Keynote with Todd Brinton, CSO & Corporate VP at Edwards Lifesciences | LSI Europe '24

Todd Brinton 00:05
All right. Thank you very much. Thank you all for being here. Thanks, Todd, for doing this. I twisted his arm a little bit, but it's a really great story, and I hope that it's as inspirational for you as it was for me because I've worked and known Todd for many, many years. Getting this opportunity to actually step through his background and what has made him a successful leader in this industry is a really cool story. So I'm just going to go right into it, Todd. Let's start with your early years. Where were you born? Tell us. Tell me about your parents.

Todd Brinton 00:38
You know, what were your original aspirations before you went to college? You know, what was inspiring to you at that time?

Todd Brinton 00:46
He was really gonna go at it, isn't he, right?

Josh Makower (Moderator) 00:49
I'm gonna do it.

Todd Brinton 00:50
We talked about this. I'm like, I'm not sure he's interested in this. Oh, yes, they are. So I was born in the Bay Area, Northern California. My mother was the medical records librarian at El Camino Hospital, which is where the Fogarty Center is now based. I was raised actually in San Luis Obispo, a small town on the central coast of California. Grew up there—a small town, great place to grow up. My vision was to get, you know, to grow a little older and go to the big city, basically, when I got older, which ended up being San Diego for college. It wasn't exactly a huge city, but it was much bigger than the town I grew up in. My interest was originally, I had early aspirations for medicine. My mom still has this report I wrote when I think I was in second grade on how to be a doctor. She still holds it over my head, but everything after that turned into, my father was an engineer. His father was an engineer. There are no physicians anywhere in the family. So when I was getting ready to go to college, touring basically in a station wagon with my sister in the back seat with me, my dad asked me, "What are you interested in doing?" I said, "You know, I really love anatomy and biology." And he goes, "Great, biomedical engineering," and that was literally the end of the discussion. And I'm really not joking. I mean, that was really the end of the discussion. So I went into biomedical engineering, and one of the premier programs to go to was UC San Diego, which is why I ended up there. I also had a small—for I played water polo through high school. I played collegiate water polo in college and on the national team. So that was a big water polo power too. So it was kind of the perfect combination. And although I'd love to tell you it was all about engineering back then, it was really all about water polo.

Josh Makower (Moderator) 02:30
And while you were there, you got involved in an early company, yeah, that was your first exposure to the entrepreneur world. So,

Todd Brinton 02:38
you know, my father, who has been just a phenomenal—and still is a phenomenal mentor—said, "You need to get involved in something in industry. Learn, get some experience. It's not just about the classes you take." So I went to the job board at UCSD, and there were literally two guys and a dog that were starting a company that had come from Bell Labs, and they were looking for someone to do kind of strategy and some engineering work. I picked up the card, and I ended up going to work for a small company called Pulse Metric, which was just north of UCSD. It was a great experience. I learned a ton and ended up working there for four and a half years out of college.

Josh Makower (Moderator) 03:09
And what was Pulse Metric?

Todd Brinton 03:11
So it was a non-invasive blood pressure company that was really trying to develop a technique to actually, you know, way ahead of its time, monitor heart failure. They were really trying to come up with a way to manage heart failure patients. They had this idea that if they gave more data to the physician, it'd be better, which I think we all realize is not the case anymore, but we were, like I said, way ahead of our time. So, but it ended up being an early-stage company that raised venture capital money, and I got to pitch. Of all people, I ended up pitching to Tom Fogarty from Three Arch back. This was back in 1993. I remember, you know, the legend Tom Fogarty and sitting across the table from him pitching, and ultimately, we raised a little money from Three Arch, and ultimately that was an incredible learning experience for me and gave me kind of the inspiration for what I wanted to do in my career.

Josh Makower (Moderator) 04:09
That's awesome. Also, that opportunity actually introduces just some other important people that became, yeah, in your life, yeah.

