COREVALVE EVOLUT R Program Next Generation Improvements and

COREVALVE EVOLUT R Program, Next Generation Improvements and Design Features Pieter Kappetein Chief Medical Officer, Medtronic

I, Pieter Kappetein, MD, Ph. D. I have relevant financial relationships: Employee of Medtronic

MEDTRONIC LEADERSHIP IN STRUCTURAL HEART THERAPIES A NUMBER OF FIRSTS 2000 2007 2013 FIRST Transcatheter Valve Commercially Approved TAVR (CE-mark) FDA-approved Early Feasibility Study Melody™ TPV Core. Valve™ TAV *Investigational devices and not approved for sale Harmony™ TPV* 2014 FIRST & ONLY Device to Demonstrate Superiority vs. SAVR in RCT 2017 FIRST LEADING TMVR to Initiate U. S. IDE Trial (Apollo) The Transformation in the Treatment of Structural Heart Disease Core. Valve™ Intrepid™ TAV Future TMV*

A DECADE OF INNOVATION WE HAVE COME A LONG WAY IN A SHORT TIME PAVR in Rotterdam : Vascular access Nov 2005

A DECADE OF CLINICAL RESEARCH WE HAVE COME A LONG WAY IN A SHORT TIME Extreme Risk High Risk Intermediate Risk ACC 2019

HEMODYNAMIC ADVANTAGE CLEAR PATIENT BENEFITS FROM EVOLUT’S SUPRA-ANNULAR DESIGN, INCREASINGLY IMPORTANT FOR YOUNGER PATIENTS Severe patient-prosthesis mismatch leads to increased mortality and HF hospitalization at 1 -year 6 Evolut R has larger EOAi’s and a lower risk of patient-prosthesis mismatch across all valve sizes

Objective Examine the incidence, predictors, and associations with 1 -year outcomes of PPM after TAVR in the large TVT registry of commercial US procedures J Am Coll Cardiol 2018; 72: 2701– 11

Study Population 1. 0 ± 0. 3 cm 2/m 2 [0. 4 - 2. 1] (2014 -2017) Histogram of EOAI (cm 2/m 2) J Am Coll Cardiol 2018; 72: 2701– 11

Mortality (%) 17. 2% Severe 15. 8% Moderate/None Adjusted HR (95% CI) 1. 19 (1. 09 -1. 31) p<0. 001

Where We Are Going

MEDTRONIC TAVR PIPELINE CONTINUOUS, MEANINGFUL INNOVATION BUILDING UPON OUR CORE Design Goals for Future Platforms: Evolut Platform Evolut PRO+ Evolut FX Next Gen TAVR • Industry Leading Hemodynamics & Durability § PRO performance with a complete range of valve sizes (including 34 mm) § Improved Positioning Accuracy • Excellent Procedural Outcomes § Transformative technologies for younger patients developed in the Horizon project • Safety with Recapturability & Repositionability • Advanced PVL solution TODAY § Lower Profile Catheter § Enhanced Visualization § 12 Fr Expandable Sheath 2019 BEYOND

NEXT GENERATION EVOLUTTM SYSTEM DESIGN GOALS: SAME PROVEN FOUNDATION WITH IMPROVED EASE OF USE EVOLUT PRO+ EVOLUT FX • Improved Deliverability & Positioning Accuracy • PRO Valve performance with a complete range (including 34 mm) • Enhanced Visualization • Lower Profile Catheter • 12 Fr Expandable Sheath In Development

MEDTRONIC CONFIDA EXPANDABLE SHEATH LOWEST PROFILE, EASIER PROCEDURE Design Goals: Medtronic Confida Expandable Sheath 12 Fr Profile Reduced Exchanges Hydrophilic Coating Expandable Sheath Stand-alone sheath reduces the need for exchanges On internal and external surfaces of sheath *Investigational devices and not approved for sale 1 5

MEDTRONIC HORIZON PROGRAM DESIGN GOALS: TRANSFORMATIVE PLATFORM TECHNOLOGIES STRIVING TO IMPROVE PATIENT OUTCOMES Medtronic is Developing Transformative Technologies to Deliver the Improved Performance Required by Future Patients Novel Deployment Mechanisms Stroke & Embolic Debris Reduction Enhanced Sealing Lifetime Management Solutions Conduction Disturbance Mitigation Solutions to Simplify the TAVR Procedure 1 6

WE ARE JUST GETTING STARTED INVESTING IN THERAPIES ACROSS STRUCTURAL HEART DISEASE Closing Option #1 Continuous innovation with therapies for specific disease states driven by patient anatomy and clinical needs PULMONIC* AORTIC *Investigational devices and not approved for sale MITRAL* TRICUSPID STRUCTURAL INTERVENTIONS

Closing OUR VISION TO TRANSFORM THE TREATMENT OF STRUCTURAL HEART DISEASE THROUGH COMMITTED COLLABORATION WITH HEALTHCARE PROVIDERS, WE ARE …Option #2

Thank You