docAATS 2008 Final Program - American Association for Thoracic Surgery
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AATS 2008 Final Program - American Association for Thoracic Surgery
6295_AATS.book Page i Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California SUNDAY AMERICAN ASSOCIATION FOR THORACIC SURGERY 2007–2008 Exhibitors i Constitution and By-Laws American Association for Thoracic Surgery Administrative Offices 900 Cummings Center, Suite 221U, Beverly, MA 01915 Phone: (978) 927-8330 Fax: (978) 524-8890 Email: [email protected] Website: www.aats.org ROSTER Geographical Board of Governors American College of Surgeons ROSTER Alphabetical Association Representative The American Board of Thoracic Surgery WEDNESDAY Historian Membership Committee TUESDAY Councilors D. Craig Miller, Stanford, CA Thomas L. Spray, Philadelphia, PA Alec Patterson, St. Louis, MO Irving L. Kron, Charlottesville, VA Thoralf M. Sundt, Rochester, MN David J. Sugarbaker, Boston, MA Andrew S. Wechsler, Philadelphia, PA (2007) Lawrence H. Cohn, Boston, MA (2008) Walter Klepetko, Vienna, Austria Bruce Lytle, Cleveland, OH John D. Puskas, Atlanta, GA Valerie W. Rusch, New York, NY Hartzell V. Schaff, Rochester, MN Craig R. Smith, New York, NY Tirone E. David, Toronto, ON, Canada Erle H. Austin, Chair, Louisville, KY Aubrey C. Galloway, Jr., New York, NY David R. Jones, Charlottesville, VA James K. Kirklin, Birmingham, AL R. Scott Mitchell, Stanford, CA Nicholas G. Smedira, Cleveland, OH Scott J. Swanson, New York, NY Curt Tribble, Gainesville, FL Bruce W. Lytle, Cleveland, OH R. Scott Mitchell, Stanford, CA David A. Fullerton, Denver, CO David A. Fullerton, Denver, CO Valerie W. Rusch, New York, NY MONDAY President President-Elect Vice President Secretary Secretary-Elect Treasurer Editors 6295_AATS.book Page ii Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY 2007–2008 COMMITTEES ANNUAL MEETING PROGRAM COMMITTEE D. Craig Miller, Chair ............................................................................ Stanford, CA Michael A. Acker ............................................................................. Philadelphia, PA David H. Adams ................................................................................... New York, NY Robert J. Cerfolio............................................................................. Birmingham, AL Lawrence H. Cohn .................................................................................. Boston, MA Joseph A. Dearani ...............................................................................Rochester, MN Christopher M. Feindel .............................................................. Toronto, ON Canada Irving L. Kron ................................................................................Charlottesville, VA James D. Luketich................................................................................Pittsburgh, PA Alec Patterson.......................................................................................St. Louis, MO Joseph F. Sabik, III.............................................................................. Cleveland, OH Thomas L. Spray .............................................................................. Philadelphia, PA Vaughn A. Starnes ............................................................................. Los Angeles, CA Thoralf M. Sundt.................................................................................Rochester, MN Lars G. Svensson ................................................................................. Cleveland, OH Shinichi Takamoto ................................................................................ Tokyo, Japan James S. Tweddell .............................................................................. Milwaukee, WI Ludwig K. Von Segesser, .......................................................... Lausanne, Switzerland Andrew S. Wechsler ......................................................................... Philadelphia, PA Cameron D. Wright ................................................................................. Boston, MA AD HOC PROGRAM COMMITTEE REVIEWERS Michael Argenziano ............................................................................. New York, NY John G. Byrne ....................................................................................... Nashville, TN John H. Calhoon ...............................................................................San Antonio, TX Yolonda L. Colson................................................................................... Boston, MA Robert A. E. Dion............................................................................. Leiden, Belgium Richard H. Feins ................................................................................ Chapel Hill, NC Charles D. Fraser ................................................................................... Houston, TX David A. Fullerton .................................................................................... Aurora, CO Eugene A. Grossi.................................................................................. New York, NY David H. Harpole, Jr............................................................................... Durham, NC John S. Ikonomidis ............................................................................. Charleston, SC James K. Kirklin ............................................................................... Birmingham, AL John J. Lamberti ..................................................................................San Diego, CA Michael J. Mack.........................................................................................Dallas, TX Michael A. Maddaus ....................................................................... Minneapolis, MN Patrick M. McCarthy ................................................................................ Chicago, IL Steven J. Mentzer .................................................................................... Boston, MA Marc R. Moon ......................................................................................St. Louis, MO Ralph S. Mosca .................................................................................... New York, NY Joe B. Putnam....................................................................................... Nashville, TN Hartzell V. Schaff.................................................................................Rochester, MN Glen S. Van Arsdell..................................................................... Toronto, ON Canada Gus J. Vlahakes ....................................................................................... Boston, MA Richard D. Weisel ...................................................................... Toronto, ON Canada ii 6295_AATS.book Page iii Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California LOCAL ARRANGEMENTS John J. and Carol Lamberti, Co-Chairs, San Diego, CA CARDIOTHORACIC RESIDENTS COMMITTEE David H. Harpole, Jr., Co-Chair ............................................................. Durham, NC Gus J. Vlahakes, Co-Chair .......................................................................Boston, MA John H. Calhoon ...............................................................................San Antonio, TX J. William Gaynor............................................................................. Philadelphia, PA Eugene A. Grossi.................................................................................. New York, NY John S. Ikonomidis............................................................................. Charleston, SC Patrick M. McCarthy ................................................................................ Chicago, IL John Stulak.........................................................................................Rochester, MN Glen Van Arsdell ....................................................................... Toronto, ON, Canada EDUCATION COMMITTEE Craig R. Smith, Chair........................................................................... New York, NY R. Morton Bolman, Chair-Elect ...............................................................Boston, MA Joseph E. Bavaria............................................................................. Philadelphia, PA Thomas A. D’Amico ............................................................................... Durham, NC Jeffrey P. Jacobs ............................................................................. St. Petersburg, FL Steven J. Mentzer .....................................................................................Boston, MA Thoralf M. Sundt.................................................................................Rochester, MN James S. Tweddell .............................................................................. Milwaukee, WI AATS/STS POSTGRADUATE ADVISORY SUBCOMMITTEE Charles D. Fraser, Jr., Chair ................................................................... Houston, TX Carl L. Backer.......................................................................................... Chicago, IL Frank L. Hanley ..................................................................................... Stanford, CA R. Scott Mitchell .................................................................................... Stanford, CA Sudish C. Murthy .................................................................................Cleveland, OH Joseph F. Sabik, III...............................................................................Cleveland, OH Richard I. Whyte.................................................................................... Stanford, CA DEVELOPING THE ACADEMIC SURGEON SUBCOMMITTEE R. Morton Bolman, III .............................................................................Boston, MA A. Marc Gillinov...................................................................................Cleveland, OH David H. Harpole, Jr. ............................................................................. Durham, NC ETHICS COMMITTEE Robert M. Sade, Chair ........................................................................ Charleston, SC Cary W. Akins...........................................................................................Boston, MA Joseph J. Amato ....................................................................................... Chicago, IL James W. Jones ................................................................................ Montgomery, TX Andrew S. Wechsler......................................................................... Philadelphia, PA iii 6295_AATS.book Page iv Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY EVARTS A. GRAHAM MEMORIAL TRAVELING FELLOWSHIP COMMITTEE Robert L. Kormos, Co-Chair ................................................................Pittsburgh, PA John C. Wain, Jr., Co-Chair..................................................................... Boston, MA Charles D. Fraser ................................................................................... Houston, TX Marshall L. Jacobs ........................................................................... Philadelphia, PA David R. Jones ...............................................................................Charlottesville, VA David C. McGiffin ............................................................................. Birmingham, AL Mark R. Moon ......................................................................................St. Louis, MO Gus J. Vlahakes ....................................................................................... Boston, MA NOMINATING COMMITTEE Fred A. Crawford Jr., Chair ................................................................. Charleston, SC Joel D. Cooper ................................................................................. Philadelphia, PA Tirone E. David......................................................................... Toronto, ON, Canada Richard A. Jonas ...............................................................................Washington, DC Bruce W. Lytle ..................................................................................... Cleveland, OH PUBLICATIONS COMMITTEE Irving L. Kron, Chair .....................................................................Charlottesville, VA Thoralf M. Sundt, Chair-Elect.............................................................Rochester, MN Elizabeth Dooley Crane ........................................................................... Beverly, MA Alec Patterson.......................................................................................St. Louis, MO Thomas L. Spray .............................................................................. Philadelphia, PA David J. Sugarbaker ................................................................................ Boston, MA SCIENTIFIC AFFAIRS AND GOVERNMENT RELATIONS COMMITTEE Pedro J. del Nido, Chair ......................................................................... Boston, MA David H. Harpole, Jr., Co-Chair ............................................................. Durham, NC David H. Adams ................................................................................... New York, NY William A. Baumgartner..................................................................... Baltimore, MD Yolanda L. Colson ................................................................................... Boston, MA Timothy J. Gardner ........................................................................... Wilmington, DE J. William Gaynor............................................................................. Philadelphia, PA Bartley P. Griffith................................................................................ Baltimore, MD John W. Hammon, Jr. ................................................................... Winston-Salem, NC Keith A. Horvath...................................................................................Bethesda, MD John S. Ikonomidis ............................................................................. Charleston, SC David R. Jones ...............................................................................Charlottesville, VA Irving L. Kron ................................................................................Charlottesville, VA Christopher G. A. McGregor................................................................Rochester, MN D. Craig Miller ....................................................................................... Stanford, CA Michael S. Mulligan ..................................................................................Seattle, WA Marc R. Moon ......................................................................................St. Louis, MO Alec Patterson.......................................................................................St. Louis, MO Mark B. Ratcliffe............................................................................San Francisco, CA iv 6295_AATS.book Page v Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California SCIENTIFIC AFFAIRS AND GOVERNMENT RELATIONS COMMITTEE (Continued) Jack A. Roth........................................................................................... Houston, TX Frank W. Sellke........................................................................................Boston, MA Thoralf M. Sundt.................................................................................Rochester, MN Andrew S. Wechsler......................................................................... Philadelphia, PA Y. Joseph Woo.................................................................................. Philadelphia, PA WEB COMMITTEE Thoralf M. Sundt, Web Editor .............................................................Rochester, MN Joseph A. Dearani...............................................................................Rochester, MN Mark J. Krasna....................................................................................... Towson, MD Ali Khoynezhad ........................................................................................ Omaha, NE Bryan F. Meyers ....................................................................................St. Louis, MO T. Brett Reece .......................................................................................... Denver, CO Frank W. Sellke........................................................................................Boston, MA Donald C. Watson ....................................................................... Biltmore Forest, NC Y. Joseph Woo.................................................................................. Philadelphia, PA AATS/STS WORKFORCES WORKFORCE ON ANNUAL MEETING (Tech-Con Task Force) A. Marc Gillinov, Co-Chair ..................................................................Cleveland, OH James D. Luketich, Co-Chair ...............................................................Pittsburgh, PA Thomas A. D’Amico .............................................................................. Durham, NC Michael Lanuti ........................................................................................Boston, MA R. Scott Mitchell ................................................................................... Stanford, CA Friedrich W. Mohr .........................................................................Leipzig, Germany Thomas A. Vassiliades ..............................................................................Atlanta, GA WORKFORCE ON NEW TECHNOLOGY Patrick M. McCarthy, Chair ..................................................................... Chicago, IL Erle H. Austin, III .................................................................................Louisville, KY Joseph E. Bavaria ............................................................................ Philadelphia, PA William E. Cohn .................................................................................... Houston, TX Pedro J. del Nido ....................................................................................Boston, MA Hiran C. Fernando ..................................................................................Boston, MA A. Marc Gillinov ..................................................................................Cleveland, OH Robert C. Gorman ........................................................................... Philadelphia, PA Marc R. Katz .......................................................................................Richmond, VA Michael J. Mack ........................................................................................Dallas, TX Dan M. Meyer ...........................................................................................Dallas, TX R. Scott Mitchell ................................................................................... Stanford, CA Friedrich W. Mohr .........................................................................Leipzig, Germany Michael S. Mulligan .................................................................................Seattle, WA Adam E. Saltman ..................................................................................Brooklyn, NY Thomas A. Vassiliades ..............................................................................Atlanta, GA Kenton J. Zehr ....................................................................................Pittsburgh, PA v 6295_AATS.book Page vi Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY WORKFORCE ON HEALTH POLICY, REFORM, AND ADVOCACY T. Bruce Ferguson, Jr., Chair ............................................................. Greenville, NC Thomas M. Beaver ............................................................................. Gainesville, FL Shanda H. Blackmon ............................................................................ Houston, TX Greg A. Bowman ..................................................................................... Pueblo, CO Joel D. Cooper ................................................................................ Philadelphia, PA William A. Cooper ................................................................................. Marietta, GA Edgar L. Feinberg, II ............................................................................. Lafayette, LA Richard K. Freeman ........................................................................ Indianapolis, IN David R. Jones ..............................................................................Charlottesville, VA Douglas J. Mathisen ............................................................................... Boston, MA Constantine Mavroudis ........................................................................... Chicago, IL Max B. Mitchell ...................................................................................... Denver, CO Mark B. Ratcliffe ...........................................................................San Francisco, CA John R. Roberts ................................................................................... Nashville, TN Todd K. Rosengart .......................................................................... Stony Brook, NY Valerie W. Rusch ................................................................................. New York, NY David M. Shahian ..................................................................................Sudbury, MA Richard J. Shemin ............................................................................ Los Angeles, CA Scott C. Silvestry .............................................................................. Philadelphia, PA Alan M. Speir .................................................................................. Falls Church, VA Alan Jeffrey Spotnitz ....................................................................New Brunswick, NJ Lars G. Svensson ................................................................................ Cleveland, OH David F. Torchiana ................................................................................. Boston, MA S. Russell Vester .................................................................................Cincinnati, OH Raghavendra R. Vijayanagar ..................................................................... Tampa, FL WORKFORCE ON NOMENCLATURE AND CODING Peter K. Smith, Chair ............................................................................. Durham, NC Verdi J. DiSesa ................................................................................ West Chester, PA Jeffrey P. Jacobs ............................................................................ St. Petersburg, FL Kirk R. Kanter ......................................................................................... Atlanta, GA Stephen J. Lahey ..................................................................................Brooklyn, NY Harold L. Lazar ...................................................................................... Boston, MA Robert B. Lee ........................................................................................ Jackson, MS Alex G. Little .......................................................................................... Dayton, OH Vassyl A. Lonchyna .................................................................................Hinsdale, IL Francis C. Nichols, III ........................................................................Rochester, MN Winfield J. Wells ............................................................................... Los Angeles, CA Michael J. Weyant ................................................................................... Denver, CO J. Mark Williams ................................................................................ Greenville, NC Cameron D. Wright ................................................................................ Boston, MA vi 6295_AATS.book Page vii Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California JOINT COUNCIL ON THORACIC SURGERY EDUCATION (AATS/ABTS/ACS/RRC/STS/TSDA/TSRA) William A. Baumgartner, Chair ...........................................................Baltimore, MD Irving L. Kron (AATS) .................................................................... Charlottesville, VA Hartzell V. Schaff (AATS).....................................................................Rochester, MN Thoralf M. Sundt (AATS).....................................................................Rochester, MN Richard H. Feins (ABTS) ................................................................... Chapel Hill, NC James Jaggers (ACS).............................................................................. Durham, NC Valerie W. Rusch (ABTS/ACS) .............................................................. New York, NY R. Morton Bolman (RRC)........................................................................Boston, MA Douglas E. Wood (STS) ............................................................................Seattle, WA Walter H. Merrill (STS) ......................................................................Cincinnati, OH James H. Calhoon (TSDA) ................................................................San Antonio, TX John W. Brown (TSDA).....................................................................Indianapolis, IN Faraz Kerendi (TSRA)...............................................................................Atlanta, GA Rishindra M. Reddy (TSRA)......................................................................Seattle, WA THE JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY Lawrence H. Cohn, Editor .......................................................................Boston, MA Eugene H. Blackstone, Statistics Editor ..............................................Cleveland, OH Pedro J. del Nido, Section Editor ............................................................Boston, MA Alec Patterson, Section Editor..............................................................St. Louis, MO Martin F. McKneally, Ethics Editor ............................................ Toronto, ON, Canada Frank W. Sellke, Section Editor ...............................................................Boston, MA Hartzell V. Schaff, Section Editor ........................................................Rochester, MN Craig R. Smith, Section Editor............................................................. New York, NY Thoralf M. Sundt, E-Editor .................................................................Rochester, MN JTCVS EDITORIAL BOARD Erle H. Austin, III..................................................................................Louisville, KY Emile A. Bacha ........................................................................................Boston, MA Carl L. Backer.......................................................................................... Chicago, IL Michael A. Borger..................................................................... Toronto, ON, Canada Edward L. Bove................................................................................... Ann Arbor, MI Raphael Bueno ........................................................................................Boston, MA Eric G. Butchart................................................................................... Cardiff, Wales Christopher A. Caldaerone........................................................ Toronto, ON, Canada Thierry-Pierre Carrel ................................................................... Berne, Switzerland George J. Despotis .................................................................................St Louis, MO John A. Elefteriades ........................................................................... New Haven, CT J. William Gaynor............................................................................. Philadelphia, PA A. Marc Gillinov...................................................................................Cleveland, OH Donald D. Glower.................................................................................. Durham, NC Bartley P. Griffith.................................................................................Baltimore, MD John W. Hammon ........................................................................ Winston-Salem, NC Alden H. Harken.................................................................................... Oakland, CA David H. Harpole, Jr. ............................................................................. Durham, NC Alan D. Hilgenberg ..................................................................................Boston, MA vii 6295_AATS.book Page viii Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY JTCVS EDITORIAL BOARD (Continued) Charles B. Huddleston ..........................................................................St. Louis, MO John S. Ikonomidis ............................................................................. Charleston, SC Walter Klepetko ................................................................................. Vienna, Austria Harold L. Lazar ....................................................................................... Boston, MA James D. Luketich................................................................................Pittsburgh, PA Michael A. Maddaus ....................................................................... Minneapolis, MN Philippe Menasche ............................................................................... Paris, France Bryan F. Meyers .....................................................................................St Louis, MO Mark R. Moon .......................................................................................St Louis, MO Ralph S. Mosca .................................................................................... New York, NY Frank A. Pigula ....................................................................................... Boston, MA Todd K. Rosengart ................................................................................. Evanston, IL Hans-Hienrich Sievers ................................................................... Lubeck, Germany Nicholas G. Smedira ........................................................................... Cleveland, OH Francis G. Spinale ............................................................................... Charleston, SC Lars. G. Svensson ................................................................................ Cleveland, OH Tom Treasure .....................................................................London, United Kingdom Marko I. Turina .......................................................................... Zurich, Switzerland James S. Tweddell .............................................................................. Milwaukee, WI Dirk E. M. Van Raemdonck..............................................................Leuven, Belgium Federico Venuta.......................................................................................Rome, Italy Jakob Vinten-Johansen............................................................................. Atlanta, GA Richard D. Weisel ..................................................................... Toronto, ON, Canada SEMINARS IN THORACIC AND CARDIOVASCULAR SURGERY Timothy J. Gardner, Editor ................................................................ Wilmington, DE OPERATIVE TECHNIQUES IN THORACIC AND CARDIOVASCULAR SURGERY Fred A. Crawford, Editor .................................................................... Charleston, SC PEDIATRIC CARDIAC SURGERY ANNUAL Richard A. Jonas, Editor ...................................................................Washington, DC THORACIC SURGERY NEWS Edward D. Verrier, Editor .........................................................................Seattle, WA Yolonda L. Colson, Associate Editor ....................................................... Boston, MA Aubrey C. Galloway, Jr., Associate Editor ............................................. New York, NY Richard N. Pierson, III, Associate Editor ........................................... Baltimore, MD William G. Williams, Associate Editor ...................................... Toronto, ON, Canada viii 6295_AATS.book Page ix Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California AMERICAN ASSOCIATION FOR THORACIC SURGERY REPRESENTATIVES 2007–2008 AMERICAN ASSOCIATION OF BLOOD BANKS Gus J. Vlahakes........................................................................................Boston, MA AMERICAN COLLEGE OF SURGEONS ADVISORY COUNCIL FOR CARDIOTHORACIC SURGERY Fred A. Crawford, Jr. ........................................................................... Charleston, SC Robert S. D. Higgins ................................................................................ Chicago, IL AMERICAN MEDICAL ASSOCIATION HOUSE OF DELEGATES L. Penfield Faber...................................................................................... Chicago, IL AMERICAN MEDICAL ASSOCIATION CPT-4 ADVISORY COMMITTEE Kirk R. Kanter...........................................................................................Atlanta, GA ASSOCIATION OF AMERICAN MEDICAL COLLEGES COUNCIL OF ACADEMIC SOCIETIES Richard J. Shemin............................................................................. Los Angeles, CA ASSOCIATION OF PHYSICIAN ASSISTANTS IN CARDIOVASCULAR SURGERY Neal D. Kon ................................................................................. Winston-Salem, NC CARDIOTHORACIC SURGERY INDUSTRY ALLIANCE Irving L. Kron ................................................................................ Charlottesville, VA D. Craig Miller....................................................................................... Stanford, CA Alec Patterson.......................................................................................St. Louis, MO Thomas L. Spray .............................................................................. Philadelphia, PA David J. Sugarbaker.................................................................................Boston, MA Thoralf M. Sundt.................................................................................Rochester, MN COMMISSION ON ACCREDITATION OF ALLIED HEALTH EDUCATION Clifford H. VanMeter, Jr. ................................................................... New Orleans, LA CTSNET BOARD OF DIRECTORS David Adams........................................................................................ New York, NY Alec Patterson.......................................................................................St. Louis, MO Thoralf M. Sundt.................................................................................Rochester, MN NATIONAL ASSOCIATION FOR BIOMEDICAL RESEARCH Keith A. Horvath...................................................................................Bethesda, MD ix 6295_AATS.book Page x Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY PERFUSION AFFAIRS (AMSECT, ABCPT, ACPE, CAHEA) Gabriel S. Aldea ........................................................................................Seattle, WA Harold L. Lazar ....................................................................................... Boston, MA THORACIC SURGERY FOUNDATION FOR RESEARCH AND EDUCATION BOARD OF DIRECTORS Lawrence H. Cohn .................................................................................. Boston, MA Fred A. Crawford, Jr. ........................................................................... Charleston, SC David A. Fullerton .................................................................................... Denver, CO Larry R. Kaiser ................................................................................. Philadelphia, PA James K. Kirklin ............................................................................... Birmingham, AL Alec Patterson.......................................................................................St. Louis, MO x 6295_AATS.book Page xi Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California PAST PRESIDENTS OF THE AMERICAN ASSOCIATION FOR THORACIC SURGERY Year Meeting Location President 1917-1918 1918-1919 1919-1920 1920-1921 1921-1922 1922-1923 1923-1924 1924-1925 1925-1926 1926-1927 1927-1928 1928-1929 1929-1930 1930-1931 1931-1932 1932-1933 1933-1934 1934-1935 1935-1936 1936-1937 1937-1938 1938-1939 1939-1940 1940-1941 1943-1944 1945-1946 1946-1947 1947-1948 1948-1949 1949-1950 1950-1951 1951-1952 1952-1953 1953-1954 1954-1955 1955-1956 1956-1957 1957-1958 1958-1959 1959-1960 1960-1961 Chicago, IL Atlantic City, NJ New Orleans, LA Boston, MA Washington, DC Chicago, IL Rochester, MN Washington, DC Montreal, QUE New York, NY Washington, DC St. Louis, MO Philadelphia, PA San Francisco, CA Ann Arbor, MI Washington, DC Boston, MA New York, NY Rochester, MN Saranac Lake, NY Atlanta, GA Los Angeles, CA Cleveland, OH Toronto, ONT Chicago, IL Detroit, MI St. Louis, MO Quebec, QUE New Orleans, LA Denver, CO Atlantic City, NJ Dallas, TX San Francisco, CA Montreal, QUE Atlantic City, NJ Miami Beach, FL Chicago, IL Boston, MA Los Angeles, CA Miami Beach, PA Philadelphia, FL (Deceased 1/11/61) Samuel J. Meltzer Willy Meyer Willy Meyer Rudolph Matas Samuel Robinson Howard Lilienthal Carl A. Hedblom Nathan W. Green Edward W. Archibald Franz Torek Evarts A. Graham John L. Yates Wyman Whittemore Ethan Flagg Butler Frederick T. Lord George P. Muller George J. Heuer John Alexander Carl Eggers Leo Eloesser Stuart W. Harrington Harold Brunn Adrian V. S. Lambert Fraser B. Gurd Frank S. Dolley Claude S. Beck I. A. Bigger Alton Ochsner Edward D. Churchill Edward J. O’Brien Alfred Blalock Frank B. Berry Robert M. Janes Emile Holman Edward S. Welles Richard H. Meade Cameron Haight Brian Blades Michael E. De Bakey William E. Adams John H. Gibbon, Jr. Richard H. Sweet xi 6295_AATS.book Page xii Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY Year Meeting Location President 1961-1962 1962-1963 1963-1964 1964-1965 1965-1966 1966-1967 1967-1968 1968-1969 1969-1970 1970-1971 1971-1972 1972-1973 1973-1974 1974-1975 1975-1976 1976-1977 1977-1978 1978-1979 1979-1980 1980-1981 1981-1982 1982-1983 1983-1984 1984-1985 1985-1986 1986-1987 1987-1988 1988-1989 1989-1990 1990-1991 1991-1992 1992-1993 1993-1994 1994-1995 1995-1996 1996-1997 1997-1998 1998-1999 1999-2000 2000-2001 2001-2002 2002-2003 2003-2004 2004-2005 2005-2006 2006-2007 St. Louis, MO Houston, TX Montreal, QUE New Orleans, LA Vancouver, BC New York, NY Pittsburgh, PA San Francisco, CA Washington, DC Atlanta, GA Los Angeles, CA Dallas, TX Las Vegas, NV New York, NY Los Angeles, CA Toronto, ONT New Orleans, LA Boston, MA San Francisco, CA Washington, DC Phoenix, AZ Atlanta, GA New York, NY New Orleans, LA New York, NY Chicago, IL Los Angeles, IL Boston, MA Toronto, ONT Washington, DC Los Angeles, CA Chicago, IL New York, NY Boston, MA San Diego, CA Washington, DC Boston, MA New Orleans, LA Toronto, ONT San Diego, CA Washington, DC Boston, MA Toronto, ONT San Francisco, CA Philadelphia, PA Washington, DC O. Theron Clagett Julian Johnson Robert E. Gross John C. Jones Herbert C. Maier Frederick G. Kergin Paul C. Samson Edward M. Kent Hiram T. Langston Thomas H. Burford John W. Strieder Frank Gerbode Lyman A. Brewer, III Wilfred G. Bigelow David J. Dugan Henry T. Bahnson J. Gordon Scannell John W. Kirklin Herbert Sloan Donald L. Paulson Thomas B. Ferguson Frank C. Spencer Dwight C. McGoon David C. Sabiston James R. Malm Norman E. Shumway Paul A. Ebert W. Gerald Austen F. Griffith Pearson Keith Reemtsma John A. Waldhausen John L. Ochsner Aldo R. Castaneda Robert B. Wallace Mortimer J. Buckley David B. Skinner Floyd D. Loop Lawrence H. Cohn Delos M. Cosgrove James L. Cox Timothy J. Gardner Fred A. Crawford, Jr. Joel D. Cooper Tirone E. David Richard A. Jonas Bruce W. Lytle xii 6295_AATS.book Page xiii Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California AMERICAN ASSOCIATION FOR THORACIC SURGERY SECRETARIES 1918-1923 1923-1925 1925-1930 1930-1935 1935-1947 1947-1951 1951-1956 1956-1963 1963-1968 1968-1973 1973-1978 1978-1983 1983-1988 1988-1993 1993-1998 1998-2003 2003- Nathan W. Green Charles Gordon Heyd Ethan Flagg Butler Duff S. Allen Richard H. Meade Brian Blades Paul C. Samson Hiram T. Langston Henry T. Bahnson Thomas B. Ferguson Myron W. Wheat, Jr. John L. Ochsner Quentin R. Stiles Martin F. McKneally James L. Cox Tirone E. David Irving L. Kron TREASURERS 1918-1923 1923-1925 1925-1928 1928-1933 1933-1939 1939-1946 1946-1954 1954-1963 1963-1968 1968-1974 1974-1979 1979-1984 1984-1989 1989-1994 1994-1999 1999-2003 2003-2007 2007- Nathan W. Green Charles Gordon Heyd Ethan Flagg Butler Carl Eggers Edward D. Churchill Isaac A. Bigger William E. Adams Julian Johnson C. Rollins Hanlon Paul C. Adkins James R. Malm Paul A. Ebert Floyd D. Loop William A. Gay, Jr. Andrew S. Wechsler Richard A. Jonas Alec Patterson David J. Sugarbaker xiii 6295_AATS.book Page xiv Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY BASIC SCIENCE LECTURERS Year Name Title 2007 Steven R. Bailey, M.D. 2006 H. Robert Horvitz, Ph.D. 2005 Harry Dietz, M.D. 2004 John B. West, M.D. 2003 Richard White, M.D. 2002 Steven A. Rosenberg, M.D. 2001 2000 1999 Gerald D. Buckberg, M.D. J. Craig Venter, Ph.D. Victor Dzau, M.D. 1998 Eric J. Topol, M.D. 1997 Ronald G. Crystal, M.D. 1994 Timothy A. Springer, Ph.D. 1993 Andrew S. Wechsler, M.D. 1992 1991 Kurt Benirschke, M.D. Fritz H. Bach, M.D. 1990 Louis Siminovitch, M.D. 1989 1988 Russell Ross, M.D. Raj K. Goyal, M.D. 1987 Gustav J. V. Nossal, M.D. Nanotechnology – Impact on Cardiovascular Medicine Genetic Control of Programmed Cell Death in C. elegasn New Insights Into the Pathogenesis and Treatment of Marfan Syndrome A Shortage of Oxygen: Lessons from the Summit of Mt. Everest Advanced Imaging: Aiding the “Mind’s Eye” of the Cardiothoracic Surgeon The Immune Response to Human Cancer: Lessons from the Molecular Analysis of Patients with a Dramatic Response to Immunotherapy The Helix and the Heart Decoding the Human Genome Gene Therapy Strategies for Research Revascularization The Future of Coronary Thrombosis Prophylaxis Implications for Gene Therapy in Treating Coronary Artery Disease and Lung Cancer Traffic Signals for Leukocyte Emigration from the Blood Stream Molecular Biology: New Common Ground for Cardiothoracic Surgery Twinning Transplant Immunology: A Broadening of the Concept for the Future Advances in Cancer Research – Bench to Bedside The Pathogenesis of Atherosclerosis Physiology and Pathophysiology of Esophageal Peristalsis Immuno-Regulation: The Key to Transplantation and Autoimmunity xiv 6295_AATS.book Page xv Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California HONORED GUEST SPEAKERS (1973–2007) Year Name 2007 2006 Mark B. McClellan John P. Howe, III, M.D. 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 Title A World in Need: Lessons Learned in Medical Diplomacy. The Project HOPE Perspective Richard D. Weisel, M.D. Cardiac Regeneration Joseph Macinnis, M.D. Leadership and Surgery: A View from Inside the Ocean Frank Culbertson, CAPT, USN The Challenges of Human Space Flight Marc R. de Leval, M.D. Beyond Flatland Mory Gharib, M.D. Bioengineering for the Exploration of Space: New Challenges James L. Barksdale Effects of the Net Economy Judah Folkman, M.D. Experimental and Clinical Application of Angiogenesis Research Ken Taylor, M.D. A Practical Affair Antoon E. M. R. Lerut, M.D. Esophageal Surgery at the End of the Millenium David H. Sachs, M.D. Tolerance to Allogeneic and Xenogeneic Transplants Edmund D. Pellegrino, M.D. Medical Ethics in the 21st Century: DNR or CPR? Rodolfo Herrera-Llerandi, M.D. A Thoracic Tale of Two Cities Mark F. O’Brien, M.D. The Structure and Function of Tissue Valves; Some Lessons Learned from the Fate of Implanted Heart Valves Rene G. Favaloro, M.D. Coronary Artery Bypass Graft Surgery; Twenty-five Years Later. Some Landmarks Magdi Yacoub, M.D. Long-Term Transplantation as a Model A. P. Naef, M.D. Pioneers and Milestones in Thoracic Surgery Francis M. Fontan, M.D. Transplantation of Knowledge Jaroslav F. Stark, M.D. Do We Really Correct Congenital Heart Defects? Jean-Paul Binet M.D. New Frontiers – New Barriers Ake Senning, M.D. The Cardiovascular Surgeon and the Liver Hans G. Borst M.D. Hands Across the Ocean: German/American Relations in Thoracic Surgery xv 6295_AATS.book Page xvi Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY Year Name Title 1984 Adib D. Jatene, M.D. 1983 1982 Alain Carpentier, M.D. Wu Ying-Kai, M.D. 1981 Roger A. Smith, M.D. 1980 1979 1978 1977 1976 1975 Left Ventricular Aneurysmectomy: Resection or Reconstruction? Valve Surgery: The French Correction Achievements in the Study and Control of Cancer of the Esophagus An Evaluation of the Long-Term Results of Surgery for Bronchial Carcinoma Cardio-Thoracic Metamorphosis Cardiothoracic Surgery in the Antipodes Cardiac Surgery – The Golden Years H. D’Arcy Sutherland, M.D. Brian Barratt-Boyes, M.D. Donald Ross, M.D. Charles Dubost, M.D. Eoin O’Malley, M.Ch., F.R.C.S.I. The Doctor’s Dilemma Gordon W. Thomas, M.D. Surgery in the Sub-Arctic: A Thoracic Surgeon’s Odyssey Shigeru Sakakibara, M.D. Experiences with Congenital Anomalies of the Heart in Japan Thomas H. Sellors, M.D. The Generality of Surgery C. Rollins Hanlon, M.D. Specialization in Medicine Roger O. Egeberg, M.D. Leo Eloesser, M.D. Milestones In Chest Surgery E. J. Zerbini, M.D. The Surgical Treatment of Tetralogy of Fallot Christiaan N. Barnard, M.D. Experience with Human Heart Transplantation Viking Olov Bjork, M.D. Methods in Open Heart Surgery Ronald Belsey, M.D. Functional Diseases of the Esophagus and their Surgical Management A. Gerard Brom, M.D. Narrowing of the Aortic Isthmus and Enlargement of the Mind I. Boerema, M.D. The Use of Hyperbaric Oxygen in Thoracic Surgery Andrew Logan, M.D. The Surgical Treatment of Carcinoma of the Esophagus and Cardia Norman R. Barrett, M.D. Publish or Perish Earle W. Wilkins, Jr., M.D. Experience With 500 Cases of Hiatus Hernia A. L. d’Abreu, M.D. Thoracic Surgery in the Commonwealth of Medicine Alfonso Topete, M.D. New Findings in the Coronary-Encephalic Perfusion in Depressive Surgical Cases 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 xvi 6295_AATS.book Page 1 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California GENERAL INFORMATION 1. REGISTRATION: Catheter-Based Approaches to Structural Heart Disease Symposium New Technologies and Procedures in General Thoracic Surgery Symposium Developing the Academic Surgeon Symposium AATS/STS Adult Cardiac Surgery Symposium AATS/STS Congenital Heart Disease Symposium AATS/STS General Thoracic Surgery Symposium 2008 Annual Meeting For members, non-members, spouses, allied personnel and exhibitors, Registration will be located in the foyer outside Hall GH of the San Diego Convention Center. Members, non-members, and allied health personnel may register during the following hours: Friday, May 9 Saturday, May 10 Sunday, May 11 Monday, May 12 Tuesday, May 13 Wednesday, May 14 1:00 p.m. – 5:00 p.m. 7:00 a.m. – 5:00 p.m. 7:00 a.m. – 6:00 p.m. 7:00 a.m. – 5:00 p.m. 6:30 a.m. – 5:00 p.m. 6:30 a.m. – 11:00 a.m. SUGGESTIONS FOR REGISTRATION: a) Badges must be worn and will be required for admission to the Sessions and Exhibit Area at all times. b) To avoid lines and delays in the registration area, we strongly suggest that attendees register on Saturday, May 10 and Sunday, May 11. c) House officers, Fellows and Residents will be admitted without payment of the nonmember registration fee upon presentation of a letter from their Chief of Service. 2. SPEAKER READY ROOM: The Speaker Ready Room will be located in Room 24B of the San Diego Convention Center. Speakers may review their presentations inasmuch as all presentations will have been submitted in advance. 3. TRANSPORTATION: Shuttle buses will run continuously between the San Diego Marriott Hotel & Marina, the Manchester Grand Hyatt, and the San Diego Convention Center. There will be no regular transportation from the Omni San Diego Hotel due to its close proximity to the convention center. However, on Tuesday evening, buses returning from the Attendee Reception will stop at all three hotels. 1 6295_AATS.book Page 2 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY 4. SPECIAL EVENTS: C. Walton Lillehei Resident Forum (Room 23 AB) Welcome Reception (Exhibit Hall GH) Business Session (Ballroom 20 A-C – Members only) Basic Science Lecture Presidential Address Luncheon (Exhibit Hall GH) Cardiothoracic Residents’ Luncheon (Room 23) International Leadership Luncheon (Room 29 A) Honored Guest Lecture Luncheon (Exhibit Hall GH) TSRA Luncheon (Room 29 AB) Academic Leadership Luncheon (Room 23 AB) Executive Session (Ballroom 20 A-C – Members only) Attendee Reception (San Diego Air & Space Museum) Sunday 3:00 p.m. – 5:00 p.m. Sunday 5:00 p.m. – 7:00 p.m. Monday 7:30 a.m. – 7:45 a.m. Monday Monday Monday 10:00 a.m. – 10:40 a.m. 11:25 a.m. – 12:15 p.m. 12:15 p.m. – 1:45 p.m. Monday 12:15 p.m. – 1:45 p.m. Monday 12:15 p.m. – 1:45 p.m. Tuesday Tuesday 11:40 a.m. – 12:20 p.m. 12:30 p.m. – 2:00 p.m. Tuesday 12:30 p.m. – 2:00 p.m. Tuesday 12:30 p.m. – 2:00 p.m. Tuesday 5:00 p.m. Tuesday 7:00 p.m. – 9:00 p.m. 5. CATHETER-BASED APPROACHES TO STRUCTURAL HEART DISEASE SYMPOSIUM: The Catheter-Based Approaches to Structural Heart Disease Symposium will take place on Saturday, May 10, 2008 in Room 28 of the San Diego Convention Center. The Symposium will begin at 8:00 a.m. and end at 12:00 p.m. Pre-registration is required. 6. NEW TECHNOLOGIES AND PROCEDURES IN GENERAL THORACIC SURGERY SYMPOSIUM: The New Technologies and Procedures in General Thoracic Surgery Symposium will take place on Saturday, May 10, 2008 in Room 25 of the San Diego Convention Center. The Symposium will begin at 8:00 a.m. and end at 12:00 p.m. Pre-registration is required. 7. DEVELOPING THE ACADEMIC SURGEON – SYMPOSIUM: The Developing the Academic Surgeon Symposium will take place on Saturday, May 10, 2008 in Room 23 of the San Diego Convention Center. The Symposium will begin at 1:00 p.m. and end at 5:00 p.m. Pre-registration is required. 2 6295_AATS.book Page 3 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California 8. AATS/STS ADULT CARDIAC SURGERY SYMPOSIUM: The Adult Cardiac Surgery Symposium will take place on Sunday, May 11 in Ballroom 20 A-C at the San Diego Convention Center. The Symposium will begin at 8:00 a.m. and end at 5:15 p.m. Pre-registration is required. Due to the large volume of registrants for our Sunday Symposia, we STRONGLY suggest registering on Friday or Saturday to avoid delays. 9. AATS/STS CONGENITAL HEART DISEASE SYMPOSIUM: The Congenital Heart Disease Symposium will take place on Sunday, May 11 in Room 28 in the San Diego Convention Center. The Symposium will begin at 7:55 a.m. and end at 5:00 p.m. Pre-registration is required. Due to the large volume of registrants for our Sunday Symposia, we STRONGLY suggest registering on Friday or Saturday to avoid delays. 10. AATS/STS GENERAL THORACIC SURGERY SYMPOSIUM: The General Thoracic Surgery Symposium will take place on Sunday, May 11 in Room 25 in the San Diego Convention Center. The Symposium will begin at 8:00 a.m. and end at 5:00 p.m. Pre-registration is required. Due to the large volume of registrants for our Sunday Symposia, we STRONGLY suggest registering on Friday or Saturday to avoid delays. 11. CARDIOTHORACIC RESIDENTS’ LUNCHEON: The 31st Annual Cardiothoracic Residents’ Luncheon will begin at 12:15 p.m. on Monday, May 12, 2008 in Room 23 of the convention center. Physicians in cardiothoracic residency programs interested in attending this luncheon as guests of the Association must be pre-registered for the luncheon and will receive a ticket with their registration materials. Residents may register on-site on a space available basis at the Registration desk of the Convention Center. This year’s luncheon will be hosted by AATS immediate past president, Bruce W. Lytle. 12. WELCOME RECEPTION: A Welcome Reception will be held on Sunday, May 11 from 5:00 – 7:00 p.m. in Exhibit Hall GH at the San Diego Convention Center. All registered members, non-members, allied health personnel, spouses and guests are invited to attend. Please note that children will be allowed in the exhibit hall during the reception only. Children under 16 years of age will not be allowed in the exhibit hall at any other time. 13. EXHIBITS: Exhibits will be located in Exhibit Hall GH on the Ground Level at the Convention Center. Exhibits will be open during the following hours: Sunday, May 11 Monday, May 12 Tuesday, May 13 5:00 p.m. – 7:00 p.m. 9:00 a.m. – 4:30 p.m. 9:00 a.m. – 4:00 p.m. There will be a Welcome Reception for all registrants in the Exhibit Hall on Sunday, May 11, 2008 from 5:00 p.m. – 7:00 p.m. Lunch will be served in the Exhibit Hall for all professional registrants on Monday, May 12 and Tuesday, May 13. Coffee breaks will also be held in the Exhibit Hall. 3 6295_AATS.book Page 4 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY 14. HOSPITALITY SUITE: The Hospitality Suite, located in the Leucadia Room in the South Tower of the San Diego Marriott, will be open during the following hours: Sunday, May 11 Monday, May 12 Tuesday, May 13 8:00 a.m. – 4:00 p.m. 8:00 a.m. – 4:00 p.m. 8:00 a.m. – 4:00 p.m. Staff will be on hand throughout the meeting to greet you, answer your questions, and be of assistance to you and your family. Special optional tours have been arranged for Saturday, Sunday, Monday and Tuesday. 15. CAMERA/RECORDING POLICY: Due to privacy issues, it is the policy of AATS that no cameras are permitted in the meeting sessions or exhibit hall. Please refrain from taking photos in these locations. Audio and videotaping is also prohibited. 16. CELL PHONES: For the courtesy of all faculty and participants, please ensure that cell phone ringers are silenced during all sessions. 17. SPECIAL ACCESSIBILITY NEEDS: If you require special accommodations to fully participate in the meeting, please visit the Registration Area at the San Diego Convention Center and an AATS staff member will be happy to assist you. 18. OBJECTIVE: The Annual Meeting of the American Association for Thoracic Surgery is designed to provide five days of comprehensive educational experience in the field of thoracic and cardiovascular surgery. It is the Association’s intent to bring together the world’s leading scientists in the specialty to freely and openly discuss their latest clinical and research efforts. This year’s program begins on Saturday morning, May 9th, with the CatheterBased Approaches to Structural Heart Disease symposium and the New Technologies and Procedures in General Thoracic Surgery symposium Each will run from 8:00 a.m. to 12:00 p.m. Saturday continues with a half-day symposium focusing on Developing the Academic Surgeon. Sunday, May 11th provides three full-day parallel symposia on Congenital Heart Disease, Adult Cardiac Surgery and General Thoracic Surgery. The AATS Eleventh Annual C. Walton Lillehei Residents’ Forum will also be held on Sunday afternoon from 3:00 p.m to 5:00 p.m. The Forum is made possible through an educational grant from St. Jude Medical, and will consist of the presentation of original work by residents in Thoracic Surgical training programs in North America. Monday and Tuesday mornings will be devoted to a plenary session which will include those presentations selected by the Program Committee from the entire cohort of abstracts submitted to the Association from leading centers throughout the world, reflecting the interest of the specialty. Monday and Tuesday afternoons will be devoted to parallel sessions in which papers of specific interest to surgeons 4 6295_AATS.book Page 5 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California involved in General Thoracic Surgery, Congenital Heart Disease, and Adult Cardiac Surgery will be presented. Participants will have the opportunity to discuss the presentations throughout the program. The Scientific Program will also include two parallel Forum Sessions, which are scheduled for Tuesday morning, May 13th, and an Emerging Technologies and Techniques Forum to be held on Wednesday morning, May 14th. These are most appropriate for the presentation of experimental and anatomical studies and for the presentation of new surgical techniques. On Wednesday morning AATS will once again hold its highly successful Controversies in Cardiothoracic Surgery. This year the session will feature two plenary debates. The first debate will be on the topic Live Surgery at National and Regional Cardiothoracic Surgical Meetings Should Be Outlawed; the second debate will be on the topic Should the Certifying Authority Provide Two Certificates: One for Cardiac Surgery and One for Thoracic Surgery? Each debate will be 60 minutes long and will include ample opportunity for audience participation. At the conclusion of the Annual Meeting, participants should have an enhanced understanding of the latest techniques and current research specifically related to General Thoracic Surgery, Adult Cardiac Surgery, and Congenital Heart Disease. Through the open discussion periods, participants will have the opportunity to hear the pros and cons of each paper presented to gain an overall perspective of their current practices and utilize results presented to select appropriate surgical procedures and interventions for their own patients and integrate state-of-the-are knowledge into their current practice. 19. ACCREDITATION: The American Association for Thoracic Surgery is accredited by the Accreditation Council for Continuing Medical Education to sponsor continuing medical education for physicians. The American Association for Thoracic Surgery designates the annual meeting program, a continuing medical education activity, for the following credit hours in Category 1 of the Physician's Recognition Award of the American Medical Association: • Catheter-Based Approaches to Structural Heart Disease Symposium, up to 3.75 hours • New Techniques and Procedures in General Thoracic Surgery Symposium, up to 3.75 hours • Developing the Academic Surgeon Symposium, up to 3.75 hours • Adult Cardiac Surgery Symposium, up to 7.25 hours • Congenital Heart Disease Symposium, up to 7.0 hours • General Thoracic Surgery Symposium, up to 7.0 hours • C. Walton Lillehei Resident Forum, up to 2.0 hours • Plenary and Simultaneous Scientific Sessions, up to 17.5 hours 5 6295_AATS.book Page 6 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY 20. DISCLOSURE POLICY: It is the policy of the American Association for Thoracic Surgery that any individual who makes a presentation or is a co-author on a program designated for AMA Physician’s Recognition Award Category 1 Credit must disclose any financial interest or other relationship (grant, research support, consultant, etc.) that individual has with any manufacturer(s) of any commercial product(s) that may be discussed in the individual’s presentation. This policy is established neither to imply any position regarding the propriety of such relationships nor to prejudice any individual from making a presentation but to allow the participants to form their own judgments regarding the presentation. Authors who may have a possible conflict of interest are denoted in the program book. Authors must disclose any material, financial, or other relationships that may pose conflict of interest at the time of presentation. 21. MEMBERSHIP APPLICATIONS: Applications for membership should be submitted to: Chair, Membership Committee American Association for Thoracic Surgery 900 Cummings Center, Suite 221-U Beverly, Massachusetts 01915 6 6295_AATS.book Page 7 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California MEMORANDA FOR GUIDANCE OF SPEAKERS AND DISCUSSANTS 1. In accordance with the By-Laws of the Association, the papers which are read at the meeting shall be given to the Session Moderator prior to the presentation. The papers submitted for consideration for publication in the Journal of Thoracic and Cardiovascular Surgery must bear a close relationship in length to the paper presented at the meeting. 2. Scientific session speakers will be limited to 8 minutes and discussants will be limited to 12 minutes. Point-counterpoint debaters in each subspecialty will be limited to 10 minutes each, followed by a 10-minute audience participation session to be moderated by the moderator. Forum speakers will be limited to 5 minutes and discussants will be limited to 7 minutes. 3. Wednesday morning Controversies will be limited in time to 60 minutes. Debaters will be limited to 10 minutes, followed by a 10-minute rebuttal and closing summary for each debater, to be followed by a 20-minute audience participation session to be moderated by the moderator. 4. Discussion of Papers: Members, non-member physicians and invited speakers have the privilege of discussing papers. All discussants should register with the Session Moderator prior to the opening of the session during which the paper is to be presented. All discussion will be presented from floor microphones and may not be accompanied by slides. 5. In publication it is customary to group discussions together on a series of papers. Transcription of the discussion will be forwarded to discussants for review and correction. Any delay in the return of corrected discussion means that publication of all papers on the subject will be held up. Such a delay is manifestly unfair to those who are conscientious in the prompt submission of their remarks for publication. Unreasonable delay will preclude publication. The submission and acceptance of an abstract constitutes a commitment by the Author(s) to present the material at the AATS Annual Meeting. The work must not have been submitted, presented, or published in abstract or manuscript form elsewhere prior to the AATS 88th Annual Meeting in May 2008. Failure to meet this requirement without prior approval of the Association will jeopardize further acceptance of abstracts for presentation and/or publication. The AATS Council seriously regards and adheres to the submission/presentation policy and will strictly enforce sanctions upon all authors who fail to meet the policies outlined in the rules for submission and presentation of abstracts once submitted. Any questions should be addressed to the Secretary of the Association. 7 6295_AATS.book Page 8 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY AMERICAN ASSOCIATION FOR THORACIC SURGERY 88th ANNUAL MEETING San Diego Convention Center San Diego, CA, May 10 – May 14, 2008 PROGRAM OUTLINE SATURDAY, MAY 10, 2008 8:00 a.m. CATHETER-BASED APPROACHES TO STRUCTURAL HEART DISEASE Room 28 A-C, San Diego Convention Center Chairman: Michael J. Davidson, Brigham & Women’s Hospital 8:00 a.m. Welcome and Introduction Michael J. Davidson Brigham & Women’s Hospital 8:10 a.m. The Cardiac Surgeon as Interventionalist Wilson Szeto University of Pennsylvania 8:20 a.m. Catheter Approaches to the Aortic Valve Matthew Williams Columbia University Medical Center 8:40 a.m. CASE PRESENTATION: Transapical Aortic Valve Implementation Matthew Williams Columbia University Medical Center 8:50 a.m. Catheter Approaches to the Mitral Valve Michael J. Davidson Brigham & Women’s Hospital 8 6295_AATS.book Page 9 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California 9:10 a.m. CASE PRESENTATION: Transcatheter Mitral Valve Repair Saibal Kar Cedars-Sinai Medical Center 9:20 a.m. Catheter Approaches to Congenital Heart Disease Emile Bacha Children’s Hospital Boston 9:40 a.m. Treatment of ASD, PFO, VSD Saibal Kar Cedars-Sinai Medical Center 10:00 a.m. Novel Therapies for Heart Failure Frederick Welt Brigham & Women’s Hospital 10:20 a.m. BREAK 10:40 a.m. Advanced Thoracic Endografting Wilson Szeto University of Pennsylvania 11:00 a.m. Endovascular Treatment of Type B Aortic Dissection Joseph Bavaria University of Pennsylvania 11:40 a.m. PANEL DISCUSSION: Cross-Training for Surgeons, Interdisciplinary Collaboration, and the Future of Structural Heart Interventions 12:00 p.m. ADJOURN 9 6295_AATS.book Page 10 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY 8:00 a.m. NEW TECHNOLOGIES AND PROCEDURES IN GENERAL THORACIC SURGERY Room 25, San Diego Convention Center Chairman: James D. Luketich, University of Pittsburgh Co-Chair: Thomas J. Watson, University of Rochester 8:00 a.m. 8:05 a.m. Welcome and Introduction Stereotactic Radiosurgery for the Treatment of Lung Cancer Neil Christie University of Pittsburgh 8:25 a.m. Endobronchial Ultrasound for Staging Lung Cancer Rafael Andrade University of Minnesota 8:45 a.m. Radiofrequency Ablation for the Treatment of Lung Cancer Arjun Pennathur University of Pittsburgh 9:05 a.m. Endobronchial Valves for the Treatment of Emphysema Robert Cerfolio University of Alabama Birmingham 9:25 a.m. Hyperthermic Chemoperfusion for the Treatment of Malignant Mesothelioma David Sugarbaker Brigham and Women’s Hospital 9:45 a.m. PANEL DISCUSSION 10:00 a.m. BREAK 10:20 a.m. Endoscopic Mucosal Resection for High Grade Dysplasia and Early Cancer Steve DeMeester University of Southern California, Los Angeles 10:40 a.m. Endoscopic Therapies for the Treatment of Reflux Disease (Endoscopic Plicator) Blair Jobe University of Pittsburgh 11:00 a.m. Robotic Thymectomy Kemp Kernstine, City of Hope National Medical Center 11:20 a.m. Radiofrequency Ablation for the Treatment of Barretts Esophagus Seth Force Emory University School of Medicine 11:40 a.m. PANEL DISCUSSION 12:00 p.m. ADJOURN 10 6295_AATS.book Page 11 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California 1:00 p.m. DEVELOPING THE ACADEMIC SURGEON—A SYMPOSIUM Room 23, San Diego Convention Center Chairman: R. Morton Bolman, III, Boston, MA 1:00 p.m. Introduction R. Morton Bolman III Brigham and Women’s Hospital 1:10 p.m. How to Plan a Successful Career In Academic Cardiothoracic Surgery Fred A. Crawford Medical University of South Carolina 1:30 p.m. Clinical Research In Cardiothoracic Surgery Tirone E. David Toronto General Hospital 1:50 p.m. Basic Research In Cardiothoracic Surgery Yolonda L. Colson Brigham and Women’s Hospital 2:10 p.m. Translational Research and the Interface with Industry Eric A. Rose Columbia University 2:30 p.m. KEYNOTE SPEAKER: The Future of Cardiothoracic Surgery William A. Baumgartner Johns Hopkins University 3:00 p.m. BREAK 3:20 p.m. Research Funding—From Seed Grants to the NIH Pedro J. del Nido Boston Children’s Hospital 3:40 p.m. How to Design and Execute a Clinical Trial Eugene H. Blackstone Cleveland Clinic Foundation 4:00 p.m. Training for the Future: The “Hybrid Specialist” Michael J. Davidson Brigham and Women’s Hospital 4:20 p.m. Training for the Future: The Program Director’s Perspective R. Morton Bolman III Brigham and Women’s Hospital 4:40 p.m. PANEL DISCUSSION 5:00 p.m. ADJOURN 11 6295_AATS.book Page 12 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY SATURDAY, MAY 10, 2008 5:00 – 7:00 p.m. General Thoracic Biology Club Location: TBA 5:00 – 7:00 p.m. Cardiac Surgery Biology Club Location: TBA 12 6295_AATS.book Page 13 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California SUNDAY, MAY 11, 2008 8:00 a.m. – 5:00 p.m. AATS/STS Adult Cardiac Symposium Ballroom 20 A–C, San Diego Convention Center Chairman: R. Scott Mitchell Stanford University Session I: Thoracic and Thoracoabdominal Aortic Aneurysms 8:00 a.m. Surgical Implications and Indications In MFS and Other Syndromic Patients Duke Cameron Johns Hopkins University 8:20 a.m. Thoracic Aortic Aneurysms: When Is Intervention (Open or Stent-Graft) Indicated? John Elefteriades Yale University 8:40 a.m. Open Surgical Results Today: Descending and Thoracoabdominal Aortic Aneurysms Joseph Coselli Baylor College of Medicine 9:00 a.m. Endovascular Stent-Graft Results: Descending and Thoracoabdominal Aortic Aneurysms Roy Greenberg Cleveland Clinic 9:20 a.m. PANEL DISCUSSION 9:40 a.m. BREAK 13 6295_AATS.book Page 14 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY Session II: Aortic Dissections 10:10 a.m. Fate of the Dissected “Downstream” Aorta: Are Distal Adjuncts Needed at the Initial Operation? Randall Griepp Mount Sinai Medical Center 10:30 a.m. Cerebral Protection During Transverse Aortic Arch Procedures Lars Svensson Cleveland Clinic 10:50 a.m. Total Arch Replacement with Multi-Branched Grafts Teruhisa Kazui Hamamatsu University School of Medicine 11:10 a.m. Total Arch and Descending Thoracic Aorta Using the “Arch First” Thoracosternotomy Approach Nicholas Kouchoukos Missouri Baptist Medical Center 11:30 a.m. PANEL DISCUSSION 12:00 p.m. LUNCH Session III: Mitral Valve Controversies 1:00 p.m. Spectrum of Degenerative Diseases Affecting the Mitral Valve David Adams Mount Sinai Medical Center 1:20 p.m. Mitral Annuloplasty Rings: Theory and Practice Reality Hugo Vanermen Aalst, Belgium 1:40 p.m. Asymptomatic Severe Mitral Regurgitation Due to FED: Indications for Repair Hartzell Schaff Mayo Clinic 2:00 