PCR London Valves 2019 best clinical cases - Heath Adams
“Between a rock and the mitral valve space”
One of the winners of the Top 3 cases is Heath Adams, an early-career Australian structural and interventional cardiologist working as a structural and valvular heart disease fellow at St. Thomas’ Hospital, London. He trained at St Vincent's Hospital Melbourne, undertaking a dedicated 2-year interventional fellowship prior to moving to the United Kingdom in 2019.
Read his answers to a few questions about his submission and how he thinks winning at PCR London Valves 2019 will benefit his career.
Could you give a short summary of your winning case?
Severe mitral stenosis from circumferential mitral annular calcification (MAC) in the elderly is a very difficult condition to treat. Valve-in-MAC procedures are associated with poor procedural success, unacceptable rates of valve migration and LVOT obstruction, with a post procedure one year mortality rate of 60%. This case highlights the complexities and unexpected challenges of a percutaneous transcatheter mitral valve replacement (TMVR) for a valve-in-MAC procedure.
What would you say is the key take-home message of your case?
Multimodality imaging and careful Heart Team assessment is crucial when performing transcatheter mitral valve interventions. Fusion imaging, bioengineering and computational fluid dynamics can be useful for optimal TMVR positioning. When complications arise it important to consult internal and external expertise, and think outside the box if time and patient safety allows!
What is the main reason you submitted to a PCR Course?
PCR London Valves is the premier Valvular Heart Disease and Structural Intervention course which has a clear focus on science, innovation, case-based learning and international collaboration. I chose to submit my case to the course both to contribute to the novel experiences of mitral valve interventions, and allow others to learn new insights in the treatment of a very difficult patient cohort.
What impact do you expect this recognition to have on your career?
The recognition of this case presentation in the Top 3 at PCR London Valves is a reflection of the excellence, expertise and teamwork of the St Thomas' Hospital valvular disease Heart Team. I am hopeful that this recognition will allow for further opportunity, networking and scientific discussion in the field of transcatheter interventions.
What is your advice to others for preparing and presenting their cases?
After completing a fascinating, novel or classic 'textbook' case write down your thoughts immediately whilst the adrenaline is still running. When preparing the submission it is important to provide the salient points in a clear and organised structure. Allow for departmental advice and feedback from seniors to help enhance the content. A 'hook' for a title may also attract the attention of reviewers.
A new PCR initiative rewards the submitter of the best case from each of 5 world regions with free participation to the Course. What effect do you think this will have?
The initiative by PCR to reward excellence in case submissions provides a major incentive to present your case on the worldwide stage, and receive recognition from your peers on the quality of your work. This award has the potential to facilitate career opportunities in the future.