PCR Perspectives

Hector Garcia joins Salvatore Brugaletta in a discussion on the concept of vulnerable plaque, a key topic in contemporary cardiology. Together, they review the well-established definition of vulnerable plaque, characterised by high-risk features that predispose to rupture and cardiovascular events, and explore how advances in invasive and non-invasive imaging allow clinicians to identify these les...

Javier Escaned and Niels Van Royen explore the evolving role of physiology in coronary assessment, with a focus on angiography-derived and imaging-derived indices, highlighting the growing potential of AI-driven tools to integrate anatomical and functional data, enabling more comprehensive and flexible decision-making without the need for pressure wires. While these technologies offer significant...

Nina Van Der Hoeven meets Roxana Mehran, winner of the Andreas Grüntzig Ethica Award 2026, the highest distinction in interventional cardiology. At this stage of her career, after major contributions to clinical trials, guidelines, and the field at large, Roxana Mehran reflects on her journey. What is she most proud of? How does she view clinical research today? And what key lessons has she learne...

Major LBT from EuroPCR 2026 This major late-breaking trial from #EuroPCR 2026 presents a landmark patient-level meta-analysis comparing PCI with drug-eluting stents (DES) versus CABG for left main coronary artery disease. Combining long-term data from the EXCEL, NOBLE, PRECOMBAT, and SYNTAX trials, the analysis found remarkably similar mortality outcomes between the two strategies at both 5 and 10...

Major LBTs from EuroPCR 2026 How should coronary artery disease (CAD) be managed in patients undergoing TAVI? At #europcr 2026, Martin Leon and Roberto Scarsini discuss the findings of a patient-level meta-analysis pooling data from four randomised trials: ACTIVATION, NOTION-3, FAITAVI, and TCW. The analysis included 1,050 patients with severe aortic stenosis and concomitant CAD, comparing medical...

This major late-breaking trial from #EuroPCR 2026 highlights new insights from the CHAMPION AF study, one of the largest randomised trials comparing left atrial appendage closure (LAAC) with direct oral anticoagulants (DOACs) in patients with atrial fibrillation. In this interview, Philippe Garot and Jens Erik Nielsen-Kudsk discuss the pre-specified age subgroup analysis, showing consistent effica...

Chronic total occlusions (CTOs) remain a key area of uncertainty in interventional cardiology, particularly regarding symptom improvement after PCI. In this EuroPCR 2026 interview, John Davies and Sarosh Khan discuss the ORBITA CTO trial and its implications for clinical practice. As the first double-blind, placebo-controlled randomised trial in CTO PCI, ORBITA CTO evaluates whether symptom relief...

In this podcast episode, Frédéric Bouisset and Louis-Marie Desroche explore why mastering AI prompting is becoming a key clinical skill for interventional cardiologists. From setting clear objectives to providing the right context and double-checking the outputs, discover the three essential pillars to get reliable and meaningful answers from AI. Hosted on Acast. See acast.com/privacy for more inf...

In this podcast episode, Juan Granada, Michael Borger and Joao Cavalcante highlight that aortic insufficiency differs from aortic stenosis and is often underestimated. Early, comprehensive evaluation and imaging are crucial. Surgery is standard for severe cases, while TAVI with dedicated devices is an option for high-risk patients. Hosted on Acast. See acast.com/privacy for more information.

Joanna Wykrzykowska and Hélène Eltchaninoff discuss challenges in treating patients with small aortic annuli, which are common, especially in women, and present risks such as higher gradients, coronary occlusion, pacemaker need, and paravalvular leak. Valve selection and positioning are critical, balancing hemodynamics and complication avoidance. Hosted on Acast. See acast.com/privacy for more inf...

Azeem Latib and Giuseppe Tarantini discuss how transcatheter therapies are increasingly used to treat critically ill patients with severe valvular disease and cardiogenic shock—patients once considered untreatable. They highlight cases ranging from severe AS with ACS to acute papillary muscle rupture and acute severe regurgitation, showing how TAVI, balloon valvuloplasty and mechanical support can...

Nina Wunderlich and Patrick Calvert discuss mitral paravalvular leaks, which are relatively common. Percutaneous closure is now the default approach, and imaging is central to success: detailed pre-procedural assessment, 3D TOE during the procedure, and careful planning of transseptal puncture.  Hosted on Acast. See acast.com/privacy for more information.