Todd Brinton 04:17
So if it doesn't come out, I'll say now I think probably the thing that's been the most impactful in my career are mentors, Josh being one of them. Those are the things that make the biggest change, you know, opportunity and create the biggest opportunities for you in your career. For me, it was a guy named Tony deMaria, who was a cardiologist, the Chief of Cardiology at UCSD, who just happened to be interested in something I was working on and kind of took me under his wing. He's ultimately the guy that considered and told me, "I think you should go to medical school." I had kind of dismissed it, thinking I was going to be in industry. Of course, I was getting older, and it was like, why would I want to go back to medical school? When I was four and a half years out of college, I'd be way behind. There wouldn't be the thing. It's long training. He was the one that really made me think, what really motivates you, what excites you. He was a huge inspiration.

Josh Makower (Moderator) 05:12
That's cool. And it was just easy getting in from there.

Todd Brinton 05:17
No, we've had this discussion. Obviously, it was very hard for me to get into med school. I graduated with a biomedical engineering degree from UCSD. I didn't have exactly the vision to go to medical school immediately, so I had to go back and take some training classes and study for the MCATs and all those things. I applied to medical school, and I was doing this research with a company, and this great, internationally known Tony deMaria was the president of cardiology. He was the editor of JACC, one of the most prestigious journals in the world. I couldn't get into med school. I sent my application in at that time. We were kind of at an all-time high. And those remember, you get kind of 92, 2000, 2008—what do these have in common? Huge recessions. It was really difficult. So whenever there's a recession, graduate school applications go up massively—lots of competition. I applied to medical school and literally didn't get a single interview the first time, which means that I really, really screwed up. DeMaria was probably the driving force that encouraged me to continue to do it. The way this cycle works, I couldn't apply the next year; the cycle had almost gone by by the time you find out. So I applied the second time, and to be honest, it chokes me up every time because I applied. I got two interviews. I bombed one of the interviews. The other interview went okay, but I didn't hear. If anyone knows about medical school, the cycle is generally that schools start, you know, July, August, and by the time May comes along, I mean, everyone's accepted their classes in January and February, and I'm sitting in May, and I have no option. It looked like I wasn't going to med school. I ended up talking to DeMaria, and he said, "How bad do you really, really want this?" I said, "You know, the hardest thing in life is when you figure out you think you know what you want to do, you've really decided, and they're not going to let you do it." He said, "Well, let me tell you what I want you to do. Get a plane. Use any excuse you can and get in front of the admissions director, and don't just say that you want to go to medical school. Tell him why you want to go to that medical school." So I took his advice. I had very little money. I bought a plane ticket, a red-eye, flew out to Chicago, rented a car, drove up to the Chicago Medical School, and sat outside the office for about four hours. The admissions director saw me, and I took an abstract that had just gotten accepted to the American Heart Association. I said, "I just want to update my resume, and I really want to go to med school." She listened to me for about four or five minutes, and then she asked me questions and said, "Why? Why do you really want to go to med school here?" Just like DeMaria told me she would. I answered the questions for a few minutes. She said, "Okay, good luck to you." I left. By the way, this was the Thursday before Memorial Day weekend. Medical school started in July, so we're like six weeks from medical school starting. I flew home, got home on Thursday night. On Friday, I got home from work. In the old days, remember the answering machines? You turned on that there were no cell phones or that stuff, right? I turned it on, and I was like, "Beep." There was a message from the Chicago Medical School in the afternoon on Friday night saying, "Please call us back." They were two hours later, and I called and talked to security. The whole weekend, I waited. I called Tuesday morning, thinking, you know, what's the news, and they never called me back. When I opened the door to go to work was my admission to medical school. So big, big, big message, which is if you want something bad enough, you got to fight for it. You know, and that's true for entrepreneurs. It's true of anything. You really have to be willing to fight for it. It was one of the best lessons I learned, and the big second lesson was DeMaria told me, "You got in, now make the most of it." I remember those two things probably as one of the big things for me.

