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www.ismics.org2015 ANNUAL MEETING 3-6 June InterContinental Hotel, Berlin Germany

2015-2016 BOARD OF DIRECTORS

President: Gregory P. Fontana, MDPast President: Volkmar Falk, MDPresident-Elect: Johannes Bonatti, MDVice President: Anson Cheung, MDSecretary: Bob Kiaii, MDTreasurer: Vinod H. Thourani, MDDirectors:

Niv Ad, MDTohru Asai, MDHusam Balkhy, MDHiran Fernando, MDMattia Glauber, MDTakashi Nitta, MDYoung Tae Kim, MDL. Wiley Nifong, MDSimon C. Moten, MDRalph A. Schmid, MDMalakh Shrestha, MDPiotr Suwalski, MDChangqing Gao, MDRobinson Poffo, MD

Editor, INNOVATIONSRalph J. Damiano, Jr., MD

Managing Editor, INNOVATIONSCarol Blasberg

Executive DirectorAurelie J. Alger, JD

Associate Executive DirectorElizabeth Chouinard

Industry RelationsStan AlgerYvonne Grunebaum

Meeting DirectorE.J. Weldon

Meeting ManagerJillian West

Meeting CoordinatorOlivia Annese

Membership CoordinatorAdam Denhard

Managing Editor, ISMICS InsiderLorraine M. O’Grady

Highlights of the 2015 Meeting

Kit Arom Lecture Delivered by HermannReichenspurner

More than 750 physicians, guests,industry personnel and speakers enjoyed anoutstanding ISMICS Annual Meeting inBerlin. The meeting offered a review of thenewest and most innovative developments incardiac, vascular, and thoracic surgery andincluded exceptional scientific sessions,presentations, debates, posters, and manyopportunities to visit with colleagues andfriends.

Traditionally, the ISMICS meeting isknown as the forum for presenting the latestinnovations in both cardiovascular andthoracic surgery and this year’s meeting didnot disappoint. The program began with afull Masters Day Program, which included “How I Do It” presentations and state-of-the-artlectures including Hybrid Coronary Revascularization, Establishing a Minimally InvasiveAortic Surgery Program, and New Innovations in LVAD Therapy.

New this year, a Thoracic Masters session was conducted off site at the BerlinerMedizinhistorisches Museum der Charite where attendees were able to experience twoparallel live operations.

Wednesday concluded with the ever-popular “Technical Challenges: Pitfalls andDisasters” course. This year, Valavanur A. Subramanian, MD, Chair, was joined by co-chairRamchandra C. Reddy, MD. Fifteen challenging and unusual cases were presented includ-

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Hermann Reichenspurner, MD, pastpresident of ISMICS, presented the Kit V.Arom Lecture during the ISMICS AnnualMeeting. Dr. Reichenspurner examined thefuture of cardiac surgery in five procedureareas: Myocardial Revascularization(CABG vs. PCI); Heart Valve Procedures(SAVR vs, TAVI); Heart Valve Procedures(Surgical vs. Interventional MVR) HeartFailure (HTx vs. VAD); and Aortic Diseases(Surgical vs. Interventional Repair.)

He examined each topic and noted theadvances that have been achieved in thespecialty, but stressed the need for continuedadaptability and change.

Prof. Wendelin Stark presented Keynote Address.

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EDWARDS EDITORIAL: Rapid Deployment with the EDWARDS INTUITY Elite Bioprosthesis: MIS-AVR Reoperations Made Simpler?Tommaso Danesi Hinna, Loris Salvador, San Bortolo Hospital, Vincenza, Italy

Optimal application of new devices typically evolves naturally with timeand experience. Yet despite the advantages of rapid deployment (or sutureless)valves, including ease of implantation, fast learning curves and the associatedreduction of procedural times, clear-cut indications remain broadly undefined.

As Minimally-Invasive Sur gical Aortic Valve Replacement (MISAVR)requires easily implantable devices, rapid deployment devices are especiallysuitable for UHS and RAT videothoracoscopy; in our view, potentially one ofthe more interesting applications is for redo-MISAVR patients.

Indeed patients undergoing redo-MISAVR due to a failed conventionalstented, stentless or full root prosthesis, often require lengthy procedures, witha high risk of injury during debridment especially in small calcified annuli orduring the removal of degenerated aortic root stentless bioprostheses. In thesechallenging cases RDAVR could prove the difference.

We report herein our first two implants of an EDWARDS INTUITY Elitevalve in complex redo-MISAVR.

The first patient was a 55-year -old male with systemic and pulmonaryhypertension, HCV chronic infection and persistent AFib. The patient under-went AVR in 2006 for severe AR and a 29 mm Toronto SPV (St. Jude Medical,Minneapolis, MN) bioprosthesis was implanted. In 2015, the patient under -went a minimally invasive upper J-resternotomy due to the recurrence of se-vere AR due to post-endocarditis with perforation of the non-coronary leafletand a peak pressure gradient (PPG) of 37 mmHg.

