PCR London Valves 2017 Editorial

Heart Team: synergy for better patient outcomes

Dear colleagues and friends, dear PCR Family members, I wish each of you a very warm Welcome to PCR London Valves 2017, the Heart Team Course focusing on transcatheter therapies for valvular heart disease. Multidisciplinary teams are playing an increasingly important role in the delivery of care to many patients suffering from various diseases, and cardiac diseases are no exception.

The Heart Team approach plays a substantial role in the decision-making process by allowing the team members - interventional cardiologist, surgeon, imaging specialist, anesthesiologist, intensive care physician, nurse and allied professional - to define the most suitable therapeutic option to be offered to an individual patient who suffers from valvular heart disease. Bringing to the patient’s bedside the knowledge, skills and experience of every team member, as well as other specialists, as often required in patients with multiple co-morbid conditions, definitely remains the way forward. Heart Team meetings represent the regular exchange platform in any Centres of Excellence for the management of valvular heart disease, as reinforced in the recently released ESC / EACTS Practice Guidelines (European Heart Journal 2017;00:1–53 doi:10.1093/eurheartj/ehx391).

For the treatment of patients with aortic stenosis, TAVI has rapidly reached a high level of maturity, based on accumulated evidence such that this very patient-friendly procedure should be considered in many as an alternative to surgical aortic valve replacement. Today, physicians can no longer advocate procedures merely based on their own professional capabilities or availability of a specific technique. Patients require a synergistic Heart Team discussion to represent all of the possible therapeutic alternatives, in order to inform them and their relatives, and to enlighten their own decision-making pathway. Because the field is on a rapid expansion track, as illustrated again by the wealth of novelty discussed during PCR Innovators Day at London Valves, interventional cardiologists and surgeons need to work hand-in-hand: it is only by adjusting practices to the evolving evidence base that patients will be offered different options for them to choose between, based on solid equipoise.

Under these circumstances, patient-related outcome metrics, including patient preference, often become the tie breaker, as illustrated by the outcome of best practice discussions within professional Heart Teams who place the patient where he/she belongs - central to the entire process. Mitral valve treatment is another clear example of how both our disciplines need to support one another in order to obtain better results. As mitral intervention continues to straddle between conventional surgery, mini-invasive surgery and percutaneous approaches, surgeons and interventional cardiologists need to join forces and demolish the walls that set their practices apart. While maintaining safety and efficacy at the highest possible level, such joint eff ort will sustain the constant quest for transformation of current standard surgical approaches into more patient friendly, less invasive procedures. Tricuspid valve therapies are no exception to the stance of a necessary collaboration between surgical and interventional disciplines. Here, the surgical standard is not so robust and as a result, many patients are treated at a late stage, or not treated at all. By pushing our joint efforts to conduct multidisciplinary research, we should be able to treat more patients in the future, as conventional surgery is complemented by an array of less invasive percutaneous options.

PCR London Valves represents a unique forum for multidisciplinary interaction at the highest level. Our dialogue will be most fruitful and relevant to our practice when designed to serve the patient’s interest. Only when the Heart Team presents the palate of treatment options to the patient will physicians have fully fulfilled their duty to the sick and suffering by listening to their wishes and convey a caring and empathic attitude.

Welcome to PCR London Valves – home to your constantly evolving speciality since 2010!

For the 8th edition of the rapidly expanding PCR London Valves Course, we remain totally dedicated to keeping participants up-to-date in the rapidly expanding and innovative field of transcatheter therapies for valvular heart disease, through the sharing of clinical knowledge and emerging techniques. Regular participants of this official EAPCI Course will know that promoting and serving the needs of the Heart Team has been a priority since the outset. This year’s Programme specifically provides you with a clarified choice of essential and applied learning: the former reaching out to those who are relatively new to the field, and the latter to those managing more advanced and challenging levels of procedures.

  • In the same way, nurses and allied professionals will discover a Programme of newly dedicated sessions on Tuesday morning which will focus on the full understanding of pathologies, improved communication within the team and their key role when procedural complications arise. Another of this edition’s features is the novel case-based approach applied throughout an increasingly interactive Programme. This approach will be particularly apparent in the new Mitral and Tricuspid track sessions that will take place in a devoted room and enlighten a rapidly developing field of innovation.
  • A plenary session on the new ESC Guidelines for Valvular Heart Disease will offer a comprehensive summary on the subject and will be followed up by a Burning Questions session in the Interactive Case Corner – an ideal opportunity to get close up to the experts and ask questions relevant to your own daily clinical practice. A similar Burning Questions session offering an “Open Forum on Percutaneous Valve Interventions’ promises similar interactivity and direct access to expert opinion.
  • The 2017 Spotlight session addresses “Standardised definitions for clinical and imaging endpoints after surgical and transcatheter valve intervention” and will enable you to learn more about important new international recommendations.
  • You will also have opportunity to listen to renowned experts providing Keynote Lecture in the Main Arena – A. Vahanian on Monday addressing “Multiple valve disease: challenges in diagnosis, assessment and treatment“, and O. Alfieri on Tuesday providing a personal perspective on “Valve surgery and valve surgeons: past, present and future“.
  • The dedicated Imaging Day on Sunday will again illustrate the fundamental importance of multimodality imaging before, during and after percutaneous valve intervention. Patient selection, procedural planning, device sizing and selection, prediction and management of procedural complications, optimization of outcomes… the Programme is fully comprehensive! Imaging will also be at the forefront of this year’s LIVE sessions with expert imaging analysis of each LIVE case demonstration from London, Milan and Rostock. Imaging will also be strongly represented in the practical sessions provided by our Industry Partners in the Training Village for valuable learning in small groups.
  • Submissions of original research abstracts and highly educational cases remain a key component of the Programme designed “By and For You”. On Monday afternoon, late-breaking TAVI trials will be presented in the Aortic Room and the Top 3 clinical cases will be presented in the Main Arena. Numerous clinical and research abstracts will also be presented or available for viewing in the Posters Lab. We encourage you to take a few moments to pass by the “15 Years of TAVI” exhibition - a newly curated addition to the “40 Years of Angioplasty” exposition that met with huge success at EuroPCR earlier this year - both will provide you with a fascinating trip down memory lane.

Lastly, please be sure to upload the revamped Course App to enhance your 3-day educational experience and get the very most out of the dynamic PCR London Valves Programme. Welcome to your Course!