highlights from sunday - eacts · martin czerny, bern ernst weingang, mainsz ... 48 monday 29...
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46 Monday 29 October 2012 EACTS Daily News
Dawn Southey Lead Nurse
Practitioner, Cardiothoracic Surgery,
New Cross Hospital, Wolverhampton,
UK
Heyman Luckraz Consultant
Cardiothoracic Surgeon, Heart &
Lung Centre, New Cross Hospital,
Wolverhampton, UK
Thecreationofwardnursepractitioner(NP)postsattheHeart&LungCen-tre,Wolverhampton,UK
wasseenasapracticalwayofen-suringthatafullservicewasof-feredtopatients.Pressuresonclinicalresourcesandtheconse-quencesofthereductioninjun-iordoctors’hourshadalreadystim-ulatedstaffinthehospitaltolookfornewwaystoimprovetheuseofresourcesandtoservetheinterestsofthepatientandaidnursesde-velopskillsandknowledgetobe-
comeskilledprofessionalstoworkatanadvancedlevel.
Asateamoffournurseprac-titioners,ourrolecoversfromadmittingpatientsthroughtoadvancedrolesconsistingofin-dependentlyprescribing,andad-vancedwoundmanagement.Wealsoplayalargeroleinthecareandstabilisationofacutelyillpa-tients,liaisecloselywiththean-aestheticteamandinitiateemer-gencytreatmentsuchasCALS.Asateamwedeveloppolicies,pro-tocolsandundertakeauditstohighlightimprovementsinprac-tice.Thecontributionofthenursepractitionerrolewasemphasisedfollowingarecentauditoftheirpractice.
Thiscurrentstudyassessedtheimpactthattheintroductionofthenursepractitionerrolehadonpatient’scare,morespecificallyonCardiacIntensiveCareUnit(CICU)
readmissionfromtheward,itsas-sociatedmortalityandlengthofstay.From1stJanuary2005to31stOctober2011,8,591oper-ationswereundertakenattheHeartandLungCentre,Wolver-hampton(2,823werethoracicsurgicaland5,768cardiacsurgi-calprocedures).Overall,192pa-tientsneededtobereadmittedbacktotheCICUforfurtherman-agement.
Patientsweregroupedaccord-ingtotwoeras:(a)priortocom-mencementoftheNursePracti-tionersinOct2007(preNP)and(b)thosewhowereadmittedaf-terthatdate(postNP).136car-diacsurgerypatientswereread-mittedtoCICU.PreNPtherewere63patientsreadmittedwithamortalityof3.4%diedwhilepostNP73patientsreadmittedresult-ingina2.1%mortality.Readmis-sionratesoverallwerelower
followingtheNPintroductionwithoutanysignificantchangeintheEuroscore.
56thoracicsurgerypatientswerereadmittedtoCICU.PreNPtherewere26patientsreadmit-tedtoICUwitha3.7%mortal-
itywhilepostNPtherewere30patientsreadmittedresultingin2.4%mortality.Readmissionratesoverallwerelowerfollowingroleintroduction.
Thisstudyshowedthatthein-troductionofthewardNurse
Practitionersimprovedpatients’outcomewithpossiblyearlieridentificationofdeterioratingpa-tientsandearlierCICUinput.Thisinreturnreducedpatientmortal-ityandreducedpatientsoveralllengthofstay.
Dawn Southey and Heyman Luckraz
The impact of the cardiothoracic ward nurse practitioner
Arno Nierich Isala Clinics, Zwolle, The Netherlands
Cardiacprocedures,suchasinsurgeryandin-terventionalcardiology,requestdiagnostictoolsinordertoimproveoutcome.Trans-esophagealechocardiography(TEE)isal-
readyapowerfuldiagnosticmodalityusedtoassesscardiacanatomyandfunction.IntraoperativeTEEhasbecomeoneofthecornerstoneimagingmodalitiesduringcardiacsurgeryandinvasivecardiovascularpro-ceduresreflectingthedailyincreasingcomplexityofsurgicaltechniquesandpatientpathology.
