The Crux of Medtech

In this episode, host Henry Norton sits down with Anat Shani, CEO of Synchrony Medical, to talk about LibAirty™, the first FDA-cleared at-home airway clearance system and what it took to carry it from a COVID-era prototype to a US commercial launch.Key TopicsThe cystic fibrosis patient whose LibAirty device sustained her through a six-month, overseas transplant waitWhat airway clearance is, and why people with chronic lung disease need it every single dayHow LibAirty mimics a respiratory therapist using a guided-breathing vest synchronised with a coaching appBuilding inside the MEDX Xelerator venture studio and the Israeli Innovation Authority ecosystemGoing from FDA 510(k) clearance to early US commercialisationRelated InsightsWhy COVID accelerated the shift from hospital-based care into the home settingHow tight feedback loops between engineers, clinicians and patients shaped the deviceLeading and reinventing yourself as a first-time founder through doubt and through conflictWhy adherence, not just efficacy, is the real battleground in chronic respiratory careCore ChallengesChronic lung conditions like COPD, bronchiectasis and cystic fibrosis trap thick secretions in damaged airways, driving a vicious cycle of flare-ups, infections and decline. Daily airway clearance is the key to breaking that cycle, but there aren’t enough respiratory therapists to deliver it, and existing home methods are hard for patients to perform correctly on their own.LibAirty delivers therapist-level airway clearance at home by synchronising guided breathing with targeted chest compressions, clearing twice as much sputum as traditional vest-based therapy in clinical studies, while improving comfort and the long-term adherence patients need.🎧 Tune in now to hear how Synchrony Medical is turning expert-level respiratory therapy into a daily routine patients can do at home.The Crux of MedTech podcast is brought to you by Cruxx, a specialist surgical robotics recruitment agency. To learn more about Cruxx,⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠click here.⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠A big thank you to our sponsors on this season of the podcast; ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠TTP plc⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ With a 35-year track record, TTP excels in turning innovative ideas into market-ready solutions. Their team of 300+ experts deliver breakthrough solutions in areas ranging from endoluminal robotics and navigation systems to ultrasound imaging. Whether you're a startup or a multinational, ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠TTP plc⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ can accelerate your development with the latest technologies. Learn more at ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠TTP.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠

Raymond Cohen has spent 40+ years in medtech, never at a big company but always building. After taking Axonics from whiteboard to $500M in revenue and a Boston Scientific exit, he's now chairman of multiple high-growth ventures.In this episode, he breaks down what actually makes a company acquirable, why founders need to get over their fear of dilution, and the immigrant work ethic that's driven his entire career.Key Topics:Why Boston Scientific is outpacing every other strategic acquirer right nowThe "go big or go home" fundraising philosophy behind Spyro Medical's $67M Series AWhat "having the goods" actually means and why most founders don't know if they have themRaymond's criteria for joining a board: clinical problem, addressable market, and the right peopleHow LSI is filling the gap JP Morgan left for private medtech companiesRelated Insights:Neuromodulation as a pharmaceutical replacement: the Spyro asthma thesisCuffless ambulatory blood pressure monitoring and the BioBeat opportunityWhy the best people won't work for paper and how to structure equity properlyThe "tone from the top" principle and cutting underperformers earlyCore Challenges:Founders are paralysed by dilution fear, leading to undercapitalisation and slow execution.Raymonds's view: sell 85% on day one if that's what it takes to win.Too many startups pursue incremental innovation or enter crowded markets "the fifth person in a four-man race."Strategic acquirers beyond Boston Scientific have been passive, limiting exit options and slowing capital recycling in the ecosystem.🎧 Tune in now to hear how a 40-year medtech veteran thinks about building, buying, and betting big.

In this episode of the Crux of Cardio, host Jordan Bergen sits down with Filip Peters, Co-founder and CEO of Acorai, to unpack how his team is building a non-invasive device that reads the pressures inside the heart, using machine learning inspired by oil and gas diagnostics.Filip shared the full founder journey: from garage prototypes in Sweden through COVID, to a 1,600-patient study across six countries and FDA Breakthrough Device designation.He explained why Acorai chose to focus on the hospitalised heart failure workflow over remote monitoring, and broke down the economics that make every heart failure admission a loss for US hospitals.Filip also discussed the challenges of fundraising in today's market, navigating EU MDR as an AI-enabled device, and his advice for cardiovascular founders on staying in "science project mode" for as long as possible.Key Topics:The transition from finance and ML into medtech entrepreneurshipHow non-invasive haemodynamic monitoring works and why it mattersInpatient vs. remote monitoring, why Acorai chose the hospital workflowThe economics of heart failure admissions and the 20x ROI caseNavigating FDA Breakthrough Device designation and the TAP Pilot programmeEU MDR challenges for AI-enabled medical devicesFundraising strategy – raising over $50M and the role of strategic investorsGo-to-market: selling directly to US hospital operational expense budgetsRelated Insights:Cross-industry inspiration: applying signal detection from oil & gas and engine diagnostics to cardiac dataThe "gold standard" problem: inherent measurement error in right heart catheterisation and what it means for AI validationWhy clinical workflow friction kills more medtech products than bad technologyHealth system venture funds as an emerging capital source for cardiovascular startupsThe value of the Cedars-Sinai Accelerator and EIC Accelerator for European foundersCore Challenges:Current non-invasive tools for estimating cardiac pressures (echo, biomarkers, X-ray) are subjective, often lagging, and vary significantly between clinicians – leading to suboptimal therapy decisions and premature discharge of heart failure patients with residual congestion.Acorai has developed a non-invasive, ML-powered sensing platform that measures both left-sided and right-sided cardiac pressures, giving clinicians a repeatable, operator-independent haemodynamic assessment, targeting better decongestion, shorter length of stay, and lower readmission rates.Tune in now to hear how Acorai is turning oil rig science into the next vital sign for heart failure management.