p.m. Mitral Valve Repair (FMR and IMR) In the Myopathic Ventricle R. Dion Genk – Leuven, Belgium 2:20 p.m. Critically Interpreting the Mitral Valve Repair Literature Anelechi Anyanwu Mount Sinai Medical Center 2:40 p.m. PANEL DISCUSSION 3:00 p.m. BREAK 14 6295_AATS.book Page 15 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California Session IV: Update on Contemporary Cardiovascular Imaging 3:15 p.m. MRI/MRA Robert Herfkens Stanford University 3:35 p.m. CTA Dominik Fleischmann Stanford University 3:55 p.m. Echocardiography David Liang Stanford University Session V Percutaneous Aortic Valve Replacement 4:15 p.m. Update on Percutaneous AVR with Edwards Sapien (Retrograde and Antegrade) John Webb St. Paul’s Hospital 4:35 p.m. Update on Percutaneous Redo AVR: Corvalve F. W. Mohr Leipzig, Germany 4:55 p.m. Identification of Appropriate Patients: Who Actually Is “Inoperable”? Michael Mack Cardiothoracic Surgery Associates of North Texas 5:00 p.m. ADJOURN TO WELCOME RECEPTION 15 6295_AATS.book Page 16 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY SUNDAY, MAY 11, 2008 8:00 a.m. – 5:00 p.m. AATS/STS GENERAL THORACIC Symposium Room 25, San Diego Convention Center Chairman: Richard I. Whyte Stanford University 8:00 a.m. INTRODUCTION Richard I. Whyte Stanford University Session I: Surgical Controversies: Open VERSUS VATS Lobectomy 8:05 a.m. The Role of VATS Lobectomy for Cancer Robert J. McKenna, Jr. Cedars Sinai Medical Center 8:20 a.m. Open Lobectomy—The Standard Operation for Lung Cancer Douglas J. Mathisen Massachusetts General Hospital 8:35 a.m. PANEL DISCUSSION Session II: Lung Cancer Staging 8:50 a.m. PET Scans — When Should We Rely on Them Carolyn E. Reed Medical University of South Carolina 9:10 a.m. Can Endobronchial Ultrasound (EBUS) and Transesophageal FNA Replace Mediastinoscopy Daniel L. Miller Emory University Clinic 9:25 a.m. PANEL DISCUSSION 9:45 a.m. BREAK 16 6295_AATS.book Page 17 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California Session III: Lung Cancer—Management 10:15 a.m. Neoadjuvant Therapy for Pancoast Tumors Eric Vallieres Swedish Cancer Institute 10:35 a.m. Surgical Techniques for Pancoast Tumors Garrett L. Walsh MD Anderson Cancer Center 11:00 a.m. The Role of Neoadjuvant Therapy for NSCCL—What the Surgeon Needs to Know Jessica S. Donington Stanford University School of Medicine 11:20 a.m. Adjuvant Chemotherapy for Lung Cancer Heather Wakelee Stanford Cancer Center 11:40 a.m. PANEL DISCUSSION 12:00 p.m. LUNCH Session IV: Esophageal Cancer 1:00 p.m. Esophagectomy: En Bloc, Transhiatal or Ivor Lewis—A Fair and Balanced Perspective Claude Deschamps Mayo Clinic 1:30 p.m. GE Junction Tumors—Neoadjuvant or Adjuvant Therapy? James M. Ford Stanford University School of Medicine 1:50 p.m. BARRETT’S ESOPHAGUS WITH HIGH-GRADE DYSPLASIA 1:50 p.m. Esophagectomy Mark Krasna St. Joseph’s Medical Center 2:05 p.m. Photodynamic Therapy Hiran C. Fernando Boston Medical Center 17 6295_AATS.book Page 18 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY 2:20 p.m. Endoscopic Mucosal Resection and Radiofrequency Ablation Steven R. DeMeester University of Southern California 2:35 p.m. PANEL DISCUSSION 3:00 p.m. BREAK Session V: Evolving Concepts and Techniques 3:30 p.m. Interventional Bronchoscopy—An Overview Armin Ernst Beth Israel Deaconess Medical Center 3:55 p.m. Germ Cell Tumors of the Mediastinum—When to Operate? Kenneth A. Kesler Indiana University 4:15 p.m. Malignant Mesothelioma—Current Approaches to a Difficult Problem Raja. M. Flores Memorial Sloan-Kettering Cancer Center 4:35 p.m. Stereotactic Radiosurgery—An Alternative to Surgery for Small Tumors Jack A. Roth MD Anderson Cancer Center 5:00 p.m. ADJOURN TO WELCOME RECEPTION 18 6295_AATS.book Page 19 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California SUNDAY, MAY 11, 2008 8:00 a.m. – 5:00 p.m. AATS/STS CONGENITAL HEART SYMPOSIUM Room 28 A-C, San Diego Convention Center Chairman: Frank L. Hanley Stanford University 7:55 a.m. INTRODUCTION Frank L. Hanley Stanford University Session I: Congenital Heart Surgery I (20 min each, with 10 min discussion) 8:00 a.m. When I Use the Bi-Directional Glenn In Septatable Hearts Vaughn A. Starnes University of Southern California 8:30 a.m. Fontan or Septation: When I Abandon Septation In Complex Lesions with Two Ventricles Richard A. Jonas Children’s National Medical Center 9:00 a.m. How I Approach Peripheral Pulmonary Artery Stenosis and Hypoplasia In William’s Syndrome John E. Mayer, Jr. Children’s Hospital Session II: Cardiology Update I (30 min, no discussion) 9:30 a.m. Transcutaneous Pulmonary Valve Placement Phillip Bonhoeffer (TBD) Great Ormond Street Hospital for Children 10:00 a.m. BREAK 10:30 a.m. Management of Pulmonary Hypertension In Patients with Structural Congenital Heart Disease Jeffrey A. Feinstein Stanford University Medical Center 19 6295_AATS.book Page 20 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY Session III: Congenital Heart Surgery II 11:00 a.m. Repair, AVR, Ross: How I Approach the Older Child with Mixed Aortic Stenosis/Aortic Insufficiency Constantine Mavroudis Children’s Memorial Hospital 11:30 a.m. How I Manage the Dilated Aortic Root In Older Patients with Repaired Conotruncal Defects John J. Lamberti Children’s Hospital of San Diego 12:00 p.m. LUNCH Session IV: Congenital Heart Surgery III 1:00 p.m. Isolated Neonatal Aortic Arch Obstruction: When to Go From the Front John W. Brown Indiana University 1:30 p.m. How I Manage Mitral Stenosis In the Neonate and Infant Thomas L. Spray Children’s Hospital of Philadelphia 2:00 p.m. How I Manage Neonatal Ebstein’s Anomaly Edward L. Bove University of Michigan Medical Center Session V: Cardiology Update II 2:30 p.m. MR and CT Imaging of the Pediatric Patient with Structural Heart Disease Frandics P. Chan Stanford University 3:00 p.m. BREAK 3:30 p.m. Noncompaction of the Left Ventricle: Recognition, Associations, and How it Affects Surgical Management Jeffrey Towbin Baylor College of Medicine 20 6295_AATS.book Page 21 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California Session VI: Congenital Heart Surgery IV 4:00 p.m. DKS or VSD Enlargement: How I Approach the Older Single Ventricle Patient with Systemic Outlet Obstruction Charles D. Fraser, Jr. Texas Children’s Hospital 4:30 p.m. Rastelli, REV, Nikaido: How I Manage Conotruncal Problems with Pulmonary Stenosis or Atresia V. Mohan Reddy Stanford University 5:00 p.m. ADJOURN TO WELCOME RECEPTION 21 6295_AATS.book Page 22 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY SUNDAY AFTERNOON, MAY 11, 2008 3:00 p.m. C. WALTON LILLEHEI RESIDENT FORUM SESSION (7 minutes presentation, 8 minutes discussion) Room 23 AB, San Diego Convention Center Moderators: David H. Harpole Gus J. Vlahakes L1. Is Mitral Valve Hinge Motion Important for Leaflet Closure? Akinobu Itoh1, Daniel B. Ennis1, Wolfgang Bothe1, Julia C. Swanson1, Gaurav Krishnamurthy1, Tom C. Nguyen1, Neil B. Ingels2, D. Craig Miller*1 1Cardiothoracic Surgery, Stanford University, Stanford, CA; 2Palo Alto Medical Foundation, Palo Alto, CA L2. Lung Injury After Cardiopulmonary Bypass Is Attenuated by Adenosine A2A Receptor Activation Turner C. Lisle1, Lucas G. Fernandez1, Leo M. Gazoni1, Ashish K. Sharma1, Andrew M. Bellizzi2, Joel M. Linden3, Victor E. Laubach1, Irving L. Kron*1 1University of Virginia Department of Surgery, Charlottesville, VA; 2University of Virginia Department of Pathology, Charlottesville, VA; 3University of Virginia Department of Medicine, Charlottesville, VA L3. Aprotinin Attenuates Genomic Expression Variability Following Cardiac Surgery Basel Ramlawi2, Hasan Otu1, Sirisha Emani1, Cesario Bianchi1, Frank W. Sellke*1 1Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA; 2University of Western Ontario, London, ON, Canada L4. CD4+ T Lymphocytes Mediate Acute Pulmonary Ischemia/ Reperfusion Injury Zequan Yang1, Ashish K. Sharma1, Joel Linden2, Victor E. Laubach1, Irving L. Kron*1 1Surgery, University of Virginia Health System, Charlottesville, VA; 2Medicine, University of Virginia Health System, Charlottesville, VA L5. Short and Long-Term Efficacy of Aspirin and Clopidogrel for Thromboprophylaxis of Mechanical Heart Valves; An In Vivo Study In Swine Stephen H. McKellar1, Jess L. Thompson1, Raul F. Garcia-Rinaldi2, Ryan J. MacDonald1, Thoralf M. Sundt*†1, Hartzell V. Schaff*1 1Cardiovascular Surgery, Mayo Clinic, Rochester, MN; 2Advanced Cardiology Center, Mayaguez, PR * AATS Member † Robert E. Gross Research Scholar 1994–1996 22 6295_AATS.book Page 23 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California L6. Remote Ischemic Preconditioning Elaborates a Transferable Blood Borne Factor Which Protects Mitochondrial Structure and Function and Preserves Myocardial Performance After Neonatal Cardioplegic Arrest Norihiko Oka, Lixing Wang, Michael Tropek, John Callahan, Gregory Wilson, Andrew Redington, Christopher A. Caldarone Hospital for Sick Children, Toronto, ON, Canada L7. β (IKKβ β) Is a Target for Specific Inhibitory Kappa B Kinase-β κB-Mediated Delayed Cardioprotection NF-κ Nancy C. Moss1, Bill Stansfield1, Ruhang Tang1, Monte S. Willis2, Craig H. Selzman1 1Surgery, University of North Carolina, Chapel Hill, NC; 2Department of Pathology and Laboratory Medicine at the University of North Carolina, Chapel Hill, NC L8. Mechanical Lung Assist Augments Forward Pulmonary Blood Flow In Primary Bidirectional Cavopulmonary Shunt Physiology In Neonatal Pigs Osami Honjo1, Sandra L. Merklinger1, John Poe1, Abdulla A. Alghamdi1, Setsuo Takatani2, Glen S. Van Arsdell*1 1The Labatt Family Heart Centre, The Hospital for Sick Children, Toronto, ON, Canada; 2Department of Artificial Organs, Institute of Biomaterial and Bioengineering, Tokyo Medical Dental University 5:00 p.m. ADJOURN TO WELCOME RECEPTION * AATS Member 23 6295_AATS.book Page 24 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY MONDAY MORNING, MAY 12, 2008 7:30 a.m. BUSINESS SESSION (Members Only) 7:45 a.m. PLENARY SCIENTIFIC SESSION (8 minutes presentation, 12 minutes discussion) Ballroom 20 A–C, San Diego Convention Center Moderators: D. Craig Miller Irving L. Kron 1. Are Stentless Valves Hemodynamically Superior to Stented Valves? Long-Term Follow-Up of a Randomized Trial Gideon Cohen, Brandon Zagorski, George T. Christakis*, Campbell D. Joyner, Jeri Sever, Stephen E. Fremes*, Fuad Moussa, Randi Feder-Elituv, Bernard S. Goldman* Cardiovascular Surgery, Sunnybrook Health Sciences Centre, Toronto, ON, Canada Invited Discussant: Hartzell V. Schaff 2. Weathering the Storm: How Can Thoracic Surgery Training Programs Meet the New Challenges In the Era of Emerging Non-Invasive Technologies? Sunil M. Prasad1, Malek G. Massad*1, Edgar G. Chedrawy1, Norman J. Snow*1, Joannie T. Yeh1, Himalaya Lele1, Ahmed Tarakji1, Hersh S. Maniar2, William A. Gay*2 1University of Illinois, Chicago, IL; 2Washington University, St. Louis, MO Invited Discussant: Irving L. Kron 3. Phase II Trial of Extrapleural Pneumonectomy with Phase II Trial of Extrapleural Pneumonectomy with Intraoperative Intrathoracic/Intraperitoneal Heated Cisplatin for Malignant Pleural Mesothelioma Tamara R. Tilleman1, William G. Richards1, Lambros Zellos1, Bruce E. Johnson2, Michael T. Jaklitsch*1, Christopher T. Ducko1, Jordan Mueller1, Raphael Bueno*1, David J. Sugarbaker*1 1Thoracic Surgery, Brigham and Women’s Hospital, Boston, MA; 2Dana Farber Cancer Institute, Boston, MA Invited Discussant: Valerie W. Rusch * AATS Member 24 6295_AATS.book Page 25 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California 4. Brain Maturation Is Delayed In Infants with Complex Congenital Heart Defects Daniel J. Licht, David M. Shera, Robert R. Clancy, Gil Wernovsky, Lisa M. Montenegro, Susan C. Nicolson, J. W. Gaynor*, Arastoo Vossough Children’s Hospital of Philadelphia, Philadelphia, PA Invited Discussant: Charles D. Fraser 9:05 a.m. AWARD PRESENTATIONS Ballroom 20 A–C, San Diego Convention Center 9:15 a.m. INTERMISSION—VISIT EXHIBITS Exhibit Hall GH, San Diego Convention Center 10:00 a.m. BASIC SCIENCE LECTURE Ballroom 20 A–C, San Diego Convention Center The Link Between Engineering, Biomechanics, and Cardiovascular Physiology and Disease Matts Karlsson, Ph.D. Professor of Biomedical Modeling and Simulation, Head of School of Mechanical Engineering, Linköping University, Linköping, Sweden Introduced By: D. Craig Miller 10:40 a.m. PLENARY SCIENTIFIC SESSION Moderators: Thomas L. Spray Irving L. Kron 5. Off-Pump Versus On-Pump CABG In Patients with ST Segment Elevation Myocardial Infarction: A Randomized, Double Blind Study Khalil Fattouch, Giuseppe Bianco, Roberta Sampognaro, Egle Corrado, Pietro Dioguradi, Gaetano Panzarella, Giovanni Ruvolo Cardiac Surgery, University of Palermo, Palermo, Italy Invited Discussant: Thoralf M. Sundt 6. Predictors of Major Morbidity and Mortality after Esophagectomy for Esophageal Cancer: An STS General Thoracic Surgery Database Risk Adjustment Model Cameron D. Wright*1, Mark S. Allen*2, Joshua D. Grab3, John C. Kucharczuk4 1Massachusetts General Hospital, Boston, MA; 2Mayo Clinic, Rochester, MN; 3Duke Clinical Research Institute, Durham, NC; 4University of Pennsylvania, Philadelphia, PA Invited Discussant: James D. Luketich * AATS Member 25 6295_AATS.book Page 26 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY 11:25 a.m. PRESIDENTIAL ADDRESS Anti-Memoirs of Rocinante D. Craig Miller Stanford, California Introduced by: Thomas L. Spray 12:15 p.m. ADJOURN FOR LUNCH—VISIT EXHIBITS Exhibit Hall GH, San Diego Convention Center CARDIOTHORACIC RESIDENTS’ LUNCHEON Room 23, San Diego Convention Center 26 6295_AATS.book Page 27 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California MONDAY AFTERNOON, MAY 12, 2008 2:00 p.m. SIMULTANEOUS SCIENTIFIC SESSION— ADULT CARDIAC SURGERY (8 minutes presentation, 12 minutes discussion) Ballroom 20 A–C, San Diego Convention Center Moderators: Christopher M. Feindel John S. Ikonomidis 7. Effects of Mild Hypothermia and Rewarming on Renal Injury Following Coronary Artery Bypass Surgery Munir Boodhwani, Fraser D. Rubens, Denise Wozny, Howard J. Nathan University of Ottawa Heart Institute, Ottawa, ON, Canada Invited Discussant: John W. Hammon, Jr. 8. Minimally Invasive Bipolar Radiofrequency Ablation of Lone Atrial Fibrillation: Early Multicenter Results Erik A. K. Beyer1, Richard Lee3, B-Khanh Lam2 1Scott and White Clinic, Temple, TX; 2University of Ottawa Heart Institute, Ottawa, ON, Canada; 3Northwestern University, Chicago, IL Counterpoint: Richard J. Shemin Open Discussion 9. Valve-Sparing Versus Valve Replacement Techniques for Aortic Root Operations In Marfan Patients: Interim Analysis of Early Outcome Joseph S. Coselli*1, Thoralf M. Sundt*†2, D. Craig Miller*3, Joseph E. Bavaria*4, Scott A. LeMaire1, Heidi M. Connolly2, Harry C. Dietz5, Dianna M. Milewicz6, Laura C. Palmero1, Xing Li Wang1, Irina V. Volguina1 1Baylor College of Medicine and The Texas Heart Institute, Houston, TX; 2Mayo Clinic, Rochester, MN; 3Stanford University, Stanford, CA; 4University of Pennsylvania, Philadelphia, PA; 5Johns Hopkins Hospital, Baltimore, MD; 6University of Texas Health Science Center, Houston, TX Invited Discussant: Alan D. Hilgenberg 3:10 p.m. INTERMISSION—VISIT EXHIBITS Exhibit Hall GH, San Diego Convention Center * AATS Member † Robert E. Gross Research Scholar 1994-1996 27 6295_AATS.book Page 28 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY 3:45 p.m. SIMULTANEOUS SCIENTIFIC SESSION— ADULT CARDIAC SURGERY Ballroom 20 A–C, San Diego Convention Center Moderators: Christopher M. Feindel John S. Ikonomidis 10. Effects of On- and Off-Pump Coronary Artery Surgery on Graft Patency, Survival and Quality of Life: Long Term Follow-Up of Two Randomised Controlled Trials Gianni D. Angelini*, Lucy Culliford, David Smith, Mark Hamilton, Gavin Murphy, Raimondo Ascione, Andreas Baumbach, Barney Reeves Bristol Heart Institute, Bristol, United Kingdom Invited Discussant: Soichiro Kitamura 11. Mitral Valve Surgery for Functional Mitral Regurgitation – Should Moderate-Or-More Tricuspid Regurgitation Be Treated? A Propensity Score Analysis Antonio M. Calafiore*1, Sabina Gallina2, Angela L. Iaco’1, Marco Contini1, Antonio Bivona1, Massimo Gagliardi1, Paolo Bosco1, Michele Di Mauro1 1Cardiac Surgery, University of Catania, Catania, Italy; 2University of Chieti – Department of Cardiology, Chieti, Italy Counterpoint: Andrew S. Wechsler Open Discussion 12. Decision-Making In Surgical Management of Ischemic Cardiomyopathy Dustin Y. Yoon, Nicholas G. Smedira*, Edward R. Nowicki, Katherine J. Hoercher, Jeevanantham Rajeswaran, Eugene H. Blackstone* Cleveland Clinic, Cleveland, OH Invited Discussant: Curt Tribble 13. Repair Oriented Functional Classification of Aortic Insufficiency: Impact on Surgical Techniques and Outcomes Laurent de Kerchove, David Glineur, Alain Poncelet, Jean Rubay, Parla Astarci, Robert Verhelst, Philippe Noirhomme, Gébrine El Khoury Université Catholique de Louvain, Cliniques St-Luc, Brussels, Belgium Invited Discussant: Hans-Hinrich Sievers 5:15 p.m. ADJOURN * AATS Member 28 6295_AATS.book Page 29 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California MONDAY AFTERNOON, MAY 12, 2008 2:00 p.m. SIMULTANEOUS SCIENTIFIC SESSION— GENERAL THORACIC SURGERY (8 minutes presentation, 12 minutes discussion) Room 25, San Diego Convention Center Moderators: James D. Luketich Robert J. Cerfolio 14. Decreased Operative Mortality for Esophageal Cancer Resection at Hospitals with Thoracic Training Programs: Should Esophagectomies Only be Performed by Thoracic Surgeons? Robert A. Meguid, Eric C. Weiss, Stephen M. Cattaneo, Marc S. Sussman, Malcolm V. Brock, Stephen C. Yang* Division of Thoracic Surgery, Johns Hopkins University, School of Medicine, Baltimore, MD Invited Discussant: Claude Deschamps 15. Should Lung Transplantation Be Performed Using Donation After Cardiac Death? The U.S. Experience David P. Mason, Lucy Thuita, Joan M. Alster, Sudish C. Murthy*, Marie M. Budev, Atul C. Mehta, Gosta B. Pettersson*, Eugene H. Blackstone* Cleveland Clinic, Cleveland, OH Invited Discussant: Kenneth R. McCurry 16. Long-Term Survival with Surgical Management for Superior Sulcus Tumors with Vertebral Resection William D. Bolton1, David C. Rice1, Adam Goodyear1, Arlene M. Correa1, Jeremy Erasmus1, Ziya Gokaslan2, Wayne Hofstetter1, Ritsuko Komaki1, Reza Mehran1, Katherine Pisters1, Jack A. Roth*1, Stephen G. Swisher*1, Ara A. Vaporciyan*1, Garrett L. Walsh*1, Jason Weaver1, Laurence Rhines1 1Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, TX; 2The Johns Hopkins University, Baltimore, MD Invited Discussant: Marc de Perrot 17. Thoracoscopic Versus Open Segmentectomy for Stage I Non-Small Cell Lung Cancer (NSCLC): 221 Consecutive Cases Matthew J. Schuchert, Brian L. Pettiford, Ghulam Abbas, Omar Awais, Arman Kilic, Robert Jack, James R. Landreneau, Joshua P. Landreneau, James D. Luketich*, Rodney J. Landreneau* Heart, Lung and Esophageal Surgery Institute, University of Pittsburgh Medical Center, Pittsburgh, PA Invited Discussant: Gian Carlo Roviaro * AATS Member 29 6295_AATS.book Page 30 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY 18. A Thoracic Surgery Clinic Dedicated to Solitary Pulmonary Nodules—Too Many Scans and Too Little Pathology? Nirmal K. Veeramachaneni, Traves D. Crabtree, Daniel Kreisel, Jennifer B. Zoole, Joanne Musick, Nicole G. Taylor, Alexander S. Krupnick, G. Alexander Patterson*, Bryan F. Meyers* Cardiothoracic Surgery, Washington University School of Medicine, St. Louis, MO Invited Discussant: Joel D. Cooper 3:40 p.m. INTERMISSION—VISIT EXHIBITS Exhibit Hall GH, San Diego Convention Center 4:15 p.m. SIMULTANEOUS SCIENTIFIC SESSION— GENERAL THORACIC SURGERY Room 25, San Diego Convention Center Moderators: James D. Luketich Robert J. Cerfolio 19. Clinical Characteristics, Biological Behavior, and Survival After Esophagectomy Are similar for Adenocarcinoma of the Gastroesophageal Junction and the Distal Esophagus Jessica M. Leers, Steven R. DeMeester, Nadia Chan, Shahin Ayazi, Arzu Oezcelik, Emmanuele Abate, Farazaneh Bank, John Lipham, Jeffrey A. Hagen, Tom R. DeMeester* Department of Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA Invited Discussant: Thomas W. Rice 20. Impact of Tumor Length and Submucosal Involvement on the Long-Term Survival of pT1 Early Stage Esophageal Adenocarcinoma William D. Bolton, Wayne Hofstetter, Ashleigh Francis, Arlene M. Correa, Jaffer A. Ajani, Banoop Bhutani, Jeremy Erasmus, Ritsuko Komaki, Dipen Maru, Reza Mehran, David C. Rice, Jack A. Roth*, Ara A. Vaporciyan*, Garrett L. Walsh*, Stephen G. Swisher* Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, TX Invited Discussant: Nasser K. Altorki * AATS Member 30 6295_AATS.book Page 31 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California 21. Clinical Stage IA Lung Cancer By CT and PET Scan: The Persistent Problem of Understaging Brendon M. Stiles, Paul C. Lee, Elliot L. Servais, Jeffrey L. Port, Subroto Paul, Danish Meherally, Nasser K. Altorki* Weill Cornell Medical College, New York Presbyterian Hospital, New York, NY Counterpoint: Robert J. Cerfolio Open Discussion 5:25 p.m. ADJOURN * AATS Member 31 6295_AATS.book Page 32 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY MONDAY AFTERNOON, MAY 12, 2008 2:00 p.m. SIMULTANEOUS SCIENTIFIC SESSION— CONGENITAL HEART DISEASE (8 minutes presentation, 12 minutes discussion) Room 28 A–C, San Diego Convention Center Moderators: Joseph A. Dearani Vaughn A. Starnes 22. Antegrade Cerebral Perfusion Improves Neurologic Outcomes with Aortic Arch Surgery In Neonates Pro: James S. Tweddell Con: Marshall L. Jacobs Open Discussion 23. Biventricular Repair In Heterotaxy Syndrome Frank Pigula*, Hong-Gook Lim, Emile Bacha*, Audrey Marshall, John Mayer*, Francis Fynn-Thompson, Pedro Del Nido* Children’s Hospital Boston, Boston, MA Invited Discussant: Marshall L. Jacobs 24. Early EEG Background Prediction of Seizures and Short-Term Outcome Measures Following Infant Heart Surgery Sandy Cho†1, Noah Cook2, Michael Badzioch3, J. William Gaynor*2, Gail Jarvik3, Sarah Tabbutt2, Susan Nicolson2, Gil Wernovsky2, Thomas Spray*2, Robert Clancy2 1George Washington University School of Medicine, Washington, DC; 2Children’s Hospital of Philadelphia, Philadelphia, PA; 3University of Washington Medical Center, Seattle, WA Invited Discussant: Erle H. Austin 25. Analysis of the U.S. Food and Drug Administration MAUDE Database for Adverse Events Involving Amplatzer™ Septal Occluder Devices and Comparison to STS Congenital Cardiac Surgery Database Daniel J. Dibardino, Doff B. McElhinney, Aditya K. Kaza, John E. Mayer* Harvard Medical School, Boston, MA Invited Discussant: Carl L. Backer 3:30 p.m. INTERMISSION—VISIT EXHIBITS Exhibit Hall GH, San Diego Convention Center * AATS Member † 2007 AATS Summer Intern Scholar 32 6295_AATS.book Page 33 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California 4:05 p.m. SIMULTANEOUS SCIENTIFIC SESSION— CONGENITAL HEART DISEASE Room 28 A–C, San Diego Convention Center Moderators: Joseph A. Dearani Vaughn A. Starnes 26. Surgical Treatment for Patients with Late Systemic Right Ventricular Failure Following Mustard/Senning Procedures for d-TGA Stephan Thelitz, Sunil P. Malhotra, Edwin Petrossian, Nicole Tselentis, Frandics P. Chan, Norman Silverman*, Vadiyala M. Reddy*, Frank L. Hanley* Stanford University School of Medicine, Stanford, CA Invited Discussant: Richard G. Ohye 27. Rate of Reoperation Has Not Changed During 30 Years of Surgery for Transposition of the Great Arteries—Long-Term Results of 913 Patients at a Single Center Jürgen Hörer, Julie Cleuziou, Christian Schreiber, Zsolt Prodan, Manfred Vogt, Klaus Holper, Rüdiger Lange German Heart Center Munich at the Technical University, Munich, Germany Invited Discussant: Winfield J. Wells 28. Double Root Translocation—A True-Meaning Anatomic Repair for Anomalies of Ventriculoarterial Connection with Pulmonary Outflow Tract Obstruction Sheng Shou Hu, Zhigang Liu, Shou Jun Li The National Cardiovascular Institute and Fu Wai Hospital Beijing, Beijing, China Invited Discussant: Victor O. Morell 5:05 p.m. ADJOURN * AATS Member 33 6295_AATS.book Page 34 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY TUESDAY MORNING, MAY 13, 2008 7:00 a.m. CARDIAC SURGERY FORUM SESSION (5 minutes presentation, 7 minutes discussion) Room 28 A–C, San Diego Convention Center Moderators: Richard D. Weisel Marc R. Moon F1. Elimination of Moderate Ischemic MR Does Not Ameliorate Long-Term LV Remodeling Kanji Matsusaki, Mio Noma, Aaron S. Blom, Thomas J. Eperjesi, Liam P. Ryan, Theodore Plappert, Martin G. St. John-Sutton, Joseph H. Gorman*, Robert C. Gorman* Surgery, University of Pennsylvania, Philadelphia, PA Invited Discussant: David H. Adams F2. Layered Implantation of Myoblast Sheets Attenuates Cardiac Remodeling of Infarcted Heart Naosumi Sekiya1, Shigeru Miyagawa1, Goro Matsumiya1, Takaya Hoashi1, Tatsuya Shimizu2, Teruo Okano2, Yoshiki Sawa1 1Cardiovascular Surgery, Osaka University Graduate School of Medicine, Osaka, Japan; 2Tokyo Women’s Medical University, Tokyo, Japan Invited Discussant: Y. Joseph Woo F3. Newly Developed Tissue-Engineered Biodegradable Material for Reconstruction of Vascular Wall Without Cell Seeding Hiroaki Takahashi1, Mitsuhiro Saito2, Eiichirou Uchimura2, Koujirou Hirakawa3, Eiichi Kaku3, Yutaka Okita*1, Yoshiki Sawa2 1Department of Surgery, Division of Cardiovascular Surgery, Kobe University Graduate School of Medicine, Kobe, Japan; 2Osaka University Graduate School of Medicine, Suita, Japan; 3Senko Medical Ins. Co., Ltd., Tokyo, Japan Invited Discussant: John E. Mayer F4. Atrophic Changes Occur In Unloaded Myocardium and May Preclude Functional Improvement In a Time Dependent Manner Henriette L. Brinks1, Hendrik Tevaearai2, Christian Muehlfeld3, Daniela Kuklinski2, Thierry P. Carrel*2, Marie-Noelle Giraud2 1Cardiovascular Surgery, Charite University Hospital, Berlin, Berlin, Germany; 2Department of Cardiac and Vascular Surgery, Inselspital University Hospital, Berne, Switzerland; 3Institute of Anatomy, University of Berne, Berne, Switzerland Invited Discussant: Michael A. Acker * AATS Member 34 6295_AATS.book Page 35 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California F5. Acute Hyperglycemia Enhances Oxidative Stress During Reperfusion and Exacerbates Myocardial Infarction Zequan Yang1, Victor E. Laubach1, Brent A. French2, Irving L. Kron*1 1Surgery, University of Virginia Health System, Charlottesville, VA; 2Biomedical Engineering, University of Virginia, Charlottesville, VA Invited Discussant: Harold L. Lazar F6. Development of Bioartificial Myocardium Using Collagen Scaffold Functionalized with RGD Peptides Olivier Schussler1, Walid Al Chare1, Mariana Louis-Tisserand1, Catherine Coirault2, Robert Michelot1, Malcolm Wood4, Didier Heude1, Alain Carpentier1, Juan Carlos Chachques1, Dan Salomon4, Yves Lecarpentier*2,3 1Laboratory of Biosurgery Pompidou Hospital, Paris, France; 2INSERM U689 Paris VII University, Paris, France; 3Le Kremlin Bicêtre, University Paris V and VII Paris, France; 4The Scripps Research Institut MEM 241, La Jolla, CA, USA Invited Discussant: Axel Haverich F7. Mitral Valve Hemodynamics Following Repair of Acute Posterior Leaflet Prolapse: Quadrangular Resection Versus Triangular Resection Versus Neo-Chordoplasty Muralidhar Padala1, Laura R. Croft1, Scott Powell1, Vinod H. Thourani2, Ajit P. Yoganathan1, David H. Adams*†3 1Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA; 2Emory University, Atlanta, GA; 3Mt. Sinai School of Medicine, New York, NY Invited Discussant: Gus. J. Vlahakes F8. Dynamic Fluid Shifts Induced by Fetal Cardiopulmonary Bypass Pirooz Eghtesady1, Scott Baker2, Christopher Lam1, Jerri Hilshorst1, Robert Ferguson1, John Lombardi1 1Cardiothoracic Surgery, Cincinnati Children’s Hospital, Cincinnati, OH; 2University of Cincinnati, Cincinati, OH Invited Discussant: James S. Tweddell F9. Toll-Like Receptor 4 on Leukocytes Is Necessary for Cardiomyocyte Hypoxia—Reoxygenation Injury Heather-Marie P. Wilson, Denise J. Spring, Christine Rothnie, Erzsebet Toth, Edward D. Verrier* Surgery, University of Washington, Seattle, WA Invited Discussant: Frank W. Sellke F10. Development of Novel Synthetic Serine-Protease Inhibitors to Reduce Postoperative Blood Loss After Cardiac Surgery Gábor Szabó1, Gabor Veres1, Tamás Radovits1, Matthias Karck1, Andreas van de Locht2 1Universtiy of Heidelberg, Heidelberg, Germany; 2Curacyte Discovery Ltd., Leipzig, Germany Invited Discussant: Craig R. Smith * AATS Member † Alton Ochsner Research Scholar 1992–1994 35 6295_AATS.book Page 36 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY TUESDAY MORNING, MAY 13, 2008 7:00 a.m. GENERAL THORACIC FORUM SESSION (5 minutes presentation, 7 minutes discussion) Room 25, San Diego Convention Center Moderators: Michael A. Maddaus Yolonda L. Colson F11. Paclitaxel-Loaded Polymer Film Prevents Local Recurrence of Non-Small Cell Lung Cancer Rong Liu1, Jesse Wolinsky2, Mark W. Grinstaff2, Yolonda L. Colson*†1 1Brigham and Women’s Hospital, Boston, MA; 2Boston University, Boston, MA Invited Discussant: Rodney J. Landreneau F12. Targeting Tumor Angiogenesis In Thoracic Malignancies Using MEK Pharmacologic Inhibitor: In Vitro and In Vivo Analysis Shailen Sehgal2, Wen-Shuz Yeow2, Mustafa Hussain2, Amy Loehfelm2, Joseph Blansfield2, Steven K. Libutti2, Craig Thomas2, Dao M. Nguyen*1 1Surgery, University of Miami, Miami, FL; 2National Cancer Institute, National Institutes of Health, Bethesda, MD Invited Discussant: Robert J. Cerfolio F13. Ambulatory Lung Assist Device Oxygenates and Removes Carbon Dioxide From Blood Across a Silicone-Coated Porous Membrane David M. Hoganson1, Jennifer Anderson1, Brian Orrick2, Joseph P. Vacanti1 1Massachusetts General Hospital, Boston, MA; 2Alito Therapeutics, Boston, MA Invited Discussant: Joseph B. Zwischenberger F14. Long Acting Oral Phophodiesterase Inhibition Preconditions Against Reperfusion Injury In an Experimental Lung Transplantation Model Eric S. Weiss1, Jason A. Williams1, William M. Baldwin2, William A. Baumgartner*1, Hunter C. Champion3, Ashish S. Shah1 1Cardiac Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD; 2Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, MD; 3Division of Cardiology, Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD Invited Discussant: Christine L. Lau * AATS Member † Second Alton Ochsner Research Scholar 2002–2004 36 6295_AATS.book Page 37 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California F15. Differential Gene Expression Profiling of Esophageal Adenocarcinoma Zane Hammoud, Sunil Badve, Qianqian Zhao, Lang Li, Karen Rieger, Kenneth Kesler* Indiana University School of Medicine, Indianapolis, IN Invited Discussant: Steven R. DeMeester F16. Screening of Epidermal Growth Factor Receptor Gene Mutation In Non-small Cell Lung Cancer Using a New PCR-Based Enzymatic Digestion Method Young T. Kim2, Sun J. Park2, Joo-yeon Park2, Hyun C. Wi2, Chang H. Kang1, Sook W. Sung2, Joo H. Kim1 1Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul, South Korea; 2Cancer Research Institite, Seoul National University, Seoul, South Korea Invited Discussant: David R. Jones F17. A Novel JAK3 and Syk-Inhibitor, R348, for Prevention of Chronic Airway Allograft Rejection Jeffrey Velotta1, Vanessa Taylor2, Esteban Masuda2, Gary Park2, David Carroll2, Robert Robbins*1, Sonja Schrepfer1 1Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, CA; 2Rigel Pharmaceuticals, South San Francisco, CA Invited Discussant: R. Duane Davis, Jr. F18. Association with Survival of the CXCL12-CXCR4 Chemokine Axis In Adenocarcinoma of the Lung P. L. Wagner1, M. Vazquez2, J. Port1, P. Lee1, A. Saqi2, N. Altorki*1 1Cardiothoracic Surgery, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY; 2Pathology, Weill Cornell Medical College, New York, NY Invited Discussant: Thomas A. D’Amico F19. Overexpression of Cyclooxygenase-2 Is Associated with Chemoradiotherapy Resistance and Prognosis In Esophageal Squamous Cell Carcinoma Patients Huang Weizhao2, Fu Jianhua1, Hu Yi1, Liu Mengzhong1, Yang Hong1, Zheng Bin1, Wang Geng1, Rong Tiehua1 1Cancer Center, Sun Yat-Sen University, Guangzhou, China; 2Cancer Center and ZhongShan Hospital, Sun Yat-Sen University, Zhongshan, China Invited Discussant: Ross M. Bremner * AATS Member 37 6295_AATS.book Page 38 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY F20. Detergent-Enzymatic Bioengineered Pig Tracheal Tubular Matrices Lack of Immunogenicity and Maintain Their Structural Integrity When Implanted Heterotopically In an Allo- and Xeno-Transplantation Model Philipp Jungebluth1, Tetsuhiko Go1, Silvia Bellini2, Chiara Calore2, Luca Urbani2, Tatiana Chioato2, Michaela Turetta2, Adelaide M. Asnaghi3, Sara Mantero3, Maria T. Conconi2, Paolo Macchiarini1 1Department of General Thoracic Surgery, Hospital Clinic, University of Barcelona, Barcelona, Spain; 2Department of Pharmaceutical Sciences, University of Padua, Padua, Italy; 3Department of Bioengineering, Politecnico di Milano, Milano, Italy Invited Discussant: Sebastien Gilbert 38 6295_AATS.book Page 39 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California TUESDAY MORNING, MAY 13, 2008 9:00 a.m. PLENARY SCIENTIFIC SESSION (8 minutes presentation, 12 minutes discussion) Ballroom 20 A–C, San Diego Convention Center Moderators: D. Craig Miller Thoralf M. Sundt 29. Mid-Term Results of Endovascular Treatment of Acute and Chronic Aortic Dissection: The Talent Thoracic Retrospective Registry (TTR) Marek P. Ehrlich1, Stephan Kische2, Herve Rousseau3, Robin Heijmen4, Philippe Piquet5, Jean-Paul Beregi6, Christoph A. Nienaber2, Rossella Fattori7 1Department Cardiothoracic Surgery, University Hospital Vienna, Vienna, Austria; 2Division of Cardiology, University Hospital Rostock, Rostock, Germany; 3Department of Radiology, Hopital de Rangueil, Toulouse, France; 4Department Cardiothoracic Surgery, St. Antonius Hospital, Nieuwegein, Netherlands; 5Hopital Sainte Marguerite, Marseille, France; 6Hopital Cardiologique CHRU, Lille, France; 7Cardiovascular Radiology, University Hospital S. Orsola, Bologna, Italy Invited Discussant: R. Scott Mitchell 30. Mechanical Valves Versus Ross Procedure for Aortic Valve Replacement In Children: Propensity-Adjusted Comparison of Long-Term Outcomes Bahaaldin Alsoufi1, Cedric Manlhiot2, Brian McCrindle2, Mamdouh Al-Ahmadi1, Ahmed Sallehuddin1, Charles Canver*1, Ziad Bulbul1, Mansoor Joufan1, Ghassan Siblini1, Zohair Al-Halees1, Bahaa Fadel1 1King Faisal Heart Institute, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia; 2Hospital for Sick Children and University of Toronto, Toronto, ON, Canada Invited Discussant: Vaughn A. Starnes 31. How Does the Use of PTFE Neochordae for Posterior