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Michael Borger stresses the importance of a multidisciplinary team approach, high-volume centres for complex cases, and timely, evidence-based interventions to improve patient outcomes.

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The next steps aim to refine the algorithm and integrate it into standardized pathways for conduction-disturbance management after TAVI.

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They reflect on what these specific needs are, why they’re often overlooked, and how clinicians can adapt their approach to offer more meaningful support to women throughout their journey.

Hit play to hear their perspectives and understand what can truly move the needle in daily practice.

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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 both strategies.

The conversation then turns to valve durability and whether the early promises of TAVR are being fulfilled when compared with surgery, what still needs to be improved on each side, and how these long-term data might influence clinical practice now that two strong options exist for low-risk patients.

They conclude by highlighting how Heart Team discussions will become even more crucial in this context.

Curious to learn more? Hit play!

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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 exchange now!

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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 procedural outcomes. Whether you're performing TAVI in complex cases or building your expertise, this conversation offers valuable takeaways you won’t want to miss!

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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, techniques to protect the side branch, and how imaging can support each step. The discussion also touches on the potential role of drug-coated balloons to limit metal use in the bifurcation segment.

Get practical tips and key considerations to make the most of this streamlined yet versatile strategy.

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Fluoroscopy showed about 22 % of valves were under-expanded, often linked to heavy calcium buildup. These valves had worse outcomes, including higher rates of death and stroke.

What’s behind this issue, and how can it be prevented?

Listen to their #europcr 2025 discussion to learn more!

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Discover what defines adequate lesion preparation for a DCB strategy in de novo disease, the role of intravascular imaging in deciding when to use DCB, and best practices for managing dissections.

Plus, get insights on upcoming data and the future of drug-coated balloon angioplasty.

Listen to this episode to get all the answers!

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They dive into the risks of coronary obstruction, the importance of preserving coronary access, and strategies to optimise hemodynamics despite higher residual gradients. The discussion also covers how the index TAVR device impacts outcomes and why CT screening is essential in planning.

Tune in to get a clear picture of the current evidence and what new data is just around the corner.

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They review key trials on asymptomatic severe aortic stenosis—RECOVERY, AVATAR, ONLY TAVR, and EVoLVeD—which show early TAVI or surgery reduces hospitalisations for heart failure and suggests lower mortality and stroke compared to clinical surveillance.

The discussion then moves to symptomatic moderate aortic stenosis, highlighting the recent TAVR UNLOAD study in heart failure patients with reduced ejection fraction.

They also touch on the PROGRESS and EXPAND II trials, and share early insights on new devices for aortic regurgitation, now entering randomised comparisons with surgery.

Listen now to stay ahead on the expanding role of TAVI.

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Liesbeth Rosseel, Davide Capodanno, and Michael Joner explore two key questions shaping the future of TAVI. They highlight findings from the EARLY-TAVI trial, which shows that early intervention in asymptomatic patients with severe aortic stenosis significantly reduces rehospitalisation. Then, they turn to the NOTION-3 trial, comparing PCI vs medical therapy for CAD prior to TAVI—revealing a benefit in reducing MACE, though at the cost of increased bleeding.

The message is clear: earlier may be better, and managing CAD is increasingly important in the TAVI landscape.

Hear what could reshape tomorrow’s practice!

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As TAVR moves into younger patients—many with bicuspid valves—questions remain about how well the procedure performs in this anatomy, which was excluded from earlier trials.

In this exchange, they review the study design, patient selection, and main outcomes, and compare results with the original Evolut Low Risk study.

The performance of the Evolut platform in bicuspid valves may even prove superior to tricuspid cases—though long-term follow-up is essential.

Valve thrombosis is also on the table.

Listen to this episode now to explore the current data and what’s still to come!

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They discuss what imaging reveals about non-culprit lesions, how it may influence treatment, and how these insights are applied in daily cathlab workflows.

The conversation also touches on expectations from the upcoming COMPLETE-2 trial.

Listen now for expert views on a common but complex cathlab scenario.

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They discuss who was included in the trial and walk through the two de-escalation strategies that were tested: reducing the number of the drugs, from dual antiplatelet therapy to single antiplatelet therapy, and lowering the prasugrel dose from 10 mg to 5 mg.

Finally, they highlight the key findings that could help refine clinical practice.

Listen now to get up to speed in just a few minutes.

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The key is assessing the side branch: if stenosis is high-grade and disease is extensive, treatment may be needed from the start—using POBA, a DCB, or a second stent. Anatomy should guide the choice between a provisional or two-stent approach.

Intracoronary imaging is essential to detect issues like abluminal rewiring and stent distortion, especially when treating the side branch. As highlighted by the OCTOBER trial, proper rewiring and final stent architecture are crucial to reduce the risk of long-term complications.

Find out how to tailor your approach to each bifurcation scenario.

