is there a role for surgery in acute pulmonary embolism?
TRANSCRIPT
EACTS Daily News Tuesday 30 October 2012 33
Thoracic: Focus Sesion 14:15–15:45 Room 133/134
Cardiac: Abstract 14:15–15:45 Room 114
Cardiac: Focus Session 16:15–17:45 Room 120/121
Wolfgang Harringer Klinikum
Braunschweig, Braunschweig, Germany
AlthoughTrendelenburgfirstdescribedsurgicalembolec-tomyforacutepulmonaryembolismbackin1908the
procedurehasonlyfounditsbreakthroughoverthelastdecades.Thisbe-comesmostobviousinthefactthatguidelinesonlyrecommendpulmonaryembolectomyincaseofserioushemo-dynamicinstabilityandhighrisk,failureorcontraindicationtolysis.
ThelowacceptanceoftheTrendelen-burgprocedureismainlyattributedtotheveryhighmortalitythatinitiallyevenreached100%.Aslysisforacutecoro-narysyndromshaslostitsmeritsoverthelastdecadethroughtheimprovementofcathetertechniquesthatintroducedthepossibilityofamoregoaldirected
treatmentofculpritlesionstheevolu-tionofsurgicalknowhowcouldlike-wisechangeourtreatmentperspectivesforacutepulmonaryembolism.Hencegivingagreaterroleforsurgeryinhe-modynamicallystablepatientswithrightventriculardysfunctioninwhomlysisre-mainsthegoldenstandard.
Thisviewseemsjustifiedbytheradicaldropofmortalityinassociationwithsur-gicaltreatment,mortalityratesaslowas6.4%beingdescribednowadays.Crucialforachievingsuchexcellentresultsareafastandaccuratediagnosisinadditiontoarapiddecisionmakingforwhichaninterdisciplinaryteamapproachbetweencardiologistsandsurgeonsappearsman-datory.Extracorporealmembraneoxy-genatorscouldplayanimportantroleinthissetupofferinganexcellentbridgingtechniquebetweenstabilization(oxygen-ationandreliefofrightventriculardys-
function)anddefinitesurgicaltreatment.Progressesmadeinthisfieldhavemadethesedevicesreadilyavailable,easytoapplyandreducedtheassociatedmor-biditytoacceptablelevels.Miniaturiza-tionandbiocompatiblecoatinghavere-sultedinareductionofforeignsurfacecontact,bleedingcomplicationsandin-flammatoryresponse.Minimizedper-fusioncircuitswhichhavefollowedasimilarphilosophymayalsocontributetothesuccessofsurgeryespeciallycon-sideringareductionofinflammatoryre-sponsethatmayplayanunderestimatedroleinthepathogenesisthatfollowspul-monaryembolism.
Inconclusionarapiddiagnosisandinterdisciplinarydecisionmakingforbesttreatmentstrategywillpromptamoreaggressivesurgicaltreatmenteveninhe-modynamicallystablepatientswithrightventriculardysfunction.Thelackofscien-
tificevidenceintermsofprospectiveran-domizedtrialsremainsthemainobstacleforamoreliberalchoiceforsurgery.Thisbarrierwillonlybeovercomethroughaheartteamapproach.
Jonida Bejko, Tomaso Bottio,
Vincenzo Tarzia, Marco De
Franceschi, Roberto Bianco,
Michele Gallo, Massimo
Castoro, Gino Gerosa
Institute of Cardiovascular Surgery.
Padova, Italy
Sternalwoundinsta-bility(SWI)and/orin-fectionarestillactiveandlife-threatening
complicationsincardiacsur-gery.Thepathogenesisisnotyetclearlydefined,andmanyauthorsidentifiedseveralfac-tors,patientorsurgeonre-lated,aspotentialcauses.
TheFlexigrip(Praesidia,Bo-logna–Italy)isasternalclosuresystem,composedofthermo-reactivealloyofNichelandTi-taniumwithamemoryeffect,whichactsasabraceholdingtogetherthesternalosteotomy.