Mitral Valve Prolapse (Loop Technique) Compare with Leaflet Resection? Results of a Prospective Randomized Trial Volkmar Falk1, Markus Czesla1, Joerg Seeburger1, Thomas Kuntze1, Patrick Perrier2, Fitsum Lakev2, Joerg Ender1, Nicolas Doll1, Franka Nette1, Michael A. Borger1, Friedrich W. Mohr*1 1Heartcenter Leipzig, Leipzig, Germany; 2Cardiovascular Center Bad Neustadt, Bad Neustadt, Germany Invited Discussant: Tirone E. David * AATS Member 39 6295_AATS.book Page 40 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY 10:00 a.m. AWARD PRESENTATIONS Ballroom 20 A–C, San Diego Convention Center 10:15 a.m. INTERMISSION—VISIT EXHIBITS Exhibit Hall GH 11:00 a.m. PLENARY SCIENTIFIC SESSION 32. Application of the Revised Lung Cancer Staging System (IASLC Staging Project) to a Cancer Center Population Edmund S. Kassis1, Ara A. Vaporciyan*1, Stephen G. Swisher*1, Arlene M. Correa1, Neby Bekele2, Jeremy J. Erasmus3, Wayne L. Hofstetter1, Ritsuko Komaki4, Reza J. Mehran1, Cesar A. Moran5, Katherine M. Pisters6, David C. Rice1, Garrett L. Walsh*1, Jack A. Roth*1 1The University of Texas MD Anderson Cancer Center, Department of Thoracic and Cardiovascular Surgery, Houston, TX; 2The University of Texas MD Anderson Cancer Center, Department of Bioinformatics & Computational Biology, Houston, TX; 3The University of Texas MD Anderson Cancer Center, Department of Radiology, Houston, TX; 4The University of Texas MD Anderson Cancer Center, Department of Radiation Oncology, Houston, TX; 5The University of Texas MD Anderson Cancer Center, Department of Pathology, Houston, TX; 6The University of Texas MD Anderson Cancer Center, Department of Thoracic/Head and Neck Medical Oncology, Houston, TX Invited Discussant: Bryan F. Meyers 33. Selective Antegrade Cerebral Perfusion Via Right Axillary Artery Cannulation Reduces Morbidity and Mortality After Proximal Aortic Surgery Michael E. Halkos, Faraz Kerendi, Richard Myung, Patrick D. Kilgo, John D. Puskas*, Edward P. Chen Emory University, Atlanta, GA Invited Discussant: Joseph E. Bavaria 11:40 a.m. ADDRESS BY HONORED SPEAKER 50 Years of Cardiothoracic Surgery Through the Looking Glass and What the Future Holds Marko I. Turina, M.D. University Hospital, Zurich, Switzerland Introduced By: D. Craig Miller 12:20 p.m. ADJOURN FOR LUNCH—VISIT EXHIBITS Exhibit Hall GH, San Diego Convention Center ACADEMIC LEADERSHIP LUNCHEON Room 23 AB, San Diego Convention Center TSRA LUNCHEON Room 29 AB, San Diego Convention Center * AATS Member 40 6295_AATS.book Page 41 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California TUESDAY AFTERNOON, MAY 13, 2008 2:00 p.m. SIMULTANEOUS SCIENTIFIC SESSION— ADULT CARDIAC SURGERY (8 minutes presentation, 12 minutes discussion) Ballroom 20 A–C, San Diego Convention Center Moderators: Joseph F. Sabik Andrew S. Wechsler 34. Equivalent Patencies of the Radial Artery, Right Internal Thoracic Artery and Saphenous Vein Beyond 5 Years: Surprising Results From the Radial Artery Patency and Clinical Outcomes Trial Philip Hayward1, Mark Horrigan2, David L. Hare2, Ian Gordon3, George Matalanis2, Brian F. Buxton*2 1Cardiothoracic Surgery, Essex Cardiothoracic Centre, Basildon, United Kingdom; 2Austin Hospital, Melbourne, VIC, Australia; 3University of Melbourne Statistical Consulting Centre, Melbourne, VIC, Australia Invited Discussant: Stephen E. Fremes 35. Efficacy of Add Mitral Valve Restrictive Annuloplasty to CABG In Patients with Moderate Ischemic Mitral Valve Regurgitation Khalil Fattouch, Francesco Guccione, Marco Muscarelli, Emiliano Navarra, Davide Calvaruso, Giuseppe Speziale, Giovanni Ruvolo Cardiac Surgery, University of Palermo, Palermo, Italy Counterpoint: Alfredo Trento Open Discussion 36. A Long Term Analysis of Percutaneous Fenestration and Stenting for Acute Type B Dissection with Malperfusion— Implications for Thoracic Aortic Endovascular Repair Himanshu J. Patel, David M. Williams, Meir Meerkov, Narasimham L. Dasika, G. M. Deeb* University of Michigan Cardiovascular Center, Ann Arbor, MI Invited Discussant: Roy K. Greenberg * AATS Member 41 6295_AATS.book Page 42 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY 37. Hybrid Endovascular Aortic Arch Repair Using Branched Endoprosthesis: The Second Generation “Branched” Open Stent Grafting Technique Kazuo Shimamura1, Toru Kuratani2, Yukitoshi Shirakawa2, Mugiho Takeuchi1, Hiroshi Takano3, Goro Mastumiya1, Yoshiki Sawa1 1Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine, Osaka, Japan; 2Department of Advanced Cardiovascular Therapeutics,Osaka University Graduate School of Medicine, Osaka, Japan; 3Department of Cardiovascular Surgery, Osaka General Medical Center, Osaka, Japan Invited Discussant: Heinz G. Jakob 3:30 p.m. INTERMISSION—VISIT EXHIBITS Exhibit Hall GH, San Diego Convention Center 4:00 p.m. SIMULTANEOUS SCIENTIFIC SESSION Ballroom 20 A–C, San Diego Convention Center Moderators: Joseph F. Sabik Andrew S. Wechsler 38. Cardiovascular Magnetic Resonance Assessment of Myocardial Scarring Predicts Recurrence of Functional Ischemic Mitral Regurgitation After Anuloplasty Tomislav Mihaljevic, Michael Flynn, Ronan Curtin, Edward R. Nowicki, Jeevanantham Rajeswaran, Scott D. Flamm, Eugene H. Blackstone* Cleveland Clinic, Cleveland, OH Invited Discussant: Robert A. E. Dion 39. Prosthesis-Patient Mismatch Is Irrelevant for Patients Greater than 70 Years of Age Undergoing Bioprosthetic Aortic Valve Replacement Marc R. Moon*, Jennifer S. Lawton, Nabil A. Munfakh, Nader Moazami, Kristen A. Aubuchon, Kelly A. Baker, Michael K. Pasque*, Ralph J. Damiano* Cardiothoracic Surgery, Washington University School of Medicine, Saint Louis, MO Counterpoint: Christopher M. Feindel Open Discussion 5:00 p.m. EXECUTIVE SESSION (MEMBERS ONLY) Ballroom 20 A–C, San Diego Convention Center * AATS Member 42 6295_AATS.book Page 43 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California TUESDAY AFTERNOON, MAY 13, 2008 2:00 p.m. SIMULTANEOUS SCIENTIFIC SESSION— GENERAL THORACIC SURGERY (8 minutes presentation, 12 minutes discussion) Room 25, San Diego Convention Center Moderators: Alec Patterson W. Roy Smythe 40. Does Reperfusion Injury Still Cause Significant Mortality After Lung Transplantation? Gorav Ailawadi, Christine L. Lau, Lynn M. Fedourk, Philip W. Smith, Courtney Kuhn, Benjamin D. Kozower, John A. Kern*, Benjamin B. Peeler, Irving L. Kron*, David R. Jones* TCV Surgery, University of Virginia, Charlottesville, VA Invited Discussant: Shaf Keshavjee 41. Does Endobronchial Ultrasonography Have a Place In the Thoracic Surgeon’s Armamentarium? Sebastien Gilbert1, David O. Wilson2, Neil A. Christie1, James D. Luketich*1, Matthew J. Schuchert1 1Heart, Lung, and Esophageal Surgery Institute, University of Pittsburgh Medical Center, Pittsburgh, PA; 2The Division of Pulmonary, Allergy, and Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA Invited Discussant: Stephen Swisher 42. Tailored Cricoplasty—An Improved Modification for Reconstruction In Subglottic Tracheal Stenosis Moishe Liberman, Douglas J. Mathisen* Thoracic Surgery, Massachusetts General Hospital, Boston, MA Invited Discussant: Erino A. Rendina 3:00 p.m. INTERMISSION—VISIT EXHIBITS Exhibit Hall GH, San Diego Convention Center * AATS Member 43 6295_AATS.book Page 44 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY 3:35 p.m. SIMULTANEOUS SCIENTIFIC SESSION— GENERAL THORACIC SURGERY Room 25, San Diego Convention Center Moderators: Alec Patterson W. Roy Smythe 43. Analysis of Surgical Results Leads to Improved Post-Operative Algorithms and Fast-Tracking of High Risk Patients After Pulmonary Resection Ayesha Bryant, Robert J. Cerfolio* Surgery, University of Alabama at Birmingham, Birmingham, AL Invited Discussant: K. Robert Shen 44. VATS Lobectomy Versus Thoracotomy for Lung Cancer – Results In 741 Patients Raja M. Flores, Bernard J. Park, Joseph Dycoco, Anna Arnova, Yael Hirth, Nabil P. Rizk, Manjit Bains*, Robert J. Downey*, Valerie W. Rusch* Thoracic Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY Invited Discussant: Scott J. Swanson 45. Operative Risk of Pneumonectomy: Influence of Preoperative Induction Therapy Henning A. Gaissert*, Dong Yoon Keum, Cameron D. Wright*, Marek Ancukiewicz, Dean M. Donahue, John C. Wain*, Michael Lanuti, Noah C. Choi, Douglas J. Mathisen* MGH, Boston, MA Counterpoint: Mark J. Krasna Open Discussion 5:00 p.m. EXECUTIVE SESSION (MEMBERS ONLY) Ballroom 20 A–C, San Diego Convention Center * AATS Member 44 6295_AATS.book Page 45 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California TUESDAY AFTERNOON, MAY 13, 2008 2:00 p.m. SIMULTANEOUS SCIENTIFIC SESSION— CONGENITAL HEART DISEASE (8 minutes presentation, 12 minutes discussion) Room 28 A–C, San Diego Convention Center Moderators: Charles D. Fraser, Jr. James S. Tweddell 46. Surgery for Adults with Congenital Heart Disease Should Be Performed by Congenital Heart Surgeons Pro: Joseph A. Dearani Con: Michael A. Acker 47. Optimal Dose of Aprotinin for Neuroprotection and Renal Function In a Piglet Model Yusuke Iwata, Toru Okamura, David Zurakowski, Richard A. Jonas* Children’s National Heart Institute, Children’s National Medical Center, Washington, DC Invited Discussant: Ross M. Ungerleider 48. Functional Health Status In an Inception Cohort of Adult Survivors with Tetralogy of Fallot Edward J. Hickey, Gruschen Veldtman, Timothy Bradley, Aungkana Gengsakul, Gary Webb, William G. Williams*, Cedric Manlhiot, Brian W. McCrindle The Hospital for Sick Children, Toronto, ON, Canada Invited Discussant: John J. Lamberti 3:10 p.m. INTERMISSION—VISIT EXHIBITS Exhibit Hall GH, San Diego Convention Center * AATS Member 45 6295_AATS.book Page 46 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY 3:45 p.m. SIMULTANEOUS SCIENTIFIC SESSION— CONGENITAL HEART DISEASE Room 28 A–C, San Diego Convention Center Moderators: Charles D. Fraser, Jr. James S. Tweddell 49. Ventricular Performance In Long-Term Survivors After Fontan Operation Yuki Nakamura, Toshikatsu Yagihara, Kouji Kagisaki, Ikuo Hagino, Shuichi Shiraishi, Junjiro Kobayashi, Soichiro Kitamura* Cardiothoracic Surgery, National Cardiovascular Center, Suita, Osaka, Japan Invited Discussant: Charles D. Fraser, Jr. 50. How Size Matters: The Complex Relationship Between Pediatric Cardiac Surgical Case Volumes and Mortality Rates In a National Clinical Database Karl F. Welke1, Sean M. O’Brien2, Eric D. Peterson2, Ross M. Ungerleider*1, Marshall L. Jacobs*3, Jeffery P. Jacobs*4 1Surgery, Oregon Health and Science Univerisity, Portland, OR; 2Outcomes Research and Assessment Group, Duke Clinical Research Institute, Durham, NC; 3St. Christopher Hospital for Children, Philadelphia, PA; 4The Congenital Heart Institute of Florida (CHIF), Saint Petersburg and Tampa, FL Invited Discussant: J. William Gaynor 51. What Is the Optimal Timing of Cardiac Transplantation for Failed Fontan: A Single Institution Experience Ryan R. Davies1, Jonathan Yang1, Robert Sorabella1, Mark Russo1, Ralph S. Mosca*1, Jonathan M. Chen2, Jan M. Quagebeur*1 1Columbia University Medical Center, New York, NY; 2Weill Medical College of Cornell University, New York, NY Invited Discussant: Charles B. Huddleston 5:00 p.m. EXECUTIVE SESSION (MEMBERS ONLY) Ballroom 20 A–C, San Diego Convention Center * AATS Member 46 6295_AATS.book Page 47 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California WEDNESDAY MORNING, MAY 14, 2008 7:00 a.m. EMERGING TECHNOLOGIES AND TECHNIQUES FORUM (7 Minutes Presentation, 6 Minutes Discussion) Room 25, San Diego Convention Center Moderators: Michael A. Acker Lars G. Svensson T1. Inflammation Is Reduced Using the Resting Heart Mini-Cardiopulmonary Bypass System In a Prospective Randomized Study Bob Kiaii, Kelly Summers, Stephanie Fox, Stuart A. Swinamer, Reiza Rayman, Andrew Cleland, Philip Fernandes, James MacDonald, Wojciech Dobkowski, Richard J. Novick* London Health Sciences Centre, London, ON, Canada Invited Discussant: John D. Puskas T2. Is Transcatheter Based Aortic Valve Implantation Really Less Invasive Than Minimal Invasive Aortic Valve Replacement? Mirko Doss, Sven Martens, Stephan Fichtelscherer, Thomas Trepels, Gerhard Wimmer Greinecker, Anton Moritz, Volker Schächinger Thoracic and Cardiovascular Surgery, J. W. Goethe University Frankfurt, Frankfurt am Main, Germany Invited Discussant: Eric E. Roselli T3. Sutureless Perceval S Aortic Valve Replacement: Multicentric, Prospective, Pilot Trial Malakh Shrestha1, Thierry Folliguet2, Paul Herijgers3, Alain Debie2, Christoph Bara1, Marie-Christin Herregods3, Nawid Khaladj1, Christian Hagl1, Willem Flameng*3, Franscois Laborde2, Axel Haverich*1 1Cardiothoracic Surgery, Hannover Medical School, Hannover, Germany; 2Institut Mutualiste Montsouris, Paris, France; 3U.Z. Gasthuisberg, Leuven, Belgium Invited Discussant: George J. Magovern, Sr. T4. Efficacy of Intramyocardial Injection of Angiogenic Cell Precursors for Dilated Cardiomyopathy: A Case Match Study Kitipan V. Arom*, Permyos Ruengsakulrach, Vibul Jotisakulratana Cardiovascular Surgery, Bangkok Heart Hospital, Bangkok, Thailand Invited Discussant: Richard D. Weisel * AATS Member 47 6295_AATS.book Page 48 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY T5. Radiofrequency Ablation for Cure In Medically Inoperable Stage I Lung Cancer: A Single Institution Experience Michael Lanuti, Amita Sharma, Subba R. Digumarthy, Cameron D. Wright*, John C. Wain*, Douglas J. Mathisen*, JoAnne O. Shepard Thoracic Surgery, MGH, Boston, MA Invited Discussant: Neil A. Christie T6. Transapical Transcatheter Aortic Valve Implantation One Year Follow-Up In 19 Patients Jian Ye, Anson Cheung, John G. Webb, Daniel R. Wong, Ronald G. Carere, Christopher R. Thompson, Samuel V. Lichtenstein Surgery, University of British Columbia, Vancouver, BC, Canada Invited Discussant: Lars G. Svensson T7. A Multicenter Prospective Randomized Trial of a 2nd Generation Anastomotic Device In Coronary Artery Bypass Surgery Lars Wiklund3, Marek Setina2, Robert J. Cusimano1, Katherine Tsang1, Terrence M. Yau*1 1Division of Cardiovascular Surgery, Toronto General Hospital, Toronto, ON, Canada; 2University Hospital FN Motol, Prague, Czech Republic; 3Sahlgrenska University Hospital, Gothenburg, Sweden Invited Discussant: Joseph F. Sabik T8. Minimally Invasive Surgical Pulmonary Vein Isolation for Atrial Fibrillation: A Multicenter Experience James R. Edgerton*1, James McClelland2, David Duke2, Marc Gerdisch3, Bryan Steinberg4, Scott H. Bronleewe5, Tara A. Weaver6, Syma L. Prince6, Michael J. Mack*1 1Medical City Dallas Hospital, Dallas, TX; 2Endovascular Research, Eugene, OR; 3Central Dupage Hospital, Winfield, IL; 4Washington Adventist Hospital, Takoma Park, MD; 5University Community Hospital, Tampa, FL; 6CRSTI, Dallas, TX Invited Discussant: Takashi Nitta * AATS Member 48 6295_AATS.book Page 49 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California 8:45 a.m. CONTROVERSIES IN CARDIOTHORACIC SURGERY PLENARY SESSION Ballroom 20 A–C, San Diego Convention Center Live Surgery at National and Regional Cardiothoracic Surgical Meetings Should Be Outlawed Moderator: D. Craig Miller Pro: Duke Cameron Con: Hugo K.I. Vanermen CONTROVERSIES IN CARDIOTHORACIC SURGERY GENERAL THORACIC CONTROVERSIES Ballroom 20 A–C, San Diego Convention Center Should the Certifying Authority Provide Two Certificates: One for Cardiac Surgery and One for Thoracic Surgery? Moderator: Bruce W. Lytle Pro: Walter Klepetko Con: Douglas J. Mathisen 10:45 a.m. ADJOURN 49 6295_AATS.book Page 50 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY SUNDAY AFTERNOON, MAY 11, 2008 3:00 p.m. C. WALTON LILLEHEI RESIDENT FORUM SESSION (7 minutes presentation, 8 minutes discussion) Room 23 AB, San Diego Convention Center Moderators: David H. Harpole Gus J. Vlahakes L1. Is Mitral Valve Hinge Motion Important for Leaflet Closure? Akinobu Itoh1, Daniel B. Ennis1, Wolfgang Bothe1, Julia C. Swanson1, Gaurav Krishnamurthy1, Tom C. Nguyen1, Neil B. Ingels2, D. Craig Miller*1 1Cardiothoracic Surgery, Stanford University, Stanford, CA; 2Palo Alto Medical Foundation, Palo Alto, CA OBJECTIVE: The mitral annulus (MA) is composed of 2 different structures: The fibrous annulus contiguous with the aortic root, and the muscular annulus subtending the commissures and posterior leaflet. 3-D echocardiographic studies have demonstrated that the MA is saddle-shaped and becomes flattened and dilated in humans with functional mitral regurgitation (FMR). The contribution of saddle-shape configuration change to leaflet closure and coaptation throughout the cardiac cycle, however, is unknown. METHODS: Five sheep had a dense array of 18 radiopaque markers implanted (16 around the MA and 2 on the middle of the anterior and posterior leaflet free edges). 4-D marker coordinates were acquired with biplane videofluoroscopy at 60 Hz. The mitral “hinge angle”() was calculated as the angle between the best fit planes through the fibrous and muscular annular markers (Figure). MA area (MAA) and coaptation distance between * AATS Member 50 6295_AATS.book Page 51 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California RESULTS: Minimum (annulus flattest) occurred during late-diastole (47 ± 11o), but increased abruptly (more saddle-shaped) during early-systole (ED vs. EndIVC, 46 ± 11o vs. 61 ± 14o, p = 0.003), where it remained during ejection (EndIVC vs. ES, 61 ± 14o vs. 63 ± 14o, p = 0.1). After ES, decreased again (e.g. a flatter annulus). Paralleling the changes in , maxima during diastole and minima during early-systole were observed for both MAA (E vs. EndIVC, 9.1 ± 1.5 vs. 7.8 ± 1.0 cm2, p = 0.01) and D (1.5 ± 0.6 vs. 0.4 ± 0.2 cm, p = 0.04). During ejection, MAA (EndIVC vs. ES, 7.8 ± 1.0 vs. 7.6 ± 1.1 cm2, P = 0.1) and D (0.4 ± 0.2 vs. 0.3 ± 0.2 cm, p = 0.2) did not change, but increased rapidly during early-diastole (Figure). CONCLUSION: The mitral hinge angle () changes more than 14o during the cardiac cycle in concert temporally with changes in MAA and D. The hinge angle reflects the interactions between the muscular annulus, fibrous annulus, and aortic root. A steeper hinge angle may contribute to pre-systolic annular area reduction and rapid leaflet closure, which enhance valve competency. Rigid, complete annuloplasty rings would abolish any such hinge angle motion. Further quantification of hinge angle dynamics in patients with mitral valve prolapse and FMR both before and after repair will shed light on how important this intrinsic motion is and aid in the design of new annuloplasty devices. 51 SUNDAY Afternoon mid-edge markers (D) were computed at early-filling (E, 50 msec after end-isovolumic relaxation), end-diastole (ED), end-isovolumic contraction (EndIVC) and end-systole (ES), and reported as mean ± SD. 6295_AATS.book Page 52 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY L2. Lung Injury After Cardiopulmonary Bypass Is Attenuated by Adenosine A2A Receptor Activation Turner C. Lisle1, Lucas G. Fernandez1, Leo M. Gazoni1, Ashish K. Sharma1, Andrew M. Bellizzi2, Joel M. Linden3, Victor E. Laubach1, Irving L. Kron*1 1University of Virginia Department of Surgery, Charlottesville, VA; 2University of Virginia Department of Pathology, Charlottesville, VA; 3University of Virginia Department of Medicine, Charlottesville, VA OBJECTIVE: Cardiopulmonary bypass (CPB) has been shown to exert a systemic inflammatory response. This response, potentially mediated through the lung, can result in postoperative pulmonary dysfunction. Several studies have shown that adenosine A2A receptor (A2AR) activation attenuates lung ischemia-reperfusion injury. The effect of A2AR activation on CPBinduced lung injury has yet to be evaluated. We hypothesized that specific A2AR activation by ATL-313, an A2AR agonist, would attenuate lung inflammation following CPB. METHODS: Adult male Sprague-Dawley rats were randomly divided into three groups: 1) SHAM group (n = 5), rats underwent cannulation + heparinization only; 2) BYPASS group (n = 5), rats underwent 90-minutes of normothermic CPB with standard priming solution; 3) ATL group (n = 5), rats underwent 90-minutes of normothermic CPB with ATL-313 (100 nM) added to the standard priming solution. Physiologic data and arterial blood gas (ABG) analysis were collected for all animals at uniform time points during the procedure. All animals were weaned from bypass without the use of ionotropes or vasopressors and allowed to recover for an additional 90-minutes. All animals were then euthanized and lung tissue, plasma, and bronchoalveolar lavage (BAL) samples were obtained for cytokine and histologic evaluation, as well as wet-to-dry lung weight ratio, a measure of pulmonary edema. RESULTS: ABG analysis and physiologic data were similar at all time points between groups. There was significantly less lung injury in the ATL group compared to the BYPASS group (Lung Injury Severity Score 0.8 vs. 2.2, p < 0.05; Table). The ATL group had significant reduction in BAL IL-1, IL-6, IFN-γ and myeloperoxidase (MPO) levels compared to the BYPASS group Summary of Data IL-1 IL-6 Lung Tissue TNF-α (pg/ml) IFN-γ MPO IL-1 Bronchoalveolar IL-6 Lavage TNF-α (pg/ml) IFN-γ MPO Wet:Dry ratio Lung Injury Severity Score Sham 10865 ± 1086 403 ± 88 811 ± 90 1870 ± 9 287946 ± 4745 382 ± 45 126 ± 41 311 ± 24 75 ± 17 38700 ± 4170 3.8 ± 0.27 0.2 ± 0.17 Group Bypass 22893 ± 536a 7402 ± 371b 2002 ± 148b 2530 ± 9c 302578 ± 4091 753 ± 45b 389 ± 70b 330 ± 10 161 ± 17b 88900 ± 1090c 7.02 ± 0.28b 2.2 ± 0.41c Values are expressed as the mean ± SEM. MPO-myeloperoxidase ap < 0.001 vs. Sham; bp < 0.001 vs. ATL and Sham; cp < 0.05 vs. ATL and Sham * AATS Member 52 ATL 21033 ± 694a 2136 ± 247 765 ± 129 1770 ± 20 283626 ± 5291 434 ± 45 178 ± 12 285 ± 43 52 ± 7 52170 ± 3885 4.26 ± 0.12 0.8 ± 0.17 6295_AATS.book Page 53 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California CONCLUSION: The addition of the A2AR agonist ATL-313 to the standard bypass priming solution prior to the initiation of CPB resulted in significantly less lung injury and pulmonary edema as well as decreased levels of several proinflammatory cytokines. ATL-313 could play an important role in reducing systemic inflammation and pulmonary dysfunction following CPB. 53 SUNDAY Afternoon (p < 0.001 for IL-1, IL-6, and IFN-γ; p < 0.05 for MPO; Table). Similarly, lung tissue IL-6, TNF-α, IFN-γ and pulmonary edema were significantly decreased in the ATL group compared to the BYPASS group (p < 0.001 for IL-6, TNF-α, and wet-to-dry ratio; p < 0.05 for IFN-γ; Table 1). 6295_AATS.book Page 54 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY L3. Aprotinin Attenuates Genomic Expression Variability Following Cardiac Surgery Basel Ramlawi2, Hasan Otu1, Sirisha Emani1, Cesario Bianchi1, Frank W. Sellke*1 1Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA; 2University of Western Ontario, London, ON, Canada OBJECTIVE: Aprotinin, a commonly used antifibrinolytic agent, was the subject of recent controversy regarding adverse clinical outcomes following cardiac surgery. We compared the role of Aprotinin and ε-aminocaproic acid, on clinical outcomes and the attenuation of the post-cardiopulmonary bypass (CPB) response at the genomic expression and cytokine (protein) level. METHODS: Thirty nine low-risk patients undergoing coronary revascularization (CABG) and/or valve procedures using cardiopulmonary CPB were enrolled into a prospective cohort study. Half-Hammersmith dose Aprotinin (1 × 106 KIU preoperatively) or ε-aminocaproic acid (100 mg/kg load, 5g pump prime and 30 mg/kg/h infusion) was administered to patients. Gene expression was assessed with Affymetrix GeneChip U133 Plus 2.0 (>40,000 genes) from whole blood mRNA samples collected preoperatively (PRE) and 6 hours (6H) postoperatively for fold-change calculation. Differential expression, clustering, gene ontology and canonical pathway analysis was performed. Validation of gene expression was performed with SYBR Green real time PCR. Cytokine values were quantified from serum using high sensitivity immunoassay technique preoperatively and postoperatively at 6h and 4 days (POD4) and analyzed in a blinded fashion using parametric statistics. GO Pathway No. 45012 43123 3988 6406 7259 12501 6944 43297 8080 16494 6959 16337 Differentially Expresed Pathways GO Pathway Description MHC class II receptor activity positive regulation of NF-kappaB cascade acetyl-CoA C-acyltransferase activity mRNA export from nucleus JAK-STAT cascade Programmed cell death membrane fusion apical junction assembly N-acetyltransferase activity C-X-C chemokine receptor activity Humoral immune response Cell-cell adhesion p-value <0.000001 0.000001 0.001001 0.004039 0.007447 0.010656 0.016926 0.017328 0.027009 0.028045 0.030155 0.037522 GO = Gene Ontology RESULTS: Preoperative baseline characteristics were similar in both characteristics with respect to age, sex, re-operative status, type of operation or intraoperative factors (pump time, temperature etc.). Serum inflammatory markers measured did not reveal significant difference between patients receiving Aprotinin (APR) and those receiving ε-aminocaproic acid (Amicar). Compared with PRE samples, 6H samples had 264 up-regulated and 548 down-regulated genes uniquely in the APR group compared to 4826 up-regulated and 1114 down-regulated genes uniquely in the NORM group (p < 0.001, Lower confidence bound ≥1.2). Compared to patients in the Amicar group, APR patients had significantly different * AATS Member 54 6295_AATS.book Page 55 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California CONCLUSION: APR leads to significantly less genomic expression variability compared to Amicar and has a differential effect on specific genomic pathways. 55 SUNDAY Afternoon gene expression pathways involving NF-κbeta regulation, programmed cell death and cell-cell adhesion (table on previous page). None of the patients developed postoperative stroke, myocardial infarction or systemic infections. 6295_AATS.book Page 56 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY L4. CD4+ T Lymphocytes Mediate Acute Pulmonary Ischemia/ Reperfusion Injury Zequan Yang1, Ashish K. Sharma1, Joel Linden2, Victor E. Laubach1, Irving L. Kron*1 1Surgery, University of Virginia Health System, Charlottesville, VA; 2Medicine, University of Virginia Health System, Charlottesville, VA OBJECTIVE: Ischemia/reperfusion (I/R) injury remains a major cause of life-threatening graft dysfunction after lung transplantation. An increasing body of evidence suggests that postischemic reperfusion triggers pro-inflammatory responses that eventually activate neutrophils to cause pulmonary injury. However, mechanisms underlying neutrophil activation remain to be defined. We hypothesize that T lymphocytes are activated during reperfusion and mediate neutrophil-induced lung I/R injury. METHODS: A mouse model with in vivo left lung ischemia/reperfusion was employed. 102 C57BL/6 mice were assigned to either sham group (left thoracotomy only) or study groups which underwent 1 hr left hilar occlusion followed by 1, 2, or 24 hr reperfusion. A murine ventilator with pressure control was used. Mice were ventilated only during procedures for hilar ligation or ligature removal (<15 min on ventilator total), so that ventilation-induced injury was minimized. At the end of reperfusion, an isolated buffer-perfused lung system was used to evaluate pulmonary function. Left-lung injury was characterized by wet-to-dry weight ratio and Evan’s blue dye permeability. RESULTS: A time course study showed that 2 hr reperfusion resulted in more severe lung injury and dysfunction than 1 or 24 hr reperfusion. Thus the model using 1 hr ischemia and 2 hr reperfusion was used throughout the rest of the study. A highly selective adenosine A2A receptor agonist, ATL313, significantly reduced lung injury and dysfunction when applied i.v. at a bolus dose of 3 µg/kg 5 min before reperfusion (*p < 0.05 vs. control). Significant protection was also found in antibody-induced neutropenic mice (Anti-NE) or CD4+ T-cell depleted mice (#p < 0.05 vs. IgG control group) but not in CD8+ T cell depleted mice. However, no additive effect in lung protection was found when ATL313 was applied to either neutropenic mice or CD4+ T-cell depleted mice (Table). Airway Pressure Groups (n) (cmH2O) Control (5) 2.20 ± 0.15 ATL313 (6) 0.95 ± 0.08a IgG control (5) 1.19 ± 0.07 Anti-NE (8) 0.76 ± 0.02b Anti-NE+ATL (5) 0.89 ± 0.07b Anti-CD4 (5) 1.12 ± 0.05c Anti-CD4 +ATL (4) 0.88 ± 0.08b Anti-CD8 (5) 1.80 ± 0.12 Pulmonary Compliance (µl/cmH2O) 1.88 ± 0.28 3.34 ± 0.22a 2.32 ± 0.15 4.54 ± 0.35b 3.68 ± 0.22b 4.23 ± 0.50b,c 3.70 ± 0.39b 2.20 ± 0.33 Pulmonary Artery Pressure (cmH2O) 14.32 ± 1.42 9.03 ± 0.73a 11.40 ± 1.01 8.44 ± 0.39b 7.20 ± 0.30b 7.50 ± 0.83b,c 7.45 ± 0.80b 11.4 ± 0.68 Data are presented as Mean ± SEM. ap < 0.05 vs. Control; bp < 0.05 vs. IgG control; cp < 0.05 vs. anti-CD8 * AATS Member 56 Evan’s blue dye Wet to (µg/g wet dry ratio lung) (n = 3) (n = 3) 6.19 ± 0.05 96.7 ± 11.2 5.57 ± 0.13a 40.9 ± 9.4a 6.25 ± 0.16 91.2 ± 10.5 5.13 ± 0.09b 36.5 ± 3.0b 5.16 ± 0.23b 22.7 ± 9.4b 4.93 ± 0.04b,c 13.1 ± 4.0b,c 5.13 ± 0.08b 20.1 ± 6.4b 6.06 ± 0.30 73.4 ± 6.4 6295_AATS.book Page 57 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California 57 SUNDAY Afternoon CONCLUSION: Both neutrophils and T lymphocytes are activated during pulmonary I/R injury. Neutrophils are end-effectors directly causing pulmonary reperfusion injury; however, CD4+ T cells play a central role in mediating pro-inflammatory responses during acute lung I/R injury. The protective effect of adenosine A2A receptor activation is likely due to its action on CD4+ T cells. 6295_AATS.book Page 58 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY L5. Short and Long-Term Efficacy of Aspirin and Clopidogrel for Thromboprophylaxis of Mechanical Heart Valves; An In Vivo Study In Swine Stephen H. McKellar1, Jess L. Thompson1, Raul F. Garcia-Rinaldi2, Ryan J. MacDonald1, Thoralf M. Sundt*†1, Hartzell V. Schaff*1 1Cardiovascular Surgery, Mayo Clinic, Rochester, MN; 2Advanced Cardiology Center, Mayaguez, PR OBJECTIVE: Chronic anticoagulation with warfarin is standard practice for patients with mechanical valves but has significant limitations. In an attempt to find an alternative to warfarin, we tested the hypothesis that clopidogrel combined with aspirin is effective for thromboprophylaxis of mechanical valves using a swine model. METHODS: Adult swine underwent heterotopic, bileaflet mechanical valve placement consisting of a modified valved conduit which bypasses the ligated native descending thoracic aorta. Animals were sacrificed at either 30 (acute) or 150 (chronic) days. In a blinded study, 34 acute animals were randomized to one of 5 arms: no anticoagulation (AC) (n = 7), 175 units/kg dalteparin (warfarin too problematic) subcutaneously twice daily (n = 9), 325 mg oral aspirin daily (n = 6), 75 mg oral clopidogrel daily (n = 6), or 325 mg oral aspirin and 75 mg clopidogrel daily (n = 6). In the chronic study, animals were randomized to one of 2 arms: no AC (n = 5) or 325 mg oral aspirin and 75 mg clopidogrel daily (n = 6). The primary end point was the amount of valve thrombus at sacrifice. The secondary end points included hemorrhagic complications, platelet inhibition assessed by aggregometry (acute study), and platelet deposition on the valve prosthesis (chronic study). RESULTS: At 30 days, mean valve thrombus was 216 ± 270 mg for no AC, 53 ± 91 mg for dalteparin, 33 ± 23 mg for aspirin, 25 ± 10 mg for clopidogrel, 17 ± 9 mg for aspirin and clopidogrel, respectively (p < 0.01 for clopidogrel and aspirin vs. no anticoagulation). No major postoperative hemorrhagic events were observed; but occult bleeding was detected in three animals (dalteparin n = 2, aspirin n = 1). Platelet aggregation decreased significantly with combination antiplatelet therapy (P = 0.03). At 150 days, mean valve thrombus was 223 ± 200 mg for the no AC group and 4 ± 4 mg for the aspirin and clopidogrel group (P = 0.02). Mean platelet deposition on the valve prosthesis was 4.1 × 109 ± 3.6 × 109 for the no anticoagulation and 6.81 × 107 ± 1.4 × 108 for the combined aspirin and clopidogrel groups, respectively (P = 0.03). No major hemorrhagic events were observed. CONCLUSION: Effective short and long-term thromboprophylaxis of mechanical valves can be achieved using dual antiplatelet therapy without excessive hemorrhagic complications in this porcine model. Prospective human trials should be conducted using combination aspirin and clopidogrel as an alternative to warfarin in patients with bileaflet mechanical aortic valves. * AATS Member † Robert E. Gross Research Scholar 1994–1996 58 6295_AATS.book Page 59 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California Remote Ischemic Preconditioning Elaborates a Transferable Blood Borne Factor Which Protects Mitochondrial Structure and Function and Preserves Myocardial Performance After Neonatal Cardioplegic Arrest Norihiko Oka, Lixing Wang, Michael Tropek, John Callahan, Gregory Wilson, Andrew Redington, Christopher A. Caldarone Hospital for Sick Children, Toronto, ON, Canada OBJECTIVE: Remote ischemic preconditioning is known to elicit production of a blood borne cardioprotective factor with infarct-sparing effects in models of ischemia-reperfusion injury. The mechanism of protection remains incompletely understood. In this study we examine the effects of the cardioprotective factor on mitochondrial structure and function in a non-infarct model of cardioplegic arrest. METHODS: Explanted neonatal rabbit hearts were mounted in a Langendorf preparation. The hearts were perfused with a dialysate of blood taken from another group of rabbits which were sham-treated or remotely preconditioned. Each heart was subsequently subjected to 1 hour of cardioplegic arrest and 30 minutes of reperfusion during which hemodynamic responses were measured. Mitochondria were then isolated for structural and functional measurements. RESULTS: Compared to hearts treated with the sham-treated dialysate, myocardial performance (systolic pressure, maximum positive dP/dT, negative dP/dT, and LVEDP) was better preserved after treatment with dialysate from preconditioned rabbits. Similarly, mitochondria isolated from hearts treated with the dialysate from preconditioned rabbits showed preserved respiration at complex I and IV in the electron transport chain (p < 0.01 and p < 0.05 respectively). Mitochondrial outer membrane integrity was also preserved with diminished sensitivity of mitochondrial respiration to exogenous cytochrome c (p < 0.01) and less diffusion of cytochrome c into the cytosol (p < 0.01). Mitochondrial resistance to calcium-mediated mPTP opening was not affected. CONCLUSION: The cardioprotective factor present in plasma dialysate following remote preconditioning preserves mitochondrial structure and function in a non-infarct cardioplegic arrest model. This protection is associated with preservation of global myocardial performance. 