Fabien Praz and Neil Fam talk about the management of patients with combined mitral and tricuspid regurgitation, who are often elderly with heart failure and multiple comorbidities. Careful assessment—including echocardiography, hemodynamics, and sometimes CT—is crucial to identify the dominant lesion. Surgery is preferred if feasible, but for high-risk patients, transcatheter repair or replacemen...

Bernard Prendergast and Fabien Praz discuss updates from the new ESC/EACTS guidelines on aortic stenosis. Key changes include expanding TAVI to patients aged 70 and older, supporting early intervention in asymptomatic patients, and providing guidance for bicuspid aortic valves. These updates emphasise shared decision-making, careful patient selection, and lifetime management strategies. Hosted on...

Lukas Stolz and Rebecca Hahn discuss advances in transcatheter tricuspid valve intervention, emphasising that reducing tricuspid regurgitation (TR) to mild levels is key for improving patient outcomes, including mortality and heart failure hospitalisations. Decision-making between transcatheter edge-to-edge repair (T-TEER) and transcatheter tricuspid valve replacement (TTVR) depends on anatomy, im...

Philipp Lurz and Saibal Kar discuss iatrogenic atrial septal defects from transseptal procedures. Small ones usually close on their own, while large defects causing significant shunting need closure to prevent right heart overload. Some moderate defects may be beneficial by decompressing the left atrium, so closure isn’t always needed. With the increasing amount of procedures, understanding the he...

Tiffany Patterson and Davide Capodanno address the increasingly common scenario of managing coronary artery disease (CAD) in patients undergoing TAVI. With up to half of TAVI candidates presenting with CAD, they highlight new evidence from NOTION-3 showing that revascularization reduces major adverse cardiac events. The takeaway: CAD in TAVI patients matters, should be assessed thoughtfully, and e...

Francesco Maisano interviews Michael Borger, co-chair of the 2025 ESC/EACS valvular heart disease guidelines, on their practical impact. The updated guidelines emphasize earlier intervention in primary mitral regurgitation, especially for asymptomatic patients with risk factors, while surgery remains preferred for low-risk patients. Michael Borger stresses the importance of a multidisciplinary tea...

Lorenz Räber and Kasper Korsholm highlight why pre-procedural imaging—particularly cardiac CT—has become essential for successful left atrial appendage occlusion (LAAO). They explain that the LAA is highly variable between patients, making detailed planning crucial for safety, device selection, and optimal procedural results. Hosted on Acast. See acast.com/privacy for more information.

Michael Joner and Francesco Saia discuss the newly developed D-PACE Score, a tool designed to predict delayed AV block occurring more than 24 hours after TAVI—an unmet clinical need given that current risk models focus mainly on early events. The next steps aim to refine the algorithm and integrate it into standardized pathways for conduction-disturbance management after TAVI. Hosted on Acast. See...

In this #pcrlv2025 conversation, Ellen Ross and Marta Sitges discuss the recent initiative from Global Heart Hub, a patient association: an in-depth look at the situation of women living with heart valve disease, the gaps identified, and the call to action that followed. They reflect on what these specific needs are, why they’re often overlooked, and how clinicians can adapt their approach to offe...

Listen to this PCR London Valves 2025 interview with Philippe Généreux and Philippe Pibarot, who explore the 7-year results of PARTNER 3 in low-risk patients. They walk through the main findings of this TAVR versus SAVR comparison in symptomatic severe aortic stenosis (AS). At 7 years, the primary endpoint — the composite of mortality, stroke and rehospitalisation — shows similar rates between bot...

While the PCR London Valves 2025 Course is underway, Francesco Maisano and Fabien Praz discuss how the latest ESC/EACTS valvular guidelines affect clinical practice. What’s changing in surgery? How do repair and replacement strategies differ under the new recommendations, and what’s the impact on transcatheter interventions? Discover key insights from this exclusive interview: watch the whole exch...

What makes TAVI in bicuspid aortic valve disease so challenging—and how can those challenges be overcome? In this #europcr 2025 expert discussion, Chiara De Biase, Kentaro Hayashida, and Didier Tchetche share practical insights on navigating anatomical variability, refining patient selection, and optimising valve sizing. They also address the critical role of calcification and how it can influence...

Listen to this #europcr 2025 interview to see Giuseppe Di Gioia and Jens Flensted Lassen as they break down the essentials of the provisional strategy for non-left main true bifurcation lesions. This approach offers a stepwise and adaptable treatment path: start with one stent in the main vessel, with the option to implant a second if needed. They highlight the importance of proximal optimisation,...