Is there a role for surgery in acute pulmonary embolism?

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 EditorOwenHaskinsowen.haskins@e-dendrite.com

Design and layoutPeterWilliamswilliams_peter@me.com

Managing DirectorPeterKHWaltonpeter.walton@e-dendrite.com

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