59 SUNDAY Afternoon L6. 6295_AATS.book Page 60 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY L7. β (IKKβ β) Is a Target for Specific Inhibitory Kappa B Kinase-β κB-Mediated Delayed Cardioprotection NF-κ Nancy C. Moss1, Bill Stansfield1, Ruhang Tang1, Monte S. Willis2, Craig H. Selzman1 1Surgery, University of North Carolina, Chapel Hill, NC; 2Department of Pathology and Laboratory Medicine at the University of North Carolina, Chapel Hill, NC OBJECTIVE: Myocardial ischemia-reperfusion (IR) injury associated with cardiac surgery and acute coronary syndromes remains a vexing problem. Translating experimental strategies that most frequently deliver protective agents prior to the ischemic insult significantly limit their clinical applicability. We have previously reported the importance of the transcription factor Nuclear Factor kappa B (NF-κB) in regulating myocardial IR. To model a more relevant therapeutic strategy, we targeted two proteins in the NF-κB pathway, Inhibitory Kappa B Kinase β (IKKβ) and the 26S cardiac proteasome, to determine their cardioprotective effects when delivered during reperfusion. METHODS: 10 week-old C47BL6 mice underwent thoracotomy, left anterior descending artery (LAD) occlusion for 30 minutes, and release. An IKKβ inhibitor (Bay 65-1942), a proteasome inhibitor (PS-519), or normal saline vehicle was administered intraperitoneally at LAD release. Infarct size, analyzed 24 hours after injury with TTC staining, was expressed as percent area at risk. Pressure-volume loops were recorded 3 days after injury for functional analysis. A third subgroup was sacrificed one hour after injury to examine protein expression in heart homogenates and serum by western blot and ELISA respectively. RESULTS: Vehicle mice suffered larger infarcts than sham animals (vehicle: 70.65% ± 3.41, sham: 5.79% ± 3.43, p < 0.05). IKKβ and proteasome inhibition significantly attenuated infarct size (IKKβ: 42.70 % ± 7.55, PS-519: 44.57 % ± 3.81, p < 0.05 compared with vehicle) and preserved ejection fraction compared to vehicle groups. When delivered even 2 hours after reperfusion, mice treated with IKKβ inhibition, but not PS-519, still had decreased infarct size. Finally, successful inhibition of the active NF-κB subunit, phosphorylated-p65, as well as decreased expression of IL-6 and TNFα occurred in mice given the IKKβ inhibitor, but not those with proteasome inhibition. CONCLUSION: Although IKKβ and proteasome inhibition at reperfusion attenuated infarct size and preserved function following acute IR, only IKKβ inhibition provides cardioprotection through specific suppression of NF-κB signaling. This feature of highly targeted NF-κB inhibition might account for its delayed protective effects and provide a clinically relevant option for treating myocardial IR associated with unknown periods of ischemia and reperfusion as seen in cardiac surgery and acute coronary syndromes. 60 6295_AATS.book Page 61 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California Mechanical Lung Assist Augments Forward Pulmonary Blood Flow In Primary Bidirectional Cavopulmonary Shunt Physiology In Neonatal Pigs Osami Honjo1, Sandra L. Merklinger1, John Poe1, Abdulla A. Alghamdi1, Setsuo Takatani2, Glen S. Van Arsdell*1 1The Labatt Family Heart Centre, The Hospital for Sick Children, Toronto, ON, Canada; 2Department of Artificial Organs, Institute of Biomaterial and Bioengineering, Tokyo Medical Dental University OBJECTIVE: Survival in patients with hypoplastic left heart syndrome might be improved by primary in-series palliation. Successful neonatal application of this approach would require lung circulatory assistance due to pulmonary vascular immaturity. We tested a novel miniature centrifugal pump as a means to augment forward bidirectional cavopulmonary shunt (BCPS) blood flow against higher neonatal pulmonary pressure and resistance in a neonatal pig model of primary 1+1/2 ventricle repair physiology (high pulmonary resistance model). METHODS: Six 3-week-old piglets (mean weight, 10.1 kg) underwent surgical creation of a BCPS. The final anatomy was that of a 1+1/2 ventricle repair with mechanical SVC blood flow assist. A 5 mL-prime miniature centrifugal pump was connected via cannulae placed in the SVC and main PA. Retrograde SVC flow caused by the pump and right ventricular pulsatility was limited by a band placed distal to the SVC cannula. Blood gas, hemodynamic and metabolic analysis were recorded at pump speeds of 1500, 2000, 2500 and 3000 RPM/min. Finally, as a means of testing conversion to an unassisted BCPS physiology, an 8Fr Mullins dilatation catheter was inserted into the SVC across the band whereby the artificially-created obstruction was dilated. RESULTS: Incremental increases in pump speed augmented SVC blood flow (p = 0.03) and diminished SVC pressure (p = 0.03) thereby normalizing cerebral perfusion pressure (p = 0.02) (Table 1). Final pump flow achieved was equivalent to the baseline SVC flow (pre SVC flow: 436 ± 96 ml/min vs. mechanical assist: 427 ± 120 ml/min; mean ± SD, p = NS). The animals were hemodynamically stable, well ventilated and oxygenated until euthanization at 3 hours following the procedure. Clinical demonstration of percutaneous conversion to unassisted SVC flow was shown with successful balloon dilation of the SVC band. Hemodynamics and metabolism of primary BCPS with mechanical lung assist p Value 1500RPM 2000RPM 2500RPM 3000RPM (ANOVA) SVC flow (mL/min) 147 ± 63* 246 ± 80 346 ± 100 427 ± 120* *0.03 SVC pressure 14.0 ± 1.8*¶ 12.1 ± 3.1 7.5 ± 6.0¶ 6.6 ± 3.7* *¶0.03 (mmHg) Cerebral perfusion 29.0 ± 4.5*¶ 32.0 ± 5.2 35.5 ± 5.6¶ 38.3 ± 5.4* *¶0.02 pressure (mmHg) pH 7.38 ± 0.03 7.39 ± 0.03 7.39 ± 0.04 7.41 ± 0.06 NS 40.6 ± 0.8 41.1 ± 1.7 40.0 ± 2.1 40.3 ± 3.1 NS PaCO2 (mmHg) PaO2 (mmHg) 327.3 ± 31.5 328 ± 36.6 385 ± 20.9 324 ± 33.8 NS Lactate 4.1 ± 1.7* 3.9 ± 1.1 3.5 ± 0.9 3.1 ± 0.8* *0.03 * AATS Member 61 SUNDAY Afternoon L8. 6295_AATS.book Page 62 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY CONCLUSION: The study demonstrates that mechanical lung assist can normalize SVC flow, in a neonatal pig high pulmonary vascular resistance physiology, thereby maintaining ventilation, hemodynamic and metabolic stability, and adequate cerebral perfusion pressure. Coupled with percutaneous dilation of the SVC, this study raises the possibility of primary creation of BCPS with an aid of mechanical lung assist followed by percutaneous completion of unassisted BCPS circulation. 5:00 p.m. ADJOURN TO WELCOME RECEPTION 62 6295_AATS.book Page 63 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California 63 SUNDAY Afternoon NOTES 6295_AATS.book Page 64 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY MONDAY MORNING, MAY 12, 2008 7:30 a.m. BUSINESS SESSION (Members Only) 7:45 a.m. PLENARY SCIENTIFIC SESSION (8 minutes presentation, 12 minutes discussion) Ballroom 20 A–C, San Diego Convention Center Moderators: D. Craig Miller Irving L. Kron 1. Are Stentless Valves Hemodynamically Superior to Stented Valves? Long-Term Follow-Up of a Randomized Trial Gideon Cohen, Brandon Zagorski, George T. Christakis*, Campbell D. Joyner, Jeri Sever, Stephen E. Fremes*, Fuad Moussa, Randi Feder-Elituv, Bernard S. Goldman* Cardiovascular Surgery, Sunnybrook Health Sciences Centre, Toronto, ON, Canada Invited Discussant: Hartzell V. Schaff OBJECTIVE: The benefit of stentless valves remains in question. In 1999, a randomized trial comparing stentless and stented valves was unable to demonstrate any hemodynamic or clinical benefits at one year post implant. This study reviews long term outcomes of patients randomized in the aforementioned trial. METHODS: Between 1996 and 1999, 99 patients undergoing aortic valve replacement were randomized to receive either a stented CE pericardial valve (CE), or a Toronto Stentless Porcine valve (SPV). Amongst these, 38 patients were available for late follow up (CE–17; SPV– 21). Echocardiography was undertaken both at rest and with dobutamine stress (DSE), and functional status (Duke Activity Status Index; DASI) was compared at a mean of 9.3 yrs postoperatively (Range 7.5–11.1 yrs). RESULTS: Although labelled mean valve size implanted was significantly larger in the SPV group, actual valve size based on internal diameter was no different between groups (CE: 21.9 ± 2.0; SPV: 22.3 ± 2.0 mm; p = 0.286). Preoperative characteristics were similar between groups. Late mortality and/or morbidity were no different between groups (p = 0.80). Two patients in the SPV group required reoperation, both for structural valve deterioration. Effective orifice areas (EOAs) increased in both groups over time. Although there were no differences in EOAs at 1 year, at 10 years EOAs were significantly greater in the SPV group (CE: 1.49 ± 0.59, SPV: 2.00 ± 0.53 cm2; p = 0.011). Similarly, mean and peak gradients decreased in both groups over time; however at 10 years, gradients were lower in the SPV group (MeanCE: 10.8 ± 3.8, SPV: 7.8 ± 4.8 mmHg; p = 0.011) (Peak- CE: 20.4 ± 6.5, SPV: 14.6 ± 7.1 mmHg; p = 0.022). Such differences were magnified with DSE (Mean- CE: 22.7 ± 6.1, * AATS Member 64 6295_AATS.book Page 65 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California CONCLUSION: Although offering improved hemodynamic outcomes, stentless valves did not afford superior mass regression or clinical outcomes up to 10 years post implantation. 65 MONDAY Morning SPV: 15.3 ± 8.4 mmHg; p = 0.008) (Peak- CE: 48.1 ± 11.8, SPV: 30.8 ± 17.7 mmHg; p = 0.001). Ventricular mass regression occurred in both groups, however no differences were demonstrated between groups (Figure; p = 0.74). Similarly, DASI scores of functional status improved in both groups over time, however, no differences were noted between groups (CE: 27.5 ± 19.1, SPV: 19.9 ± 12.0; p = 0.69). Measures of ventricular function including ejection fraction and fractional shortening, along with NYHA functional class were similar between groups both at 1 and 10 years postoperatively (p > 0.3). 6295_AATS.book Page 66 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY 2. Weathering the Storm: How Can Thoracic Surgery Training Programs Meet the New Challenges In the Era of Emerging Non-Invasive Technologies? Sunil M. Prasad1, Malek G. Massad*1, Edgar G. Chedrawy1, Norman J. Snow*1, Joannie T. Yeh1, Himalaya Lele1, Ahmed Tarakji1, Hersh S. Maniar2, William A. Gay*2 1University of Illinois, Chicago, IL; 2Washington University, St. Louis, MO Invited Discussant: Irving L. Kron OBJECTIVE: Recent introduction of new technologies such as drug eluting stents, endografts, robotics and non-surgical treatment of lung and chest pathology has shifted common procedures from the ABTS index case requirements and to non-cardiothoracic specialists. We examined case volume in cardiothoracic surgery over the last five years to identify changes and direct future training algorithms with objective, verifiable training data. METHODS: Program and resident data between 2002 to 2006 were obtained from the NRMP and ABTS. These data were combined in a database and statistically analyzed. Data is presented as MEAN ± SD. RESULTS: During this period, 606 residents qualified for the written ABTS exam. 82.7% (501/606) of residents graduated from 2 year (2Y) programs and 17.3% (105/606) from 3 year programs (3Y) (p < 0.01). More residents trained at a 2 resident/year (2R) program (252) than 1 resident/year (1R) (191) or 3 resident/year (3R) (163) program (p < 0.01). The most common program was a 2Y, 2R (203) followed by 2Y, 1R (151). Total thoracic cases per resident were higher in 1R (180 ± 68) and 3R (191 ± 84) programs than 2R (168 ± 59) (p < 0.01). Total cardiothoracic cases were higher in 3R than 2R or 1R programs (612 ± 135,571 ± 153,573 ± 165; respectively) (p < 0.05). Myocardial revascularizations (REVASC) were significantly higher in 1R programs than 2R and 3R (130 ± 62; 122 ± 48; 120 ± 60; respectively) (p < 0.01). Including all programs, there was a significant decrease in REVASC (p < 0.01), an increase in acquired valvular cases (p < 0.05), and no change in total thoracic, congenital, or cardiac cases over the last five years (p > 0.1)(Table). 3Y programs had significantly higher volumes than 2Y (p < 0.001) in every requirement (Table). 93.3 % (98/105) of 3Y residents and only 71.7% (359/501) of 2Y residents had over 80 REVASC cases. 85.7% (90/105) of 3Y residents and only 64.5% (323/501) of 2Y residents had over 100 chest, lung, pleura cases. CONCLUSION: In an era of dynamic changes due to new technologies, training programs have so far weathered the storm by maintaining overall case volume and expanding the diversity of cases. This study clearly documents the significant advantage in case volume of 3Y programs, and suggests changing current training to a minimum of 3 years. Furthermore, optimization of resident case volume could be achieved by reorganizing programs to high volume 3R centers and changing low volume 2R programs to a 1R program. * AATS Member 66 6295_AATS.book Page 67 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California 2 Year Programs 77 ± 30a All All All All All 3 Year Programs Programs Programs Programs Programs Programs 2002 2003 2004 2005 2006 110 ± 52a 79 ± 28 82 ± 37 82 ± 31 85 ± 47 84 ± 34 a 14 ± 9 15 ± 11 14 ± 12 16 ± 15 14 ± 10 169 ± 55 176 ± 71 177 ± 60 184 ± 85 178 ± 69 64 ± 29 72 ± 44 66 ± 44 62 ± 37 60 ± 31 50 ± 28a 55 ± 32 62 ± 40 62 ± 37 57 ± 35a 134 ± 52a 136 ± 51 123 ± 63 124 ± 60 110 ± 50a 573 ± 131 594 ± 144 588 ± 153 593 ± 187 565 ± 137 = p < 0.01 67 MONDAY Morning Pulmonary Resections 13 ± 10a 21 ± 15a Esophageal Resections 167 ± 61a 228 ± 88a Total Thoracic 60 ± 30a 88 ± 56a Total Congenital 53 ± 33a 80 ± 37a Acquired Valve 115 ± 47a 168 ± 72a Myocardial Revascularization 546 ± 123a 759 ± 162a Total Cardiothoracic 6295_AATS.book Page 68 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY 3. Phase II Trial of Extrapleural Pneumonectomy with Phase II Trial of Extrapleural Pneumonectomy with Intraoperative Intrathoracic/Intraperitoneal Heated Cisplatin for Malignant Pleural Mesothelioma Tamara R. Tilleman1, William G. Richards1, Lambros Zellos1, Bruce E. Johnson2, Michael T. Jaklitsch*1, Christopher T. Ducko1, Jordan Mueller1, Raphael Bueno*1, David J. Sugarbaker*1 1Thoracic Surgery, Brigham and Women’s Hospital, Boston, MA; 2Dana Farber Cancer Institute, Boston, MA Invited Discussant: Valerie W. Rusch OBJECTIVE: To determine the feasibility and safety of treating malignant pleural mesothelioma (MPM) patients with hyperthermic intraoperative intracavitary cisplatin perfusion (HIOC) METHODS: This study registered 121 patients with confirmed MPM who were candidates for extrapleural pneumonectomy (EPP) in an intent-to-treat design. Patients underwent EPP followed by HIOC. HIOC consisted of a 1-hour lavage of the chest and abdomen with cisplatin (41°C; 225 mg/m2), at the maximal tolerated dose (J Clin Oncol 10:1561–7, 2006). Intravenous sodium thiosulfate was administered following HIOC. A subset of patients also received intraoperative IV amifostine prior to HIOC. Patients were followed prospectively for morbidity and mortality. RESULTS: Of 121 patients, 96 were resectable (79%). Twenty-five were unresectable due to tumor involvement of chest wall (21) or vessels (3) or diffuse metastatic disease (1). Four of the 96 patients resectable by EPP did not receive HIOC treatment per protocol: 3 due to intraoperative hemodynamic instability; 1 patient had partial duration HIOC due to a technical failure of the perfusion system. Among the 92 resectable patients who received treatment per protocol, the median age was 60 years, and the median hospitalization was 12 days. Pathologic staging of this cohort by Brigham criteria (J Thorac Cardiovasc Surg 1999; 117:54–65) revealed six stage I, 23 stage II and 63 stage III. Fifty-eight patients had epithelial and 34 had sarcomatoid or mixed histology. Perioperative mortality rate was 1% (1/92 patients died of cardiac arrest) among resectable patients and 1.7% (2/121) among all patients. Perioperative grade 4 morbidity among resectable cases included 6 patients with thromboembolism (7%), 6 metabolic acidosis (7%), 5 atrial fibrillation (5%), 5 ARDS (5%), 3 prolonged intubation (3%). Among 64 patients treated only with thiosulfate, 4 had grade 3 renal toxicity and 3 had grade 4. Among 26 patients who also received amifostine, one had grade 3 renal toxicity and none had grade 4 (IMIG Conf. 2006). * AATS Member 68 6295_AATS.book Page 69 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California CONCLUSION: 1. EPP can be performed with acceptable morbidity and low mortality in the setting of HIOC 2. HIOC is feasible and safe and does not contribute significant perioperative morbidity or mortality. 4. EPP with HIOC represents a novel platform for cisplatin delivery including future multidrug combinations. 69 MONDAY Morning 3. Strategies involving pharmacologic cytoprotection allow high-dose cisplatin perfusion without significant renal toxicity. 6295_AATS.book Page 70 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY 4. Brain Maturation Is Delayed In Infants with Complex Congenital Heart Defects Daniel J. Licht, David M. Shera, Robert R. Clancy, Gil Wernovsky, Lisa M. Montenegro, Susan C. Nicolson, J. W. Gaynor*, Arastoo Vossough Children’s Hospital of Philadelphia, Philadelphia, PA Invited Discussant: Charles D. Fraser OBJECTIVE: Periventricular leukomalacia (PVL) is a risk factor for neuro-cognitive dysfunction in premature infants and has been attributed to maturation-dependent vulnerability of the cerebral white matter to hypoxic-ischemic injury. Neuroimaging studies have identified PVL in >50% of neonates with congenital heart disease (CHD) after surgical intervention. This study was undertaken to test the hypothesis that the presence of CHD alters in-utero brain development leading to delayed brain maturation, even in full term infants. METHODS: Full-term infants with hypoplastic left heart syndrome (HLHS) or transposition of the great arteries (TGA) were prospectively evaluated with pre-operative brain magnetic resonance imaging (MRI). Exclusion criteria included acidosis at birth (pH <7.10) and gestational age (GA) <36 weeks. Brain maturation was independently measured by two MRI readers blinded to clinical data, using the “total maturation score” (TMS), a previously validated semi-quantitative anatomical scoring system. The TMS evaluates four developmentallysensitive parameters of maturity: (i) myelination, (ii) cortical infolding, (iii) involution of glial cell migration bands and (iv) the presence of germinal matrix tissue. RESULTS: Infants with HLHS (n = 25) and TGA (n = 11) with an average GA of 39.0 ± 1.1 weeks underwent MRI prior to surgery, on day of life 4.0 ± 2.3. Mean head circumference (HC) and birth weight (BW) were 34.6 ± 1.2 cm (z = –0.6) and 3.41 ± 0.56 kg (z = –0.2). There was good agreement of TMS values between the blinded MRI readers (intra-class * AATS Member 70 6295_AATS.book Page 71 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California correlation: r = 0.73), with a mean score for the cohort of was 10.19 ± 1.0. This is significantly lower than reported mean TMS scores in non-cardiac infants with GA of 36 to 37 weeks (n = 28, mean TMS = 11.1 ± 1.5, p = 0.009) and from 38 to 43 weeks (n = 16, mean TMS = 13.0 ± 2.3, p < 0.0001). 9:05 a.m. AWARD PRESENTATIONS Ballroom 20 A–C, San Diego Convention Center 9:15 a.m. INTERMISSION—VISIT EXHIBITS Exhibit Hall GH, San Diego Convention Center 71 MONDAY Morning CONCLUSION: Brain development at birth is significantly delayed in full term neonates with HLHS and TGA, both on semiquantitative interpretation of MRI and by HC measurements. This finding suggests that in-utero brain development is altered in fetuses with CHD, possibly secondary to altered cerebral oxygen delivery or other sequelae of CHD. Delay in maturation of cerebral white matter may increase susceptibility to hypoxic-ischemic injury and thus the risk of PVL during the peri-operative period in these patients. 6295_AATS.book Page 72 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY NOTES 72 6295_AATS.book Page 73 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California 10:00 a.m. BASIC SCIENCE LECTURE Ballroom 20 A–C, San Diego Convention Center 10:40 a.m. PLENARY SCIENTIFIC SESSION Moderators: 5. Thomas L. Spray Irving L. Kron Off-Pump Versus On-Pump CABG In Patients with ST Segment Elevation Myocardial Infarction: A Randomized, Double Blind Study Khalil Fattouch, Giuseppe Bianco, Roberta Sampognaro, Egle Corrado, Pietro Dioguradi, Gaetano Panzarella, Giovanni Ruvolo Cardiac Surgery, University of Palermo, Palermo, Italy Invited Discussant: Thoralf M. Sundt OBJECTIVE: Emergency coronary artery bypass grafting (CABG) in patients with acute myocardial infarction (AMI) is still associated with high mortality and morbidity. Several retrospective studies suggested the benefits role of Off-pump surgery on in-hospital mortality and postoperative outcomes. This study was aimed to evaluate prospectively and randomly the impact of Off-pump vs On-pump CABG on early and midterm mortality and morbidity. METHODS: Sine February 2003, 128 patients with AMI underwent emergency CABG within 48 hours from onset of symptoms. Thrombolytic and/or primary PTCA therapies were applied or considered for all patients before surgery. Patients were randomly assigned in 2 groups (On-pump Group: 66 pts [51.5 %] and Off-pump Group: 62 pts [48.5 %]). A standardized CABG was performed in 2 groups. No statistical difference was found preoperatively between two groups except for gender, previous AMI, preoperative use of IABP. The mean number of grafts/patient was 2.8 ± 0.4 in the On-pump group and 2.6 ± 0.5 in the Off-pump group. Follow-up was completed in all survivors. Mean follow-up was 22 ± 8 months. RESULTS: Overall in-hospital mortality was 4.6%. In-hospital mortality in the On-pump group was 7.7% (5 pts) compared to 1.6% (1 pt) in the Off-pump group (p = 0.04). There were postoperative statistical significant difference between 2 groups with regard to incidence of low cardiac output syndrome (LCOS), use of inotrope drugs, time of mechanical ventilation, ICU and hospital stay, in On-pump group vs Off-pump group. The serum levels of Troponin I and CK-MB were most higher in On-pump group vs Off-pump group, during the first 48 hours from surgery. Variables such as hypertension, postoperative LCOS, high dose of inotrope drugs support, and On-pump emerged as predictors for in-hospital mortality (by multiple regression analysis). Preoperative PTCA and IABP use, time of CPB and use of high dose inotrope drugs emerged as predictors for postoperative ICU stay. There were no late deaths. All patients were free from recurrent angina and re-interventions (PTCA or surgery). 73 MONDAY Morning The Link Between Engineering, Biomechanics, and Cardiovascular Physiology and Disease Matts Karlsson, Ph.D. Professor of Biomedical Modeling and Simulation, Head of School of Mechanical Engineering, Linköping University, Linköping, Sweden Introduced By: D. Craig Miller 6295_AATS.book Page 74 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY CONCLUSION: Off-pump CABG in patients with AMI is better than On-pump CABG in term of early mortality and morbidity. Our results suggests that CABG without CPB is effective in patients with AMI and can be performed safely with good results. Off-pump surgery could be challenge in this kind of patients and must be performed by experienced surgeons. 74 6295_AATS.book Page 75 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California 6. OBJECTIVE: The prediction of perioperative risk in esophagectomy for esophageal cancer is unreliable. We sought to create a model adjusted for preoperative risk factors using the STS General Thoracic Database (STS GTDB). METHODS: The STS GTDB was queried for all patients treated with esophagectomy for esophageal cancer for the time period from January 2002 to June 2006. A multivariable risk model for mortality and major morbidity was constructed and confirmed with a bootstrap analysis. RESULTS: There were 1393 esophagectomies performed by 50 participating centers. Patients older than 75 constituted 17% (293/1393) of the cohort. The hospital mortality was 2.4% (33/1393). Major morbidity (defined as reoperation for bleeding [n = 5], anastomotic leak [n = 143], pneumonia [n = 97], reintubation [n = 108], ventilation beyond 48 hours [n = 37] or death [n = 33]) occurred in 20.6% (287/1393) of patients. The mean length of stay was 14 days for the entire cohort (median 9 days) and 27 days for patients with major morbidity. Induction therapy was administered in 42% (590/1393) of patients and was not associated with increased morbidity or mortality. Preoperative spirometry was obtained in 36% (507/1393) of patients. A FEV1<60% of predicted was associated with major morbidity (OR 1.80, p = 0.002). The multivariate predictors of major morbidity are seen in the Table. Variable Age>75 Race- Black CHF PVD Diabetes Smoker ASA rating 3 or 4 Predictors of Major Morbidity after Esophagectomy Odds Ratio 95% CI 1.36 1.06–1.74 2.95 1.67–5.24 2.88 1.40–5.93 1.93 1.30–2.90 1.43 1.03–2.00 1.42 1.08–1.86 1.45 1.14–1.84 p-Value 0.015 <0.001 0.004 0.001 0.034 0.011 0.002 ASA = American Society of Anesthesiology rating CONCLUSION: Thoracic surgeons participating in the STS GTDB perform esophagectomy with a low mortality. Age, race, medical co-morbidities, smoking status and significant obstructive lung disease are predictors of major morbidity and mortality after esophagectomy for esophageal cancer. Prognostic factors identified in this analysis may help to predict risk in individual patients and guide quality improvement by risk-adjusted feedback. * AATS Member 75 MONDAY Morning Predictors of Major Morbidity and Mortality after Esophagectomy for Esophageal Cancer: An STS General Thoracic Surgery Database Risk Adjustment Model Cameron D. Wright*1, Mark S. Allen*2, Joshua D. Grab3, John C. Kucharczuk4 1Massachusetts General Hospital, Boston, MA; 2Mayo Clinic, Rochester, MN; 3Duke Clinical Research Institute, Durham, NC; 4University of Pennsylvania, Philadelphia, PA Invited Discussant: James D. Luketich 6295_AATS.book Page 76 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY 11:25 a.m. PRESIDENTIAL ADDRESS Anti-Memoirs of Rocinante D. Craig Miller Stanford, California Introduced by: Thomas L. Spray 12:15 p.m. ADJOURN FOR LUNCH—VISIT EXHIBITS Exhibit Hall GH, San Diego Convention Center CARDIOTHORACIC RESIDENTS’ LUNCHEON Room 23, San Diego Convention Center 76 6295_AATS.book Page 77 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California NOTES MONDAY Morning 77 6295_AATS.book Page 78 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY MONDAY AFTERNOON, MAY 12, 2008 2:00 p.m. SIMULTANEOUS SCIENTIFIC SESSION— ADULT CARDIAC SURGERY (8 minutes presentation, 12 minutes discussion) Ballroom 20 A–C, San Diego Convention Center Moderators: Christopher M. Feindel John S. Ikonomidis 7. Effects of Mild Hypothermia and Rewarming on Renal Injury Following Coronary Artery Bypass Surgery Munir Boodhwani, Fraser D. Rubens, Denise Wozny, Howard J. Nathan University of Ottawa Heart Institute, Ottawa, ON, Canada Invited Discussant: John W. Hammon, Jr. OBJECTIVE: Hypothermia has been proposed as a potential strategy for visceral organ protection during cardiopulmonary bypass. However, the effects of intraoperative temperature on postoperative renal function are not known. We report data from randomized studies conducted to evaluate the effects of mild hypothermia and rewarming in patients undergoing coronary surgery. METHODS: Patient undergoing non-emergent, isolated coronary artery bypass surgery were enrolled into two separate study protocols. In the first protocol, patients (n = 223) were all cooled to 32°C during CPB and then randomly assigned to rewarming to 37°C (RW-37°) or 34°C (RW-34°). In the second protocol, patients (n = 267) were randomized to sustained mild hypothermia at 34°C (S-34°) or normothermia (S-37°) during the entire operative period without any rewarming. Serum creatinine levels were measured preoperatively and on post-operative days (POD) 0, 1, 2, 4, and later if clinically indicated and creatinine clearance was calculated. Significant renal injury was defined as a 25% increase in serum creatinine (or a 25% decrease in creatinine clearance) in the postoperative period. Repeated measures analyses were employed. RESULTS: Post-operative serum creatinine levels were persistently higher in the patients rewarmed to 37°C (RW-37°) compared to their hypothermic counterparts (RW-34°, p < 0.01, Fig. 1). Rewarmed patients (RW-37°) also had a higher incidence of renal injury (17% vs. 9%, p = 0.07) compared to hypothermic patients (RW-34°). Sustained mild hypothermia had no beneficial effect on post-operative serum creatinine levels (p = 0.44, Fig. 1) or the incidence of significant renal injury (S-34° vs. S-37°, 20% vs. 15%, p = 0.28). Multivariate analysis identified diabetes (OR [95% CI] - 1.6 [1.3–2.1]), prolonged CPB time (1.1 [1.0–1.2]), and rewarming (1.4 [1.0–1.9]) as independent risk factors for significant renal injury. Renal injury was associated with longer hospital stay (8.4 ± 0.8 vs. 6.8 ± 04 days, p <0.001). 78 6295_AATS.book Page 79 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California MONDAY Afternoon Baseline and Post-operative Serum Creatinine Levels CONCLUSION: In these randomized trials of patients undergoing isolated coronary surgery, sustained mild hypothermia does not improve renal outcome. However, rewarming on cardiopulmonary bypass is associated with increased renal injury and should be avoided. 79 6295_AATS.book Page 80 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY 8. Minimally Invasive Bipolar Radiofrequency Ablation of Lone Atrial Fibrillation: Early Multicenter Results Erik A. K. Beyer1, Richard Lee3, B-Khanh Lam2 1Scott and White Clinic, Temple, TX; 2University of Ottawa Heart Institute, Ottawa, ON, Canada; 3Northwestern University, Chicago, IL Counterpoint: Richard J. Shemin Open Discussion OBJECTIVE: With the advent of new technologies, the surgical treatment of lone atrial fibrillation (AF) can be performed via a minimally invasive technique using bipolar radiofrequency ablation. The objectives of this study were to report on the safety and early efficacy of this novel therapeutic modality. METHODS: At three North American institutions between February 2005 and August 2007, 100 patients underwent thoracospic- assisted bilateral pulmonary vein isolation, autonomic denervation and left atrial appendage resection via bilateral mini-thoracotomies. The mean age was 65 ± 11 years with 70% being male. Median duration of AF was 5.0 years; AF was paroxysmal in 40 (40%) patients, persistent in 29 (29%) and permanent in 31 (31%). Main indications for surgery were failure of medical therapy or percutaneous ablation and severe symptoms. Mean follow-up was 13.6 ± 8.2 months and 99% complete; all patients had a 24-hour Holter monitor following a blanking period. RESULTS: The mean operative time was 253 ± 65 minutes and median hospital length of stay was 5 days. There were no intra-operative conversions. Postoperative complications included pacemaker requirement in 3 (3%) patients, phrenic nerve palsy in 3 (3%), hemothorax in 2 (2%), TIA in 1 (1%) and PE in 1 (1%). There has been no mortality at any time point. At time of follow-up, 87% of patients were in normal sinus rhythm (paroxysmal 93%, persistent 96%, permanent 71%; p < .05); anti-arrhythmic and anticoagulation therapy was discontinued in 62% and 65% of patients respectively. CONCLUSION: Minimally invasive bipolar radiofrequency ablation of lone AF is a safe and efficacious therapeutic option in selected patients. Further development is needed to reduce the rate of complication. Long-term prospective results are required to further validate this modality as a therapeutic option to treat lone AF. 80 6295_AATS.book Page 81 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California 9. OBJECTIVE: It is unclear which aortic root replacement technique works best in patients with Marfan syndrome; therefore, as part of a prospective, international registry study conducted at 21 institutions, we compared early outcomes in Marfan syndrome patients who underwent aortic root replacement with either valve replacement (AVR) or valve-sparing (AVS) methods. METHODS: An interim analysis was performed on the first 99 patients enrolled. All patients met strict Ghent diagnostic criteria for Marfan syndrome and underwent aortic root replacement with either AVR (n = 33) or AVS (n = 66) techniques; the choice of operation was based on clinical factors and surgeon and patient preference. In the AVR group, valve replacement was done with a mechanical composite valve graft in 28 patients (85%) and a bioprosthetic valve in 5 (15%). In the AVS group, David V procedures were performed in 42 patients (64%), David I in 19 (29%), David IV in 4 (6%), and Florida sleeve in 1 (2%). We compared preoperative factors, intraoperative variables, and early postoperative outcomes in the AVR and AVS groups. RESULTS: Except for age, preoperative factors (see Table), including NYHA class, aortic root size, left ventricular ejection fraction, comorbidities, medications, and smoking, did not differ significantly between the 2 groups. Concomitant procedures were similar in both groups. Despite longer cross-clamp and pump times in the AVS group, there were no significant differences in postoperative complications. No in-hospital or 30-day deaths occurred. One patient suffered a transient neurologic deficit 7 days after an AVS procedure. Valve-related Perioperative Variables and Outcomes Variable AVR AVS Age (yrs) 40 ± 14 31 ± 11 Preoperative aortic root diameter (mm) 51 ± 8 52 ± 6 Emergent or urgent operation (n) 3/33 (9%) 6/66 (9%) Aortic dissection (n) 5/33 (15%) 8/66 (12%) Aortic clamp time (min) 111 ± 48 185 ± 76 Cardiopulmonary bypass time (min) 149 ± 78 231 ± 93 30-day valve-related complications (n) 7/33 (21%) 10/66 (15%) Early reoperation (n) 5/33 (15%) 6/66 (9%) * AATS Member † Robert E. Gross Research Scholar 1994-1996 81 p-Value 0.01 0.6 1.0 0.8 <0.001 <0.001 0.6 0.5 MONDAY Afternoon Valve-Sparing Versus Valve Replacement Techniques for Aortic Root Operations In Marfan Patients: Interim Analysis of Early Outcome Joseph S. Coselli*1, Thoralf M. Sundt*†2, D. Craig Miller*3, Joseph E. Bavaria*4, Scott A. LeMaire1, Heidi M. Connolly2, Harry C. Dietz5, Dianna M. Milewicz6, Laura C. Palmero1, Xing Li Wang1, Irina V. Volguina1 1Baylor College of Medicine and The Texas Heart Institute, Houston, TX; 2Mayo Clinic, Rochester, MN; 3Stanford University, Stanford, CA; 4University of Pennsylvania, Philadelphia, PA; 5Johns Hopkins Hospital, Baltimore, MD; 6University of Texas Health Science Center, Houston, TX Invited Discussant: Alan D. Hilgenberg 6295_AATS.book Page 82 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY complications included bleeding (n = 13), embolism (n = 2), nonstructural dysfunction (n = 1), and structural deterioration (n = 1). Ten patients required reoperations for bleeding, and 1 patient required early reoperation for revision of an AVS root replacement. CONCLUSION: This interim analysis revealed that AVS was the most common operation in Marfan syndrome patients undergoing root replacement. Although AVS procedures, which tended to be used in younger patients, required longer aortic clamp and cardiopulmonary bypass times, the complexity of AVS aortic root replacement did not translate into adverse early outcomes. Subsequent long-term analysis is underway to compare the durability of these 2 approaches. 