Wesoughttoassesstheef-ficiencyoftwodifferentsternalclosuretechniquesinpreventing
sternalwoundinstabilityinhighriskpatients.
BetweenJanuary-09andFeb-ruary-12,2,068consecutivecar-diac-patientshavebeenprospec-tivelycollectedinourdatabase.
Basedontheobservationthatinthevastmajorityofcasesofsternalwoundinfectionssomedegreeofsternalinstabil-ityisalwayspresent,wecom-
paredtheresultsobservedintwopopulationofmatchedpa-tientsinwhomtwodifferentsternalwiringtechniqueswereadopted,usingthesametriple-layersutureforfascia,subcuta-neoustissueandskin.
The561patientsinwhomthethermoreactive-Nitilium-clips(Flexigrip)havebeenused(GroupA),werematched1:1
with561patientswhoreceivedastandardparasternalwiringtechnique(GroupB)on10avail-ableriskfactorsknowntoaffectsternalwoundhealing(age,age>75-year,gender,diabetes-mel-litus,cardiac-procedure,obes-ity,re-intervention,cross-clamp,andtotaloperativetimes).Thestudywascompletedwithacostanalysis.
Thetwogroupswerewellmatched,althoughdifferentforbilateralinternalthoracichar-vesting,chronicobstructivepul-monarydisease,renalinsuffi-ciency,andcongestiveheartfailurewhichweresignificantlymorefrequentinGroupA.At30-daysoffollow-up,theas-sociationwound-complicationandsternalinstabilitywassig-nificantlylessfrequentinGroupAversusGroupB(0.2%ver-sus1.6%)(p=0.04).Overallin-cidenceofsternalwoundcom-plicationwaslowerinGroupA(2%versus3.5%)(p=0.28).Inpresenceofwoundinfec-tion,asternalwoundinstabil-itywasneverobservedinGroupA(p=0.06).Overallcostswere€8,701,854and€9,243,702inGroupAandB,respectively,thusFlexigripclosuretechniqueoffereda€541,848costsaving.
Flexigripusedinhighriskpa-tientsshowedalowerincidenceofsternalwoundinstabilitywithnoneedofsternalre-wiringinanycase,eveninpresenceofwoundinfection.Flexigripprovedtobealsocost-effective.
Bernard Prendergast John Radcliffe
Hospital, Oxford, UK
Infectiveendocarditisisanelusiveanddangerousconditionwhichchallengesallthoseinvolvedinitsmanagement.Cardiologistsand
cardiacsurgeons,whoencounterpa-tientswithseverecomplicationsofthediseasedestinedforcomplexcardiacsurgeryorpostmortem,fearitscon-sequencesandhavemaintainedthedogmaofpreventionbymeansofanti-bioticprophylaxispriortoinvasivepro-cedures.TheevidencetosupportthisstanceislimitedandrevisedEuropeanandUSguidelinesinrecentyearshaveresultedinamajorshiftofemphasisinthiscontentiousarea.Moreover,guid-ancefromtheUKNationalInstituteforHealthandClinicalExcellence(NICE)publishedin2008abolishedthisprac-ticecompletelywithnoadversecon-sequencestodate.Isitnowtimeforfurtherevaluationandadefinitiveran-domisedcontrolledtrial?Changing epidemiology and evi-dence to date
TheclinicalprofileofIEischangingwithincreasingfrequencyofStaphylo-
coccusaureusandfallingincidenceofIEsecondarytooralstreptococci.IEof-tenarisesinpatientswithoutpreviouslydocumentedcardiacdiseasewhenthequestionofprophylaxisisirrelevant.