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While transcatheter edge-to-edge repair (TEER) remains a safe and effective approach, it doesn’t work for every patient. That’s why alternatives like TMVR, annuloplasty, or NeoChords—all currently under investigation—are generating attention.

The field is moving toward transseptal, transcatheter options that may deliver better reduction of mitral regurgitation, along with improved symptoms and quality of life. They offer the added advantage of allowing future valve-in-valve procedures if needed.

Should a strong mitral program combine both repair and replacement? How do we decide between the two?

There are still challenges—but innovation is pushing the field forward.

Listen now and get a glimpse of what’s next for mitral therapies!

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In this #europcr 2025 interview, Dejan Milasinovic, Miroslaw Ferenc, and Mohamed Abdel Wahab explore why this topic deserves special attention.

They break down how intra-coronary imaging can guide the approach, help tailor strategy, and ultimately improve outcomes. Discover how to move beyond anatomy alone - by factoring in the patient’s clinical profile and procedural context - to find a strategy that’s not only effective, but also simple and safe.

Listen to this eppisode now to sharpen your approach to one of the most demanding lesion subsets in daily practice.

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Bernard Prendergast and Rajesh Kharbanda take a deep dive into this key procedural question, reviewing the latest evidence from two major randomised trials—PROTECTED TAVR and BHF PROTECT-TAVI.

Although both studies individually failed to demonstrate a clinical benefit for cerebral protection devices, a new patient-level meta-analysis presented at #EuroPCR2025 offers fresh insights.

Listen to this episode now to understand how aligning endpoints and patient profiles has helped uncover new signals that could shape future practice.

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This conversation offers practical insights for improving patient care by refining diagnosis and treatment strategies in cases where traditional imaging may fall short.

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Is coronary angiography always necessary? When should PCI be performed—before, during, or after the procedure? And how do you decide?

Tune in for a practical exchange on strategy, timing, and patient selection!

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Key takeaways

1. Calcified left main stem disease is complex but can be simplified with the right tools.

2. Intravascular imaging is crucial for accurate assessment and treatment planning.

3. A careful, step-by-step approach leads to the best angiographic results.

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Recorded during #europcr 2025, this discussion features Michael Haude and Thomas Cuisset as they review key insights from this major study of over 1,600 patients with physiologically non-significant but vulnerable plaques identified by intracoronary imaging—mainly IVUS.

Patients were randomised to receive either optimal medical therapy (OMT) alone or combined with preventive PCI, and followed over several years. While the composite endpoint favored the PCI group, the benefit was driven solely by a reduction in target lesion revascularisation—without differences in death or myocardial infarction.

Should PCI be systematically performed in such cases? Tune in for a nuanced expert perspective!

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As coronary artery disease is the most common cardiac comorbidity in patients undergoing TAVI, the trial set out to evaluate whether physiology-guided decision-making could offer better clarity.

When performing diagnostic angiography before TAVI, clinicians often find intermediate coronary lesions that don’t obviously require revascularisation — so what's the right strategy in these cases?

FAITAVI is the first randomised trial comparing angiography-guided versus FFR-guided PCI decisions in the TAVI setting. Learn more about the study design, inspired by FAME-1, and how the results support the feasibility and value of FFR measurements in patients with CAD undergoing TAVI. The data also confirm that intermediate lesions can safely be left untreated.

Listen to this episode now to understand how these findings could change practice!

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Why were these guidelines created specifically for Latin America? What are their key recommendations? And how can they be applied in day-to-day practice, especially when deciding between PCI and surgery?

Tune in to hear how these guidelines reflect the region’s unique healthcare challenges and may help tailor treatment to the specific needs of Latin American patients.

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From differences in patient selection on either side of the Atlantic—high bleeding risk in Europe vs. broader indications in the US—to upcoming pivotal trials comparing LAA closure to DOACs, this conversation covers it all.

They also break down what defines a state-of-the-art LAA procedure, with an emphasis on pre-procedural imaging (cardiac CT or 3D TEE), and share key insights on post-procedural management, including antithrombotic therapy and follow-up imaging.

Hit play for a quick yet comprehensive update on where LAA closure is headed.

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The discussion begins with angiographic assessment, emphasising the importance of identifying key anatomical features upfront. Based on this evaluation, operators determine the most appropriate strategy—typically beginning with an antegrade approach, with readiness to escalate to retrograde or dissection techniques depending on case complexity and progression.

The panel outlines essential tools for CTO procedures, including a 7 Fr guiding catheter, various wires (from soft to stiff), and microcatheters, while also addressing how these tools are introduced into routine practice. Attention is given to operator experience, decision-making flexibility, and technique sequencing.

In parallel, the importance of progressive skill acquisition is highlighted. Failure is positioned not as an endpoint, but as a learning opportunity—integral to refining technique and gaining confidence.

Listen to this discussion for structured guidance on navigating CTOs in a safe and effective way.

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