Oneoftherecentultrasoundinnovationsisthree-dimensional(3D)tyransesophagealechocardiogra-phy(3DTEE),atechniqueinwhichsoundwavesfromamatrixarrayultrasoundprobearetranslatedtoreal-timedetailedon-line3Dimagesoftheheartandma-jorbloodvesselsofthebody.Unlike2DTEE,whichre-liesonstandardlimitedimagingplanes,3DTEEusesvolumedatasets.These3Ddatasetsaredirectoff-linetranslatedbyanalyticalsoftwareinto3Dmodelsen-ablingimprovedassessmentofvalvestructuresandquantificationofventricularfunction.Normalorpath-ologiccardiacstructurescannowbeviewedfrommul-tipleperspectives.Thisisaninvaluablevisualaidinun-derstandingbetterspecificpatientanatomy.
3DTEEenablessurgeons,cardiologistsandanesthe-siologiststomakeacompleteinvestigationandim-agingoftheheart,viewedfrommultipleperspec-tives.Thisprovidesthesurgeonorcardiologistdirect
diagnosticinformationjustbeforethefirstincisionismadeandallowsadjustmentsofthetreatmentplan
basedonpotentialnewinformation.3Dultrasoundal-lowsrealtimedynamicimagingofthecontractilityoftheheart,thestructureofthevascularstructuresandtheopeningandclosingoftheheartvalves.Theim-agesareeasilytranslatedtoanatomicalviewsdur-ingsurgery.Theseviewsareimportantbecausedur-ingsurgerytheheartismostlyastaticemptystructureduringtheperiodofextra-corporealcirculation.Eval-uationofthesurgicalresultduringtheprocedureal-lowstimelycorrectionandevaluationinordertode-terminewhethertheoperativeproblemshavebeen
solvedcompletely.Duringclosedchestcardiacprocedures,suchas
transcatheteraorticvalveimplantations(TAVI)orport-accesroboticsurgery,3DTEEenablesmoreeasilypa-tientmonitoringinthephaseofplacementofcath-etersanddevicesinthemainvesselsandtheheart.However,thereisverylimitedinformationavailablefortheuseofRT3DTEEintheperioperativesetting.Uptillnow,theindicationtouse3DTEEisasafo-cusedexaminationofspecificpathologyortherapeu-tictreatmentsratherthanperformingacomprehen-sive3Dexamination.
The3Dultrasoundpresentationwillhighlightsomeimportantspecificapplicationssuchas:nWhatis3DTEEnPeri-operativeMitralvalveevaluationnAcuteAorticdissections:complete3Dultrasound
diagnosisandperi-operativemonitoringofthebrainperfusion
nStrokepreventionstrategyincardiacsurgeryandTAVIprocedureswith3DTEEA-Viewtechnique
Insummary,3DTEEisofaddedvalueforcardiologists,surgeonsandanesthesiologistssince:n3DTEEisasurgicalequivalentofGPS,nLeadstoeffectiveperi-operativedecisionmaking,
treatmentplanningandevaluation,nProvidesimprovedcommunicationbetweenthe
specialists,because3DTEEisquiteunderstandableforallstakeholders.
3D ultrasound: preoperative and perioperative benefits
Figure 1
Figure 2
PublisherDendriteClinicalSystems
Editor in ChiefPieterKappetein
Managing [email protected]
Design and [email protected]
Managing [email protected]
Head OfficeTheHubStationRoadHenley-on-Thames,RG91AY,UnitedKingdomTel+44(0)1491411288Fax+44(0)1491411399Websitewww.e-dendrite.com
Copyright2012©:DendriteClinicalSystemsandtheEuropeanAssociationforCardio-ThoracicSurgery.Allrightsreserved.Nopartofthispublicationmaybereproduced,storedinaretrievalsystem,transmittedinanyformorbyanyothermeans,electronic,mechanical,photocopying,recordingorotherwisewithoutpriorpermissioninwritingoftheeditor.
EACTSDaily News
Highlights from Sunday
Resident’s Luncheon 2012Minimal invasive cardiothoracic surgery
26th EACTS Annual MeetingConference center, Barcelona
Monday 29th October 12:45-14:00
ModeratorsPeyman Sardari Nia, Breda, Netherlands.
