Miami Valves 2022 Brings International Perspective to Advances in Treatment Devices and Procedures
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Richard Westlund
March 7, 2022
Miami Valves 2022 Brings
International Perspective to
Advances in Treatment Devices
and Procedures
Advances in treating structural heart disease were highlighted
at Miami Valves 2022, a three-day conference presented by the
University of Miami Miller School of Medicine, the UM
International Medicine Institute, and UHealth – the University
of Miami Health System.
Attendees from Miami Valves featuring
cardiologists from the Miller School and
across the world.
“New tools to treat valvular heart disease and other
structural problems are being developed at a rapid pace,” said
conference director Eduardo de Marchena, M.D., professor of
medicine and surgery, associate dean for International
Medicine, and director of Interventional Cardiology. “We also
https://physician-news.umiamihealth.org/miami-valves-2022-brings-international-perspective-to-advances-in-treatment-devices-and-procedures/ 1/8
Richard Westlund
March 7, 2022
learn from our colleagues by sharing insights from challenging
and complex patient cases.”
More than 360 professionals from 22 states and 18 countries
attended Miami Valves 2022, held virtually and in person on
February 3-5 at the Marriott Miami Biscayne Bay.
“After the global challenges of COVID, we were glad to bring
professionals together again for our 22nd conference,” said Dr.
de Marchena, noting that there were 141 sessions, presented by
79 UM and guest faculty members.
“More than 50 abstracts were submitted and presented by
residents and fellows as our conference continues to engage
future and early-stage cardiologists in research and
education.”
In addition to the structural heart meeting, moderated by Dr.
de Marchena, the Miami Valves conference included a
Percutaneous Coronary Intervention (PCI) Symposium directed by
Mauricio G. Cohen, M.D., professor of medicine, and director
of the Cardiac Catheterization Laboratory; an
Electrophysiology Symposium directed by Raul D. Mitrani, M.D.,
professor of clinical medicine and director of clinical
cardiac electrophysiology; and a Heart Failure Symposium led
by Luanda Grazette, M.D., M.P.H., clinical associate professor
of cardiology.
Presentation Highlights
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March 7, 2022
From left, Igor Palacios,
M.D., and Eduardo de
Marchena, M.D.
Igor Palacios, M.D., professor of medicine at Harvard Medical
School and Massachusetts General Hospital, gave the keynote
lecture, “Mitral Valve Disease: What a Journey,” discussing
the progress in interventional cardiology since treating his
first 10 patients in Venezuela in 1987.
Joseph Lamelas, M.D., chief and program director of
cardiothoracic surgery, gave presentations on using minimally
invasive surgical procedures to replace an aortic root and
valve, and to treat mitral annular calcification (MAC).
“Mini-thoracotomy is an acceptable alternative to conventional
and transcatheter procedures in patients with extensive valve
disease and calcification,” he said. “While there is a long
learning curve for these complex procedures, patients
typically have shorter hospital stays and faster recoveries
compared with traditional surgeries.”
Advances in TAVR
Dr. de Marchena opened the conference with a talk on “Catheter
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March 7, 2022
Based Treatment of Structural Heart Disease,” focusing on
transcatheter aortic valve replacement (TAVR) procedures, in
patients with mitral, bicuspid and tricuspid disease.
“We have seen immense growth in TAVR procedures since 2012,”
he said. “We are now treating low, intermediate and high-risk
patients, and the median age has declined. However, Blacks and
Hispanics are dramatically underrepresented, as Whites
constitute 92 percent of TAVR patients nationally. We must do
a better job to be sure that all groups have access to these
procedures.”
Dr. de Marchena said most TAVR patients have one-day
admissions, and feel better after their procedures. While the
procedure costs more than an equivalent surgery, the follow-up
costs are lower, and after two years TAVR is slightly less
expensive.
Following the talk, Eberhard Grube, M.D., professor at
University Hospital in Bonn, Germany, emphasized the
importance of using CT imaging to determine the right valve
size, as well as other TAVR best practices in maximizing
patient outcomes.”
Understanding Neuroprotection
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March 7, 2022
Carlos Alfonso, M.D.
In a talk on neuroprotection, Carlos Alfonso, M.D.,
associate professor of medicine, looked at the use of embolic
protection devices (EPDs), such as mesh baskets, to capture
debris from valve replacement procedures and reduce the risk
of a stroke or other brain injuries.
