PCR London Valves: a pioneering course at the centre of advances in the treatment of heart valve disease for over 15 years

Seven years after the first transcatheter aortic valve implantation (TAVI) procedure and coincident with initial clinical rollout across Europe and the USA, the London Valve Live meeting was created in 2009 in response to the increasing demand for clinical and technical information concerning rapidly emerging transcatheter treatments for heart valve disease (HVD). Renamed PCR London Valves shortly thereafter, the 2024 edition of this landmark course celebrated its 15th year with an offering of more than 230 sessions under the auspices of a faculty of over 300 interventional cardiologists, imaging specialists, and surgeons from around the world. With over 400 presenters and an audience of over 4000 participants, the 2024 edition clearly showed itself to be the world's largest meeting dedicated to the field of HVD. Participant driven from the outset, PCR London Valves has kept pace with the rapid evolution of HVD treatment by creating an interactive forum that is specifically designed to offer participants access to clinical knowledge and the tools that they need to improve their practice and the welfare of their patients. With a strong emphasis on interaction and open exchange of knowledge, PCR London Valves keeps pace with developments in the field through participant involvement. Key topics are covered in a series of educational sessions based on live or specially pre-recorded cases supplemented by innovative sessions to encourage advanced training. International partnership (with linked PCR Valve meetings in China, Japan, Spain, and the Middle East and strong collaborations with the US-based Cardiovascular Research Foundation) is fundamentally important, allowing access to a wide range of clinical experience, while cross-speciality collaboration further expands and supports the central role of the heart team. It is no accident that PCR London Valves describes itself as a course rather than a regular meeting. Offering an open exchange among participants, its philosophy is based upon the long-standing tradition of progressive clinical education that is the hallmark of PCR. There is a natural affiliation with EAPCI (the ESC Association for interventional cardiologists), which maintains active partnership with PCR London Valves and launched the new EAPCI Core Curriculum for percutaneous valvular and structural interventions in a dedicated session led by its President, Prof. Alaide Chieffo, during the 2024 course. Meanwhile, the EAPCI PCR Textbook remains a frequently updated reference in the field with several chapters on HVD and its current treatment. Alongside these institutional components, a key element of PCR London Valves is the active participation of the wider community. In 2024 alone, the course received a record number of almost 1000 scientific abstracts and case reports from all around the world. Emphasizing the global theme, live cases came from London (UK), Toulouse (France), and Cologne (Germany), with recorded cases from Montreal (Canada), Vigo (Spain), and Tokyo (Japan)—showcasing international collaboration and expertise. Late-breaking research and trials are of significant importance in the rapidly evolving field of HVD: the course included five late-breaking trial sessions derived from 56 submissions. These sessions culminated in an innovative ‘Meet the Trialists’ session focussing on the three highest-ranked trials in a question-and-answer forum that allowed direct interaction with the investigators and set the stage for open and constructive discussions on recent research, new data, and findings. In 2024, these trials included the following: COMPARE-TAVR—1-year results of a randomized study comparing two balloon-expandable TAVI valves; TRISCEND II—transcatheter valve replacement vs. medical therapy for tricuspid regurgitation; and J-VALVE—30-day outcomes of TAVI in chronic aortic regurgitation. Simulation-based training and the opportunity for practical exposure offer a truly hands-on experience for specialists at all levels and have been a critical element of the recent success of PCR London Valves. The highly popular ‘Simulation Learning Pathway’ allows participants to follow a specially designed track: first, the ‘Simulation Learning Room’ to watch experienced operators demonstrate and explain simulation-based procedures, then to the ‘Hands-On Lab’ to practise first-hand and learn in small groups, and finally the ‘Training Village’ to train further in device-specific, hands-on workshops conducted by industry partners. This step-by-step approach enables course participants to practice procedures in a simulated environment before performing them on patients, thereby improving their skills and patient safety. The heart team partnership between interventional cardiologists, surgeons, and imaging specialists is essential in the modern management of HVD, and PCR London Valves actively promotes this philosophy. Imaging is critical for the planning and execution of surgical and transcatheter valve procedures. The structure of the course is designed to emphasize this central importance by incorporating imaging into all live cases and by creating a dedicated ‘Imaging Learning Centre’ with two separate training rooms and themes: Imaging Learning Lab—covering multimodality imaging and 3D orientation in didactic and highly interactive sessions; and Imaging Skills Lab—offering hands-on experience with specialized imaging software for aortic, mitral, and tricuspid valves in small-group tutorials. Recent advances in the treatment of HVD have been driven by innovative devices and techniques, underpinned by clinical experience and a continuing sequence of pivotal randomized trials. Underlining this in 2024, PCR London Valves offered an ‘Innovation Track’ that focussed on new devices and the innovation process in a series of special sessions allowing free interaction between inventors and investors, clinicians, and industry partners. Further novel sessions designed to facilitate interaction between the faculty and large numbers of participants included unscripted ‘Meet the Masters’ sessions that allowed direct audience questions to high-volume, experienced transcatheter valve operators and a ‘Newsflash’ session that focussed on recent evidence concerning the advantages of pre-emptive TAVI for asymptomatic severe aortic stenosis. Cooperation and collaboration, enhanced clinical experience, and shared knowledge, as well as a global reach across five continents ensure that the educational content of PCR London Valves is geared towards improving clinical practice worldwide—a winning formula that has proven its worth over 15 years of evolution and innovation. The PCR London Valves Course Directors and Team Simon Redwood, Gina Adams, Sally Collingridge, Claire Jackson, Francesco Maisano, Nicolo Piazza, Didier Tchetche, Ilia Touli, Nina Wunderlich, and Bernard Prendergast Bernard Prendergast, Consultant Cardiologist, St Thomas' Hospital and Cleveland Clinic London. [email protected] All authors declare no disclosure of interest for this contribution.

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