Mathias Siepe, Freiburg, Germany.
ProgramTable 1: Minimal invasive mitral valve surgery
Fredrich Mohr, LeipzigThom De Kroon, Nieuwegein
Table 2: Minimal invasive aortic valve surgeryMattia Glauber, Massa
Marjan Jahangiri, London
Table 3: Minimal invasive maze proceduresWim-Jan Van Boven, Amsterdam
Jos Maessen, Maastricht
Table 4: Minimal invasive thoracic proceduresWilliam Walker, Edinburgh
Paul Van Schil, Antwerp
Table 5: Minimal invasive aortic surgeryMartin Czerny, Bern
Ernst Weingang, Mainsz
Table 6: Minimal invasive revascularization proceduresJean-Luc Jansens, BrusselsAnthony De Souza, London
Table 7: Hybrid congenital proceduresDavid Anderson, London
Christian Schreiber, Munich
The Luncheon is sponsored by an unrestricted educational grant from AtriCure.Registration for the luncheon is only possible on site in the conference center
EACTSDaily News
48 Monday 29 October 2012 EACTS Daily News
Floor plan
27 A&EMedicalCorporation
39 AATS
115 AbbottVascularInternationalBVBA
17 Andocor
28–29AsanusMedizintechnikGmbH
45 AtriCureInc
114 BBraunSurgicalS.A.
13–14BaxterHealthcareSA
82 BerlinHeartGmbH
16 BioCerEntwicklungs-GmbH
12 BiometMicrofixation
92–93BioVentrixInc
129 BoltonMedical
80 BracePlus/SlimstonesBV
70 CardiaInnovationAB
125 CardiaMedBV
10 CardioMedicalGmbH
53 CareFusion
90 CASMED
4–8 CircuLiteGmbH
59–61CookMedical
31 CorMatrixCardiovascularInc
122 CoroneoInc
24 CorrexInc
79 CryolifeEuropaLtd
37 CTSNET
117 Delacroix-Chevalier
98–99DendriteClinicalSystems
123 DePuySynthes
35 EACTS
104 EdwardsLifesciences
107–109 EstechInc
120 Ethicon–Johnson&Johnson
112 Euromacs
78 EurosetsSRL
118 FehlingInstrumentsGmbH&CoKG
34 GeisterMedizintechnikGmbH
119 GeneseeBioMedicalInc
69 Geomed®Medizin-TechnikGmbH&Co.KG
23 GunzeLimited
68 HamamatsuPhotonics
72 HeartandHealthFoundation
26 HeartHugger/GeneralCardiacTechnology
32 HeartWareInc
11 Integra
100–101 IntuitiveSurgicalSarl
38 ISMICS
81 JarvikHeartInc
63–64JenaValveTechnologyGmbH
121 JOTECGmbH
43–47KarlStorzGmbH&CoKG
94–95KLSMartinGroup
51 LabcorLaboratoriosLtda
66 LepuMedicalTechnology(Beijing)CoLtd
110–111 LSISolutions
102 ManiInc
86 MaquetCardiopulmonaryAG
15 MasterSurgerySystemsAS
74 MDDMedicalDeviceDevelopmentGmbH
3 MedaforInc
65 MedexResearchLtd
116 MedistimASA
40 MedosMedizintechnikAG
105 MedtronicInternationalTradingSÁRL
88–89MiCardiaCorporation
9 MicromedCVInc
67 NeoChordInc
131 NeomendInc
42 On-XLifeTechnologiesINC™
30 OxfordUniversityPress
134 PCR
124 PetersSurgical
62 PraesidiaSrl
128 QualiteamSRL
25 RedaxSRL
18 RumexInternationalCo
71 SanofiBiosurgery
33 ScanlanInternationalInc
87 SiemensAG
91 SmartcanulaLLC
85 Sorin
106 StJudeMedical
96 StarchMedicalInc
36 STS
73 SunshineHeart
41 SymetisSA
126–127 SynCardiaSystemsInc
77 TerumoEuropeCardiovascularSystems(TECVS)
103 TheSocietyforHeartValveDisease
113 ThoratecCorporation
55 TianjinPlasticsResearchInstitute
132 TransMedicsInc
19 TransonicSystemsEurope
130 ValveXchange
20–21WexlerSurgicalInc
1–2 WisepressOnlineBookshop
97 WLGore&AssociatesGmbH
42414034333231
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119117
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CateringCatering CateringCatering
ENTRANCEENTRANCE
Training Village
50 Monday 29 October 2012 EACTS Daily News
Medtronic reports over 1,000implantations of the 3f Enable®
Aortic Bioprosthesis, the world’s firstcommercially available sutureless tissueheart valve. The Medtronic 3f Enable®Aortic Bioprosthesis received CE-Markin December 2009 with first implantstakingplacein2007.Medtronicformallyannounced this milestone during thisyear’s edition of the Sutureless Club,recently held in Amsterdam, TheNetherlands.
