Boston arrives late to the mitral valve party

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Boston Scientific has become the latest cardiovascular player to make a bet on the transcatheter mitral valve space. But, unlike other companies that have acquired new technology outright, Boston has taken the more conservative step of investing in MValve Technologies, with rights to buy it later.

Boston’s deal means that rival St. Jude Medical is the only major cardiology player that has not yet got a piece of the mitral valve action (see table below). If St. Jude wants to keep up with its peers it might make a move for one of the remaining smaller mitral valve specialists.

These are increasingly hard to come by, but one that sticks out is Canada’s Neovasc which is at a relatively advanced stage of development but has stayed out of the acquisition frenzy so far. Whether this is because of ongoing litigation with CardiAQ – now part of Edwards – or because of drawbacks with its technology is unclear.

Or perhaps Neovasc, which already has sales coming in from its Reducer product and $100m in the bank, is happy to go it alone for now.

Recent deals involving mitral valve companies
Buyer Target Deal type Date Up-front fee ($m) Total value ($m)
Edwards Lifesciences CardiAQ Acquisition July 10, 2015 350 400
Abbott Laboratories Tendyne Acquisition July 30, 2015 225 Undisclosed
Abbott Laboratories Cephea Valve Technologies Investment with right to acquire July 30, 2015 Undisclosed Undisclosed
Medtronic Twelve Acquisition August 25, 2015 408 458
HeartWare Valtech Cardio Acquisition September 2, 2015 ~360 ~818
Boston Scientific MValve Technologies Investment with right to acquire October 8, 2015 Undisclosed   Reportedly 200

Boston’s reasons for picking MValve seem sound: the Israeli company has developed a docking system that can be used in conjunction with its existing transcatheter aortic valve, Lotus.

Lotus – which is CE marked in the aortic space but not yet approved in the US – can be deployed inside the MValve docking system for use in transcatheter mitral valve replacement. The procedure has been described as similar to the valve-in-valve approach that can already be used in TAVI.

MValve recently announced the first human implantation of its system, which seems to have triggered the announcement of Boston’s investment. The bigger company has in fact been funding MValve since 2012, and in July 2014 the Israeli newspaper Globes reported that Boston had provided a $15m loan, with the option to acquire the company for $200m.

Like the recent Medtronic purchase Twelve, MValve has been in stealth mode until now, and further details on the company are scant.

Repair vs replacement

The latest deal raises the question of whether St. Jude will also soon get involved in the mitral valve space. As well as Neovasc, other potential targets include HighLife Medical and Caisson Interventional, both of which have received investment from Italian cardiovascular specialist Sorin, and Micro Interventional Devices, which is developing the Endovalve device.

But as well as replacement – where no products are currently approved in Europe or the US – there is also transcatheter mitral valve repair. Abbott leads the way with its FDA-approved MitraClip, while there are also a few CE-marked devices from Cardiac Dimensions, NeoChord and Valtech. The latter was recently acquired by HeartWare (Mitralmania continues as HeartWare buys Valtech, September 3, 2015). 

Smaller players in the repair space could also be ripe for picking, including Harpoon Medical, Valcare, coramaze technologies and Cardiosolutions. MitrAssist has developed a device that it claims is neither repair nor replacement, but is placed on top of the existing valve to assist it.

With all the activity in the transcatheter mitral valve space in the past few months, it would not be surprising if one or several of these companies were also acquired in the not-too-distant future. 

To contact the writer of this story email Madeleine Armstrong in London at madeleinea@epvantage.com or follow  @medtech_ma on Twitter

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