Leading Researchers Outline Advances in Treating Heart Disease at Miami Valves 2019
New biomedical devices and advances in cardiac procedures are improving outcomes for patients with heart disease, according to leading researchers and clinicians at Miami Valves 2019, an annual international conference hosted by the University of Miami Miller School of Medicine January 30 to February 2 at the InterContinental Hotel.
“Miami Valves has expanded beyond structural cardiology this year,” said Eduardo de Marchena, M.D., professor of medicine and surgery, and associate dean for UHealth’s International Medicine Institute, which organized the conference, “Our 2019 annual conference also included symposiums on percutaneous coronary intervention and electrophysiology, as well as a board-review course for fellows and an exciting ‘Ibis Tank’ innovation session.”
More than 360 physicians and other health care professionals from 97 institutions throughout the Americas, Europe and Asia attended the four-day conference on “Advancements in Transcatheter Techniques for Valvular and Structural Heart Disease.” Eberhard Grube, M.D., professor of medicine, and chief of the Department of Cardiology and Angiology at Siegburg Heart Centre in Bonn, Germany, received a lifetime achievement award.
“Year after year, Miami Valves continues to grow without losing its friendly atmosphere,” said Giselle Baquero, M.D. a former Miller School structural cardiology fellow who is now an assistant professor at Southern Illinois University.
There were more than 120 learning sessions, ranging from lectures to panel discussions and clinical case presentations at the conference. The four symposium directors were Mauricio Cohen, M.D., “Complex PCI,” Amit Badiye, M.D., “Heart Failure,” Raul Mitrani, M.D., “Electrophysiology,” and Carlos Alfonso, M.D., “Board Review and Fellows Course.”
One of the many well-attended sessions was an update on transcatheter aortic valve replacement (TAVR) by Dr. de Marchena, who was course director of the conference.
“We continue to see an increase in TAVR procedures for aging patients with aortic stenosis,” he said. “In the past four years, we are seeing fewer extreme-risk patients, and more who fall into the intermediate-risk category. We expect to see the results for low-risk patients in 2019.”
Other trends include a reduction in mortality rates and hospital length of stay, he said, adding that 80 continues to be the median age for TAVR patients.
“With the aging of the boomer generation, we expect to see greater need for TAVR procedures in the next decade, he added.
In his talk on “Minimally Invasive Mitral Valve Surgery,” Joseph Lamelas, M.D., UHealth’s new chief of cardiothoracic surgery, discussed the advantages of direct access to the heart through a small incision on the right side of the chest.
“We can do any mitral valve repair through this approach,” he said. “However, treating this pathology requires a lot of subspecialty experience.”
Dr. Lamelas said being able to see the mitral valve directly helps him determine the most appropriate treatment, such as inserting a device to reduce mitral regurgitation, tying a “sling” to bring muscle tissues together or debriding calcium buildup on the valve.
“Mitral valves are like snowflakes,” he added. “Every one is different, so surgeons need a toolbox of techniques.”
In the heart failure symposium, Amit Badiye, M.D., spoke on “What is New in Heart Failure With Preserved Ejection Fraction?”
“There are novel invasive and pharmacological therapies in the pipeline,” he said. “However, cardiologists need to carefully examine the structure and functioning of each patient’s heart, including the inflammatory pathway.”
Dr. Badiye was among the 35 Miller School faculty members who participated in the conference, along with renowned researchers such as Greg Stone, M.D., from New York-Presbyterian, who discussed using the new MitraClip to treat heart failure patients with mitral regurgitation in the multi-site COAPT trial, called the most impactful structural trial of 2018.
“From reduced hospitalizations to higher quality of life, every one of the study’s secondary endpoints was positive — something I had never seen before,” Dr. Stone said. “While not a cure, two-year mortality was reduced from 46 percent to 29 percent, and I believe the MitraClip should be considered the new standard of care for patients meeting the eligibility criteria.”
Focus on innovation
Dr. de Marchena and Peter de Jaegere, M.D., Ph.D., of Erasmus Medical Center in The Netherlands, co-hosted the opening “Ibis Tank” session, modeled after the popular TV show, “Shark Tank.” A panel of clinical, engineering and business professionals provided feedback on eight brief presentations of eight promising therapies and devices.
“Medical innovations are changing the way we practice,” de Marchena said. “Virtually none of the devices I use today were available 15 years ago.”
Joshua M. Hare, M.D. spoke about using a specific combination of mesenchymal and cardiac stem cells for treating heart failure.
“We created a mixture from the Miller School’s Interdisciplinary Stem Cell Institute that amplifies the therapeutic potential,” he said. “The safety profile is outstanding, and this regenerative therapy could be an alternative to heart transplants.”
Other Ibis Tank presenters included Dileep Yavagal, M.D., on “A Continuous Automated Suction Device: An Endotracheal Tube Innovation;” Jeffrey Goldberger, M.D., on “Mapping and Ablation of Persistent Atrial Fibrillation: Challenges and Approaches;” and Christian Marin y Kall, M.D., MBA, on “SwiftSync – Temporary Synchronized Pacing.”
Reflecting on the presentations, panelist Jeff Franco, president and CEO of Tendyne Holdings in Baltimore, said, “Miami is a great place for biomedical innovation, and UM has been in the forefront of research. A session like this brings the business and research side together, creating a great experience.”
Following the Ibis Tank presentations, Norma Kenyon, Ph.D., UM vice provost for innovation, led a “Cardiovascular Innovation Workshop,” which focused on ways to accelerate the translation of laboratory research to patient care.
“A clinical trial is typically just the beginning of getting new therapies and treatments to people,” she said.
Other Miller School conference presenters included Lilian Abbo, M.D.; Felipe Albuquerque, M.D.; Eugene Bauerlein, M.D.; Joao Braghiroli, M.D.; Nicolas Brozzi, M.D.; Sandra Chaparro, M.D.; Michael Dyal, M.D.; Imran Farooq, M.D.; Alexandre Ferreira, M.D.; Ali Ghodsizad, M.D.; Jeffrey Goldberger, M.D.; Joshua Hare, M.D.; Litsa Lambrakos, M.D.; Alexander Llanos, M.D.; Matthias Loebe, M.D., Ph.D.; Brijeshwar Maini, M.D.; Brigitte Marciniak-Bednar, RN, BSN, CCTC; Christian Marin, M.D.; Pedro Martinez-Clark, M.D.; Saqib Masroor, M.D.; Cesar Mendoza, M.D.; Robert Myerburg, M.D.; Vicente Orozco-Sevilla, M.D.; Valrie Reid, Ph.D.-c, APRN-BC; Jean-Louis Renaud, APRN; Nina Thakkar Rivera, D.O., Ph.D.; Paolo Rusconi; Tomas Salerno, M.D.; Satinder K. Sandhu, M.D.; Alan Schob, M.D.; Neeraj Sinha, M.D.; and Bin Yan, Ph.D., J.D.