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The Top Trends and Research From TCT 2026
By Viktor Zarev
November 4, 2026
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Together with
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“Give me enough blood tests and imaging procedures, and I can find something wrong with you. A lab value outside the normal range. A thyroid nodule. A bulging disc. A few premature heartbeats. Human bodies are wonderfully uncooperative with our preference for tidy categories.”
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Kirsten Balin, NP on “What Is Health For?”
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As you’ll read below, TCT is increasingly becoming an intersection between cardiac imaging and cardiac intervention. So I’m pretty stoked to unveil our two interviews from the conference that cover that intersection better than a municipally-appointed crossing guard.
First we heard from Haemonetics’ Gautam Natarajan about the freshly FDA-approved PerQSeal Elite vascular closure device, which is a key aspect of any catheter-based therapy.
Then we learned from Jaimin Chung and his team at Canon Medical Systems about the full suite of interventional cardiac imaging they offer for helping manage a patient’s procedural journey from start to end.
Hope you enjoy our coverage from the show,
Viktor Zarev, Senior Editor
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This year marked the 38th Transcatheter Cardiovascular Therapeutics conference, back on Cardiac Wire’s home turf in San Diego for only the second time. As the name implies catheter-based heart therapies are still the core of the meeting, but this year’s late-breakers and booth conversations showed just how much this cutting-edge cardiac segment is maturing.
Structural Heart Keeps Its Crown – TCT traditionally attracts cath lab interventionists and structural heart cardiologists with its mix of procedural focuses, but this year’s biggest late-breaker, PROGRESS, reaffirms that much of the buzz at the show is still about valves.
PCI Decisions and Planning Keep Getting Easier – Knowing when to intervene is half the battle in cardiology, and the imaging research and vendors at TCT 2026 leaned heavily on that paradigm. From fully integrated coronary imaging workflows to superb software accuracy that enables wire-free FFR, it’s clear imaging’s role in the specialty will only grow from here.
Cardiologists Have a Lot of Choices – While we’re on the topic of decision making, it’s clear that both the structural heart and PCI options are seeing a boom. There are now so many more approved devices for procedures like TAVR, TMVR, TTVR, M-TEER, T-TEER, ISR, IVL, etc… The alphabet soup is boiling over.
Consolidation is Key to Innovation – Both the therapy and imaging companies have figured out that time really is money to PCI and valve specialists. So, it’s no surprise many of the medtech innovations unveiled at TCT this year focused on combining procedural steps, shortening workflows, or keeping the process as simple as possible.
TCT Isn’t Just About The Heart – While not traditionally a stroke or vascular show, TCT is increasingly expanding its appeal to that side of the interventional coin as well with studies on renal denervation and thrombectomy making a splash.
It’s a Steady Show – Attendance numbers for catheter-based cardiology’s biggest show are stable, with TCT 2026 bringing in roughly 10-11k attendees compared to last year’s 11-12k. That’s a trend other major cardiology shows like AHA and ACC have not been able to replicate.
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A Rad’s Eye View
AI-enabled post-processing software dramatically reduces cardiac imaging analysis times while improving consistency and collaboration between radiologists and cardiologists. Hear from Laura Dragonetti, MD on how detailed CMR quantification enabled by Circle Cardiovascular Imaging detects disease much earlier.
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Canon’s 30 Years of Caring
For over 30 years, Canon has helped advance pediatric interventional cardiology through innovation and a commitment to better care. Learn more about how and why modern pediatric cardiac angiography came to be from one of its founding members, Dr. John P. Cheatham.
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- HBR Doesn’t Pick Aspirin-Free Winners: Aspirin is a big part of many cardiac patients’ drug regimens, but how high bleeding risk plays into the drug’s use is unclear. Presented at TCT, a post-hoc analysis of 2,189 patients from the PREMIUM trial who had been randomized to low-dose prasugrel monotherapy or DAPT found that HBR patients had far higher rates 12-month death, stroke, or MI (16.2% vs. 6.2%). Curiously, prasugrel monotherapy’s effect looked similar regardless of HBR status.
