mounting. It includes integrations with the wireless Vscan Air POCUS ultrasound for use in vascular access and 3D Stent imaging reconstruction from rotational angiography, and allows the operator to change overhead screen layouts using table side controls.

Transcatheter tricuspid valve planning on CT scans using the 3mensio CAAS software at TCT 2023. The software allows placement of different sized valve shapes to determine sizing and how it will sit within the anatomy. The software also has planning tool for where to place TEE probes to get optimal imaging.

Medis QFR FFR-angio vessel assessment technology showing a 3D coronary segment that is color coded by FFR flow. This can help interventional cardiologists in determining if a stent is needed. The technology works using a rotational angiography spin of the C-arm around the patient and does not require FFR pressure wires.

Sahil Parikh, MD, of Columbia, one of the co-directors for the 2023 TCT meeting, presents at the TCT Shark Tank competition during TCT 2023. Parikh is an expert in peripheral interventions, including critical limb ischemia, renal stenting, carotid stenting, and  treatment of pulmonary embolism. All of these areas are growing areas of interest at TCT.

A large crowd watches the Shark Tank innovation competition on day one at TCT 2023. 

Elena Amin, MBChB, a pediatric cardiologist with UCSF Health, presented her case for why the HeartPoint Global IntelliStent to treat pulmonary artery hypertension (PAH) is a unique device and can fill a void in therapies for congenital heart disease. The device won the TCT 2023 Shark Tank innovation competition. Read more in the article New pediatric interventional device for PAH wins ‘Shark Tank’ event at TCT 2023.

TCT 2023 Shark Tank cardiology innovation competition presentation showing whether the audience would invest in the technology being presented. 

Paul Sorajja, MD, of Minneapolis Heart, speaking at a TCT 2023 Shark Tank presentation for the xDot large-bore vascular closure device.

Attendees waiting to get into a TCT 2023 session on hemodynamics. There were several packed sessions during the first day's innovation forum, where some attendees had to wait until people left before they were allowed to enter the room because it was so packed. 

A view of San Francisco from the TCT 2023 classrooms at the top of the Moscone Center.

The Medtronic CoreValve Evolut TAVR device in the Medtronic booth at TCT 2023.

Two different sizes of the Medtronic Evolut TAVR system at TCT 2023.

Aortic stenosis from a 3D print of a patient's CT showing valve calcium in the Medtronic booth at TCT 2023.

David Adams, MD, a cardiac surgeon with Mt. Sinai, speaks at a late-breaking clinical trial press conference on the results of the TRILLUMINATE trial at TCT 2023. Hear more about this trial.

Martin Leon, MD, presenting the PARTNER 3 Low-Risk TAVR 5-year results, which was the most impactful late-breaking trial at TCT 2023. The main stage area was packed with a standing room only crowd.

Martin Leon, MD, presents the PARTNER 3 low-risk transcatheter aortic valve replacement (TAVR) 5-year results, which was the most impactful late-breaking trial at TCT 2023. 

Jason Rogers presents the late-breaking SUMMIT trial for the Abbott Tendyne transcatheter mitral valve replacement (TMVR) during a press conference at TCT 2023. The trial showed positive results.

Rebecca Hahn, MD, presents the PARTNER 3 low-risk transcatheter aortic valve replacement (TAVR) trial 5-year echocardiography results during a press conference at TCT 2023. This was the second part of the what turned out to be the most impactful late-breaking trial at TCT 2023. Read more.

The MitralClip G4 transcatheter edge-to-edge repair (TEER) system in the Abbott booth at TCT 2023. The G4 has the ability to open and close one clip arm at a time, making it easier to capture the mitral valve leaflets. 

The Amulet left atrial appendage (LAA) occluder from Abbott. The self-expanding nitinol device has two lobes and small spikes to secure the device and promote a better seal of the LAA.

Optical coherence tomography (OCT) intravascular imaging showing stent struts are well apposed to the vessel wall after stent expansion to avoid complications from malapposition. The system's artificial intelligence (AI) locates and highlights the stent struts in each frame. Shown in Abbott booth at TCT 2023. 

The FDA town hall theater, where regulatory issues were discussed at TCT 2023.

Zoll's super-saturated oxygen (SSO2) therapy display at TCT 2023. Approved by the FDA in 2019, the technology offers a 26% reduction in infarct size in STEMI patients in trials. The console shown here uses a high pressure hyperbaric chamber operating at 625 PSI to created liquid oxygen droplets that are infused into saline and then is mixed with arterial blood. The content of O2 is 7-10 times the amount of normal oxygen levels and helps cardiac tissues survive and recover from a heart attack and aids in microvascular recovery.

