After knocking Johnson & Johnson off its long-held top position last year, Medtronic has successfully retained the lead in the global medtech market for the second year running in Medtech Insight's MTI 100 rankings. Meanwhile, movement and reshuffling in the ranks continued among other top-tier industry players as they reaped the rewards from previous M&A deals and long-term growth strategies. In this article, we take a closer look at the top-10 overall players, and see who's leapt in front of rivals and who's left eating dust in Medtech Insight's 2017 edition of its annual ranking.

Medtronic's revenue of $7.1bn for the second fiscal quarter of 2018 was down 4% year-over-year on an as-reported basis, but up 4% on a comparable constant-currency basis. –It would have been even greater if not for the hurricane that hindered manufacturing operations in Puerto Rico, the company reported Nov 21.

The expanded labeling gives Medtronic's HVAD, acquired when it bought HeartWare last summer, the same indication as Abbott's HeartMate II ventricular assist device.

The global market for products treating heart valve disease is expected to exceed $8bn by 2021, driven largely by the rising number of elderly patients with cardiovascular disease, obesity and growing prevalence of diabetes. This, in turn, is fueling significant innovation in minimally invasive techniques, particularly in the leading area of transcatheter aortic valve replacement (TAVR), but also in transcatheter mitral valve repair (TMVrep) systems, both of which offer patients quicker recovery times, less discomfort and greater safety compared to traditional surgical heart valve repair and replacement. This feature looks more closely at the competitive landscape and dynamics of these two fast-growing market segments, as well as gives insight into what the users – the physicians – think of these technologies.