TCTMD’s Top 10 Most Popular Stories for September 2022

Almost all of the top stories this month stemmed from late-breaking presentations at the TCT 2022 meeting, including our coverage of PROTECTED TAVR, UNIVERSAL, CLASP IID, and more. One exception was news that the PROACT Xa trial of apixaban in the setting of mechanical valve implantation had been stopped due to an excess risk of blood clots with the direct oral anticoagulant (DOAC). Finally, our now-retired COVID-19 Dispatch, which has been on the Top 10 list since its inception in early 2020, got one last month in the limelight.

1. TCT 2022 PROTECTED TAVR: No Less Stroke With Embolic Protection, but Some See Hope

There were fewer disabling strokes with protection and the procedure itself was safe, so it’s not the end of the story.

2. TCT 2022 Sizing Mismatch a Problem for Balloon-Expandable Valves in Small Annuli TAVI

Worryingly, mismatch at 1 year also predicted 3-year all-cause death, spurring calls for RCTs in this setting.

3. TCT 2022 Ultrasound for Femoral Access? Neutral Results vs Common Sense: UNIVERSAL

UNIVERSAL missed its primary endpoint, but one investigator likened ultrasound use to wearing a seatbelt that’s already in the car.

4. COVID-19 TCTMD’s Dispatch

For 31 months we summarized top COVID-19 health and policy news. On September 26, we wrapped up the Dispatch.

5. Another DOAC Fails in the Setting of Mechanical Heart Valves

The PROACT Xa trial of apixaban has been stopped due to an excess risk of blood clots compared with warfarin.

6. TCT 2022 Pascal TEER Device as Good as MitraClip in Head-to-Head CLASP IID

The device met its primary noninferiority endpoint for safety and efficacy against MitraClip in degenerative MR patients.

                             SEE ALSO: FDA Approves Pascal TEER Device for Degenerative MR

7. TCT 2022 Surgical TAVI Explants Are Risky and Rising: STS Data Carry a Warning

Worrisome signals seen in a comparison of redo procedures carry a message for interventionalists and surgeons alike.

8. TCT 2022 RADIANCE II Confirms Ultrasound-Based Renal Denervation Lowers BP

Some issues still need to be worked out, but denervation will be an important addition for treating high BP, Sripal Bangalore says.

9. TCT 2022 SYMPLICITY HTN-3’s Late Surprise: Sustained BP Drop at 3 Years Despite Earlier Miss

Experts grappled with how to understand the positive findings given that the trial missed its primary endpoint at 6 months.

10. TCT 2022 SCAAR Registry Delves Into Left Main Revascularization Outcomes

The observational data raised red flags for many, including the fact that CABG survival curves appeared to separate so quickly.

Find all the big news from TCT 2022, plus slides, cases, video interviews, and more on our conference page. Our ESC 2022 coverage is also still hot—find it here—as well as a blog by Senior Clinical Editor Mamas Mamas, BMBCh, DPhil (Keele University/Royal Stoke University Hospital, Stoke-on-Trent, England), inspired by an encounter in Barcelona: Beyond the Shining Lights and Science at ESC: Bullying Works in Shadows