The Navitor transcatheter aortic valve replacement (TAVR) device in the Abbott booth. This is the third TAVR valve currently on the market, cleared by the FDA in January 2023. Read more.

Navitor transcatheter aortic valve replacement (TAVR) device in the Abbott booth. This is the third TAVR valve currently on the market, cleared by the FDA in January 2023. Read more.

Perclose Prostyle vascular closure devices used for demonstrations in the Abbott booth.

Abbott CSI Diamondback 360 athetectomy system diamond tipped bur on display at TCT 2023. The device is used to grind away calcified lesions in the coronary arteries as it rotates.

Abbott Xience stent crimped on balloon before expansion on display.

Abbott Xience coronary stent after balloon expansion.

Michael Reardon, MD, Houston Methodist Hospital, wore his late-breaking clinical trial tie for his presentation of the late-breaking Evolut Low-Risk TAVR trial 4-year data at TCT 2023. He said he always wears his lucky tie when presenting late-breakers at conferences. The results he presented were positive for Medtronic, makers of the Evolut CoreValve TAVR system. Data show TAVR in low-surgical risk patients performed as well as surgical aortic replacement (SAVR). In some data points, TAVR performed better than SAVR. As a cardiac surgeon, Reardon was surprised TAVR has performed so well in trials over the past decade and that this trial shows an early trend toward better outcomes than surgery. Watch an interview with Reardon on the trial results

The Edwards Lifesciences Pascal TEER clip device, which was cleared by the FDA in 2022. Read more.

The Edwards Lifesciences Sapien 3 Ultra Resila TAVR valve on display at TCT 2023. The Sapien has undergone several design iterations to improve it since it was first cleared by the FDA in 2012. This version has a skirt of material at the base to better seal along the valve annulus and prevent paravalvular leaks.

Co-registered angiography and OCT imaging displayed in the Abbott booth. OCT has higher image resolution than IVUS, but IVUS has better tissue depth penetration. Both technologies help improve outcomes. Read more.

Coronary computed tomography angiography (CCTA) hands-on training session for interventional cardiologists to learn how to create curved planar views and analyze soft plaques. The GE Healthcare session at TCT 2023 was designed to give interventional cardiologists a better understanding of how to use cardiac CT, since its use is rapidly rising and the image datasets have a lot of value for preplanning PCI procedures.

Coronary computed tomography angiography (CCTA) screen view of a patient during a hands-on training session for interventional cardiologists to learn how to create curved planar views and analyze soft plaques. The GE Healthcare session at TCT 2023 was designed to give interventional cardiologists a better understanding of how to use cardiac CT, since its use is rapidly rising and the image datasets have a lot of value for preplanning PCI procedures.

Rebecca Hahn, MD, positions a TEE probe in a simulator during a training session for how to implant a MitraClip at TCT 2023. Read more on advances in structural heart echo imaging.

Cephea TMVR trial data being explained by Juan Granada, MD, president and CEO of the Cardiovascular Research Foundation, and the original developer of that valve.

Example of 3D/4D TEE imaging of the mitral valve during a training session for how to implant a MitraClip at TCT 2023. 

Susheel Kodali, MD, running a training session for how to implant a MitraClip at TCT 2023. Read more on advances in structural heart echo imaging.

Radiation monitor badges and a real-time monitor showing the accumulated dose exposure in each person in the cath lab. The monitoring system is from from Raysafe and was displayed at the Egg Medical booth.

The HyperVue OCT-NIRS intravascular imaging system. This system allows for deeper imaging in the vessel walls than traditional OCT systems. It also combines near-infrared spectroscopy to determine the chemical makeup of the soft plaques to determine if they are stable or unstable, which adds more diagnostic information than the anatomical imaging alone. OCT has higher resolution than IVUS so it is easier for most operators to clearly understand what they are looking at and to better define the luminal borders. OCT traditionally has lower tissue penetration that IVUS, by image enhancing software with this system enables a deeper view.

Cardiac computer modeling to create a digital twin to test devices and techniques in a virtual environment using real patient data parameters. Displayed by Virtonomy.IO.

Ziad Ali, MD, with St. Francis Hospital and Heart Center in Roslyn, New York, leads a coronary computed tomography angiography (CCTA) hands-on training session for interventional cardiologists to learn how to create curved planar views and analyze soft plaques. The GE Healthcare session at TCT 2023 was designed to give interventional cardiologists a better understanding of how to use cardiac CT, since its use is rapidly rising and the image datasets have a lot of value for preplanning PCI procedures.

The Egg Nest radiation protection system to reduce scatter radiation in the cath lab. The system consists of a series of movable shields, an under table apron and carbon fiber walls attaches to the edges of the table around the patients head. Displayed by Egg Medical.