Externally the aortic root was heavily calcified with massive mediastinaladhesions; the valve hada fully calcified root, and severe fibrosis with a perfo-ration of the non-coronary cusp. After leaflet excision, a 23 mm EDWARDS

INTUITY Elite valve was easily implanted. Aortic crossclamp and CPB time were 57 and 1 17 minutes respec-tively. The patient was weaned from CPB with a mini-mal inotropic support. Postoperative TEE showed noPVLs and low gradients. The patient was extubated af-ter 5 hours of AMV. Inotropic agents were suspendedafter 6 hours. ICU stay and hospital stay were 2 and 9days respectively. No transfusions were needed.

The second patient was a 57-year -old male affected by systemic hyper-tension. In 2009 the patient underwent AVR for severe AR due to aortic rootenlargement; at that time a 25 mm homograft was implanted. In 2015, thepatient presented with a severe calcific degeneration of the homograft andunderwent a minimally invasive upper J-resternotomy with a 21 mmEDWARDS INTUITY Elite. Aortic cross clamp and CPB time were 62 and113 minutes respectively. No inortopic agents were needed. AMV time, ICUstay and hospital stay were 3 hours, 1 and 6 days respectively.

These two cases demonstrate how the prosthetic choice at the time of thefirst and second operation is crucial. The classical sur gical approach wouldhave required a redo-Bentall-de Bono procedure with a higher grade of surgi-cal complexity and risk.

Rapid deployment bioprostheses demonstrated to be safe and suitable forredo-MISAVR patients, allowing performing fast and efficient reoperation ina safe minimally invasive fashion. In our experience redo-MISA VR has fi-nally become “minimal” for patients and “simpler” for surgeons.

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ing: A Tale of Surviving Three Consecutive CardiorespiratoryArrests on Table During a Right Sided Pneumonectomy; Manage-ment of Stuck Leaflet and Transcatheter Vale Embolization Into theLeft Ventricle; and Late Injury to the Thoracic Aorta from SpinalFusion Procedure.

Speaker highlights included the Presidential Address byVolkmar Falk, the Kit V. Arom Lectureship on “The Evolution ofModern Cardiac Surgery and the Necessity to Change” by HermannReichenspurner, MD, and Prof. Wendelin Stark’s Keynote Addresson “Nanotechnology and Soft Machines for the Heart.”

The ISMICS Exhibition Hall provided the perfect opportunity tointeract with industry colleagues and preview the newest develop-ments in the specialty and “SIMCity”, once again, provided handson simulation and training, where attendees were able to practicevarious techniques, technologies, and equipment.

The Social Program took advantage of the historical culture ofBerlin and the Attendee Reception at Meistersaal Berlin, providedthe perfect opportunity to enjoy live music and time with colleagues.

Please see all three issues of the ISMICS Insider to enjoy anoverview of the Annual Meeting.

Meeting Highlights (continued from page one)

Moderated Poster Competition Winner

Yvonne SchneebergerMinimally Invasive Surgery for Congenital Atrial SeptalDefects vs. Catheter Based Device-Occlusion in Adults

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The ISMICS International Resident and Fellows Luncheon was hosted by Past President Francis Ferdinand and provided a wonderfulopportunity for the attendees to interact with each other and with ISMICS leaders. Dr. Ferdinand provided a brief overview of the organiza-tion and welcomed the residents and fellows to the ISMICS Annual Meeting. Noting the collegial atmosphere that encompasses ISMICSevents, he encouraged those who were ISMICS members to participate in ISMICS’ activities and to volunteer for service on ISMICSCommittees. Dr. Ferndinand was joined by current president Volkmar Falk, past presidents James Fonger and Mani Subramanian, and boardmember Anson Cheung.

ISMICS International Resident and Fellows Luncheon

ISMICS’ Attendee Reception “Rocks” the Meeting

The ISMICS Attendee Reception provided a wonderful finale to the AnnualMeeting and gave meeting participants the opportunity to relax and enjoy livemusic in the Meistersaal, an historic concert hall built in 1910 and one of thebuildings that survived the Second World War. Several members of the rock bandREKORD! which includes Hubert Stein, Piotr Suwalski, Marco Serra, ThomasWalther, and Volkmar Falk entertained at the Reception, an appropriate event forthe music hall, which is used as a recording studio and has hosted many worldwidemusic stars, including U2, David Bowie, Snow Patrol, and Jon Bon Jovi.

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Young Investigator AwardCesare Quarto, MD

Transcatheter Mitral Valve Implantation for the Treatmentof Mitral Regurgitation- Thirty Days Outcomes of First-in-Man Experience with an Apically Tethered Device

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