Josh Makower (Moderator) 08:49
This is amazing, Todd, because knowing you as an incredible physician and leader, to imagine you might not have been allowed to get to medical school is just mind-blowing. I just think there's a lot of parallels in your story, where you know, you've accomplished things, you know, despite many, many barriers and obstacles. I think it's really amazing. So, along the way through medical school, there was some eventual interest in Stanford, or what was going on with the Device Center with Fitzgerald and Yock? Talk about how you got there.

Todd Brinton 09:29
So Tony DeMaria, being an incredible mentor all the way through med school, I ended up paying for a good portion of med school, still working for the startup company. I was still working at night as a consultant for this company that ultimately failed in the long run, but it was an incredible opportunity—lots of learning—but it also helped me pay for med school. Along the way, Tony DeMaria was mentoring me, saying, "What do you want to do?" He was a big imaging guy and medical devices. But I really thought from my time and training and the time I spent in industry, I really loved interventional cardiology. I loved the cath lab, the excitement of trying to really figure out stuff and take care of patients. He said, "Look, the two best guys in the field were Paul Yock and Peter Fitzgerald that were at Stanford." He said, "If you really want to do that, that's where you want to look at going." Ultimately, that's what directed me to Stanford. There was no Biodesign yet. None of that stuff had happened yet until 2000, and so that was really the impetus for going there. I interviewed there, and I was very fortunate. I ended up applying for my internship at Stanford and got accepted. When I got accepted, I was probably three or four months in, and then they had a program that exists at about 15 universities, which is called short tracking, which, by the way, is long tracking, but you spend two years of your residency in exchange for five years of fellowship so you can go deeper in subspecialty. You had to track into a lab. I remember interviewing with both Paul and Peter, and I was ultimately running Paul's lab for the first couple of years while I was a resident, and then tracked into cardiology fellowship and ultimately had an extra research year, which is how I ended up doing a Biodesign fellowship.

Josh Makower (Moderator) 11:07
And that's where we met. Talk about your Biodesign experience. Maybe, for some people who may not know what it is, maybe describe the fellowship.

Todd Brinton 11:18
I just, as someone who, obviously, the guy who started it, but ultimately someone who tried to follow in, switch ups and run it for the next 15 years. After that, it evolved a lot over time. Right in the early years, it was, you know, Josh really hands-on with, you know, three—the first year. For I think my year, there were five fellows, and it was an opportunity to kind of focus purely on innovation. I chose a different area to go into. For me, I was interested in cardiovascular, and I'll tell you, we didn't talk about this, but this was another big failure point for me because I had this great idea that I would go invent something great during my fellowship, and I did this, like, two or three months of discovery with some of the leading experts at Stanford. I brought the list to Josh. I must remember, he does remember. I was like, "This is all really good stuff." He spent a couple of minutes being very polite looking at it, and he said, "This is 20 solutions. There's not 20 problems here. There's not needs." The whole idea behind Biodesign was needs-driven innovation—to look at a space that you thought was interesting. Of course, I proceeded to argue with Josh, and it really taught me a lot that most of our thinking, especially as a physician engineer, we think in the solution world. We don't think in the problem world. We think about what we know already, as opposed to trying to flip around and say what we feel uncomfortable with, what we don't understand. That was a good lesson for me too.

Josh Makower (Moderator) 12:46
I vaguely do remember that conversation.

Todd Brinton 12:48
And you eventually, obviously, I mean, as I said last night, you're an incredible leader, and you really, I think, are, you know, sort of a powerful presence and were the perfect choice to step in. I ran into this point in my career where I had made the mistake of creating four companies all within four years, and they were all really begging for my time. I just was having trouble juggling everything, and I felt like I really needed to invest myself in my startups for a while. So we needed, I needed someone to come run the fellowship at Biodesign, and we picked Todd. So talk about that experience and becoming the fellowship director and sort of how you and I will say the Biodesign fellowship got shaped substantially under Todd's leadership. You really reimagined things and brought many, many new things to it.