Evenifantibioticprophylaxisisap-pliedappropriately,theevidencetosupportitsefficacyislimitedtocase-controlanalyses.Evenifthesestudiesarenegative,theyalsofailtodemon-stratethatantibioticprophylaxisofIEisineffective.Theydo,however,sug-gestthatahugenumberofprophy-laxisdosesarenecessarytopreventaverylownumberofIEcasesandthattheriskofdevelopingIEafteranun-protectedat-riskdentalprocedureisextremelylow.WhilstarandomisedplacebocontrolledtrialtoaddressthebenefitsofantibioticprophylaxisinpreventingIEisdesirable,suchastudywouldbeamassiveundertaking,re-quiringlargenumbersofpatientsineacharmtoprovideadequatestatis-ticalpower.Theheterogeneityoftheunderlyingcardiacconditionsandin-vasiveprocedureswouldmakestratifi-cationextremelydifficultbutatrialfo-cussingonthehighestriskgroups(eg.thosewithaprostheticvalve)could
beachievedwithsufficientstatisticalpowertoallowextrapolationtootherlowerriskcohorts.TheUKistheonlynationwheresuchatrialcouldbeeth-icallyperformedandpreliminaryplansarecurrentlybeingconceived.Guidelines and philosophy
Theoriginal“treatall”philoso-phywasbaseduponanunderstanda-blefearofinfectiveendocarditisanditscomplications.However,thenumberneededtotreatforeffectivepreventionisexceedinglyhighandroutineantibi-oticadministrationisnotriskfree.Ana-phylaxisto -lactamantibioticsoccursin15-40per100,000usesandtherearelegitimateconcernsregardingcommu-nity-derivedantibioticresistance.More-over,thecost-effectivenessofroutineantibioticprophylaxisisquestionable.
TheEuropeanandUSguidelinesad-vocatethe“numberneededtotreat”or“bangforyourbuck”philosophy,re-strictinguseofantibioticprophylaxistopatientsatthehighestriskofIEunder-goingthehighestriskprocedures.An-tibioticprophylaxisisnolongerrecom-mendedforpatientswithnativevalvediseasenorforanygastrointestinalorgenitourinaryprocedures.
Goingonestepfurther,theUKNICEguidelinesespousethe“proofofprinci-ple”philosophyandrecommendedanendtothepracticeofantibioticproph-ylaxisaltogether.Todate,thisseeminglyradicalrecommendationhasnotbeenaccompaniedbythepredictedsurgeintheincidenceormortalityofinfec-tiveendocarditisintheUK,thoughcon-tinuedprescribingtohighriskgroupsseemslikelymaybeaconfoundingsourceofpositivereassurance.Let’s test the hypothesis...
Notwithstandingthecurrentpaucityofevidence,itisclearthattheefficiencyofcurrentpracticeisrestrictedduetotheexorbitantnumberneededtotreattopreventasinglecaseofIE,withpo-tentialforoverallharm.Ashiftofthefundamentalquestionfrom“Whoisatrisk?”to“Whomightbenefit?”there-foreseemsappropriate.Nationalorin-ternationalregistriesmayprovideuse-fulinformationandpreviousethicalconcernsobstructingtherequiredran-domisedcontrolledtrialhavenowbeenremoved.Whether,therewillbesuffi-cientpoliticalimperativeandenthusiasmtoundertakesuchamajorendeavourremainstobeseen.
Is there a role for surgery in acute pulmonary embolism?
Nitinol flexigrip sternal closure system and standard sternal steel wiring: Insight from a matched comparative analysis
Antibiotic prophylaxis for infective endocarditis: Time for a definitive answer?