3:10 p.m. INTERMISSION—VISIT EXHIBITS Exhibit Hall GH, San Diego Convention Center 82 6295_AATS.book Page 83 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California NOTES MONDAY Afternoon 83 6295_AATS.book Page 84 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY 3:45 p.m. SIMULTANEOUS SCIENTIFIC SESSION— ADULT CARDIAC SURGERY Ballroom 20 A–C, San Diego Convention Center Moderators: Christopher M. Feindel John S. Ikonomidis 10. Effects of On- and Off-Pump Coronary Artery Surgery on Graft Patency, Survival and Quality of Life: Long Term Follow-Up of Two Randomised Controlled Trials Gianni D. Angelini*, Lucy Culliford, David Smith, Mark Hamilton, Gavin Murphy, Raimondo Ascione, Andreas Baumbach, Barney Reeves Bristol Heart Institute, Bristol, United Kingdom Invited Discussant: Soichiro Kitamura OBJECTIVE: Patients have less post-operative morbidity and shorter ICU and hospital stays with off-pump (OPCAB) than on-pump coronary artery bypass grafting (CABG-CPB). However, only about 15%–20% of coronary bypass operations worldwide are carried out using OPCAB. Surgeons may be reluctant to use OPCAB due to concerns about graft patency. The aim of this study was to assess long-term patency rate and health outcomes of patients enrolled in the BHACAS 1&2 trials METHODS: Participants in two randomised trials comparing OPCAB and CABG were followed for 6–8 years after surgery to assess graft patency, major adverse cardiac-related events (MACE) and health-related quality of life (HRQoL). Patency was assessed by multidetector computed tomography coronary angiography (MDCTA) with a 16-slice scanner. Two blinded observers classified proximal, body and distal segments of each graft as occluded or not. MACE and HRQoL were obtained from questionnaires to participants and family practitioners. RESULTS: Fifty-two (13.0%) of 401 randomised participants had died; of the remaining 349, 298 (85%) completed HRQoL questionnaires and 199 (57%) had MDCTA scans. There was no evidence of attrition bias for any outcome. Patency was studied in 505 grafts. Mean duration of follow-up from operation to MDCTA was 85.1 months (SD 4.8) and 85.8 months (SD 4.7) for CABG-CPB and OPCAB groups. Overall, 439/492 (89.2%) of grafts were patent. Percentages of grafts classified as patent were similar in CABG-CPB and OPCAB groups, both overall (228/255, 89.4% and 211/237, 89.0%; odds ratio = 1.00, 95% CI 0.55–1.82, p > 0.99) and for arterial and vein grafts separately. Vein grafts were less likely to be patent (218/250, 87.2%) than arterial grafts (221/242, 91.3%). Graft occlusion was more likely at the distal than the proximal anastomosis (odds ratio = 1.11, 1.02–1.20). There were also no differences between OPCAB and CABG-CPB groups in: the hazard of death (hazard ratio = 1.24, 0.72–2.15), or MACE or death (hazard ratio = 0.84, 0.58–1.24); mean HRQoL across a range of domains and instruments. CONCLUSION: Long term graft patency and other health outcomes are similar with OPCAB to those with CABG-CPB when both operations are performed by experienced surgeons. * AATS Member 84 6295_AATS.book Page 85 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California 11. OBJECTIVE: The aim of this retrospective study was to evaluate the clinical outcome of treating/untreated moderate-or-more functional tricuspid regurgitation (FTR) in patients with functional mitral regurgitation (FMR) undergoing mitral valve surgery (MVS). METHODS: From January 1988 to March 2003, 110 patients with FMR undergoing MVS showed moderate-or-more FTR, which was treated (group T) in 51 and untreated in 59 (group UT) cases. A non-parsimonious regression model (c-statistic = 0.83, bootstrapping = 500 samples) was built to obtain the propensity score. The latter was used by means of a sample matching to select a cohort of 100 patients (50 group T and 50 group UT). The two groups were similar for all evaluated preoperative and operative variables, but tricuspid valve annulus (21.4 ± 2.3 mm/m2 group UT vs 25.1 ± 2.3 mm/m2 group T, p < 0.001). Tricuspid valve was always repaired using DeVega technique. Mitral valve was repaired in 75 and replaced in 25 cases; no residual moderate-or-more FMR was assessed at hospital discharge. Impact of untreated moderate-or-more FTR was estimated by Cox analysis. The results were reported as regression coefficient (b) ± standard error (SE) and p-value. The final model was validated in 500 bootstrap samples. RESULTS: Thirty-day mortality was 6.0% (10% group UT vs 2% group T, p = 0.204). Fiveyear survival was 53.0 ± 5.0 (36.0 ± 6.8 group UT vs 70.0 ± 6.5 group T, p < 0.001); The possibility to be alive in I-II NYHA class was 40.6 ± 4.9 (34.6 ± 4.9 group UT vs 66.8 ± 7.1 group T, p < 0.001). Untreated moderate-or-more FTR resulted a risk factor for worse midterm survival (b ± SE = 2.5 ± 0.5, p < 0.001) and the possibility to be alive in I-II NYHA class (b ± SE = 2.2 ± 0.5, p < 0.001) CONCLUSION: Tricuspid annuloplasty is an easy and safe procedure, mandatory in case of at least moderate FTR to achieve better mid-term outcome in patients with functional mitral regurgitation undergoing mitral valve surgery. * AATS Member 85 MONDAY Afternoon Mitral Valve Surgery for Functional Mitral Regurgitation – Should Moderate-Or-More Tricuspid Regurgitation Be Treated? A Propensity Score Analysis Antonio M. Calafiore*1, Sabina Gallina2, Angela L. Iaco’1, Marco Contini1, Antonio Bivona1, Massimo Gagliardi1, Paolo Bosco1, Michele Di Mauro1 1Cardiac Surgery, University of Catania, Catania, Italy; 2University of Chieti – Department of Cardiology, Chieti, Italy Counterpoint: Andrew S. Wechsler Open Discussion 6295_AATS.book Page 86 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY 12. Decision-Making In Surgical Management of Ischemic Cardiomyopathy Dustin Y. Yoon, Nicholas G. Smedira*, Edward R. Nowicki, Katherine J. Hoercher, Jeevanantham Rajeswaran, Eugene H. Blackstone* Cleveland Clinic, Cleveland, OH Invited Discussant: Curt Tribble OBJECTIVE: The surgical approach to ischemic cardiomyopathy that yields the best shortand long-term survival remains controversial, and surgeons’ decisions may be further complicated by secondary conditions of mitral regurgitation, left ventricular remodeling and dilatation, and ultimately, heart failure. We sought to develop comparative prediction models that can be used to estimate short- and long-term survival after 4 operative interventions: CABG alone, CABG+mitral valve (MV) anuloplasty, CABG+surgical left ventricular restoration (SVR), and cardiac transplantation. METHODS: From 1997 to 2007, 1,321 patients with ischemic cardiomyopathy (ejection fraction <.3) underwent CABG alone (n = 386), CABG+MV anuloplasty (n = 212), CABG+SVR (n = 360), or cardiac transplantation (n = 363). Median follow-up was 4 ± 2.8 years, with 5,455 patient-years of data available for analysis. Survival was estimated, and multivariable analyses were performed in the multiphase hazard function domain to identify risk factors for early and late mortality separately for each procedure. All final models contained all variables identified in any of the 4 analyses. These were programmed as a web-based strategic decision support tool. RESULTS: Survival estimates at 1, 3, 5, and 9 years were: CABG, 92%, 83%, 72%, and 53%; CABG+MV anuloplasty, 87%, 72%, 57%, and 33%; CABG+SVR, 93%, 85%, 75%, and 54%; cardiac transplantation, 90%, 85%, 80%, and 63% (Figure). Multiphase hazard analyses identified lower ejection fraction, older age, higher NYHA class, numerous comorbidities, and long interval from myocardial infarction to operation as risk factors. Patient-specific simultaneous solutions of the 4 procedure modules revealed the procedures that potentially provide maximum survival benefit. (Figure: patient age 60 years; NYHA class II; ejection fraction .17; complete heart block; 3-system disease; several comorbidities.) CONCLUSION: Prediction models incorporating specific clinical and angiographic data can help surgeons recommend the patient-specific treatment plan that optimizes short- and longterm survival for ischemic cardiomyopathy. * AATS Member 86 6295_AATS.book Page 87 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California 13. Repair Oriented Functional Classification of Aortic Insufficiency: Impact on Surgical Techniques and Outcomes Laurent de Kerchove, David Glineur, Alain Poncelet, Jean Rubay, Parla Astarci, Robert Verhelst, Philippe Noirhomme, Gébrine El Khoury Université Catholique de Louvain, Cliniques St-Luc, Brussels, Belgium Invited Discussant: Hans-Hinrich Sievers METHODS: From 1996 to 2006, 264 patients underwent elective AV repair for AI. Mean age was 54 ± 16 years (range: 11 to 85) and 79% (209/265) were male. The table describes our functional classification of AI and the corresponding surgical techniques. AV was tricuspid in 171 patients, bicuspid in 90 and quadricuspid in 3. One hundred fifty three patient had type I dysfunction (aortic dilatation), 134 had type II (cusp prolapse), and 40 had type III (restrictive). Thirty one percent (83/264) of the patients had more than one dysfunction. RESULTS: Hospital mortality is 1.1% (3/264). Six patients experienced early repair failure, of them 3 were re-repaired. Follow-up (mean: 50 ± 34 months, range: 9 to 136) is 94% complete. Late mortality is 4.2% (11/261,10 cardiac). Five years overall survival is 96 ± 3%. During the follow-up period, 4 patients suffered from strokes, 1 from TIA and 1 from AV endocarditis. Late AV reoperation was necessary in 10 patients with one re-repair. Five years freedom from AI >2 and from AV reoperation is respectively 84 ± 7% and 92 ± 4% with no significant difference between tricuspid (80 ± 10%; 90 ± 6%) and bicuspid (86 ± 10%; 93 ± 5%). Patients with type I (82 ± 9%, 93 ± 5%) or II (95 ± 5%, 94 ± 6%) show better results than patients with type III (76 ± 17%; 84 ± 13%). Moreover, the multivariate analysis showed that 2° pump run and residual AR on discharge are independent risk factors for repair failure. Type I Functional Classification of AI Type 1a Dilatation of sino-tubular junction and ascending aorta Techniques of repair Sino-tubular junction remodeling (= supra coronary aortic replacement) + subcommissural anuloplasty Aortic valve sparing: Reimplantation or Remodeling techniques (+ subcommissural anuloplasty in remodeling) Subcommissural anuloplasty (+ sino-tubular junction plication) Autologous pericardial patch (+ subcommissural anuloplasty) Central plication, triangular resection, free margin shortening with PTFE suture, autologous pericardial patch + subcommissural anuloplasty Shaving, decalcification, resection and patch repair (+ subcommissural anuloplasty) Type 1b Dilatation of sino-tubular junction and sinuses of Valsalva Type 1c Dilatation of aortoventricular junction Type 1d Cusp perforation Type II Cusp prolapse Type III Restrictive cusp motion 87 MONDAY Afternoon OBJECTIVE: In patients with aortic valve insufficiency (AI), valve repair requires a tailored surgery determined by the leaflets and proximal aorta anatomy which prompt us to develop a functional classification of AI. This classification has implication on the surgical strategy and outcome. In this study, we analyze one decade experience with aortic valve (AV) repair. 6295_AATS.book Page 88 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY CONCLUSION: The functional classification allows a systematic approach of AI and may enhance the reparability rate. Moreover, it facilitates anticipation of the surgical technique and the prediction of the durability. Cusp restrictive motion (type III), due to fibrosis or calcification, is an important limitation for conservative surgery. 5:15 p.m. ADJOURN 88 6295_AATS.book Page 89 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California NOTES MONDAY Afternoon 89 6295_AATS.book Page 90 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY MONDAY AFTERNOON, MAY 12, 2008 2:00 p.m. SIMULTANEOUS SCIENTIFIC SESSION— GENERAL THORACIC SURGERY (8 minutes presentation, 12 minutes discussion) Room 25, San Diego Convention Center Moderators: James D. Luketich Robert J. Cerfolio 14. Decreased Operative Mortality for Esophageal Cancer Resection at Hospitals with Thoracic Training Programs: Should Esophagectomies Only be Performed by Thoracic Surgeons? Robert A. Meguid, Eric C. Weiss, Stephen M. Cattaneo, Marc S. Sussman, Malcolm V. Brock, Stephen C. Yang* Division of Thoracic Surgery, Johns Hopkins University, School of Medicine, Baltimore, MD Invited Discussant: Claude Deschamps OBJECTIVE: Historically, esophageal cancer surgery has been performed by both general and thoracic surgeons. Lower mortality for esophageal resection has been demonstrated at high-volume centers and for specialty-trained surgeons. It is unclear if this distinction holds true at centers with thoracic residency programs. Therefore, we studied outcomes after esophageal cancer resection stratified by surgical residency type. METHODS: Data on esophageal cancer resections in the Nationwide Inpatient Sample dataset (1998-2005) were enriched with data from the Accreditation Council for Graduate Medical Education to reliably identify presence of thoracic surgery (TS) and general surgery (GS) residency programs. The association of hospital teaching status with postoperative inhospital mortality was assessed via multivariate logistic regression, adjusting for patient demographics and comorbidities. RESULTS: Of 4,080 esophagectomies, 48% were performed at GS-hospitals, 32% at TShospitals (all hospitals with TS residencies also had GS residencies) and 34% at GS-hospitals without TS residencies. Postoperative mortality was significantly lower at GS vs. non-GShospitals (7.4% vs. 11.1%; p < 0.001) and at TS vs. non-TS-hospitals (6.2% vs. 10.8%; p < 0.001). At GS-hospitals without TS residencies, mortality rate was significantly higher than TS-hospitals (9.8% vs. 6.2%; P = 0.01). On multivariate regression, overall risk of postoperative death was independently reduced by 38% at GS vs. non-GS-hospitals (Odds Ratio [OR] 0.62, 95% confidence interval [CI] 0.46–0.83; P = 0.001) and by 45% at TS vs. nonTS-hospitals (OR 0.55, 95% CI 0.40–0.75; p < 0.001). TS-hospitals did not confer a statistically significant protective effect when compared to GS-hospitals without TS residencies. * AATS Member 90 6295_AATS.book Page 91 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California CONCLUSION: In-hospital mortality is reduced for patients undergoing esophagectomy for cancer at teaching hospitals with thoracic and/or general surgery residencies. However, the greatest reduction in risk of death was at hospitals with thoracic surgery residencies, as opposed to those with general surgery residencies only. These data may serve to stimulate further study into the processes of care associated with these settings, as well as shape esophageal cancer patient-preference toward treatment by thoracic surgeons. MONDAY Afternoon 91 6295_AATS.book Page 92 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY 15. Should Lung Transplantation Be Performed Using Donation After Cardiac Death? The U.S. Experience David P. Mason, Lucy Thuita, Joan M. Alster, Sudish C. Murthy*, Marie M. Budev, Atul C. Mehta, Gosta B. Pettersson*, Eugene H. Blackstone* Cleveland Clinic, Cleveland, OH Invited Discussant: Kenneth R. McCurry OBJECTIVE: Single institution experience using donation after cardiac death (DCD) in lung transplantation (LTx) is limited and outcomes unclear. Therefore, we compared 1) survival of recipients of DCD lungs vs. that of those receiving lungs from donors meeting brain death criteria who were transplanted in the U.S., and 2) characteristics of recipients of DCD donation vs. brain death donation. METHODS: Donor, recipient and transplant variables, and follow-up data were obtained from the United Network for Organ Sharing (UNOS) for LTx from October 1987 to May 2007. Median follow-up among survivors of DCD LTx was 1 year, range 13 days to 8.6 years (unknown in 1). Unadjusted Kaplan-Meier survival estimates were compared for recipients of DCD organs vs. recipients of organs from brain death donors. To adjust the survival comparison for differences among recipients of DCD vs. brain death donor organs, a propensity score was developed incorporating recipient age, BMI, indication for transplant, diabetes, spirometry, single vs. double LTx, cold ischemic time, and donor age. The propensity score was used in a Cox proportional hazards model to adjust the comparison of survival for DCD vs. brain death donor LTx recipients. RESULTS: 14,939 transplants were performed, for which 36 patients received organs from DCD donors (9 single, 27 double LTx). Among the 36, 3 died, 1 each on days 1 and 11, and 1.54 years. Unadjusted survival at 1, 3, and 6 months and 1 and 2 years was 94%, 94%, 94%, 94%, and 87% for DCD donors, compared with 92%, 88%, 84%, 78%, and 69% for brain death donors (unadjusted P = .04; Figure). DCD recipients were more likely to undergo double LTx and have diabetes, a lower FEV1, and longer cold ischemic times. Once these were accounted for and propensity adjusted, survival was still better for DCD recipients, although P = .06. * AATS Member 92 6295_AATS.book Page 93 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California CONCLUSION: Concern over organ quality and ischemia-reperfusion injury has limited the application of lung DCD. This analysis shows that DCD as practiced in the United States results in survival at least equivalent to that after brain death donation. However, it also demonstrates selection bias in choosing recipients for transplantation, particularly in performing more double LTx, making generalization regarding survival difficult. Nevertheless, the data support expanded experience with DCD. MONDAY Afternoon 93 6295_AATS.book Page 94 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY 16. Long-Term Survival with Surgical Management for Superior Sulcus Tumors with Vertebral Resection William D. Bolton1, David C. Rice1, Adam Goodyear1, Arlene M. Correa1, Jeremy Erasmus1, Ziya Gokaslan2, Wayne Hofstetter1, Ritsuko Komaki1, Reza Mehran1, Katherine Pisters1, Jack A. Roth*1, Stephen G. Swisher*1, Ara A. Vaporciyan*1, Garrett L. Walsh*1, Jason Weaver1, Laurence Rhines1 1Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, TX; 2The Johns Hopkins University, Baltimore, MD Invited Discussant: Marc de Perrot OBJECTIVE: Superior sulcus tumors with involvement of the spine are classified as stage IIIB and are usually considered unresectable. We have previously documented 2-year survival of 54% in patients (pts) treated with a multimodality approach including combined pulmonary and vertebral resection. This work builds on our previous experience and examines the long term outcomes with this aggressive regimen. METHODS: This IRB approved retrospective review was performed on pts with NSCLC and superior sulcus tumors with involvement of the vertebral column (n = 39) treated at MDACC from 1990 to 2006. Their clinical and pathologic data were analyzed for short and long-term outcome. RESULTS: Median age was 56 years and there were 29 men. Pts were divided into 3 groups based on the degree of vertebral body resection. Group I included 8 pts (21%) with neuroforamen or transverse process involvement (no vertebrectomy), Group II had 16 pts (41%) with partial vertebrectomy, and Group III had 15 pts (38%) with total vertebrectomy. Of pts who had vertebrectomy (n = 31), 13 (42%) had one, 14 (45%) had two and 4 (13%) had three vertebrae resected. 14 pts had preoperative radiation (12 with chemotherapy). There were no complete pathologic responses, 2 pts (14%) had microscopic residual disease and 12 (86%) had gross disease at the time of surgery. There were 2 (5%) postoperative deaths (both from respiratory failure) and 11 (28%) pts had major complications. Median hospital stay was 11 days (range 4–48 days). Margins were positive in 17 pts (44%) and did not correlate with extent of resection or preoperative treatment. N-stage was N1 in 5 pts (13%), N2 in 6 (15%) and N3 (scalene) in 3 (8%). Recurrence occurred in 23 pts (59%) and was local in 11 (28%), distant in 11 (28%) and both in 1 (3%). Median time to local recurrence was 7 months in pts with positive margins and has not been reached for pts with negative margins (p = 0.007). Median, 2-yr and 5-yr overall survival were 18 months, 47% and 27% respectively. Positive margins and nodal metastases were associated with shorter survival (see Table). On multivariate analysis the only independent predictor of shorter survival was nodal metastases (p = 0.001, HR 6.5; CI 2.2–19.2). * AATS Member 94 6295_AATS.book Page 95 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California 5-year (%) 38 14 22 41a 0 39a 12 a p < 0.03 CONCLUSION: An aggressive multimodality approach involving surgical resection can be performed with an acceptable morbidity on selected pts with superior sulcus tumors and vertebral invasion. Encouraging long-term survival can be achieved in pts with negative margins and no lymph node involvement. 95 MONDAY Afternoon Survival Data for Group, Nodal and Margin Status Survival n Median (Mo) 2-year (%) Group I 8 36 63 Group II 16 24 47 Group III 15 11 29 71a Node negative 25 68a Node positive 14 9 0 Negative margin 22 39a 62a Positive margin 17 13 29 6295_AATS.book Page 96 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY 17. Thoracoscopic Versus Open Segmentectomy for Stage I Non-Small Cell Lung Cancer (NSCLC): 221 Consecutive Cases Matthew J. Schuchert, Brian L. Pettiford, Ghulam Abbas, Omar Awais, Arman Kilic, Robert Jack, James R. Landreneau, Joshua P. Landreneau, James D. Luketich*, Rodney J. Landreneau* Heart, Lung and Esophageal Surgery Institute, University of Pittsburgh Medical Center, Pittsburgh, PA Invited Discussant: Gian Carlo Roviaro OBJECTIVE: Anatomic segmentectomy is increasingly being considered as a means of achieving an R0 resection for peripheral, small stage I NSCLC. The use of VATS in accomplishing anatomic segmentectomy has been slow to gain favor due to perceived technical complexity and concerns regarding oncologic efficacy. In the current study, we compare the results of VATS (n = 101) vs. open (n = 120) segmentectomy in the treatment of stage I NSCLC. METHODS: A total of 221 consecutive anatomic segmentectomies were performed for Stage IA (n = 135) or IB (n = 86) NSCLC from 2002–2007. Primary outcome variables included hospital course, complications, mortality, recurrence patterns and survival. Statistical analysis included paired and one-sample t-tests. The probability of overall and recurrence-free survival was estimated with the Kaplan-Meier method, with significance being estimated by the log rank test. RESULTS: Mean age (69.8 years; range: 45–100) and gender distribution were similar between the VATS and Open groups. Average tumor size was 2.3 cm (2.1 cm VATS; 2.4 cm Open). There was no clinical difference in the average number of lymph nodes sampled between the VATS and open groups (mean = 7.9). Mean follow-up was 20.7 months. There were two perioperative deaths (2/221; 0.9%), both in the Open group. VATS segmentectomy was associated with decreased length of stay and pulmonary complications compared to Open segmentectomy (see Table). Overall mortality, complications, local and systemic recurrence, and survival were similar between VATS and Open segmentectomy groups. Comparison of Peri-Operative Outcomes Following VATS vs.Open Segmentectomy VATS (n = 101) Open (n = 120) Sig. (p-value) Operative Time (min) 136 143 0.56 Estimated Blood Loss (ml) 171 220 0.18 Length of Stay (days) 5 7 0.005 PulmonaryComplications 19 (18.8%) 39 (32.5%) 0.02 Mortality 0 (0%) 2 (1.7%) 0.50 CONCLUSION: VATS segmentectomy can be performed with acceptable morbidity, mortality, recurrence and survival. The VATS approach affords a shorter length of stay and fewer postoperative pulmonary complications compared with open techniques. The potential benefits of segmentectomy vs. lobectomy will need to be further evaluated by prospective, randomized trials (ACOSOG Z4032; CALGB-Altorki study). However, this data suggests that the VATS approach represents a safe and effective option when considering segmentectomy for earlystage lung cancer. * AATS Member 96 6295_AATS.book Page 97 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California 18. OBJECTIVE: Widespread application of CT has increased detection of asymptomatic pulmonary nodules. A dedicated clinic was established to encourage referral and manage large numbers of patients with such nodules. METHODS: Patients were evaluated periodically by a nurse practitioner with surgeon oversight, and follow-up CT was centralized. Patients were re-scanned at intervals based upon radiologist advice for at least two years. RESULTS: 414 patients, 189 male and 225 female with a median age of 60.3 (20.7–86.6) years, were seen since April 2000. Median follow-up was 1.51 (0–6.65) years. 40% (153/414) were older than 60 years with at least 10 pack-years of tobacco use, while 30% (123/414) had never smoked. 286 patients completed at least 2 years of follow-up evaluation. The median initial nodule size was 0.6 cm (0.2–4.3). After 2 years, 23.8% (68/286) were deemed radiographically stable and were discontinued from further follow-up. 30% (88/286) of patients were followed longer than two years due to the development of new nodules. 2.1% (6/286) were scanned longer than 2 years despite radiographic stability. At least 1111 CT scans were performed. 10.1% (42/414) underwent FDG-PET imaging which suggested malignancy in 8 patients. A pathological diagnosis was made by CT FNA in 3 patients and by operative procedure in 17 patients. Of the 20 patients undergoing an invasive procedure, 11 had preliminary FDG-PET imaging. Overall, 3% (13/414) of our patients have been shown to have a malignancy. Nine patients had non-small cell lung cancer, 1 patient had small cell lung cancer, 1 patient had lymphoma, and 2 patients had lung metastasis of a distant tumor. Of the 10 patients with lung cancer, the median age was 64 (58.0–78.0) years with a mean smoking history of 57.3 ± 30.8 pack-years. All patients with lung cancer underwent biopsy procedure due to change in the nodule on follow-up CT scan. An operative procedure was performed in 7 patients for a benign process. CONCLUSION: In a population of patients with indeterminate nodules in routine clinical practice, few patients required intervention and few cancers were detected. Older patients with extensive smoking history were more likely to be diagnosed with lung cancer. Intensive follow-up CT evaluation may be reserved for patients with high probability for cancer, avoiding unnecessary follow-up and CT scans. Benefits of a “nodule clinic” are difficult to prove but may include patient reassurance and convenience to referring physicians. 3:40 p.m. INTERMISSION—VISIT EXHIBITS Exhibit Hall GH, San Diego Convention Center * AATS Member 97 MONDAY Afternoon A Thoracic Surgery Clinic Dedicated to Solitary Pulmonary Nodules—Too Many Scans and Too Little Pathology? Nirmal K. Veeramachaneni, Traves D. Crabtree, Daniel Kreisel, Jennifer B. Zoole, Joanne Musick, Nicole G. Taylor, Alexander S. Krupnick, G. Alexander Patterson*, Bryan F. Meyers* Cardiothoracic Surgery, Washington University School of Medicine, St. Louis, MO Invited Discussant: Joel D. Cooper 6295_AATS.book Page 98 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY NOTES 98 6295_AATS.book Page 99 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California 4:15 p.m. SIMULTANEOUS SCIENTIFIC SESSION— GENERAL THORACIC SURGERY Room 25, San Diego Convention Center Moderators: James D. Luketich Robert J. Cerfolio Clinical Characteristics, Biological Behavior, and Survival After Esophagectomy Are similar for Adenocarcinoma of the Gastroesophageal Junction and the Distal Esophagus Jessica M. Leers, Steven R. DeMeester, Nadia Chan, Shahin Ayazi, Arzu Oezcelik, Emmanuele Abate, Farazaneh Bank, John Lipham, Jeffrey A. Hagen, Tom R. DeMeester* Department of Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA Invited Discussant: Thomas W. Rice OBJECTIVE: The Siewert classification system differentiates between adenocarcinoma of the gastroesophageal junction and the distal esophagus. The purpose of this study was to confirm that there is a significant difference between these cancers. METHODS: Records of 608 consecutive patients who underwent esophagectomy for adenocarcinoma were retrospectively reviewed. In 296 patients the tumors were categorized as Type I (tumor in the distal third of the esophagus) and in 194 patients as Type II (tumor located at the gastroesophageal junction). It was not possible to definitively categorize the tumor location in 118 patients and they were excluded. The pattern of lymph node spread was analysed in a subgroup of patients that underwent an en bloc esophagectomy with extended lymphadenectomy. Clinical and pathologic features and long term outcome were compared. RESULTS: There were no significant differences in age, gender, or BMI. Patients with Type I tumors were more likely to have reflux symptoms (75% vs 55%, p = 0.0001) and peritumoral intestinal metaplasia (72% vs 54%, p = 0.0003) compared to Type II tumors. There were no significant differences in the type of resection or the use of neoadjuvant therapy between groups. Tumor length and the prevalence of nodal metastases were similar (Type I: median length 3.1 cm, N1 51%; Type II: median length 3.5 cm, N1 58%; p = 0.2407 and p = 0.1387 respectively). The depth of invasion was also similar although the prevalence of a transmural tumor was higher in Type II tumors (T3 & T4: Type I = 43%, Type II = 57%, p = 0.0042). Subcarinal node metastases were more common in Type I tumors compared to Type II (16% vs 5%, p = 0.02). The prevalence of at least one positive lymph node in the mediastinum was not significantly different (Type I = 49%, Type II = 41%; p = 0.5746). Long term survival was similar (log rank, p = 0.1406). (Figure). * AATS Member 99 MONDAY Afternoon 19. 6295_AATS.book Page 100 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY CONCLUSION: In contrast to the reported differences between adenocarcinomas located in the distal esophagus versus the gastroesophageal junction, we found the patient and tumor characteristics were similar, and there was no difference in overall survival. Further, over 40% of patients with these tumors have at least one positive mediastinal lymph node. These tumors should be treated in a similar fashion, and efforts to distinguish the precise location of the tumor are not necessary. 100 6295_AATS.book Page 101 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California 20. OBJECTIVE: Recent studies have suggested that submucosal invasion in pT1 early stage esophageal cancer impacts long-term survival and lymph node involvement. The impact of esophageal tumor length on pT1 esophageal cancer has not previously been evaluated. METHODS: All patients (N = 129) undergoing esophageal resection from 1985 to 2003 with pT1 adenocarcinoma of the esophagus were reviewed. Resected esophageal tumors were assessed pathologically for submucosal invasion and esophageal tumor length in a craniocaudal dimension. Patients were stratified into three groups based on length and submucosal involvement. Long-term survival was assessed by Kaplan Meier analysis. Univariate and multivariate analyses were performed and compared with other standard prognostic factors including grade and lymph node involvement. RESULTS: Early stage pT1 esophageal adenocarcinoma patients with tumors >3 cm and submucosal invasion were found to be at increased risk of lymph node involvement: (Lymph Node Involvement: submucosal + and >3 cm = 4/9 (44%); submucosal – and >3 cm or submucosal + and <3 cm = 13/61 (21%); submucosal – and <3 cm = 2/59, (3%); p < 0.001): Esophageal tumor length (>3 cm) and submucosal involvement were associated with decreased long-term survival in early stage pT1 adenocarcinoma of the esophagus: (3 yr Survival: submucosal + and >3 cm = 33%; submucosal + and <3 cm or submucosal – and >3 cm = 83%; submucosal – and < 3 cm = 100%, p < 0.001). Multivariable Cox regression analysis showed that esophageal tumor length (>3 cm) and submucosal involvement were independent risk factors for survival in pT1 early stage esophageal cancer patients (p < 0.001, p = 0.01) even when controlled for lymph node involvement CONCLUSION: This study demonstrates for the first time that tumor length (>3 cm) as well as submucosal involvement are independent risk factors for lymph node involvement and long-term survival in early stage pT1 esophageal adenocarcinoma. Both factors should be utilized to better predict long-term survival and identify high-risk pT1 patients for adjuvant therapy. * AATS Member 101 MONDAY Afternoon Impact of Tumor Length and Submucosal Involvement on the Long-Term Survival of pT1 Early Stage Esophageal Adenocarcinoma William D. Bolton, Wayne Hofstetter, Ashleigh Francis, Arlene M. Correa, Jaffer A. Ajani, Banoop Bhutani, Jeremy Erasmus, Ritsuko Komaki, Dipen Maru, Reza Mehran, David C. Rice, Jack A. Roth*, Ara A. Vaporciyan*, Garrett L. Walsh*, Stephen G. Swisher* Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, TX Invited Discussant: Nasser K. Altorki 6295_AATS.book Page 102 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY 21. Clinical Stage IA Lung Cancer By CT and PET Scan: The Persistent Problem of Understaging Brendon M. Stiles, Paul C. Lee, Elliot L. Servais, Jeffrey L. Port, Subroto Paul, Danish Meherally, Nasser K. Altorki* Weill Cornell Medical College, New York Presbyterian Hospital, New York, NY Counterpoint: Robert J. Cerfolio Open Discussion OBJECTIVE: There appears to be an increased interest in limited resection for clinical stage IA NSCLC. This treatment strategy depends upon the accuracy of clinical staging, which has not been validated for stage IA NSCLC using all currently available imaging technology. The purpose of this study was to determine the accuracy of clinical staging for stage IA NSCLC patients who underwent both CT and PET scans and to determine factors associated with understaging. METHODS: A retrospective review of a prospectively maintained database of patients with NSCLC was performed. Clinical stage IA patients by preoperative CT and PET scan were reviewed. The influence of the following factors was analyzed with regard to accuracy of clinical staging: tumor size, location, histology and PET positivity. RESULTS: Of the 266 patients identified, only 65% were correctly staged. Final pathologic stages also included IB (15%), IIA (2.6%), IIB (4.1%), IIIA (4.9%), IIIB (7.5%), and IV (.08%). Positive lymph nodes were found in 11.7% of patients. Pathologic T-stage changed in 28.2% of patients. Patients with clinical tumor size >2 cm (n = 35) were significantly more likely to be understaged than patients with tumors ≤2 cm (49% vs. 29%, p = .003). Overall, patients with a PET +ve primary (n = 218) were also more likely to be understaged than those with PET –ve primaries; (39% vs. 15%, p = .001). Fifty-five percent of patients with PET +ve tumors >2 cm were clinically understaged, compared to 32% for PET +ve tumors ≤2 cm, and only 17% for PET–ve tumors <2 cm. Lobar location and histology were not predictors of accuracy of clinical staging. CONCLUSION: Patients with clinical stage IA lung cancer are frequently understaged, despite the performance of preoperative CT and PET scans. Size >2 cm and PET positivity are risk factors for understaging. Limited resection should be undertaken with caution in such patients. 