Is there a role for surgery in acute pulmonary embolism?
Transcript of Is there a role for surgery in acute pulmonary embolism?
EACTSâDailyâNewsâ Tuesdayâ30âOctoberâ2012â 33
Thoracic: Focus Sesion 14:15â15:45â Roomâ133/134
Cardiac: Abstract 14:15â15:45â Roomâ114
Cardiac: Focus Session 16:15â17:45â Roomâ120/121
Wolfgang Harringerâ Klinikumâ
Braunschweig,âBraunschweig,âGermany
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 Gerosaâ
InstituteâofâCardiovascularâSurgery.â
Padova,âItaly
Sternalwoundinsta-bility(SWI)and/orin-fectionarestillactiveandlife-threatening
complicationsincardiacsur-gery.Thepathogenesisisnotyetclearlydefined,andmanyauthorsidentifiedseveralfac-tors,patientorsurgeonre-lated,aspotentialcauses.
TheFlexigrip(Praesidia,Bo-lognaâItaly)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).OverallcostswereâŹ8,701,854andâŹ9,243,702inGroupAandB,respectively,thusFlexigripclosuretechniqueofferedaâŹ541,848costsaving.
Flexigripusedinhighriskpa-tientsshowedalowerincidenceofsternalwoundinstabilitywithnoneedofsternalre-wiringinanycase,eveninpresenceofwoundinfection.Flexigripprovedtobealsocost-effective.
Bernard Prendergastâ JohnâRadcliffeâ
Hospital,âOxford,âUK
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
Theoriginalâtreatallâphiloso-phywasbaseduponanunderstanda-blefearofinfectiveendocarditisanditscomplications.However,thenumberneededtotreatforeffectivepreventionisexceedinglyhighandroutineantibi-oticadministrationisnotriskfree.Ana-phylaxistoă-lactamantibioticsoccursin15-40per100,000usesandtherearelegitimateconcernsregardingcommu-nity-derivedantibioticresistance.More-over,thecost-effectivenessofroutineantibioticprophylaxisisquestionable.
TheEuropeanandUSguidelinesad-vocatetheânumberneededtotreatâorâbangforyourbuckâphilosophy,re-strictinguseofantibioticprophylaxistopatientsatthehighestriskofIEunder-goingthehighestriskprocedures.An-tibioticprophylaxisisnolongerrecom-mendedforpatientswithnativevalvediseasenorforanygastrointestinalorgenitourinaryprocedures.
Goingonestepfurther,theUKNICEguidelinesespousetheâproofofprinci-pleâphilosophyandrecommendedanendtothepracticeofantibioticproph-ylaxisaltogether.Todate,thisseeminglyradicalrecommendationhasnotbeenaccompaniedbythepredictedsurgeintheincidenceormortalityofinfec-tiveendocarditisintheUK,thoughcon-tinuedprescribingtohighriskgroupsseemslikelymaybeaconfoundingsourceofpositivereassurance.Letâs test the hypothesis...
Notwithstandingthecurrentpaucityofevidence,itisclearthattheefficiencyofcurrentpracticeisrestrictedduetotheexorbitantnumberneededtotreattopreventasinglecaseofIE,withpo-tentialforoverallharm.AshiftofthefundamentalquestionfromâWhoisatrisk?âtoâWhomightbenefit?âthere-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 Howtodoaminiaorticvalvereplacementâ P.âSardariâNiaâ(Breda)
10:10 Howtodoamini-mazeâ W.-J.âVanâBovenâ(Amsterdam)
10:30 Break11:00 Howtodoathoracicendovascularaorticrepair
â M.âCzernyâ(Berne)
11:20 Howtodoanendovascularcoronaryarterybypassâ N.âBonaros,â(Innsbruck)
11:40 Howtodovideo-assistedthoracoscopicepicardialleadplacementâ B.âVanâPutteâ(Breda)
12:00 Ends
Advanced Techniques
09:00 Lateral Thinking
Room 111
09:00 Whyareweheretoday?Introduction,backgroundandgoalsofthissessionâ J.âSeeburgerâ(Leipzig)
09:09 Howsimpleideascaninfluenceourpracticeâ O.âAlfieriâ(Milan)
09:18 Whatdopatientswantandneed?â M.âMisfeldâ(Leipzig)
09:27 Societies(EACTS,AATS,STS,ESC...):Lobbyforwhom?â V.âFalkâ(ZĂźrich)
09:36 ArandomizedtrialintheNEJM:theholygrailofmarketing?â M.âMackâ(Dallas)
09:45 Thenextgenerationofcardiacsurgeons:wheretogo?â T.âNoackâ(Leipzig)