Wolfgang Harringer
09:40 Howtodoaminiaorticvalvereplacement P. Sardari Nia (Breda)
10:10 Howtodoamini-maze W.-J. Van Boven (Amsterdam)
10:30 Break11:00 Howtodoathoracicendovascularaorticrepair
M. Czerny (Berne)
11:20 Howtodoanendovascularcoronaryarterybypass N. Bonaros, (Innsbruck)
11:40 Howtodovideo-assistedthoracoscopicepicardialleadplacement B. Van Putte (Breda)
12:00 Ends
Advanced Techniques
09:00 Lateral Thinking
Room 111
09:00 Whyareweheretoday?Introduction,backgroundandgoalsofthissession J. Seeburger (Leipzig)
09:09 Howsimpleideascaninfluenceourpractice O. Alfieri (Milan)
09:18 Whatdopatientswantandneed? M. Misfeld (Leipzig)
09:27 Societies(EACTS,AATS,STS,ESC...):Lobbyforwhom? V. Falk (Zürich)
09:36 ArandomizedtrialintheNEJM:theholygrailofmarketing? M. Mack (Dallas)
09:45 Thenextgenerationofcardiacsurgeons:wheretogo? T. Noack (Leipzig)
09:54 Doctorandbusinessman:conflictofinterest? J. Pomar (Barcelona)
10:03 Technologytransferincardiacmedicine:money,ego,career? E. Schwammenthal (Tel Aviv)
10:12 Break10:30 Howtomakethemostofyourideasandyour
futureself F. Litvack (Los Angeles)
10:39 Iscardiacmedicineworththeeffort?Insightsfromeconomy M. Rosenmoller, IESE Business School (Barcelona)
10:48 WillImakemoneyinvestingincardiacsurgery? J Mack (Mounds View)
10:57 Ontheroadagain:whygiveupcardiacsurgery? M. Studer (Dübendorf)
11:06 ThinkTankcardiacsurgery S. Haider (Erlangen)
11:15 Discussion11:51 ClosingRemarks V. Falk (Zürich)
Advanced Techniques
09:00 The mitral and tricuspid valves: repair techniques
Room 113
Moderator: J. R. Pepper, London; P. van de Woestijne, Rotterdam
09:00 Pathophysiologyoffunctionalmitralandtricuspidregurgitation K. M. J. Chan (London)
09:25 Assessmentoffunctionalmitralandtricuspidregurgitation L Pierard (Liege)
09:50 Naturalhistoryandmedicaltreatmentoffunctionalmitralandtricuspidregurgitation T. McDonagh (London)
10:15 Break10:45 Surgicaltreatmentoffunctionalmitral
regurgitation R. Dion (Genk)
11:10 Surgicaltreatmentoffunctionaltricuspidregurgitation G. Dreyfus (Monte-Carlo)
11:35 Newerapproaches:whendopercutaneoustechniquesofferasolution? F. Maisano (Milan)
11:35 Analternativesurgicaltreatmenttotricuspidregurgitation J-P Couetil (Paris)
11.55 Newerapproaches:whendopercutaneoustechniquesofferasolution F. Maisano (Milan)
12:15 Conclusion
This session is supported by an unrestricted educational grant from Edwards Lifesciences
Advanced Techniques
09:00 New surgical treatment concepts for heart failure
Rooms 131/132
Organized by the the Roland Hetzer International Cardiothoracic Vascular Surgery Society (RHICS)
Moderators: F. Beyersdorf, Freiburg; R. Hetzer (Berlin)
09:00 Organ-conservingsurgery F. Beyersdorf (Freiburg)
09:20 Cardiacresynchronizationtherapy C. Butter (Berlin)
09:40 Revascularizationsurgery J. Ennker (Lahr)
10:00 Stateoftheartinhearttransplantation R. Hetzer (Berlin)
10:20 Roleofleftventricularassistdevice M. Morshuis (Bad Oeynhausen)
10:40 Roleofrightventricularassistdevice T. Krabatsch (Berlin)
Continued from page 32
Continued on page 34
Tomaso Bottio
34 Tuesday 30 October 2012 EACTS Daily News
11:00 Roleofbiventricularassistdevice E. Potapov (Berlin)
11:20 Totalartificialheart M. Loebe (Houston)