Todd Brinton 13:52
I think that, you know, I think it got brought up last night, which is we used to have a dartboard with Josh's picture up on it, and we threw darts at it. The theme I learned from Josh after I became fellowship director is they love you in July. That's when you start. They hate you in December. The key is, you want them to still love you in June when you finish. His point was, if they don't hate you in December, they'll never love you in June. So I became kind of legendary for tough love. I was the tough love guy, which was, "You're not driving hard enough; you're not doing it enough." Working with, trying to drive the fellows on their projects was ultimately what my job was. I was very fortunate the first couple of years because, you know, I just finished the fellowship. I finished my cardiology training and my interventional fellowship. I joined the faculty. I was in clinical practice at the same time I was trying to mentor these fellows, and they explained these programs they were working in in other areas where it wasn't necessarily cardiovascular disease. I would go, "Hmm, very interesting. Okay, you know what? Let me think about it, and I'll get back to you on what we should do." Then I would run into the office and call Josh, and Josh and I would talk about it for half an hour. I would walk out and go, "You know, I've been thinking about this very deeply." After over the 15 years, it was one of the best experiences I had because I got to see so many projects and so many challenges and needs and, you know, defining what they were and solutions and a lot of the hang-ups that we all run into along the way, and that became the basis for me starting companies. I became an entrepreneur because I watched others and learned and got trained by people like Josh.

Josh Makower (Moderator) 15:29
And I would just say, you know, Todd, you know, obviously, is an impressive guy with many accomplishments and, you know, a tremendous success just in recent history, but incredibly, actually really humble. When we first started talking about you taking that on, I remember you saying to me, "I haven't had any big successes yet. I mean, how can I, like, you know, teach these people and represent myself?" I was just like, you know, that was me too. I was there. I was there too. When we first started the fellowship, I had a few companies, but I didn't have any real successes to point to yet. But I think it would be great now to sort of pivot because while this arc of, you know, training and then running Biodesign and being an active interventional cardiologist, you've also got a thread along the lines of your entrepreneurial experiences. I want, let's just sort of step through those—the early ones, the successes and failures—who wound up getting integrated and attached to your world, and despite those failures, some of those fails still saw something in you that they wanted to work on your next things. Maybe let's go back to those early companies. Maybe, what would it be, VenoMatrix? Would they be the first one?

Todd Brinton 16:46
So I started a company out of the fellowship. A very common thing was, you know, you work on a project. I thought that I had this, you know, really interesting area for, as it turns out, heart failure management, which was basically a kind of ultrasound patch to sit over, basically the liver over the IVC and look at measurements to kind of manage patients. I didn't, I just had some experience in basically learning through the Biodesign fellowship. I'd had experience in industry as an engineer, but I really didn't know how to put it all together. Luckily, Paul introduced me to Casey McGinn at Wilson Sonsini, and he sat down with me and said, "I really like this idea. We'll work with you. We'll help you. We'll support you." I didn't have any money. That was a common theme you hear, but he supported me and connected me to Jim Shay and Ben Glen, who were two phenomenal IP attorneys that were at that time. They eventually spun their own firm out, but they were at Wilson. I ran up a pretty significant bill filing my first patents, and then the dark period ended, and we found a patent that literally read on my IP that I filed that literally was about two weeks earlier, and it didn't look like we had a patent. So I made the tough decision to not pursue the company. I had this, I think it was about a $17,000 or $18,000 bill with Wilson Sonsini, and I walked into Casey's office and sat down with him, and he said, "Well, we gotta deal with this bill." I couldn't pay the bill. I mean, there was no way. I had a two-year-old at home. I was junior faculty in interventional cardiology. I was working 100 hours a week. I just didn't have any way to pay a $17,000 bill or whatever it was. Casey looked at me, and he said, "Tell you what. I’ll write this off on one condition." I literally thought he'd say, "You never show your face here again." Casey said, "You bring your next project to me." That ended up being a company called Bioparadox, which was a company I did with a guy named Allan Mishra, and ultimately, that's how I met Jay Watkins. It was De Novo Ventures that backed that project. I learned a ton. The experience I got was probably the most notable because ultimately, Bioparadox, like VenoMatrix, didn't make it, but I got the chance to work with Jay Watkins. Jay basically had us meet at the De Novo office every week, and he spent two hours with us. Two hours a week with someone like Jay Watkins was an unbelievable experience. I think that was also very, very instrumental in my development and learning. We did all the animal work. We developed this therapy, we peripheral vascular and cardiac, and we thought we were very close to a deal with a strategic, and ultimately, in the end, it blew up. We couldn't raise more money, and we ended up having to shut down the company. But I learned a ton through that experience. I don't think that these two experiences were the whole basis for probably why I started at the same time Shockwave, which was started to actually—I looked back at some things the other day. We started in December 2007. We incorporated in 2009, but the project started in 2007, so I was only a couple of years out of training, and I learned so much from the experiences and a lot of the failures that really helped a lot.