5:25 p.m. ADJOURN * AATS Member 102 6295_AATS.book Page 103 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California NOTES MONDAY Afternoon 103 6295_AATS.book Page 104 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY MONDAY AFTERNOON, MAY 12, 2008 2:00 p.m. SIMULTANEOUS SCIENTIFIC SESSION— CONGENITAL HEART DISEASE (8 minutes presentation, 12 minutes discussion) Room 28 A–C, San Diego Convention Center Moderators: Joseph A. Dearani Vaughn A. Starnes 22. Antegrade Cerebral Perfusion Improves Neurologic Outcomes with Aortic Arch Surgery In Neonates Pro: James S. Tweddell Con: Marshall L. Jacobs Open Discussion 104 6295_AATS.book Page 105 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California 23. Biventricular Repair In Heterotaxy Syndrome Frank Pigula*, Hong-Gook Lim, Emile Bacha*, Audrey Marshall, John Mayer*, Francis Fynn-Thompson, Pedro Del Nido* Children’s Hospital Boston, Boston, MA Invited Discussant: Marshall L. Jacobs METHODS: Between Jan 1990 and July 2007, 371 patients were diagnosed with heterotaxy syndrome; 91 (91/371, 24.5%) underwent (BVR). Left atrial isomerism was present in 73% (66/91), right atrial isomerism in 10% (9/91), with indeterminate atrial anatomy in 17% (16/91). Median age at BVR was 6.8 months (5 days –22.3 years). Systemic venous anomaly was present in 75 patients, pulmonary venous anomaly in 26, and endocardial cushion defect in 36. Transposition complexes were present in 15 patients with AV discordance in 10; 8 underwent double switch, 2 received a physiologic repair, 2 underwent arterial switch, and 3 underwent Rastelli. Conotruncal anomalies included DORV in 10 patients, tetralogy in 3, and hemitruncus in 2. Combined lesions were common, occuring in 99% (90/91). Separation of systemic from pulmonary venous return included intraatrial baffling 48 patients, and extracardiac graft in 2. Statistical analysis using Kaplan-Meier and Cox proportional harzard models were performed. RESULTS: Average follow-up was 44.9 ± 57.5 months (3 days – 189.3 months). There were 4 deaths (4/91, 4.4%); unbalanced CAVC was the only risk factor for mortality (p = 0.006). Pulmonary stenosis (p = 0.001), pulmonary atresia (p = 0.002), and common AV valve (p = 0.008) were risk factors for reintervention. Arrhythmias occurred in 36 patients (39.6%); * AATS Member 105 MONDAY Afternoon OBJECTIVE: Complex intra- and extra-cardiac anatomy is often confronted during biventricular repair (BVR)in patients with heterotaxy syndrome. We examined factors affecting surgical outcomes in these patients. 6295_AATS.book Page 106 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY bradyarrhythmia in 27 (29.7%), and tachyarrhythmia in 15 (16.5%). At 15 years, freedom from any arrhythmia was 41.2 ± 9.8%. Pulmonary stenosis (p = 0.038) was related to bradyarrhythmia, while older age at operation (p = 0.005) was associated with tachyarrhythmia. CONCLUSION: Excellent survival for heterotaxy patients undergoing BVR can be expected, even for multiple, complex lesions. Reintervention is common, and arrhythmia is a longterm concern.Patients with unbalanced CAVC represent a high risk group for which single ventricle palliation can be considered. 106 6295_AATS.book Page 107 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California 24. OBJECTIVE: Short-term outcomes after infant heart surgery for complex congenital heart defects using CPB with or without DHCA include seizures (Sz), duration of mechanical ventilation (DMV), need for re-intubation (RI) after initial extubation, length of hospital stay (LOS) and the need for tube feeding (TF) at discharge. Post-op EEGs reflect the brain’s global response to hypothermia, anesthesia and cardiac surgery. We hypothesized that the quality of the EEG during the first 12 hours post-op predicts early outcomes: those with better EEGs would have fewer adverse outcomes than those with more abnormal EEGs. METHODS: A subset of patients in our prospective apoE polymorphisms study underwent conventional EEG (CEEG) monitoring for 48 hrs post-op. The first 12-hours was judged for the quality of the background using traditional interpretive criteria and assessed as “normal”, or “mildly”, “moderately” or “markedly” abnormal; EEG seizures were noted for the whole 48 hrs. The CEEGs were also converted to amplitude-integrated EEGs (aEEG) and independently scored using the Al-Naqueeb classification into “normal”, or “moderately-” or “markedly” abnormal. DMV, RI, LOS and TF status were acquired from chart review. Uni-and multivariate linear and logistic regression analyses were performed to determine statistical parameters and significance. The c-statistic (C-stat) of the receiver operator characteristic curve was used to measure predictive accuracy. RESULTS: 178 infants underwent CEEG monitoring from 2001–2003. Complete data were available in 164, of whom 4 died. 59% were neonates and 39% had single-ventricle physiology. Age at surgery was 41 ± 50 days. There was only moderate agreement between CEEG and aEEG interpretations (κ = 0.529; p < 0.0001). EEG seizures occurred in 18/164 (11%) and were not predicted by CEEG or aEEG. Among 160 survivors, 54% with abnormal backgrounds were still receiving tube feedings at hospital discharge, but only 13% with normal backgrounds. CEEG background abnormality predicted DMV (p < 0.0001), LOS (p = 0.0150) and TF (p < 0.0001) (Figure) but not RI (p = 0.1540). aEEG similarly predicted outcomes. The predictive accuracy was best for CEEG background with c-stats for both DMV (≤48 hrs vs. >48 hrs) and LOS (≤7 days vs >7 days) of 0.73 and 0.69 for TF. * AATS Member † 2007 AATS Summer Intern Scholar 107 MONDAY Afternoon Early EEG Background Prediction of Seizures and Short-Term Outcome Measures Following Infant Heart Surgery Sandy Cho†1, Noah Cook2, Michael Badzioch3, J. William Gaynor*2, Gail Jarvik3, Sarah Tabbutt2, Susan Nicolson2, Gil Wernovsky2, Thomas Spray*2, Robert Clancy2 1George Washington University School of Medicine, Washington, DC; 2Children’s Hospital of Philadelphia, Philadelphia, PA; 3University of Washington Medical Center, Seattle, WA Invited Discussant: Erle H. Austin 6295_AATS.book Page 108 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY CONCLUSION: The CEEG background during the first 12 post-operative hours, a global marker for early brain dysfunction or injury, significantly predicts some short-term outcome measures of well-being at the end of the hospitalization. 108 6295_AATS.book Page 109 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California 25. OBJECTIVE: Amplatzer septal occluder devices have significantly altered the care of patients with congenital heart disease and are becoming standard care in many institutions. The incidence, nature and consequence of complications resulting from attempted device placement, however, have not been well-assessed. The purpose of this study was to utilize large available databases to generate meaningful data. METHODS: The United States Food and Drug Administration (FDA) on-line database for device-related adverse events was queried for brand name search field “Amplatzer” and all events concerning closure of the atrial septum were recorded and analyzed. The Society of Thoracic Surgeons (STS) Congenital Cardiac Surgery Database was likewise queried for surgical atrial septal closure over the same time interval such that comparison could be made. RESULTS: The first Amplatzer adverse event report was filed to the FDA on 1/24/02 and a total of 218 reports are now available. Attempts to obtain the total number of devices placed since the first report were unsuccessful. There were 16 deaths among the 218 complications (7.3%). The most common mode of failure was device embolization (n = 111/218, 51%) with the left atrium being the most common site (n = 25/111, 23%) and resulting in a 1.8% mortality (2/111). Cardiac erosion/rupture was the next most common (n = 41/218, 19%), resulting in a 14.6% mortality (6/41). Attempts to manage complications in the catheterization lab were reported for 66 patients (30%) but were only successful in 29 patients with the remaining 37 requiring urgent/emergent operative management. An additional 105 patients were sent directly to surgery for a total of 142 urgent or emergent operations. STS data for the same time interval revealed 1,537 surgical atrial defect closures; there were 2 deaths (2/1,537, 0.13%) with 167 patients having any type of complication (167/1,537, 10.9%). Serious complications were rare; there were 2 re-operations for bleeding (0.13%), 4 other unplanned re-operations (0.26%), 2 persistent postoperative neurologic deficits (0.13%) and no acute renal failure. Median postoperative length of stay was 3 days. CONCLUSION: Although the overall complication rate for device closure cannot be calculated, the available reported adverse events from device closure were more numerous than for surgical closure and resulted in more deaths. Device complications commonly necessitate urgent or emergent operation. 3:30 p.m. INTERMISSION—VISIT EXHIBITS Exhibit Hall GH, San Diego Convention Center * AATS Member 109 MONDAY Afternoon Analysis of the U.S. Food and Drug Administration MAUDE Database for Adverse Events Involving Amplatzer™ Septal Occluder Devices and Comparison to STS Congenital Cardiac Surgery Database Daniel J. Dibardino, Doff B. McElhinney, Aditya K. Kaza, John E. Mayer* Harvard Medical School, Boston, MA Invited Discussant: Carl L. Backer 6295_AATS.book Page 110 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY NOTES 110 6295_AATS.book Page 111 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California 4:05 p.m. SIMULTANEOUS SCIENTIFIC SESSION— CONGENITAL HEART DISEASE Room 28 A–C, San Diego Convention Center Moderators: Joseph A. Dearani Vaughn A. Starnes Surgical Treatment for Patients with Late Systemic Right Ventricular Failure Following Mustard/Senning Procedures for d-TGA Stephan Thelitz, Sunil P. Malhotra, Edwin Petrossian, Nicole Tselentis, Frandics P. Chan, Norman Silverman*, Vadiyala M. Reddy*, Frank L. Hanley* Stanford University School of Medicine, Stanford, CA Invited Discussant: Richard G. Ohye OBJECTIVE: Late RV failure occurs in 10–15% of Senning/Mustard pts. Atrial baffle takedown and arterial switch operation (ASO) is an important management option for these pts. From 1993–2007 22 atrial switch pts,mean age 16.7 ± 7.5 (SD) yrs, were diagnosed with severe RV failure and/or severe tricuspid regurgitation. We initiated a treatment program aimed at conversion to ASO. METHODS: Staged retraining of the LV by PAB was performed in 19 pts; 3 pts with intrinsic LVOTO underwent primary ASO. PAB was performed at an interval of 11.9 ± 5.2 (SD) yrs following atrial switch procedure. Adequacy of PAB and LV status was evaluated by echo, cardiac cath, and more recently MRI.Criteria for judging an adequate LV response has evolved. Readjustment of PAB was necessary in 12 pts. RESULTS: Fourteen (14/19) PAB pts. were judged to have positive LV retraining response. To date, seven have had ASO. Two (2/7) died perioperatively of acute LV failure. The other seven positive responders are awaiting ASO with PABs in place for 0.2 to 11 yrs. Five (5/19) PAB pts had poor LV retraining response, necessitating cessation of PAB tightening or even PAB loosening in 3; the other 2 died at 156 and 259 days following PAB of biventricular failure. The ASO was performed primarily in the 3 pts with LVOTO, with one early death. At 8.2 ± .6 yrs following conversion to ASO, all 7 living ASO pts are in NYHA class I-II. All 10 living PAB pts are in NYHA class I-II. Overall, 5/22 pts died (3 ASO pts early, and 2 PAB pts late). All 5 deaths occurred in the first half of the experience. Age, PAB-ASO interval, and an inadequately pressurized LV were not implicated in any deaths. Further observations include: 1) LV mass may be more important that LV pressure in predicting success, 2) the PAB itself may provide palliation by relieving tricuspid regurgitation; 3) individual response to LV retraining is unpredictable 4) an important learning curve exists for patient selection and subsequent management. * AATS Member 111 MONDAY Afternoon 26. 6295_AATS.book Page 112 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY CONCLUSION: Conversion remains an option for pts. with failing systemic RV; however, careful pt selection is critical. Selection for PAB requires a systemic RV that can continue to perform during the prolonged training period, and selection for the ASO in PAB pts requires fully trained LVs that have been functioning adequately at systemic workloads for at least a year and have a normal mass. Even when these criteria are met, substantial risks remain related to the uncertain performance of the LV when placed in the systemic circulation. 112 6295_AATS.book Page 113 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California 27. OBJECTIVE: The Mustard (MO) and the Senning operation (SO) were the treatment of choice for patients with transposition of the great arteries (TGA) with intact ventricular septum (IVS), or ventricular septal defect (VSD), until they were abandoned in favor of the arterial switch operation (ASO). The Rastelli operation (RO) is applied for patients with additional left ventricular outflow tract obstruction (LVOTO). METHODS: Data of hospital survivors after the MO (81), SO (314), ASO (479), and RO (39) were analyzed. RESULTS: Mean follow-up times were for the MO 22.6 ± 8.1, SO 18.2 ± 5.7, ASO 9.5 ± 5.7, and RO 9.9 ± 6.5 years, respectively. The best survival at 20 years was observed after the ASO (96.6 ± 1.3%), followed by the SO (92.6 ± 1.5%), MO (82.4 ± 4.3%), and RO (57.5 ± 15.1%). Patients with TGA+IVS showed better survival at 20 years (95.7 ± 1.1%) compared to patients with TGA+VSD (88.0 ± 2.7%), and TGA+VSD+LVOTO (72.8 ± 8.4%). Among morphology, prior operations, age, and type of correction, VSD emerged as the only risk factor (HR = 2.6, 95% CI = 1.5–4.8, p = 0.001), and ASO as the only protective factor (HR = 0.3, 95% CI = 0.1–0.7, p = 0.004) for late death. The best freedom from reoperation at 20 years was observed after the SO (88.7 ± 1.9%), followed by the ASO (75.0 ± 6.4%), MO (70.6 ± 5.4%), and RO (32.6 ± 10.1%). Patients with TGA+IVS showed better freedom from reoperation at 20 years (87.2 ± 1.9%) compared to patients with TGA+VSD (71.6 ± 4.0%), and TGA+VSD+LVOTO (50.8 ± 7.2%). CONCLUSION: The change in surgical strategy from atrial to arterial switch led to improved long-term survival but not lower incidence of reoperations. Outcome in terms of survival and freedom from reoperation is determined by morphology. The results of the RO are not satisfactory. 113 MONDAY Afternoon Rate of Reoperation Has Not Changed During 30 Years of Surgery for Transposition of the Great Arteries—Long-Term Results of 913 Patients at a Single Center Jürgen Hörer, Julie Cleuziou, Christian Schreiber, Zsolt Prodan, Manfred Vogt, Klaus Holper, Rüdiger Lange German Heart Center Munich at the Technical University, Munich, Germany Invited Discussant: Winfield J. Wells 6295_AATS.book Page 114 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY 28. Double Root Translocation—A True-Meaning Anatomic Repair for Anomalies of Ventriculoarterial Connection with Pulmonary Outflow Tract Obstruction Sheng Shou Hu, Zhigang Liu, Shou Jun Li The National Cardiovascular Institute and Fu Wai Hospital Beijing, Beijing, China Invited Discussant: Victor O. Morell OBJECTIVE: Surgical management for patients with ventriculoarterial discordance, ventricular septal defect (VSD), and pulmonary outflow tract obstruction (PS) remains a challenge. As the conventional treatment for this lesion, Rastelli procedure has been revealed with poor long-term results, an alternative surgical technique is required. Aiming to preserve the competence and growth potential of the native pulmonary valve and acquire a better long-term results, we proposed the “double root translocation” technique for biventricular outflow tract reconstruction. Herein we present our successful experiences in 25 consecutive patients. METHODS: Between November 2004 and August 2007, 25 consecutive patients underwent “double root translocation” procedure. The median age at operation was 4.3 (range from 0.7 to 18) years. Transposition of great arteries (TGA) with VSD and PS were diagnosed in nineteen patients (four had atrioventricular discordance) and double outlet right ventricle (TaussigBing anomalies) with PS in six cases. The operative technique includes that both aortic and pulmonary root were mobilized, excised and translocated. A monovalved bovine jugular vein patch was used to repair the stenotic pulmonary artery. Coronary arteries re-attachment was needed in five patients. Major concomitant procedure included Senning operation in four cases and Glenn in one. RESULTS: The mean cardiopulmonary bypass and aortic cross clamp time were 322 ± 56 min. and 224 ± 41 min. respectively. The mean mechanical ventilation time was 141 ± 157 hours. Three patients required ECMO support and recovered. All patients survived and discharged. There was no late death in the present series. Post-op echocardiography demonstrated a physiological hemodynamics in LVOT and normal heart function in 24 cases. Four patients had a competent pulmonary valve and twenty had mild to medium pulmonary insufficiency. Only one patient presented mild aortic and mitral valve regurgitation. No re-intervention needed during follow-up. CONCLUSION: The “double root translocation” technique is a feasible and effective procedure for the patients with anomalies of ventriculoarterial connection, VSD, and PS. Its long-term benefits need to be demonstrated by a larger number of patients and longer follow-up study. 5:05 p.m. ADJOURN 114 6295_AATS.book Page 115 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California NOTES MONDAY Afternoon 115 6295_AATS.book Page 116 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY TUESDAY MORNING, MAY 13, 2008 7:00 a.m. CARDIAC SURGERY FORUM SESSION (5 minutes presentation, 7 minutes discussion) Room 28 A–C, San Diego Convention Center Moderators: Richard D. Weisel Marc R. Moon F1. Elimination of Moderate Ischemic MR Does Not Ameliorate Long-Term LV Remodeling Kanji Matsusaki, Mio Noma, Aaron S. Blom, Thomas J. Eperjesi, Liam P. Ryan, Theodore Plappert, Martin G. St. John-Sutton, Joseph H. Gorman*, Robert C. Gorman* Surgery, University of Pennsylvania, Philadelphia, PA Invited Discussant: David H. Adams OBJECTIVE: The efficacy of mitral valve repair for ischemic mitral regurgitation (IMR) has been difficult to demonstrate clinically. Clinical studies are confounded by lack of randomization, concomitant coronary revascularization and variability in repair/replacement techniques. Using a well established ovine model of IMR we tested the ability of rigid, complete, undersized annuloplasty to durably relieve established IMR as well as its effect on global LV remodeling during a clinically relevant follow-up period (6 months). METHODS: Twenty-three sheep were subjected to a posterolateral infarction of 20 to 25% of the LV mass that is known to result in chronic IMR. Animals were studied with 3D echocardiography to assess LV size before infarction. Three sheep died between 1 and 14 days post infarction. Twenty sheep survived to 8 weeks after infarction. Fourteen of these animals underwent placement of a 26 mm rigid, complete annuloplasty using standard surgical techniques. Six animals were untreated controls. The degree of IMR (0 to 4 scale) was assessed at the time of annuloplasty placement using 2D color flow Doppler echocardiography. LV remodeling and degree of IMR were assessed 6 months after surgery using 3D echocardiography. End systolic (ESV) and end diastolic (EDV) volumes were used to assess global remodeling. RESULTS: All animals had similarly sized hearts at baseline (ESV = 27.6 ± 1.4 ml; EDV = 53.7 ± 2.5 ml). All 20 animals that survived to 8 weeks completed the study. The degree of IMR at 8 weeks was similar in both groups (treatment = 2.3 ± 0.3; Control 2.1 ± 0.3). At the six month follow-up the degree of IMR was significantly less in the treatment group (0.4 ± 0.4 vs. 2.9 ± 0.6); however, the LV volumes in the treatment group (ESV = 79.9 ± 5.7 ml; EDV = 107.7 ± 7.9) were not significantly different from the control group (ESV = 87.9 ± 10.7 ml; EDV = 119.3 ± 9.9). CONCLUSION: Rigid, complete, undersized annuloplasty provides durable relief from IMR over a clinically relevant follow-up period but does not significantly influence LV remodeling. These conclusions may be invalid for more severe degrees of IMR. * AATS Member 116 6295_AATS.book Page 117 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California F2. Layered Implantation of Myoblast Sheets Attenuates Cardiac Remodeling of Infarcted Heart Naosumi Sekiya1, Shigeru Miyagawa1, Goro Matsumiya1, Takaya Hoashi1, Tatsuya Shimizu2, Teruo Okano2, Yoshiki Sawa1 1Cardiovascular Surgery, Osaka University Graduate School of Medicine, Osaka, Japan; 2Tokyo Women’s Medical University, Tokyo, Japan Invited Discussant: Y. Joseph Woo OBJECTIVE: We have shown that autologous myoblast sheets constructed with tissue-engineering technique improve the function of impaired heart. In this study, we evaluated the effect of the layered myoblast sheets to clarify the optimal number of cell sheets to efficiently improve cardiac function. RESULTS: Grafted anterior wall thickness significantly increased in dose dependent manner. In functional assessment, Ejection fraction (EF) of S5 and S3 at 4 and 8 weeks significantly improved. The dilatation of end diastolic area (EDA) at 8 weeks in S5 was significantly reduced than other groups. In catheterization study at 8 weeks, ESPVR of S3, S5 groups significantly improved. All the angiogenic and myocardial protective factor mRNA expressions were most upregulated in S5 group than those in the other groups. In histological examination, %fibrosis most decreased in S5, vascular density increased and the dilatation of cell attenuated in S5 and S3 groups. In Elastica-Masson stain, elastic fibers were massively expressed in infarcted area and implanted sheets in S3, S5 groups with significantly more elastin gene expressing. Cardiac function and histological data Sham S1 S3 S5 Wall thickness (mm) 0.38 ± 0.01 0.44 ± 0.03 0.81 ± 0.09a,b 0.96 ± 0.04a,b LVEF (%) at 4 weeks 38.6 ± 1.3 38.5 ± 2.8 45.3 ± 1.4a,b 51.3 ± 1.6a,b,c LVEF (%) at 8 weeks 34.6 ± 2.2 38.2 ± 5.8 43.7 ± 1.9a,b 47.8 ± 2.8a,b EDA (mm2) at 8 weeks 1.02 ± 0.02 0.99 ± 0.04 0.96 ± 0.02 0.91 ± 0.05a ESPVR (mmHg/ml) 719 ± 180 726 ± 65 1831 ± 276a,b 2071 ± 361a,b %fibrosis (%) 6.62 ± 0.30 6.48 ± 0.23 4.58 ± 0.16a,b 2.48 ± 0.15a,b,c Vascular density (/mm2) 3.71 ± 0.41 4.32 ± 0.38 12.54 ± 0.80a,b 11.42 ± 0.61a,b Cell diameter (µm) 20.23 ± 0.13 19.72 ± 0.13 17.21 ± 0.12a,b 17.56 ± 0.14a,b a p < .05 vs Sham group, b p < .05 vs S1 group, c p < .05 vs S3 group 117 TUESDAY Morning METHODS: Myoblast sheets were constructed with temperature-responsive, polymer-grafted cell-culture dishes, which release the confluent cells from the dish surface at less than 20 degrees centigrade. After two weeks from LAD ligation, sixty Lewis rats had implantation of myoblast sheets (3 × 106 cells per sheet) on the infarcted area. Rats were divided into the following 4 groups depending on the number of layered myoblast sheets (n = 15, in each group), S1 group: one layer, S3 group: three layers, S5 group: five layers and Sham group. We examined cardiac function by echocardiography and pressure-volume analysis with a conductance catherter and examined histology and mRNA expression of growth factors (hepatocyte growth factor (HGF), vascular endothelial growth factor (VEGF), insulin-like growth factor-1 (IGF-1), stromal cell-derived factor-1 (SDF-1), midkine, thymosin b4, b10) by real time RT-PCR. 6295_AATS.book Page 118 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY CONCLUSION: Five layered myoblast sheets implantation seems to be favorable with better improvement of cardiac function, induction of angiogenesis, less fibrosis, and less hypertrophy. Elastic fibers were possibly derived from myoblast sheets and might play a mechanically protective role for attenuating cardiac remodeling. 118 6295_AATS.book Page 119 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California F3. Newly Developed Tissue-Engineered Biodegradable Material for Reconstruction of Vascular Wall Without Cell Seeding Hiroaki Takahashi1, Mitsuhiro Saito2, Eiichirou Uchimura2, Koujirou Hirakawa3, Eiichi Kaku3, Yutaka Okita*1, Yoshiki Sawa2 1Department of Surgery, Division of Cardiovascular Surgery, Kobe University Graduate School of Medicine, Kobe, Japan; 2Osaka University Graduate School of Medicine, Suita, Japan; 3Senko Medical Ins. Co., Ltd., Tokyo, Japan Invited Discussant: John E. Mayer METHODS: The tissue-engineered patch (TEP) was fabricated by compounding a collagen microsponge with biodegradable polymeric scaffold, which was woven with double layer thread composed of polyglycolic acid (PGA) and poly-L-lactic acid (PLLA) [core: PGA, sheath: PLLA]. The TEP (25 × 20 mm) without precellularization were implanted into the canine pulmonary arterial trunk. And no anticoagulants or antiplatelets were administered postoperatively. At 1, 2 and 6 months after implantation (n = 4 at each end point), the TEP were explanted and evaluated by histologic, biochemical and immunologic analyses. And reverse transcription-polymerase chain reaction was used to qualify the cellular population in the explanted tissues. For the biochemical examination, a 4-hydroxyproline assay was used to measure the collagen content in the explanted TEPs. The maximal tensile strength of the TEP was measured before implantation and 1, 2 and 6 months after implantation with a mechanical tester. RESULTS: There were no sign of thrombus formation on the internal surface of the TEP. Right ventricular angiography showed no evidence of stenosis or aneurismal change. Their luminal surfaces were similar to native arterial tissue. Immunohistological finding showed factor VIII positive endothelial cell monolayer, a parallel alignment of smooth muscle cells at any points after implantation. As for the dry weight collagen content, the difference between the TEP at 6 months after implantation and the native pulmonary arterial wall, was not statistically significant. The quantification of the cell population by polymerase chain reaction showed the vascular endothelial growth factor mRNA expression in the TEPs was higher than that of native pulmonary artery at any points after implantation. The mechanical tensile strength of the TEP before and after implantation was greater than that of the native pulmonary artery. CONCLUSION: Novel tissue-enginnered patch has the enough potential to accelerate in situ cellularization. This study suggested the patch can be promising as a novel surgical material for the repair of cardiovascular system. * AATS Member 119 TUESDAY Morning OBJECTIVE: Biodegradable materials with autologous cell seeding have attracted much interest as potential cardiovascular grafts. However, the ex vivo cell-seeding pretreatment is complicated, invasive, and can lead to infection. We developed the tissue engineered biodegradable graft material that can promote tissue regeneration without ex vivo cell-seeding to overcome of these obstacles. 6295_AATS.book Page 120 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY F4. Atrophic Changes Occur In Unloaded Myocardium and May Preclude Functional Improvement In a Time Dependent Manner Henriette L. Brinks1, Hendrik Tevaearai2, Christian Muehlfeld3, Daniela Kuklinski2, Thierry P. Carrel*2, Marie-Noelle Giraud2 1Cardiovascular Surgery, Charite University Hospital, Berlin, Berlin, Germany; 2Department of Cardiac and Vascular Surgery, Inselspital University Hospital, Berne, Switzerland; 3Institute of Anatomy, University of Berne, Berne, Switzerland Invited Discussant: Michael A. Acker OBJECTIVE: Recent studies have shown that mechanical unloading with ventricular assist devices (LVADs) may result in functional improvement of the myocardium. However, possible benefit might be counterbalanced by myocardial atrophy. Using a model of heterotopic transplantation (HTx), we aimed to characterize, in a time course approach, myocardial atrophy and functional changes induced by long-term unloading. METHODS: HTx was performed in 80 adult Lewis rats and transplants were unloaded for 3, 8, 15, 30, 60 and 90 days (n = 12/group). Atrophy and fibrosis of ventricles were assessed stereologically with point counting and disector analysis. mRNA expression of SERCA, TNF-β1, MHC-isoforms and caspase-3 were analyzed by quantitative RT-PCR. Left ventricular developed pressure (LVP) was measured on isolated, perfused transplants. RESULTS: A decreased ventricular volume of 23.9 ± 5.5% was observed at 3 days, 68.2 ± 3.6% at 90 days, heart weight diminished from 990 ± 49 mg to 769 ± 59 mg and 320 ± 27 mg, respectively. Simultaneously, cellular atrophy and rate of fibrosis increased over time, indicated * AATS Member 120 6295_AATS.book Page 121 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California by a decrease in the absolute volume of myocyte nuclei from 7.4 + 07 ± 4.7 + 06 to 2.2+07 ± 3.7 + 06 after 30. On the molecular level immediate 3-fold upregulation of the fetal isoform β-MHC occurred while α-MHC remained unchanged. SERCA-2α expression was upregulated after 3 and 8 days of u loading but RNA-levels returned to normal after 15 days of HTx. Atrophic remodeling was associated with a leftward shift of the pressure/volume relationship in the left ventricle after 30 days (Figure) indicating progressive functional impairment. The maximally developed pressure was not significantly changed in the groups after 30 and 60 days. CONCLUSION: Our results suggest atrophic changes associated with chronic ventricular unloading may counteract the possibility of functional recovery. Optimizing the unloading timing and/or a partially unloading of the failing heart might improve success rates of “bridge to recovery” programs. TUESDAY Morning 121 6295_AATS.book Page 122 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY F5. Acute Hyperglycemia Enhances Oxidative Stress During Reperfusion and Exacerbates Myocardial Infarction Zequan Yang1, Victor E. Laubach1, Brent A. French2, Irving L. Kron*1 1Surgery, University of Virginia Health System, Charlottesville, VA; 2Biomedical Engineering, University of Virginia, Charlottesville, VA Invited Discussant: Harold L. Lazar OBJECTIVE: Clinical evidence has shown that acute hyperglycemia is independently associated with larger myocardial infarct size (IF) in both diabetic and non-diabetic patients. Admission hyperglycemia is an independent risk factor for post-operative mortality in nondiabetic patients after coronary artery bypass grafting (CABG). We hypothesize that the oxidative stress imposed by acute hyperglycemia contributes to the exacerbation in IF during reperfusion, such as following CABG. METHODS: An in vivo mouse model with myocardial ischemia/reperfusion injury was employed. C57BL/6 mice underwent 30 min of LAD occlusion followed by 60 min of reperfusion. Acute hyperglycemia was induced with an IP injection of dextrose (2 g/kg body weight) 30 min prior to the occlusion of LAD. An anti-oxidant, N-2-mercaptopropionyl glycine (MPG), was injected IV 2 min before and 1 min after the onset of reperfusion in two equal doses of 20 mg/kg. At the end of 60 min reperfusion, plasma lipid peroxidation products (malondialdehyde, MDA) was measured using ELISA and myocardial infarct size was determined using TTC staining. * AATS Member 122 6295_AATS.book Page 123 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California RESULTS: The blood glucose level before LAD occlusion was 195 ± 6.6 mg/dl in control mice and 464 ± 24 mg/dl in hyperglycemic (HG) mice (p < 0.05). There were no statistical differences in risk region size (RR, % of LV) among the 4 groups of mice. In Control mice, IF, (% of RR) was 34.0 ± 2.7%. However, IF in HG mice increased by 49% to 50.5 ± 1.4% (p < 0.05 vs. Control). Administration of MPG to control mice (MPG group) reduced IF to 22.8 ± 5.3, (33% reduction from Control). Administration of MPG to HG mice (HG + MPG group) reduced IF to 28.6 ± 5.6 (a 43% reduction, p < 0.05 vs. HG mice, Fig.). In Control mice, plasma MDA was significantly increased during reperfusion to 2.38 ± 0.07 mM from the 0.71 ± 0.02 mM measured in Sham mice (p < 0.05). Acute hyperglycemia further increased plasma MDA to 2.96 ± 0.07 mM (p = 0.08 vs. Control). Treatment with MPG significantly reduced the plasma MDA in both Control and HG mice to 1.21 ± 0.14 mM and 1.03 ± 0.02 mM, respectively (p < 0.05 vs. either Control or HG mice). 