This innovative valve technology hasa self-expanding Nitinol™ frame thatallowsthe3fEnable®AorticBioprosthesistobe folded intoa smalldiameter. Thisfacilitates placement through a smallerincision,withouttheuseofconventionalsuturesforfixation.Instead,radialforcesoftheself-expandingframeholdthevalveinplaceintheannulus.Nootherpointsof fixation are required. Implantationis therefore reduced to a single-stepprocedure and without the need forballooning. If needed, the 3f Enable®AorticBioprosthesiscanbe repositionedto achieve optimal outcomes for eachpatient.
Medtronic’s 3f Enable® AorticBioprosthesis helps the surgeon simplifythe procedure with a reproducibletechniquethatmaycontributetoshortercross-clamp times and reduced traumato the patient. The 3f Enable® self-expanding Nitinol™ frame houses a
stentlesspericardialvalvewitha tubulardesign that preserves sinus form andfunction. Improved stress distributionmimicsthefunctionalcharacteristicsofanativevalve.Thevalvehasalargeorificearea with laminar flow for excellenthemodynamics.Publicationshaveshownlowandstablegradientsacrossallsizes,from19to27mm.
“Medtronicispleasedtobringour3fEnable® Aortic Bioprosthesis to cardiacsurgeonsandtheirpatients”saidShawnMonaghan,vicepresidentoftheSurgicalBased Therapies business unit. “The3f Enable® tissue heart valve providesa new and simplified way to replacediseased, damaged or malfunctioningaortic valves, and in a way that is lessinvasiveforpatients.”
Over 1,000 implantations of the Medtronic 3f Enable® Aortic Bioprosthesis
M Yuksel Course Director, Istanbul;
EACTS House, Windsor, UK
ChestWallInterestGroup(CWIG)isagroupbelongingtotheEACTSThoracicDo-
main.ItwasfoundedduringTheSec-ondInternationalNussProcedureWorkshopheldinIstanbulinJune2009.
Wehavesetouttoestablishachannelofcommunicationacrossdif-ferentcontinentswithaviewtoal-lowtheexchangeofknowledgeamongthoseexperiencedpracti-tionerswhoarestudying,develop-ingandinnovatingmethodstotreatchestwalldiseases.InJune2010,wegottogetheragaininIzmir,forTheThirdInternationalWorkshopontheMinimallyInvasiveRepairofPec-tusDeformitiesunderthecustodyofEACTS.TheWorkshopwasagreatsuccessandwehadthechancetodiscussthefutureprojectionsoftheCWIG.
OurnextimportantmeetinginthecalendarwasTheFourthInter-nationalChestWallInterestGroupWorkshoponChestWallDiseaseswhichwasheldinIstanbulonJune
22–23,2012,underthecustodyofEACTS,withtheparticipationof35invitedfacultyfromaroundtheworld.
Nowwewanttoreachabroaderspectrumofresidents,specialistsandacademicians,thusweareorganiz-ingaworkshopon“ChestWallDis-eases”inWindsor,UK,atEACTSHouse,28-30November2012.
ThemainsubjectsareCongenitalChestWallDeformities,ChestWallResectionandReconstruction,Tho-racicOutletSyndromeandSternalDehiscence.