Josh Makower (Moderator) 19:58
I just want to dwell on that a little because at that moment, you've had two unsuccessful experiences, and there are people who've been on that ride with you, but somehow you didn't give up. You decided to continue to proceed and do another one. How can you take us to what that felt like and what it was like? Jay, remind people what De Novo was because the firm doesn't exist.

Todd Brinton 20:31
De Novo Ventures was known from John Simpson's, right? We've got a John Simpson's venture fund. There were five partners, and Jay Watkins was one of them. I got connected with him by Paul Yock again, another incredible mentor. Why did I do it? I would say that they were all running in parallel, so I didn't know any better. I mean, I think that they were, you know, much like Josh, who had four companies, I was kind of had three. One of them failed; one of them is still going because Bioparadox went from probably 2008 to 2012, and Shockwave started in 2007. We incorporated in 2009, and ultimately, luckily, still exists today. To me, it was the opportunity to do something that was meaningful. The way I was raised, my parents, the values were, "Do something that matters." I still, as a child, remember growing up, high school, college—do something that matters. I would say that this was probably the most important theme. Along the way in my career, I really wanted to be doing something that was impactful. It could be different things. I felt that what I did in the cath lab, operating three full days a week for most of my career, mattered, that I was doing something that was life-saving. Therefore, it mattered. The things I was working on, I felt like they were big enough and interesting enough that they could change medicine if I was very lucky enough to have them work out. That was probably what drove me more than it was thinking about the failures. There's no way that I would have ever gotten to any of the things we thought about at Shockwave. I mean, I took Shockwave to Casey, you know, and Casey, you know, denoted, but ultimately, Bioparadox failed as well. Eventually, he backed that program as well. He backed Shockwave. I think he made plenty of money back, by the way. That's the way it works. It was a whole group of people that you met along the way, and Shockwave was the one I probably met the most people.

Josh Makower (Moderator) 22:31
Obviously. I know this is an international audience, and there are a lot of different cultures and a lot of different feelings about failure. But I think just, I want to just pause on that because, you know, from those failures came, you know, the next thing was one of the biggest outcomes in medical technology, and that's something really to just, you know, just step back a second. Let's just think about it. Everybody has their companies here, and it's a struggle, and so on. I think the longer-term view of the things that you learn from that, the people that you meet along the way, and how you treat them and how they treat you really forms the bonds that actually turn out to be fibers of your career that create a foundation for an ultimate success, right? So let's talk about Shockwave and the, you know, sort of how did it come about? How did you get, you know, where, what was your role, or who were the people that you then got connected to on that journey?