CathWorks demonstration of its FFR-Angio vessel assessment technology fused with fluoroscopy to help interventional cardiologist in determining if a stent is needed and if so, provides information for the stent diameter and length. The technology works using a rotational angiography spin of the C-arm around the patient to create a 3D coronary segment that is color coded by FFR flow (right side of the screen). This is then translated into the data fused with the image on the left side of the screen.

Medtronic Onyx Frontier DES stent with an enlarged 3D print of the stent used in bifurcation stenting in the Medtronic booth.

Enlarged 3D prints of bifurcation stenting from CT scans in the Medtronic booth to show operators a how-to step-by-step process to perform PCI in these challenging lesions.

Medtronic Onyx Frontier DES stent with an enlarged 3D print of the stent used in bifurcation stenting.

A Structural Heart Theater cardiac valve surgery presentation at TCT 2023.

The most popular photo spot at the TCT 2023 conference in front of the expo hall entrance.

Massive Medtronic Evolut FX TAVR valve signs on a building leading to TCT 2023 in San Francisco.

Dynamic Coronary Roadmapping that fuses a previously acquired beating heart contrast image of the coronaries from a specific view on live fluoroscopy to enable a reduction in contrast. This is enabled on Philips angiography systems.

Mitral valve on 3D/4D echocardiography demonstrated on the Philips Epiq system.

Left atrial appendage occlusion using an Amulet LAA device seen on intracardiac echo (ICE) using the Philips Verisight Pro 3D/4D ICE catheter at TCT 2023. Read more on advances in structural heart echo imaging.

The Philips AngioSculpt Evo PTCA scoring balloon showing its nitinol wires that help score calcium in the vessel walls to help break it up as the balloon 

Excimer laser atherectomy system displayed by Philips at TCT 2023.

Excimer laser atherectomy system cutting through an apple as part of demo by Philips at TCT 2023.

IVUS measurements displayed by Philips at TCT 2023.

Demonstration of an Impella CP hemodynamic support system flowing 4 liters per minute in a model in the Abiomed booth.

Display of Abiomed Impella percutaneous hemodynamic support pumps, from left, the Impella RP (curved to fit the right heart anatomy), Impella 5.5 and the Impella CP.

The Radiaction radiation protection system displayed at TCT 2023.  It uses leafs of extendable radiation blocking material on both the X-ray source and detector of the angiographic C-arm. The system will deploy and has sensors to stop before touching the patient or table. The shields fold back to move the C-arm or enable better patient access.

Virtual reality cath lab training to implant a Watchman left atrial appendage occluder (LAAO) in the Boston Scientific booth.

The East End Medical Safecross septal crossing system for use in structural heart and electrophysiology procedures. It is the first all-in-one transseptal RF puncture and steerable balloon introducer system to provide predictable left atrium access. The steerable catheter incorporates an integrated radio-frequency ablation tip to cut through the septum. A balloon inflates as an atraumatic buffer to push against the septal wall where the operator wants to cross. 

Boston Scientific's new Avvigo intravascular ultrasound (IVUS) system being demonstrated for the first time at TCT 2023. The IVUS offers much faster automatic pullback speeds up to 8 mm per second to help cut procedure time, and has automated lesion assessment including vessel measurements. The multimodality console also enables DFR physiologic measurements. 

A closeup view of the JenaValve Trilogy transcatheter aortic valve replacement (TAVR) designed specifically to treat aortic regurgitation in non-stenotic valves. This device was discussed in the positive late-breaking trial ALIGN-AR at TCT 2023. The currently cleared TAVR valves are all designed for use in calcified native valves as stable anchoring point. But in valves without heavy calcium, a TAVR valve needs to be anchored to the soft tissue to prevent embolization. The Trilogy has three nitinol clips that grasp the native leaflets during deployment to secure the device to the valve annulus. There was a lot of excitement about this new device at TCT, which will allow AR patients to be treated without open heart surgery. Read more.

Transcatheter tricuspid valve planning on CT scans using the 3mensio CAAS software has planning tool for where to place TEE probes to get optimal imaging.

3D stent volume rendering using the rotational angiography feature on the new GE Healthcare Allia IGS system.

Siemens launched its new 3D/4D Lumos ICE catheter at TCT 2023, which features higher frame rates for live imaging, which can help better guide procedures such as LAAO and transcatheter tricuspid valve interventions.

Siemens Healthineers recently unveiled its Acuson Origin, a new cardiovascular ultrasound system with robust artificial intelligence (AI). The AI capabilities allow it to identify the anatomy being imaged and anticipate the next steps needed to complete the imaging exam. This includes AI algorithms to automate approximately 500 different measurements. Read more.

The TCT Innovation and Science main stage at TCT 2023.