11:40 Paediatricventricularassistdevice V. Alexi-Meskishvili (Berlin)
12:00 End-stagecongenitalheartdisease E. M. Delmo Walter (Berlin)
12:20 Regenerativemedicine C. Stamm (Berlin)
12:40 Paneldiscussion R. Hetzer (Berlin), F. Beyersdorf (Freiburg), G. Schuler (Leipzig), F. Musumeci (Rome), C. Mestres (Barcelona), H. Schafers (Homburg/Saar)
Advanced Techniques
08:30 Controversies and catastrophies in adult cardiac surgery
Room 115
Organiser: M. Shrestha, Hannover
Moderators: R. Haaverstad, Bergen; G. Rajbhandary, Nepal; A. Martens, Hannover
08:30 Introduction M. Shrestha (Hannover)
08:40 Completioncoronaryangiogramaftercoronaryarterybypassgrafting:isitnecessary? J. Bauersachs (Hannover)
08:50 Presentationofsingle-centredata F. Fleissner (Hannover)
09:00 Tissue-engineeredvalves:allsmokewithoutfire? G. Gerosa (Padua)
Viewfromindustry J. McKenna, (United Kingdom)
09:20 Aorticvalveendocarditis:whentooperate? C. Mestres (Barcelona)
09:40 Aorticvalvereplacementinhigh-riskpatients:classicalaorticvalvereplacementthroughmini-thoracotomyissuperiortotranscatheteraorticvalveimplantation M. Glauber (Massa)
10:00 ClosureofcircumflexarteryduringMICmitralvalveoperation:isthedangerreal? V. Falk, Zürich
10:20 Coffee10:40 Redomitralvalvereplacementforreiterative
desinsertion:whattodo T. Folliguet (Nancy)
11:00 AorticvalveinacuteaorticdissectiontypeA:torepairorreplace? C. Hagl (Munich)
11:20 Closingremarks M. Shrestha (Hannover
Advanced Techniques
09:00 Part I: Aortic valve repair for the non-expert: a stepwise approach
Rooms 133/134
Moderators: D. Pagano, Birmingham; R. Sádaba, Pamplona
Howtostartanaorticvalverepairprogramme J. Vojacek (Hradec Kralove)
Howtoselectagoodcandidate V. Delgado (Leiden)
Howtorepairatricuspidaorticvalve E. Lansac (Paris)
Howtorepairabicuspidaorticvalve G Mecozzi, (Enschede)
Wetlab Training Session
10:45 Part II: Wetlab: Valve-sparing aortic root replacement
Rooms 120/121
Organiser: D. Pagano (Birmingham)
Lead Convenors: M. Lewis, Brighton; E. Lansac, Paris; M. Redmond, Dublin
Learning objectives:
At the end of this wetlab, the candidate will be able to:
ndescribe the methods used to perform valve sparing root replacement
nexplain the reasons that one technique might be used in place of another
nperform the techniques in a wetlab environment
Welcome M. Lewis
Re-implantationtechniques M. Redmond (Dublin)
Re-modellingtechniquesincludingtheLansacRing E. Lansac (Paris)
Wetlab session
Summary,feedbackandclose E. Lansac, M. Lewis
Limited to 40 participants
Attendees at the wet lab should attend Part I: Aortic valve repair for the non-expert, a stepwise approach
Wetlab Training Session
09:00 Strategies to deal with mitral repair using Gore-tex chords
Rooms 122/123
Organiser: D. Pagano (Birmingham)
Lead Convenors: M. Lewis (Brighton)
Faculty: P. Perier (Bad Neustadt/Saale), W. C. Hargrove III, Philadelphia, S. Livesey (Southampton), M. Lewis, (Brighton)
Continued from page 33
Continued on page 35
Complete EACTS Membership Applications for 2012Wearepleasedtoconfirmthatwehavereceived347completeEACTSmembershipapplicationsfor2012.TheseapplicationshavebeenformallyacceptedbytheGeneralAssemblyonMonday,29October.