Todd Brinton 23:30
So Shockwave was conceived in a very interesting way. Daniel Hawkins and John Adams were backed by Three Arch and Prospect Ventures and a small little incubator. They had some money to start to go find a program, and they were, frankly, struggling to do so. I got hired by Prospect Ventures. What I used to do a lot of diligence for, again, the theme of me trying to get paid to make money to pay the bills. They said to me, "Why don't you meet with these guys and see if you guys can come up with an idea together?" The idea that I had was I was struggling in the cath lab with calcified coronary disease. I was doing roto-blader training. I was a high-volume coronary interventionalist doing a lot of complex PCI. The staff was like, "Oh God," every time you pull that roto-blader. There were complications. It was difficult. You only use it in a few cases. I said, "This is a problem everybody has, but it doesn't seem like we have a good solution." I kind of framed the problem to Daniel and John. We sat around, I wrote out a needs spec, a Biodesign needs spec, and said that the fundamentals were it needed to have something that could ultimately dilate a vessel that was highly calcified in a radial direction. But the key was it had to be flexible and deliverable. What I put as the predicate was studying interventional cardiology. The things that I had learned were that we call a front-end balloon, an everyday working angioplasty balloon, crosses 99% of the time, and most of the devices are between calcium cross like 70% of the time. They weren't flexible; they couldn't deliver. I said, "It's got to be like that, but it's got to have the behavior." We all sat around and said, "Well, how do you treat calcium today?" We all went, "Lithotripsy." Ultimately, that became the basis for the idea of trying to put lithotripsy inside of a balloon, and that became the fundamental discovery and invention for Shockwave. At the time, we were a virtual company. I was still in practice as an interventional cardiologist. We couldn't get the project funded. We went to every venture group on Earth. The original investment had been done by Prospect and Three Arch, but no one—and this was the recovery of 2008—was interested in doing new investments, and not a big project that looked like it was going to be long. We really couldn't raise money. We ultimately convinced Three Arch and Prospect to spin out the IP and give it directly to us. In fact, the invention was really Daniel Hawkins and John Adams. They invented. I was at Stanford. I didn't want to invent. I did want to participate in the invention process. They ultimately drew up the invention. I spoke, sat, and kind of defined the need. Ultimately, we put the company together. They flew down and walked into Casey's office one night and incorporated the company in 2009, and that became the basis for Shockwave.

Josh Makower (Moderator) 26:12
And how did Fred Moll get involved? When did that happen?

Todd Brinton 26:15
Fred got involved in like late 2010, 2011 because we were looking to raise money. We had no money. We wrote—we had $180,000 basically we'd raised from friends and family. Probably another proud moment is my dad wrote the first check, $50,000. My parents are not super wealthy, and they said, "Why do you believe in this?" I said, "Look, I've learned enough. I've failed enough. I really think this one really has a chance." They wrote a check. We opened a small little 600 square foot office. I said, "We—it was me and an engineer. We hired Tom Goff at the time." Basically, I used to flush out Ibis catheters from the cases I did during the day. I bought an Ibis machine, an intravascular ultrasound machine in Japan, had it shipped on a pallet for 500 bucks, and I built a lab, basically. I still have a picture of my daughter at the time, who was about four or five, with crayons, which is I would dissect. I would show up to the office. I'd have amputated limbs for the posterior lower leg, and I would dissect out the posterior tib. I'd put it basically in the water bath, and I put a balloon in it. We did all the experiments at night from the Ibis catheter I used during the day. Unfortunately, even as much as you flush them, they'd clot if I didn't do it that day. We did that for, you know, that was probably 9 to 10 months. Fred, at the time, had worked at Intuitive and now is at Hansen Medical, and he was interested and had said, "Well, this is kind of interesting." He invested in different things. He saw our pitch a couple of different times, and not until he actually was in Europe doing cases in peripheral did he all of a sudden say, "This calcium thing seems like a really big problem." He called us one day and said, "What was that thing you were talking about?" He ended up doing our first kind of non-institutional equity round, and he became chairman of the company.