09:54 Doctorandbusinessman:conflictofinterest?â J.âPomarâ(Barcelona)
10:03 Technologytransferincardiacmedicine:money,ego,career?â E.âSchwammenthalâ(TelâAviv)
10:12 Break10:30 Howtomakethemostofyourideasandyour
futureselfâ F.âLitvackâ(LosâAngeles)
10:39 Iscardiacmedicineworththeeffort?Insightsfromeconomyâ M.âRosenmoller,âIESEâBusinessâSchoolâ(Barcelona)
10:48 WillImakemoneyinvestingincardiacsurgery?â JâMackâ(MoundsâView)
10:57 Ontheroadagain:whygiveupcardiacsurgery?â M.âStuderâ(DĂźbendorf)
11:06 ThinkTankcardiacsurgeryâ S.âHaiderâ(Erlangen)
11:15 Discussion11:51 ClosingRemarksâ V.âFalkâ(ZĂźrich)
Advanced Techniques
09:00 The mitral and tricuspid valves: repair techniques
Room 113
Moderator:âJ.âR.âPepper,âLondon;âP.âvanâdeâWoestijne,âRotterdam
09:00 Pathophysiologyoffunctionalmitralandtricuspidregurgitationâ K.âM.âJ.âChanâ(London)
09:25 Assessmentoffunctionalmitralandtricuspidregurgitationâ LâPierardâ(Liege)
09:50 Naturalhistoryandmedicaltreatmentoffunctionalmitralandtricuspidregurgitationâ T.âMcDonaghâ(London)
10:15 Break10:45 Surgicaltreatmentoffunctionalmitral
regurgitationâ R.âDionâ(Genk)
11:10 Surgicaltreatmentoffunctionaltricuspidregurgitationâ G.âDreyfusâ(Monte-Carlo)
11:35 Newerapproaches:whendopercutaneoustechniquesofferasolution?â F.âMaisanoâ(Milan)
11:35 Analternativesurgicaltreatmenttotricuspidregurgitationâ J-PâCouetilâ(Paris)
11.55 Newerapproaches:whendopercutaneoustechniquesofferasolutionâ F.âMaisanoâ(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:âF.âBeyersdorf,âFreiburg;âR.âHetzerâ(Berlin)
09:00 Organ-conservingsurgeryâ F.âBeyersdorfâ(Freiburg)
09:20 CardiacresynchronizationtherapyâC.âButterâ(Berlin)
09:40 Revascularizationsurgeryâ J.âEnnkerâ(Lahr)
10:00 Stateoftheartinhearttransplantationâ R.âHetzerâ(Berlin)
10:20 Roleofleftventricularassistdeviceâ M.âMorshuisâ(BadâOeynhausen)
10:40 Roleofrightventricularassistdeviceâ T.âKrabatschâ(Berlin)
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Tomaso Bottio
34â Tuesdayâ30âOctoberâ2012â EACTSâDailyâNews
11:00 Roleofbiventricularassistdeviceâ E.âPotapovâ(Berlin)
11:20 Totalartificialheartâ M.âLoebeâ(Houston)
11:40 Paediatricventricularassistdeviceâ V.âAlexi-Meskishviliâ(Berlin)
12:00 End-stagecongenitalheartdiseaseâ E.âM.âDelmoâWalterâ(Berlin)
12:20 Regenerativemedicineâ C.âStammâ(Berlin)
12:40 Paneldiscussionâ R.âHetzerâ(Berlin),âF.âBeyersdorfâ(Freiburg),âââ G.âSchulerâ(Leipzig),âF.âMusumeciâ(Rome),âââ C.âMestresâ(Barcelona),âH.âSchafersâ(Homburg/Saar)
Advanced Techniques
08:30 Controversies and catastrophies in adult cardiac surgery
Room 115
Organiser:âM.âShrestha,âHannover
Moderators:âR.âHaaverstad,âBergen;âG.âRajbhandary,âNepal;âA.âMartens,âHannover
08:30 Introductionâ M.âShresthaâ(Hannover)
08:40 Completioncoronaryangiogramaftercoronaryarterybypassgrafting:isitnecessary?â J.âBauersachsâ(Hannover)
08:50 Presentationofsingle-centredataâ F.âFleissnerâ(Hannover)
09:00 Tissue-engineeredvalves:allsmokewithoutfire?â G.âGerosaâ(Padua)
Viewfromindustryâ J.âMcKenna,â(UnitedâKingdom)
09:20 Aorticvalveendocarditis:whentooperate?â C.âMestresâ(Barcelona)
09:40 Aorticvalvereplacementinhigh-riskpatients:classicalaorticvalvereplacementthroughmini-thoracotomyissuperiortotranscatheteraorticvalveimplantationâ M.âGlauberâ(Massa)
10:00 ClosureofcircumflexarteryduringMICmitralvalveoperation:isthedangerreal?â V.âFalk,âZĂźrich
10:20 Coffee10:40 Redomitralvalvereplacementforreiterative
desinsertion:whattodoâ T.âFolliguetâ(Nancy)
11:00 AorticvalveinacuteaorticdissectiontypeA:torepairorreplace?â C.âHaglâ(Munich)
11:20 Closingremarksâ M.âShresthaâ(Hannover
Advanced Techniques