“Many patients fear stroke more than death, and it is
important to look at how to incorporate neuroprotection into
cardiology practices,” he said. “Good valve implant techniques
can reduce the risk of embolization, and deploying filters can
catch debris that could lead to a clinical or silent
cerebrovascular problem.”
Recent studies show both in-hospital and 30-day stroke rates
have trended down for cardiology intervention patients, but
increased use of EPDs is not associated with better outcomes.
“We are hoping to have answers on EPD effectiveness from a
multicenter PROTECT-TAVR trial, and will be enrolling
participants sometime this summer,” said Dr. Alfonso.
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March 7, 2022
PCI Symposium
Symposium session from Miami
Valves.
Dr. Mauricio Cohen moderated the PCI Symposium, which included
a variety of topics and a panel discussion with experts from
leading institutions in the U.S.
“The highlights included case presentations showing the
challenges practitioners face in their daily practices,” he
said. “There were animated discussions about the best ways to
approach these procedures in the cardiac catheterization lab.”
Attendees heard Jacquie Tamis-Holland, M.D., of Mount Sinai in
New York, discuss the new 2021 Coronary Revascularization
Guidelines that will guide the care of patients with coronary
artery disease, and Dr. Alfonso gave a presentation on new
tools and approaches for chronic total occlusion
interventions.
Interventional cardiologist William O’Neill, M.D., of the
Henry Ford Health System in Detroit, shared his journey of
taking care of patients with myocardial infarctions and how
PCI became the standard of care, and Rajiv Gulati, M.D.,
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March 7, 2022
Ph.D., of the Mayo Clinic in Rochester, Minnesota, gave a tour
de force presentation on the management of spontaneous
coronary artery dissection, a problematic condition that
mostly affects women. Other panelists included Drs. Pedro
Moreno, Ian Gilchrist, Abdulla Damluji, and Michael Dyal.
Roger Alvarez, D.O., M.P.H., a vascular specialist with the UM
Division of Pulmonary, Allergy, Critical Care & Sleep
Medicine, closed the symposium with a presentation on the
development of team protocols for pulmonary embolism response
teams (PERTs), a very relevant topic, as interventional
techniques are central in the care of patients with pulmonary
embolisms.
Addressing Atrial Fibrillation
At Friday’s Electrophysiology Symposium, Jeffrey J.
Goldberger, M.D., M.B.A., chief of the Cardiovascular
Division, discussed risk factor modification strategies for
controlling atrial fibrillation (AF).
“While not a hot new device or procedure, risk-factor
modification can be an important step in improving outcomes in
patients with atrial fibrillation,” he said. “An aggressive,
physician-led program to control risk factors such as weight,
blood pressure, sleep apnea, and smoking can be beneficial to
patients in many ways.”
Dr. Goldberger is co-leading a Miller School study on the use
of liraglutide, a weight-loss medication, to improve long-term
outcomes following atrial fibrillation procedures.
“It is important to address the underlying disease process
that generates atrial fibrillation, just as statins are used
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March 7, 2022
for treating coronary artery disease,” he said.
Enrollment is now underway for the study, funded by the
National Institutes of Health (NIH), which involves assessing
medical treatments to reduce epicardial fat around the heart
prior to electrophysiology treatments.
“By getting the heart tissue into better shape, we hope to
achieve better patient outcomes,” said Goldberger said. “We
are also conducting other studies looking at the genes
affected by epicardial fat in atrial fibrillation patients, as
well as metabolic products in the blood. Hopefully, we will
see significant advances in the next few years.”
Discussing Heart Failure
In the Heart Failure Symposium on Saturday, Joshua M. Hare,
M.D., Louis Lemberg Professor of Medicine, and the founding
director of the Miller School’s Interdisciplinary Stem Cell
Institute, presented new findings on using stem cells for
treating muscle damage to the heart.
Nina Thakkar Rivera, D.O., Ph.D., a specialist in heart
failure and transplantation cardiology, led a case-based
discussion and review of invasive hemodynamics and updates to
current recommendations. Leslie Miller, M.D.. professor of
medicine and past president of the International Society of
Heart and Lung Transplantation (ISHLT) and the American
Society of Transplant Physicians discussed future innovations
in mechanical circulatory support for heart failure.
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