Josh Makower (Moderator) 28:04
Yeah. And was he chairman when you went to that Bohemian meeting and met Anton?

Todd Brinton 28:09
He was. He was chairman when we went. It was Fred, Jay Watkins, myself, and we got introduced to Antoine Papinck for dinner in the Bay Area. Jay really organized it all. Fred was chairman. Jay was even involved in the company at that time. We started the company, Antoine. We had this data. I presented to Antoine at the Bohemian conference, basically in Istanbul. After getting beat up for nine months of diligence, we ended up getting a term sheet from Antoine. Ultimately, we ended up putting together a really good group. I think one of the reasons for success, I believe, for Shockwave was a really good team—not just the people, but the board. We had a really strong board, and Jay Watkins became our independent board member. Jay, Fred, and Juan Papinck—we added several other people to it. It was a great—it just had all the right pieces to it.

Josh Makower (Moderator) 29:00
And again, we got lucky.

Todd Brinton 29:01
Yeah, and I mean, but so it's just an easy course from there. Shockwave wound up getting all the financing it needed and never—

Todd Brinton 29:09
It still struggled. You know, every round was difficult. Lots of—so we were having dinner last night. We were talking about one of the experiences. I think we all have PTSD from different rounds of financing. I remember discovering, I think it was the Series B or C, discovering some patent that was in some other language that we thought. I remember I was driving in Palo Alto, I was on the phone, and they were calling, "You're dead; you're done; the company is not going to be financeable." It turns out that the claims, when they got converted to English, didn't mean the same things, and we ended up having space and claims to ultimately be able to fund the company. For those of you there, you know, you're all on this journey. I mean, it's normal to have the ups and downs. I used to say that the only way mentally that I felt I could get through was the portfolio approach. At any point in time, something I was working on hopefully was working, something hopefully was going okay in the cath lab, and some other project was probably failing. That just kept me enough mentally through the day. I think probably one of the things that was the most instrumental is that it was really the challenges of failure, of feeling like you put all your resources, everything you did into something, and it wasn't going to go were scary enough that balancing it out with being a practicing interventionist that day at least—I tell myself, at least one at home that night, I did something that mattered. If everything else was failing, at least that day, that patient did better or survived, or their big acute, you know, infarct, or shock, or whatever it was I was treating. At least that really helped me a lot and get through it because it is a roller coaster, and those of you that—most of you are in it—it is the ultimate roller coaster.

Josh Makower (Moderator) 30:43
Yeah, amazing, amazing story. I want to—so at the time that Mike Lu first approached you, had Shockwave gone public yet? Or was it—

Todd Brinton 30:56
No, we had filed, actually, confidentially, to go public. Really out of nowhere, I got a phone call that, ironically, I look back and I ignored multiple times. I thought, "I'm not going to call this person back." It was a headhunter, ultimately. I ultimately got on the phone, and they were actually—and they were originally interested in Josh, of all people. They were looking for somebody who could run this, but we're thinking about Josh Makower and said, "Oh, sounds great to me." They were like, "Bob, we're not sure. Do you know anybody else that might be interested in this?" I actually said, "No, I don't." The honest truth is, I ultimately found out it was Edwards and Mike Mussallem. After a number of months going back and forth, I actually learned about the role, interviewed, was offered the role, and actually told them no because we were going through—at that time, we were very close to the IPO. I was very busy. I think one of the things that was really, really important to me when I thought about it was multiple people I talked to. I talked to Jay, I talked to Fred, my parents. I said, "Should I leave and should I go to the dark side? Should I go to industry? Should I go to corporate?" I've been an entrepreneur, and people said, "Nina, I think to this day, I remember Josh telling me, 'What are you doing?'" Mike really convinced me there was a big opportunity to do something very meaningful, that Edwards was going through the evolution of what they developed with TAVR things and had this real growth period that they were going to be going through. To have the opportunity to grow internally, to run the internal innovation program and external evaluation, evaluate companies and make decisions about what we buy and what we don't buy. It seemed like a great opportunity, but I turned it down because I was scared. I was very—things in my life finally—Shockwave looked like it was going to go to an IPO. I was going to have some liquidity. I thought my practice was actually finally established. I was teaching and kind of established myself. I thought, "It can't get better." I was basically afraid. Actually, the reason I took the job was I used to tell the fellows every day, "You cannot let fear drive your decision-making." I said, "I'm the biggest hypocrite if I don't take this job." Ultimately, my wife and I sat down. She was incredibly supportive of changing her whole life and moving to Southern California because Mike's big one lever was, "You need to be on my team here in Southern California." That was not negotiable. He was willing to be flexible on lots of other things, but that was not negotiable. I decided, "Okay, what the hell?" It was her that really helped me make that decision, and I took the leap. I'm really glad that I took it. I've learned a ton. I love what we're doing at Edwards. I love the things I'm learning along the way, kind of seeing the other side completely. I see now entrepreneurs, and I just think how I see things very differently, what's on the other side of strategic. Again, all strategics are different, but there are some common themes, and it's been a great opportunity to run a large group of—I have lots of projects, the things I like, but I also get to sit on outside boards. I get to make investments. So it's been very, very fulfilling.