Fromnowon,wearehappytoreceivenewEACTSMembershipApplicationsfortheyear2013.Please,spreadthewordamongstyourcolleagues.EACTSMembershipprovidesaccesstoanetworkofknowledgeandtheopportunitytodevelopyourownexper-tiseandsharethiswithfellowprofessionals.
http://www.eacts.org/content/membership-application
EACTS Daily News Tuesday 30 October 2012 35
Learning objectives:
At the end of this wetlab, the candidate will be able to:
nDescribe the methods used to repair the mitral valve using Gore-tex neochords and a mitral ring
nExplain the reasons why one technique might be used in place of another
nPerform the techniques in a wetlab environment
Programme (90 minutes per iteration)
Welcome: M. Lewis
Anatomyofthemitralvalve(Lecture,10minutes) W. C. Hargrove III
Repairtechniques(Lecture,10minutes) P. Perier, W. C. Hargrove III
Wetlab session (70 minutes)
Summary,feedbackandclose M. Lewis
Limited to 40 participants
10:30 Sessionends
Congenital Heart Disease
Advanced Techniques in Cardiothoracic and Vascular Surgery Wetlab Training Session
09:00 Operative techniques – aortic valve repair and the MAZE procedure
Rooms 129/130
Co-ordinator: W. Brawn, London
Faculty: C. Brizard, Melbourne; V. Hraska, Sankt Augustin; S. Tsao, Chicago
Learning objectives:
nTo understand the aortic valve repair procedures and the maze procedure pertaining to congenital heart malformations
Programme:
nDifferent techniques for aortic valve repair V. Hraska, Sankt Augustin; C. Brizard, Melbourne
nMaze procedure: B Brawn (Birmingham) S. Tsao (Chicago); A. Coane (AtriCure)
Target Audience:
nSurgeons performing congenital heart surgery in patients from infancy through to adulthood
Limited to 40 participants
Advanced Techniques
09:00 Part I: Aortic valve repair for the non-expert: a stepwise approach
Rooms 118/119
08:30 InterestingcasesandsmallseriesonorphanaorticdiseasesandpathologicalmechanismsModerators: M. Czerny, Berne; A. Moritz, Frankfurt
08:30 AtouristicdangerintheAlps:acutetypeAaorticdissectioninalpineskiers N. Fischler, J. Holfeld, W. Schobersberger, A. Strasak, M. Grimm (Austria)Discussant: R. Haaverstad (Bergen)
08:45 UsefulnessofcoiltreatmentfortypeIendoleakinthoracicendovascularaorticrepairusingafenestratedstentgraft K. Hanzawa, T. Okamoto, O. Namura, M. Tsuchida, Y. Yokoi (Japan)Discussant: B. Zipfel (Berlin)
09:00 Arterialuzoriaasariskfactorforspinalcordischaemia L. Bockeria, V. Arakelyan, N. Gidaspov (Russian Federation)Discussant: D. Kotelis (Heidelberg)
09:15 Endovascularstentgraftrepairoftheascendingaorta:assessmentofaspecificnovelstentgraftdesigninphantom,cadaverandclinicalapplication M. Funovics, M. Popovic, G. Erman, J. Lammer (Austria)Discussant: C. Antona (Milan)
09:30 AcuteretrogradetypeAaorticdissectionaftercompletedebranchingofthesupra-aorticbranchesandstentgraftingofthetransverseaorticarch M. Luehr, C. Etz, L. Lehmkuhl, F. Mohr, M. Borger (Germany)Discussant: L. Di Marco (Bologna)
09:45 Break
10:00 Clinical tips and tricks in vascular access for open and endovascular therapy
Moderators: E. Weigang, Mainz; M. Grabenwöger, Vienna
10:00 Apicalaccess E. Weigang (Mainz)
10:15 Ascendingaorticaccess J. Bavaria (Philadelphia)
10:30 Carotidaccess P. Urbanski (Bad Neustadt)
10:45 Subclavianaccess M. Grabenwöger (Vienna)
11:00 Infrarenalaccess M. Grimm (Innsbruck)
11:15 Retroperitonealaccess M. Czerny (Berne)
11:30 Femoralaccess T. Friess (Mainz)
11:45 Percutaneousaccessusingclosuredevices M. Funovics (Vienna)
12:00 Sessionends
Continued from page 34
36 Tuesday 30 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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CateringCatering CateringCatering
ENTRANCEENTRANCE
Training Village
38 Tuesday 30 October 2012 EACTS Daily News
Introducing the Future of Transapical TAVI- the Medtronic Engager System*
M Yuksel Course Director, Istanbul;
EACTS House, Windsor, UK
ChestWallInterestGroup(CWIG)isagroupbelongingtotheEACTSThoracicDo-
main.ItwasfoundedduringTheSec-ondInternationalNussProcedureWorkshopheldinIstanbulinJune2009.