- DECISION-CTO Holds Steady at 10: A decade of follow-up data from DECISION-CTO presented at TCT offers us a rare 10-year randomized look at opening chronic total occlusions. Researchers randomized patients to CTO-PCI or no CTO-PCI, with 688 completing the study’s 10-year follow-up. After a decade of data collection, analysis found that the composite of death, MI, stroke, or any revascularization hit 33.9% with CTO-PCI vs. 37.4% without. Earlier reports found no difference at three and five years, so the real question is whether that gap holds up statistically.
- A Second Balloon Tap for TAVR: Should operators re-inflate the delivery balloon after every balloon-expandable TAVR? To answer this, the DUOTAP randomized trial tested routine postdilation (re-inflation) and found that the practice cut transcatheter valve asymmetry by 70%. Looking back at earlier studies, we know uneven valve expansion has been tied to worse hemodynamics and earlier valve dysfunction, so the geometry of the re-inflation matters. Whether it translates into better clinical outcomes will depend on the trial’s planned five-year follow-up.
- Moderate AS Makes Its TAVR Case: EARLY TAVR made strides toward redefining what we think of as asymptomatic AS, but moderate aortic stenosis is still a watch-and-wait condition for many. That could be changing though, after the PROGRESS trial randomized 744 patients with moderate AS plus at least one at-risk feature to TAVR or clinical surveillance. At two years, death or HF events hit 16.7% with TAVR vs. 23.9% with surveillance. That 33% relative reduction was driven mostly by HF hospitalizations. Some details worth noting – Edwards funded the trial and it has the same PI as EARLY TAVR.
- J&J’s Javelin Spears Tough Lesions: Moving to tech news from TCT, Johnson & Johnson’s investigational Shockwave Javelin coronary IVL catheter beat both performance goals in its 158-patient FORWARD CAD IDE study. Unlike balloon-based IVL, Javelin fires acoustic pressure waves from a single distal emitter, reaching lesions a balloon can’t cross. Technical success hit 93.6% and 30-day MACE freedom was 93.4%. These results were for lesions averaging 81% stenosis, 20% of which were CTOs. As a single-arm study, it doesn’t offer head-to-head comparison with existing calcium modification tools.
- Philips Gives HyperVue a Home: One angiographic view is all the X1-FFR technology needs to produce an FFR value, and now Philips is building it into its cath lab offerings. The company launched the HyperVue Integrated System in the U.S. It’s a 510(k)-cleared, permanently installed setup that pairs DeepOCT+NIRS intravascular imaging with AI-powered X1-FFR physiology, controlled from a table-mounted touchscreen. The X1-FFR technology was at the center of Philips’ acquisition of SpectraWAVE early this year.
- ANDES: Less Bleeding, New Clot Question: New data suggests that two months of a DOAC after LAAO beats DAPT on bleeding, but late blood clots can complicate things. One-year ANDES data from 510 patients showed less overall bleeding with DOACs (24.1% vs. 32.3%), driven by minor bleeds, with no differences in death, stroke, or major bleeding. Device-related thrombosis, however, ran numerically higher at one year (5.2% vs. 2.3%) and reached significance among patients who switched to single antiplatelets. Investigators consider ANDES to be hypothesis-generating, citing incomplete imaging.
- SIMPLAAFY Lives Up to Its Name: In more post-LAAO drug news, Boston Scientific’s SIMPLAAFY trial went much bigger than ANDES. The 1,857-patient RCT found that aspirin alone and reduced-dose NOACs were both noninferior to DAPT after WATCHMAN FLX Pro implantation. The six-month composite of death, stroke, systemic embolism, or major bleeding hit 6.9% with DAPT, 5.1% with NOACs, and 3.3% with aspirin, and ischemic stroke rates were identical at 0.7%. NOACs had the least 45-day device thrombus (0.9% vs. 3.4%), though ANDES suggests watching for late DRT.
- Big-Bore Thrombectomy Holds Up in Women: Good news for women with pulmonary embolism. A prespecified SYMPHONY-PE IDE analysis of 106 intermediate-risk PE patients (42 women) suggests that Imperative Care’s Symphony thrombectomy system performed comparably in both sexes. Neither group had deaths or device-related serious adverse events through 30 days. Women even posted lower 48-hour RV/LV ratios (1.03 vs. 1.14) despite more baseline cardiac stress. With just 42 women, larger studies are still needed.