Josh Makower (Moderator) 34:15
I mean, it's amazing because at the time, Edwards was already a powerhouse. You know, valves were just suddenly coming into their own, particularly TAVR, and you made it next level. I mean, everybody, I would say people that, like, "How can it even get better?" And you have taken it to the next level, Todd.

Todd Brinton 34:37
Yeah, so we're—I hope we do. I think a lot of what you do takes a long time. They, you know, they start companies say, you know, it takes a decade. I'm five years in at Edwards, and we're starting to peel the story out for other people to see. I'm really excited about where we know. I think it's going to—we've read it. We're redefining kind of the role that Edwards will have, or in some ways, it's narrower. We're saying we only do structural heart disease, as you know, we sold off our critical care business and closed that about two weeks ago. We're doing basically structural heart disease, valvular and now non-valvular structural heart diseases. We have a whole portfolio of stuff that we're going to bring out. So we're really, I think, the chance to be there with great people, great team, and frankly, the chance to work for Mike. Mike is one of the greatest leaders, I think, and the chance to work with him. I spend 15 to 20% of my time, you know, every day with him, just spending time with Mike and seeing how he managed, how he thought, how he strategized. It was incredible, you know. He's obviously now transformed his career. He left Edwards, is no longer the CEO or chairman, but now he just put his name on the Biodesign Center. He continues to make a big impact on the industry.

Josh Makower (Moderator) 35:45
Absolutely. I know we're at time, but I wonder if I can beg for two minutes—one minute on the future of Edwards that you see, and then one minute about the future for Todd Brinton. Talk about those two things.

Todd Brinton 35:59
So I'll be real quick. I am very excited about the future of Edwards. I think that companies go—the biggest thing is they get, just like Shockwave, they go through evolution, right? Different stages of development. TAVR has been an incredible ride for Edwards, such a successful platform that we talk about the triple win—big impact for patients, healthcare systems, and also for, you know, economics for patients and for the providers. I think that now we have a whole other generation of stuff that's coming out that makes Edwards a much broader player in the structural heart space. As far as me, I go back to the theme that, you know, I've had some incredible mentors along the way. I mean, I'm unbelievable. I have a big impact, and they continue to have a big impact. For me, I just want to continue doing something that matters. If it matters, if it's impactful, I'm interested in doing it. I am far from anywhere near thinking about the end of my career at all. I feel like I'm just getting started.

Josh Makower (Moderator) 36:57
That is awesome and a great way to end. Thank you, Todd, for that amazing story. Thank you so much.

Todd Brinton 37:02
Thank you. Thanks, everybody.

Josh Makower (Moderator) 37:06
Thank you so much.