09:00 Part I: Aortic valve repair for the non-expert: a stepwise approach
Rooms 133/134
Moderators:âD.âPagano,âBirmingham;ââR.âSĂĄdaba,âPamplona
Howtostartanaorticvalverepairprogrammeâ J.âVojacekâ(HradecâKralove)
HowtoselectagoodcandidateâV.âDelgadoâ(Leiden)
Howtorepairatricuspidaorticvalveâ E.âLansacâ(Paris)
Howtorepairabicuspidaorticvalveâ GâMecozzi,â(Enschede)
Wetlab Training Session
10:45 Part II: Wetlab: Valve-sparing aortic root replacement
Rooms 120/121
Organiser:âD.âPaganoâ(Birmingham)
LeadâConvenors:âM.âLewis,âBrighton;ââE.âLansac,âParis;âM.âRedmond,âDublin
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
Welcomeâ M.âLewis
Re-implantationtechniquesâ M.âRedmondâ(Dublin)
Re-modellingtechniquesincludingtheLansacRingâ E.âLansacâ(Paris)
Wetlab session
Summary,feedbackandcloseâ E.âLansac,âM.âLewis
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:âD.âPaganoâ(Birmingham)
LeadâConvenors:âM.âLewisâ(Brighton)
Faculty:âP.âPerierâ(BadâNeustadt/Saale),ââW.âC.âHargroveâIII,âPhiladelphia,âS.âLiveseyâ(Southampton),âM.âLewis,â(Brighton)
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Complete EACTS Membership Applications for 2012Wearepleasedtoconfirmthatwehavereceived347completeEACTSmembershipapplicationsfor2012.TheseapplicationshavebeenformallyacceptedbytheGeneralAssemblyonMonday,29October.
Fromnowon,wearehappytoreceivenewEACTSMembershipApplicationsfortheyear2013.Please,spreadthewordamongstyourcolleagues.EACTSMembershipprovidesaccesstoanetworkofknowledgeandtheopportunitytodevelopyourownexper-tiseandsharethiswithfellowprofessionals.
http://www.eacts.org/content/membership-application
EACTSâDailyâNewsâ Tuesdayâ30âOctoberâ2012â 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:â M.âLewis
Anatomyofthemitralvalve(Lecture,10minutes)â W.âC.âHargroveâIII
Repairtechniques(Lecture,10minutes)â P.âPerier,âW.âC.âHargroveâIII
Wetlab session (70 minutes)
Summary,feedbackandcloseâ M.âLewis
Limited to 40 participants
10:30 Sessionends
Congenital Heart Disease
Advanced Techniques in Cardiothoracic and Vascular Surgery Wetlab Training Session
09:00 Operative techniques â aortic valve repair and the MAZE procedure
Rooms 129/130
Co-ordinator:âW.âBrawn,âLondon
Faculty:âC.âBrizard,âMelbourne;âV.âHraska,âSanktâAugustin;âS.âTsao,âChicago
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:âM.âCzerny,âBerne;âA.âMoritz,âFrankfurt
08:30 AtouristicdangerintheAlps:acutetypeAaorticdissectioninalpineskiersâ N.âFischler,âJ.âHolfeld,ââ W.âSchobersberger,âA.âStrasak,âM.âGrimmâ(Austria)Discussant:âR.âHaaverstadâ(Bergen)
08:45 UsefulnessofcoiltreatmentfortypeIendoleakinthoracicendovascularaorticrepairusingafenestratedstentgraftâ K.âHanzawa,âT.âOkamoto,ââ O.âNamura,âM.âTsuchida,âY.âYokoiâ(Japan)Discussant:âB.âZipfelâ(Berlin)
09:00 Arterialuzoriaasariskfactorforspinalcordischaemiaâ L.âBockeria,âV.âArakelyan,ââ N.âGidaspovâ(RussianâFederation)Discussant:âD.âKotelisâ(Heidelberg)
09:15 Endovascularstentgraftrepairoftheascendingaorta:assessmentofaspecificnovelstentgraftdesigninphantom,cadaverandclinicalapplicationâ M.âFunovics,âM.âPopovic,ââ G.âErman,âJ.âLammerâ(Austria)Discussant:âC.âAntonaâ(Milan)
09:30 AcuteretrogradetypeAaorticdissectionaftercompletedebranchingofthesupra-aorticbranchesandstentgraftingofthetransverseaorticarchâ M.âLuehr,âC.âEtz,âL.âLehmkuhl,ââ F.âMohr,âM.âBorgerâ(Germany)Discussant:âL.âDiâMarcoâ(Bologna)
09:45 Break
10:00 Clinical tips and tricks in vascular access for open and endovascular therapy
Moderators:âE.âWeigang,âMainz;ââM.âGrabenwĂśger,âVienna
10:00 Apicalaccessâ E.âWeigangâ(Mainz)
10:15 Ascendingaorticaccessâ J.âBavariaâ(Philadelphia)
10:30 Carotidaccessâ P.âUrbanskiâ(BadâNeustadt)