- A Pocket ECG for Heart Attacks: Picture a patient with chest pain recording a 3D ECG at home on a credit-card-sized device. HeartBeam’s 132-patient ALIGN-ACS pilot in Serbian EDs showed its patient-recorded ECGs had sensitivity for ACS comparable to a standard 12-lead (60.2% vs. 63.0%) and higher specificity (81.8% vs. 71.4%). Every patient’s ECG was recorded successfully. While HeartBeam’s heart attack indication, granted through FDA Breakthrough Device Designation, remains investigational, a U.S. pivotal study is slated for Q1 2027. The device is already cleared for arrhythmia detection.
- Abbott Doubles Up at TCT: It was a busy TCT for Abbott. Its own investigational SonicForce coronary IVL system hit both primary endpoints in the 335-patient TECTONIC IDE study, with 97% procedural success and a 0.3% rate of 30-day target lesion failure. Meanwhile, one-year VERITAS data showed its next-gen Amulet 360 LAA occluder achieved complete closure in 96.3% of TEE-evaluated patients, with over 98% free from ischemic stroke or systemic embolism. Both devices remain investigational in the U.S., and SonicForce is heading into an increasingly crowded IVL field.
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State-of-the-Art Cardiac Monitoring at Scale
Cleared for 13 different heart rhythm interpretations, AccurKardia’s AccurECG 2.0 shortens the time from an arrhythmia incident to clinical intervention. Watch here to find out how AccurKardia and Specialized Medical are teaming up to bring the AccurECG 2.0 technology to clinicians across the U.S.
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- Pulmonary Hypertension Detection With a Single Echo Clip: Pulmonary hypertension is often diagnosed late, when irreversible vascular remodelling has already occurred. That’s changing, however, with Us2.ai’s spatiotemporal transformer technology that can process apical four-chamber echo and accurately detects pulmonary hypertension far beyond the single-view echocardiographic benchmark.
- VASCADE MVP® XL Vascular Closure System: Sometimes EP procedures call for a venous vascular closure system that is simply bigger. Haemonetics’ VASCADE MVP XL closure system comes with 58% more collagen and a 9% larger disc compared to the VASCADE MVP system as well as an expanded indication for utilizing 10-14F inner diameter sheaths.
- How AI Expands the Role of CMR Experts: If you’re an MRI technologist, AI could be the best thing that ever happened to your career. Read here to learn about the benefits of AI for CMR experts and how it can accelerate both your training and career.
- Meet with Optum at RSNA 2026: Whether you’re evaluating PACS replacement, cloud migration, AI readiness or enterprise imaging expansion, meet with Optum at RSNA to see the latest advancements and explore practical strategies for modernizing imaging while reducing complexity.
- Beyond Heart Rate – What ECG Intervals Can Reveal: The ECG waveform contains more information than heart rate alone. For device makers and cardiac software developers, interval measurement is an important part of translating raw signals into usable data. Explore Monebo’s Kinetic Intervals technology and its role in ECG analysis.
- Fujifilm’s Ultrasound for every Cardiovascular Ultrasound Environment: From academia to clinical diagnostics, versatility in cardiac ultrasound is essential. Discover why clinicians are choosing Fujifilm’s LISENDO 880 for exceptional image quality, comprehensive strain analysis, stress imaging, and innovative Virtual Contrast technology — all while delivering outstanding value.
- Integrating AI for Enhanced Echo: Sometimes it pays dividends to be an early adopter. Find out how the Christ Hospital’s early evaluation of Merge Cardio 12.5 allowed for remote echocardiography measurements, enhanced reporting accuracy, and a seamless user experience, bringing even greater efficiencies and clinical confidence.
- HFSA Late-Breaker Findings: New research presented as a Late Breaker at HFSA demonstrated that patients receiving CCM® Therapy experienced significant long-term improvements in heart failure hospitalization rates and other key measures of cardiac health, including NT-proBNP, functional status, quality of life, and diuretic use… Read More.
- Making the Leap to Outsource Post-Processing: Interested in how to outsource cardiac image post-processing, but not sure where to start? PIA walks you through how to assess and compare vendors, understand pricing models and payment options, and outline your requirements to identify vendors who meet your clinical needs.
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