TheLearningObjectivesare;Learningtheindications,techniquesandfollowupofminimallyinva-siveandopensurgeryinpectusde-formities;Learningthealternativetreatments–surgicalandnonsurg-cal-forpectusdeformities;Learn-ingchestwallresectionandrecon-structiontechniquesinchestwalldiseases;Learningthesurgicaltech-niquesinthoracicoutletsyndromeandLearningthetreatmentoptions–surgicalandnonsurgical-insternaldehiscence.
TheTargetAudienceis;ThoracicSurgeryResidents,Specialistsandthe
AcademiciansworkinginthefieldofThoracicSurgery.
WeverymuchlookforwardtowelcomingyoutoWindsor.
Toregisterforthiscoursepleasevisit:www.eacts.org/academy/specialist-courses/chest-wall-diseases.aspx
Regards,Prof.MustafaYuksel,MD
Advanced Module: Heart Failure – State of the Art and Future Perspectives 12–17 November 2012 – 2 days of wetlabs
EACTSHouse,Windsor,UKCourse Directors: G Gerosa, Padua; M Mor-shuis, Bad OeynhausenThecoursewillbeorganisedin10modules:1 Epidemiology/Pathology;2 Diagnostic/Imaging;3and4
OptimalMedicalTherapy/IC;Resynchronization;5 CardiacSurgery(Indications,Techniques,
Results);6 HeartTransplant(Indications,Techniques,Re-
sults)7 VADs/TAH(Indications,Techniques,Results);8 HTx/VADsinPaediatricPopulation;9 StemCellsRegenerativeMedicine;10WetLabs/LiveinaBox/GroupProjectsCourse Objectives:Toupdateknowledgeoftheoreticalandtechnicalissuesofsurgeryforheartfailure.
Leadership and Management Development for Cardiovascular and Thoracic Surgeons20– 23 November 2012 EACTSHouse,Windsor,UKCourse Directors – J L Pomar, Barcelona
TheLeadershipandManagementDevelopment
Courseisanintensivefive-dayprogrammeintwopartswithathreedayinitialtrainingsessionfol-lowedbyafurthertwodaysoftrainingscheduledsixmonthslater.Thecoursewillutiliseamixofpreandpostprogrammeactivitiesandeachdelegatewillbetaskedwithexploringleadershipbestprac-tiseduringthebreakbetweenthetwopartsoftheprogramme.Course Objectives:Improve,enhanceandmaximiseyourleadershipat-tributes
Thoracic Surgery Part II3rd – 7th December 2012 EACTSHouse,Windsor,UKCourse Directors – P Rajesh, BirminghamnThecourseprogrammeincludes:nTrachealSurgerynTracheobronchialinjuriesnTracheal-mainbronchusobstruction;nEsophagusCancer–Staging,preoperative;nOesophagealcancer;nThoracoscopictechnique;nMesotheliomatreatments;nMetastaticdisease;nChestwallreconstruction;nCasepresentations.
Course Objectives:Togainmoreinsightandup-to-dateknowledgeondifferentaspectsofthoracicsurgeryrelatedtotracheal,pleural,mediastinalandoesophagealdis-ease.
Chest Wall Diseases 28–30 November 2012
EACTS events
Jin XY. Implications of Stentless Valve Design and Implantation Techniques for Aortic Root Geometry [abstract]. Paper presented at: Advanced Cardac Techniques in Surgery; May 2-3, 2007; New York, NY. Cox J, Ad N, Myers K, Gharib M, Quijano RC. Tubular heart valves: A new tissue prosthesis design—Preclinical evaluation of the 3f aortic bioprosthesis. J Thoracic Surg 2005; 130:520-7. Sadowski J, et al. Sutureless aortic valve bioprosthesis ‘3F/ATS Enable’ – 4.5 years of single-centre experience. Kardiol Pol 2009; 67(8a):956-63. Martens et al. Clinical experience with the ATS 3f Enable Sutureless Bioprosthesis. Eur J Cardiothorac Surg 2011;40:749-55.