10:45 Subclavianaccessâ M.âGrabenwĂśgerâ(Vienna)
11:00 Infrarenalaccessâ M.âGrimmâ(Innsbruck)
11:15 Retroperitonealaccessâ M.âCzernyâ(Berne)
11:30 Femoralaccessâ T.âFriessâ(Mainz)
11:45 Percutaneousaccessusingclosuredevicesâ M.âFunovicsâ(Vienna)
12:00 Sessionends
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36â Tuesdayâ30âOctoberâ2012â EACTSâDailyâNews
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ENTRANCEENTRANCE
Training Village
38â Tuesdayâ30âOctoberâ2012â EACTSâDailyâNews
Introducing the Future of Transapical TAVI- the Medtronic Engager System*
M Yukselâ CourseâDirector,âIstanbul;â
EACTSâHouse,âWindsor,âUK
ChestWallInterestGroup(CWIG)isagroupbelongingtotheEACTSThoracicDo-
main.ItwasfoundedduringTheSec-ondInternationalNussProcedureWorkshopheldinIstanbulinJune2009.
Wehavesetouttoestablishachannelofcommunicationacrossdifferentcontinentswithaviewtoallowtheexchangeofknowledgeamongthoseexperiencedpracti-tionerswhoarestudying,develop-ingandinnovatingmethodstotreatchestwalldiseases.InJune2010,wegottogetheragaininIzmir,forTheThirdInternationalWorkshopontheMinimallyInvasiveRepairofPectusDeformitiesunderthecus-todyofEACTS.TheWorkshopwasagreatsuccessandwehadthechancetodiscussthefutureprojec-tionsoftheCWIG.
OurnextimportantmeetinginthecalendarwasTheFourthInter-nationalChestWallInterestGroupWorkshoponChestWallDiseaseswhichwasheldinIstanbulonJune
22â23,2012,underthecustodyofEACTS,withtheparticipationof35invitedfacultyfromaroundtheworld.
Nowwewanttoreachabroaderspectrumofresidents,specialistsandacademicians,thusweareorganiz-ingaworkshoponâChestWallDis-easesâinWindsor,UK,atEACTSHouse,28-30November2012.
ThemainsubjectsareCongenitalChestWallDeformities,ChestWallResectionandReconstruction,Tho-racicOutletSyndromeandSternalDehiscence.
TheLearningObjectivesare;Learningtheindications,techniquesandfollow-upofminimallyinva-siveandopensurgeryinpectusde-formities;Learningthealternativetreatmentsâsurgicalandnonsurg-cal-forpectusdeformities;Learn-ingchestwallresectionandrecon-structiontechniquesinchestwalldiseases;Learningthesurgicaltech-niquesinthoracicoutletsyndromeandLearningthetreatmentoptionsâsurgicalandnonsurgical-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 â State of the Art and Future Perspectives 12â17 November 2012 â 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 Surgeons20â 23 November 2012 EACTSHouse,Windsor,UKCourse Directors â J L Pomar, Barcelona
TheLeadershipandManagementDevelopment
Courseisanintensivefive-dayprogrammeintwopartswithathreedayinitialtrainingsessionfol-lowedbyafurthertwodaysoftrainingscheduledsixmonthslater.Thecoursewillutiliseamixofpreandpostprogrammeactivitiesandeachdelegatewillbetaskedwithexploringleadershipbestprac-tiseduringthebreakbetweenthetwopartsoftheprogramme.Course Objectives:Improve,enhanceandmaximiseyourleadershipat-tributes
Thoracic Surgery Part II3rd â 7th December 2012 EACTSHouse,Windsor,UKCourse Directors â P Rajesh, BirminghamnThecourseprogrammeincludes:nTrachealSurgerynTracheobronchialinjuriesnTracheal-mainbronchusobstruction;nEsophagusCancerâStaging,preoperative;nOesophagealcancer;nThoracoscopictechnique;nMesotheliomatreatments;nMetastaticdisease;nChestwallreconstruction;nCasepresentations.
Course Objectives:Togainmoreinsightandup-to-dateknowledgeondifferentaspectsofthoracicsurgeryrelatedtotracheal,pleural,mediastinalandoesophagealdis-ease.
Chest Wall Diseases 28â30 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
Copyright2012Š: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 PositioningEngagerâs 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