Wehavesetouttoestablishachannelofcommunicationacrossdifferentcontinentswithaviewtoallowtheexchangeofknowledgeamongthoseexperiencedpracti-tionerswhoarestudying,develop-ingandinnovatingmethodstotreatchestwalldiseases.InJune2010,wegottogetheragaininIzmir,forTheThirdInternationalWorkshopontheMinimallyInvasiveRepairofPectusDeformitiesunderthecus-todyofEACTS.TheWorkshopwasagreatsuccessandwehadthechancetodiscussthefutureprojec-tionsoftheCWIG.
OurnextimportantmeetinginthecalendarwasTheFourthInter-nationalChestWallInterestGroupWorkshoponChestWallDiseaseswhichwasheldinIstanbulonJune
22–23,2012,underthecustodyofEACTS,withtheparticipationof35invitedfacultyfromaroundtheworld.
Nowwewanttoreachabroaderspectrumofresidents,specialistsandacademicians,thusweareorganiz-ingaworkshopon“ChestWallDis-eases”inWindsor,UK,atEACTSHouse,28-30November2012.
ThemainsubjectsareCongenitalChestWallDeformities,ChestWallResectionandReconstruction,Tho-racicOutletSyndromeandSternalDehiscence.
TheLearningObjectivesare;Learningtheindications,techniquesandfollow-upofminimallyinva-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
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
Since our entrance into the TAVImarket,Medtronichasalwaysbeen
committed to providing multiple TAVIplatforms. Heart teams need optionstobesttreattheirpatients.Byofferingmultiple valve platforms and accessrouteoptions(transapical,transfemoral,directaortic,andsubclavian),Medtroniccan help your team achieve the bestoutcomeforeachpatient.
Fulfillingthisvision,theinterimresultsfromtheMedtronicEngagerEuropeanPivotal Trial were presented yesterdayduring the Late Breaking AbstractSession. The early clinical experienceis positive and demonstrates that theEngager System successfully puts youincontrol forprecisepositioning, tightannular sealing, and true anatomicalignment.
Precise PositioningEngager’s unique control arms
provide tactile feedback as they areplaced into the sinuses of the native
valve, securing the valve throughoutdeployment. With tactile control,deployment is simple and repeatable-during the Pivotal Trial, 100%devices were implanted in the correctanatomic position and there were noembolizations,secondvalvesimplanted,orannularruptures.
PVL MinimizedWhile the self-expanding frame
conforms to the native anatomy,Engager further seals the annulus bycapturing the native leaflets betweenthe control arms and the frame. Anindependent echo core lab found noPVLgreaterthantraceat30daysduringthePivotalTrial.
True Anatomic AlignmentTranscatheter valves must recreate
hemodynamicfunctionineverypatientregardless of aortic shape or size. TheEngagervalveisdesignedtoalignwithand conform to the native anatomy.Fixationof thenative leafletsand truecommissure-to-commissure alignmentprovide clearance for the coronaryostiawhilesupra-annularvalvepositionminimizes frame deformation at theleaflets tooptimizecoaptation innon-circularanatomy.
Please join us today for theMedtronic TAVI Symposium (Room113 12:45-14:00) to learn moreabout the futureof TAVI, including a
live-case with the Medtronic EngagerTransapical TAVI System and anintroduction to the CoreValve InVia**surgicalaccessdeliverysystem.
We look forward to sharing the future with you.
*CE submitted. **Non-CE marked