123 TUESDAY Morning CONCLUSION: Acute hyperglycemia significantly increases oxidative stress and exacerbates myocardial IF in mice. The efficacy of MPG in reducing hyperglycemic IF when administered only minutes prior to and/or after reperfusion demonstrate that this can be accomplished in a practical and clinically-relevant manner. This manipulation could result in reducing the impact of acute hyperglycemia on perioperative myocardial infarction. 6295_AATS.book Page 124 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY F6. Development of Bioartificial Myocardium Using Collagen Scaffold Functionalized with RGD Peptides Olivier Schussler1, Walid Al Chare1, Mariana Louis-Tisserand1, Catherine Coirault2, Robert Michelot1, Malcolm Wood4, Didier Heude1, Alain Carpentier1, Juan Carlos Chachques1, Dan Salomon4, Yves Lecarpentier*2,3 1Laboratory of Biosurgery Pompidou Hospital, Paris, France; 2INSERM U689 Paris VII University, Paris, France; 3Le Kremlin Bicêtre, University Paris V and VII Paris, France; 4The Scripps Research Institut MEM 241, La Jolla, CA, USA Invited Discussant: Axel Haverich OBJECTIVE: Collagen matrix (CM) seeded with neonatal cardiomyocytes represents the unique scaffold in which contractile activity has been demonstrated in vitro. However, contractility is variable and terminal cell differentiation has been achieved only in the presence of the tumor extract: Matrigel™ that also compromises nutriment diffusion. In addition, angiogenesis in collagen scaffolds remains very poor. We hypothesized that improving cell matrix interactions by coupling adhesive peptides containing Arg-Gly-Asp (RGD) which interact with integrin adhesion molecules on endothelial cells and cardiomyocytes would enhance cell survival, differentiation and angiogenesis without requiring Matrigel. METHODS: Mouse endothelial cells (MS1) (n = 7) or neonatal rat cardiomyocytes (n = 16) were cultured in RGD~CM. Controls were cellurized CM-RGD± cultivated in the presence ± of soluble RGD (sRGD) (n = 11). Angiogenesis was evaluated quantitatively and qualitatively by electron microscopy. Parameters of contractility (spontaneous or under electrostimulation) during contraction and relaxation phases were mesuared by using a force length microtransducer under isotonic or isometric conditions. Cell number was evaluated by Flow Cytometry and apoptosis by in situ labeling with annexin-V-FITC and confocal examination. RESULTS: By EM, vascular profiles 8.0 ± 1.2 per mm2 were present only in RGD + CM (p < 0.001). In addition these profiles were ramified in 45% of cases. sRGD prevents angiogenesis. Contractile activity was present in 80% of RGD+ vs 50% of RGD- constructs. All isotonic and isometric mechanical parameters, spontaneous and electro-stimulated contraction and relaxation, were improved in RGD+ constructs (each p < 0.01). Stimulation threshold was decreased in RGD+ (<3 V/cm) and was in the range of that required for papillary muscle. At optimal electrostimulation frequency (0.17 Hz), RGD+ had a nearly 3-fold increase in both maximum extent of shortening (31 ± 3 vs 9 ± 4 µm, p < 0.05) and maximum shortening velocity (633 ± 180 vs 256 ± 55 µm/s, p < 0.05). As in the myocardium, matrix contraction and relaxation appear to be an active mechanism. By classical and confocal microscopy, cardiomyocytes changed their morphology in RGD+ scaffolds with reorganization of contractile apparatus and development of cross-striation. CONCLUSION: By promoting angiogenesis and contractile activity, the use of collagen matrix modified with RGD adhesive peptides may be an important step for the development of engineered artificial myocardium. * AATS Member 124 6295_AATS.book Page 125 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California F7. Mitral Valve Hemodynamics Following Repair of Acute Posterior Leaflet Prolapse: Quadrangular Resection Versus Triangular Resection Versus Neo-Chordoplasty Muralidhar Padala1, Laura R. Croft1, Scott Powell1, Vinod H. Thourani2, Ajit P. Yoganathan1, David H. Adams*†3 1Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA; 2Emory University, Atlanta, GA; 3Mt. Sinai School of Medicine, New York, NY Invited Discussant: Gus. J. Vlahakes METHODS: Twenty-four porcine mitral valves (size 36 mm) were evaluated in an in-vitro left heart simulator prior to surgical manipulation (Control). Severe mitral regurgitation (MR) was created in these valves by transecting marginal chordae resulting in severe P2 prolapse. MR was corrected using 3 surgical techniques: quadrangular resection with compression (n = 8), limited triangular resection (n = 8), and chordal replacement without leaflet resection (n = 8). A custom rigid annuloplasty ring was used to reinforce the repairs. All valves were tested at 120 mmHg peak trans-mitral pressure, 5L/min cardiac output, and a heart rate of 70 beats/min. Mitral regurgitant fraction, peak systolic leaflet coaptation length (mm), and the posterior leaflet mobility index (mm) were measured. p < 0.05 was considered statistically significant. RESULTS: Transection of the marginal chordae resulted in severe P2 prolapse and significant mitral regurgitation (19.7 ± 17.7 ml/beat, Figure A). The mitral regurgitant volume was significantly decreased using all 3 surgical approaches (Quadrangular: 2.6 ± 1.6 ml/beat, Triangular: 3.2 ± 4.4 ml/beat, and Neochordae: 4.9 ± 5.0 ml/beat, Figure A). While the Quadrangular (9.8 ± 0.9 mm) group had significantly smaller leaflet coaptation lengths compared to the Control valves (12.5 ± 0.7 mm), the Triangular (11.3 ± 1 mm)and Neochordae groups (13.4 ± 1 mm) restored better peak systolic coaptation (Figure B). Posterior leaflet mobility was reduced in the Quadrangular resection (7.0 ± 2.1 mm) group, while it was higher in the Triangular (11.8 ± 2.1 mm) and Neochordae (17.2 ± 1.9 mm) groups, when compared to the Control valves (14.3 ± 1.6 mm) (Figure C). CONCLUSION: All three reparative techniques evaluated proved successful in treating mitral regurgitation. However, triangular resection and neo-chordoplasty were associated with better coaptation length and preserved posterior leaflet mobility in this experimental model of fibroelastic deficiency with acute leaflet prolapse and minimal leaflet distension. * AATS Member † Alton Ochsner Research Scholar 1992–1994 125 TUESDAY Morning OBJECTIVE: Fibro-elastic deficiency is a dominant form of degenerative mitral valve disease, and may present with acute chordal rupture, minimal leaflet distension and severe segmental prolapse. In this study, we compare the hemodynamics and functional efficacy of three techniques used for degenerative mitral valve repair: quadrangular resection with annular compression, limited triangular resection and Gortex neo-chordoplasty. 6295_AATS.book Page 126 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY F8. Dynamic Fluid Shifts Induced by Fetal Cardiopulmonary Bypass Pirooz Eghtesady1, Scott Baker2, Christopher Lam1, Jerri Hilshorst1, Robert Ferguson1, John Lombardi1 1Cardiothoracic Surgery, Cincinnati Children’s Hospital, Cincinnati, OH; 2University of Cincinnati, Cincinati, OH Invited Discussant: James S. Tweddell OBJECTIVE: Significant fluid shifts have been reported with fetal bypass. The degree or mechanisms behind these volume changes have not been defined. Therefore, we characterized changes in fetal plasma volume and third space fluid losses with fetal bypass, and correlated the findings to fetal plasma vasopressin concentrations, the critical peptide of osmoregulation. METHODS: Eight ovine fetuses at 105–111 days gestation underwent 30 minutes of bypass using maternal blood prime (placenta as oxygenator) and were followed for up to 2 hours post-bypass. Fetal hemodynamics were measured continuously and volume infusions required to maintain normal physiologic parameters noted. Blood samples were collected before, during and after bypass to assess gas exchange and vasopressin levels and plasma volume was calculated. All blood sampling was accounted for and no transfusions were given. Statistical analysis was performed using 2-tailed Students t-test with significance at p < 0.05, and best-fit correlations. RESULTS: Fetal plasma volume declined from 177 ± 50 to 164 ± 51 (mean ± SD) by 30 min post bypass, p = 0.02, averaging 0.1 ml/kg/min over that one hour period. Fetal hematocrits did not differ at baseline. Hematocrit declined by 30 minutes of bypass to 27 ± 4% from 30 ± 6, p = 0.02, then elevated to 32 ± 5 by 30 minutes post-bypass, p = 0.04. All bypass animals required crystalloid volume addition during and after bypass to maintain normal fetal hemodynamics. Vasopressin levels increased dramatically by 30 min of bypass, going from 39 pg/ml to 51.5 pg/ml. Increasing vasopressin levels strongly correlated with declining fetal plasma volumes, R2 = 0.91. CONCLUSION: Bypass leads to significant fluid shifts (third space fluid losses) and hemoconcentration which strongly correlates with rising vasopressin levels. This is consistent with osmoregulation mediated by vasopressin. Rehydration of the fetus is necessary post bypass for adequate fluid regulation, especially in setting of associated placental dysfunction. 126 6295_AATS.book Page 127 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California F9. Toll-Like Receptor 4 on Leukocytes Is Necessary for Cardiomyocyte Hypoxia—Reoxygenation Injury Heather-Marie P. Wilson, Denise J. Spring, Christine Rothnie, Erzsebet Toth, Edward D. Verrier* Surgery, University of Washington, Seattle, WA Invited Discussant: Frank W. Sellke OBJECTIVE: Cardiac ischemia reperfusion (I/R) injury occurs after most heart surgery. Previous work in our laboratory suggests that in response to ischemic stress, Toll-like receptor 4 (TLR4) mediates myocardial damage. Our overall objective is to determine the cellular and molecular mechanisms by which the innate immune system contributes to myocardial ischemic damage. The specific objective of this study is to determine the role of TLR4 on leukocytes and cardiomyocytes in mediating I/R injury in an in vitro model. RESULTS: In vitro studies indicate that the presence or later addition of wildtype primary WBCs to hypoxia-treated cardiomyocytes during reperfusion resulted in a 20% decrease of viability in primary and cell line-derived murine cardiomyocytes compared to untreated control cardiomyocytes. TLR4-null WBCs had no effect on hypoxia-stressed cardiomyocyte viability. These preliminary data suggest that immune cells significantly contribute to the extent of myocardial damage from I/R and TLR4 may mediate this damage. WBCs do not need to be exposed to hypoxia for this effect to occur indicating that hypoxia-stressed cardiomyocytes release signal(s) to activate the leukocytes. CONCLUSION: We provide evidence for the role of TLR4-expressing leukocytes in ischemic damage of cardiomyocytes. We have developed an in vitro model of I/R for defining the role of individual cell populations (specifically cardiomyocytes and circulating leukocytes) in this process, which will allow us to further explore the TLR4 signaling pathways as targets for therapeutic intervention. * AATS Member 127 TUESDAY Morning METHODS: An in vitro I/R model was developed to determine the effect of leukocytes (WBCs) on cardiomyocyte viability following hypoxia/reperfusion. Primary WBCs were isolated from the buffy coat of peripheral blood collected from wildtype and TLR4-null mice. Murine primary adult cardiomyocytes or HL-1 cells (a murine cardiomyocyte cell line) were plated on laminin or gelatin-coated plates 24 hr prior to experiment. Cardiomyocytes were exposed to the following conditions: 1) 1 hr normoxia (control: constant pH, 21% O2) or 1 hr hypoxia (0.05% O2) in the presence of WBCs (wildtype or TLR4-null) followed by 1 hr reoxygenation with addition of fresh media; 2) 1 hr normoxia (control) or 1 hr hypoxia followed by 1 hr reoxygenation with primary WBCs (wildtype or TLR4-null). At the conclusion of the experiment, the cardiomyocytes were collected, stained with trypan blue, and counted for viability using a hemocytometer. 6295_AATS.book Page 128 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY F10. Development of Novel Synthetic Serine-Protease Inhibitors to Reduce Postoperative Blood Loss After Cardiac Surgery Gábor Szabó1, Gabor Veres1, Tamás Radovits1, Matthias Karck1, Andreas van de Locht2 1Universtiy of Heidelberg, Heidelberg, Germany; 2Curacyte Discovery Ltd., Leipzig, Germany Invited Discussant: Craig R. Smith OBJECTIVE: The non-specific serine-protease inhibitor aprotinin is used to reduce perioperative blood loss after cardiopulmonary bypass. Because of allergic and infectious risk and clinical side effets substitutes of aprotinin would be highly preferable. We investigated the efficacy of the novel synthetic serine-protease inhibitors CJ2010 and CJ2020 on blood loss in a canine model. METHODS: 37 dogs were divided into five groups: control (n = 5), aprotinin (n = 8; Hammersmith scheme), CJ2010 I. (n = 8, 1,6 mg/kg Hammersmith scheme) CJ2010 II. (n = 8, 1,6 mg/kg continuous infusion) and CJ2020 (n = 8, 8,9 mg/kg, Hammersmith scheme). All animals underwent 90-minute cardiopulmonary bypass. Endpoints were blood loss during the first two hours after application of protamin, activated clotting time (ACT), partial thromboplastin time (PTT), and prothrombin time (PT). RESULTS: CJ2010 and CJ2020 significantly reduced blood loss comparable to aprotinin (Figure, *p < 0.05). While ACT and PTT normalized after protamine in the control, aprotinin and CJ2010 I. groups they remained elevated in the CJ2010 II. and CJ2020 groups. PT values did not differ beween the groups. Figure 1. Blood Loss After 20 (T120) 40 (T160) and 120 (T220) Minutes After Aplication of Protamin, As Well As Cumulative Total Blood Loss CONCLUSION: The novel serine-protease inhibitors CJ2010 and CJ2020 significantly reduce blood loss after cardiac surgery comparable to aprotinin. Furthermore, an additional antithrombotic protective effect is implicated by prolonged PTT and ACT values. 128 6295_AATS.book Page 129 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California TUESDAY MORNING, MAY 13, 2008 7:00 a.m. GENERAL THORACIC FORUM SESSION (5 minutes presentation, 7 minutes discussion) Room 25, San Diego Convention Center Moderators: Michael A. Maddaus Yolonda L. Colson F11. OBJECTIVE: Surgical resection remains the most effective treatment option for patients with non-small cell lung cancer; however medical comorbidities and poor pulmonary reserve often limit the extent of resection. Unfortunately, limited resections are associated with 2–3 times higher rates of locoregional recurrence, suggesting that microscopic disease is present near the resection margin. Therefore, the focus of this study is to establish proof of concept that the implantation of biocompatible paclitaxel-loaded polymer films at the time of tumor resection can prevent local recurrence. METHODS: Poly(ester-co-carbonate) films (1.0 × 0.8 cm2) were synthesized onto bovine pericardial strips with or without the addition of 30 µg paclitaxel (Pax-film or unloaded film, respectively). The subcutaneous injection of 7.5 × 105 Lewis Lung Carcinoma (LLC) cells on the dorsum of C57BL/6J female mice resulted in development of the primary tumor. A complete resection of the primary tumor was performed and Pax-loaded and unloaded polymer films were randomly assigned for implantation at the site of surgical resection prior to wound closure. RESULTS: Primary subcutaneous tumor resections were performed 10–18 days after injection of LLC. There was no difference in the average tumor size (588 ± 160 vs 581 ± 96 mm3) between mice that subsequently received unloaded films or Pax-films. All mice treated with unloaded films (n = 3) had visible local recurrence at the site of the film at 7.3 ± 1.8 days after resection and required sacrifice secondary to large locally recurrent tumor by 15.6 ± 1.5 days. In contrast, there was no evidence of locally recurrent disease at the site of Pax-films in any of the recipient mice (n = 4) at 20 days (p < 0.05 vs unloaded films, Fisher Exact Test; Figure). Similarly, survival was markedly prolonged before Pax-films recipients eventually succumbed to progressive metastatic disease from the primary tumor (27.0 ± 2.0 days; p < 0.01 vs unloaded films, t-test). * AATS Member † Second Alton Ochsner Research Scholar 2002–2004 129 TUESDAY Morning Paclitaxel-Loaded Polymer Film Prevents Local Recurrence of Non-Small Cell Lung Cancer Rong Liu1, Jesse Wolinsky2, Mark W. Grinstaff2, Yolonda L. Colson*†1 1Brigham and Women’s Hospital, Boston, MA; 2Boston University, Boston, MA Invited Discussant: Rodney J. Landreneau 6295_AATS.book Page 130 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY CONCLUSION: Implantation of Pax-films at the time of surgical resection can prevent local tumor recurrence and prolong survival in a subcutaneous LLC tumor model in mice, without significant impairment in wound healing. These findings suggest that Pax-loaded polymer films incorporated at the surgical margin, may afford enhanced local drug delivery aimed at preventing the growth of occult disease present following parenchyma-sparing surgery, and offer the means to decrease local recurrence rates in patients with stage I lung cancer in the future. 130 6295_AATS.book Page 131 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California F12. Targeting Tumor Angiogenesis In Thoracic Malignancies Using MEK Pharmacologic Inhibitor: In Vitro and In Vivo Analysis Shailen Sehgal2, Wen-Shuz Yeow2, Mustafa Hussain2, Amy Loehfelm2, Joseph Blansfield2, Steven K. Libutti2, Craig Thomas2, Dao M. Nguyen*1 1Surgery, University of Miami, Miami, FL; 2National Cancer Institute, National Institutes of Health, Bethesda, MD Invited Discussant: Robert J. Cerfolio METHODS: 5 lung, 6 mesothelioma, 6 esophageal cancer cell lines and primary human umbilical endothelial cells (HUVEC) were treated with UO126 and cell viability was determined by MTT assay. Levels of pro-angiogenesis cytokines VEGF, IL8, prostaglandin E2 in supernatant of cancer cells were measured by ELISA. Total and phosphorylated MEK or ERK were determined by western blots. The in vivo growth inhibitory effect of UO126 was studied in nude mice bearing subcutaneous H513 mesothelioma xenografts. RESULTS: UO126 mediated profoundly inhibition of MEK-mediated ERK1/2 phosphorylation and suppression of cell proliferation via cell cycle arrest at G0/S checkpoint with IC50’s ranging from 10.0 ± 2.0 to 42.0 ± 4.5 µM in TCC. UO126 substantially suppressed the production of pro-angiogenesis cytokines VEGF, IL-8 and prostaglandin E2 (product of COX-2 activity) at drug concentrations well below growth IC50’s (range: 0.5 to 20 µM). Conditioned media of UO126-treated TCC with depleted pro-angiogenesis cytokines did not support viability of HUVECs. UO126 directly inhibited HUVEC growth and strongly abrogated the angiogenesis functions of endothelial cells (proliferation, migration, invasion of extracellular matrix and tube formation) as shown by the rat aortic ring assay. Similar in vitro findings were observed using the clinically relevant MEKI PD148352 (CI-1040). Daily administration of UO126 at either 20 mg/kg or 40 mg/kg to nude mice bearing H513 tumor xenografts resulted in statistically significant suppression of tumor growth (Figure). CONCLUSION: MEKIs exert their antitumor effect directly by inhibiting tumor cell proliferation and indirectly by anti-angiogenesis mechanism via suppression of tumor-derived production of pro-angiogenesis cytokines and abrogation of endothelial cell functions. As angiogenesis is essential for metastasis development, ongoing efforts are focused on evaluating MEKIs as anti-metastasis drugs which may particularly be useful in chemopreventive or postoperative adjuvant settings. * AATS Member 131 TUESDAY Morning OBJECTIVE: Constitutive active MEK/ERK1,2 signaling in tumor cells promotes their malignant potentials via up-regulation of proliferation, survival, motility/invasion, angiogenesis thus making this pathway an attractive target for cancer therapy. Unless harboring B-raf mutations (rare in thoracic cancers) tumors are resistant to the antiproliferative effect of MEK inhibitors (MEKIs). This study aims to evaluate the antiangiogenesis effect of MEKIs UO126 and PD148352 in thoracic cancer cells (TCC). 6295_AATS.book Page 132 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY 132 6295_AATS.book Page 133 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California F13. Ambulatory Lung Assist Device Oxygenates and Removes Carbon Dioxide From Blood Across a Silicone-Coated Porous Membrane David M. Hoganson1, Jennifer Anderson1, Brian Orrick2, Joseph P. Vacanti1 1Massachusetts General Hospital, Boston, MA; 2Alito Therapeutics, Boston, MA Invited Discussant: Joseph B. Zwischenberger METHODS: In-vitro testing of the lung assist device (18 cm2 surface area) was performed with three different membranes. An uncoated porous polycarbonate (PC) membrane (1.0 µm pores, 12 µm thick) was used as a control membrane as it has excellent gas transfer but is unacceptable for this application as it allows some plasma leakage. Two fluid impermeable membranes, a thin silicone membrane (63 µm thick) and a silicone-coated porous PC membrane (1.0 µm pores, 14.8 µm thick with coating) were tested as potential membranes for the device. Anticoagulated porcine blood was pumped through the channel network of the lung assist device while oxygen flowed through the gas chamber (40 ml/min). Gas transfer was assessed at blood flow rates of 0.6, 1.0, 2.0, 4.0 and 8.0 ml/min using blood gas analysis (n = 4 for each flow rate and membrane type). RESULTS: The oxygen transfer was similar between all groups and increased with increasing blood flow. For the silicone-coated PC membrane, oxygen transfer varied from 0.05 ± 0.01 to 0.24 ± 0.19 ml/min, similar to the uncoated PC membrane (0.05 ± 0.01 to 0.21 ± 0.1 ml/min) and the silicone membrane (0.05 ± 0.01 to 0.25 ± 0.08 ml/min) for the given blood flow range. The carbon dioxide transfer through the lung assist device is shown in Figure. An effective lung assist device may need to remove 20% of CO2 generated at rest or 50 ml/min of CO2. With the silicone coated porous membrane, the lung assist device would have 0.64 m2 surface area and 1.4 L/min blood flow. 133 TUESDAY Morning OBJECTIVE: Transplantation is a current treatment for patients with end stage lung disease. An implantable lung assist device would allow ambulation and hospital discharge and is currently under development as a bridge to or an alternative to lung transplantation. The device has a gas permeable membrane that exchanges oxygen and carbon dioxide between a gas chamber and blood in a network of channels which were computationally designed to replicate the function of a vascular network. Optimizing the membrane material is critical to achieve adequate gas transfer, minimize size of the assist device and avoid plasma leakage. 6295_AATS.book Page 134 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY CONCLUSION: The lung assist device with a silicone-coated porous membrane oxygenates and removes carbon dioxide at rates similar to an uncoated porous membrane. A scaled-up version of this technology may serve as a bridge to or an alternative to lung transplantation for patients with end stage lung disease and become a platform for the development of a tissue engineered lung. 134 6295_AATS.book Page 135 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California F14. Long Acting Oral Phophodiesterase Inhibition Preconditions Against Reperfusion Injury In an Experimental Lung Transplantation Model Eric S. Weiss1, Jason A. Williams1, William M. Baldwin2, William A. Baumgartner*1, Hunter C. Champion3, Ashish S. Shah1 1Cardiac Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD; 2Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, MD; 3Division of Cardiology, Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD Invited Discussant: Christine L. Lau METHODS: New Zealand White rabbits (4 Kg), were given oral tadalafil (n = 6) 24 hours prior to lung harvest and compared to rabbits given oral vehicle alone (n = 8). Lungs were recovered with Perfadex, and cold stored for 18 hours. Following storage, lung blocs were reperfused with donor rabbit blood in an ex vivo apparatus. Pulmonary artery pressures (PAP) were recorded with serial arterial and venous blood gas sampling and animals served as their own controls. PDE-5 and protein kinase G (PKG) tissue activity assays confirmed drug effects. Luminol chemoluminescence assay was used to measure reactive oxygen species (ROS). RESULTS: Extended cold storage, followed by reperfusion produced a consistent reproducible decrease in oxygenation and increase in pulmonary pressure. Tadalafil treated animals exhibited greater initial PaO2 levels (563 vs. 470 mmHg, p = 0.07) and at each subsequent time point post reperfusion (p = 0.04) (Figure-1). Mean PAP was lower in tadalafil treated animals (26 vs. 39 mmHg, p = 0.04). PDE-5 activity was decreased (143 ± 8 vs. 205 ± 32 mP, p < 0.001) with PKG activity increased (25 ± 12 vs. 12 ± 2.4 fU/microgram, p = 0.01) in the experimental group confirming that oral pretreatment resulted in active PDE inhibition in the lung tissue. ROS (as measured by luminol activity) were decreased in tadalafil treated animals (7.8 ± 1.5 vs. 15.5 ± 1.2 RLU, p = 0.002). CONCLUSION: Our experimental model demonstrates that oral donor pretreatment with a long acting PDE inhibitor is an effective strategy for improving pulmonary performance following reperfusion. Importantly, PDE enzymes and their downstream effectors may play a critical role in reperfusion injury after LTx. * AATS Member 135 TUESDAY Morning OBJECTIVE: Ischemia-reperfusion (IR) injury remains a devastating complication of Lung Transplantation (LTx). Phosphodiesterase (PDE) inhibitors have been shown to precondition tissues against IR injury. Little is known, however, about the utility of PDE inhibition in reperfusion injury after LTx. We evaluated the long acting PDE-5 inhibitor, tadalafil, in an ex-vivo LTx model. 6295_AATS.book Page 136 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY 136 6295_AATS.book Page 137 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California F15. Differential Gene Expression Profiling of Esophageal Adenocarcinoma Zane Hammoud, Sunil Badve, Qianqian Zhao, Lang Li, Karen Rieger, Kenneth Kesler* Indiana University School of Medicine, Indianapolis, IN Invited Discussant: Steven R. DeMeester OBJECTIVE: Quantitative gene expression was performed on 89 esophageal adenocarcinomas, treated exclusively by surgery with complete 2 field lymphadenectomy, in an attempt to identify genes involved in disease development, progression, and survival. RESULTS: Sixty-three genes were overexpressed in T1-2 compared with T3-4 tumors (21 genes had false discovery rate of 0). Overexpression of 16 genes and underexpression of 1 gene was seen in LN+ compared with LN– tumors (underexrpession of MYB gene had false discovery rate of 0). For overall survival, overexpression of 82 genes and underexpression of 8 genes correlated with prolonged survival (5 overexpressed and 2 underexpressed genes had false discovery rate of 0). CONCLUSION: High-throughput gene expression profiling from archived tissue using DASL offers an attractive means of studying genetic alterations and pathways involved in tumor progression. Using differential gene expression of 502 known cancer genes, we identified genes that are involved at various stages in the progression of esophageal adenocarcinoma. We also identified genes that appear to correlate with prolonged survival and may serve as prognostic markers. Further studies are needed to verify and understand the role of these genes in the development and/or progression of esophageal adenocarcinoma. * AATS Member 137 TUESDAY Morning METHODS: RNA was extracted from archived formalin fixed, paraffin embedded tissue. Gene expression profiling was accomplished by the DASL (cDNA-mediated annealing, selection, extension, and ligation) assay using 502 known cancer genes. Differential gene expression was analyzed for T1-2 (n = 26) vs. T3-4 (n = 63) tumors and for tumors with lymph node involvement (LN+, n = 66) vs. tumors without (LN–, n = 23). Gene expression was also correlated with overall survival. 6295_AATS.book Page 138 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY F16. Screening of Epidermal Growth Factor Receptor Gene Mutation In Non-small Cell Lung Cancer Using a New PCR-Based Enzymatic Digestion Method Young T. Kim2, Sun J. Park2, Joo-yeon Park2, Hyun C. Wi2, Chang H. Kang1, Sook W. Sung2, Joo H. Kim1 1Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul, South Korea; 2Cancer Research Institite, Seoul National University, Seoul, South Korea Invited Discussant: David R. Jones OBJECTIVE: Currently available methods for detection of Epidermal Growth Factor Receptor (EGFR) mutation rely on direct DNA sequencing. We developed a simplified method using PCR-based enzymatic digestion for the detection of exons 19 and 21 mutations and validated its usefulness as a screening tool. METHODS: We selected 74 samples of adenocarcinoma of the lung whose EGFR exons 19 and 21 had been previously sequenced. Based on the sequencing result, we designed PCR primers and chose DNA restriction enzyme. The PCR products were tested on the agarous gel directly for exon 19 and after enzymatic digestion for exon 21. To validate its accuracy, we set up the second sets of 74 lung cancer samples. For those samples, PCR-based method was performed first and the result was validated by DNA sequencing. 138 6295_AATS.book Page 139 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California RESULTS: In the first sample group, we found 15 (20.3%) and 9 (12.2%) mutations for exons 19 and 21 using sequencing method, respectively. By using PCR-based method, we were able to identify all the mutated samples detected by sequencing method. At the same time, we could detect mutations in additional 3 and 1 samples for exons 19 and 21, respectively. Those additionally detected 4 mutations were confirmed by performing a repeated sequencing. In the second set of samples, PCR-based method detected 10 (13.5%) and 7 (9.5%) mutations for exons 19 and 21, respectively. Additional mutations of exon 19 were identified in 2 samples by sequencing method. However, sequencing method failed to identify mutation of exon 21 in one sample. 139 TUESDAY Morning CONCLUSION: The sensitivity of PCR-based enzymatic digestion method seems to be comparable to that of the traditional sequencing method for detecting EGFR mutations. As our new method is simple, cheap, rapid and sensitive, it can be widely used as a screening test for patient selection who may benefit from EGFR targeted therapy. 6295_AATS.book Page 140 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY F17. A Novel JAK3 and Syk-Inhibitor, R348, for Prevention of Chronic Airway Allograft Rejection Jeffrey Velotta1, Vanessa Taylor2, Esteban Masuda2, Gary Park2, David Carroll2, Robert Robbins*1, Sonja Schrepfer1 1Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, CA; 2Rigel Pharmaceuticals, South San Francisco, CA Invited Discussant: R. Duane Davis, Jr. OBJECTIVE: This is the first study to investigate the role of a novel JAK3 and Syk inhibitor, R348, in the prevention of chronic airway allograft rejection. Both kinases are vital for cytokine signal transduction and immune cell differentiation. METHODS: Trachea from Brown-Norway donors were heterotopically transplanted in the greater omentum of Lewis rats. Recipients were treated for 28 days with R348 (10, 20, 40, or 80 mg/kg) or rapamycin (0.75 or 3 mg/kg) or left untreated. Grafts were harvested and tracheal segments were processed for histological evaluation by computer morphometry determining degree of luminal obliteration and percentage of respiratory epithelium coverage. Thymus and spleen weights were quantified and compared between all groups. Side effects of R348 and rapamycin were assessed using animal weights calculated every week. Plasma levels of R348 and R333, its active metabolite, were quantified by high-power liquid chromatography and pharmacokinetics were determined. RESULTS: R348 at 20, 40, and 80 mg/kg significantly inhibited luminal obliteration (69 ± 20%, 20 ± 13%, 15 ± 7%; p = 0.003 vs. no medication). Rapamycin in both concentrations significantly inhibited luminal obliteration (37 ± 15%, 11 ± 6%; p < 0.001 vs. no medication) similarly to R348 at 40 and 80 mg/kg and was more effective than R348 at 10 and 20 mg/kg (37 ± 15%, 11 ± 6% vs. 94 ± 10%, 69 ± 20%; p = 0.003). R348 at 40 and 80 mg/kg significantly preserved respiratory epithelium compared to R348 at 10 and 20 mg/kg (49 ± 35%, 76 ± 27% vs. 0 ± 0, 3 ± 7%; p = 0.004) and was superior to rapamycin in luminal preservation (49 ± 35%, 76 ± 27% vs. 27 ± 17%, 36 ± 15%; p = 0.01). All R348 treated recipient thymus and spleen weights were significantly lower compared to the non-treated group (p = 0.001). Animal weight gain over 28 days was similar between all groups with the exception that recipients treated with 80 mg/kg of R348 had significantly reduced weight gain compared to the rest (p < 0.0001). Plasma levels of R333 were more stable (6000 ng/ml at 2 hours, 6500 ng/ml at 8 hours) than R348 and showed a slower decrease. CONCLUSION: R348 effectively prevented the development of obliterative airway disease (OAD) and significantly preserved respiratory epithelium with 40 mg/kg being the optimal dose. Rapamycin significantly inhibited luminal obliteration with minimal effects on respiratory epithelium preservation. R348 occupies a favorable pharmacokinetic profile compared to rapamycin and is highly effective at precluding chronic airway allograft rejection. * AATS Member 140 6295_AATS.book Page 141 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California F18. Association with Survival of the CXCL12-CXCR4 Chemokine Axis In Adenocarcinoma of the Lung P. L. Wagner1, M. Vazquez2, J. Port1, P. Lee1, A. Saqi2, N. Altorki*1 1Cardiothoracic Surgery, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY; 2Pathology, Weill Cornell Medical College, New York, NY Invited Discussant: Thomas A. D’Amico OBJECTIVE: Although the chemokine CXCL12 and its receptor, CXCR4, have been implicated in the metastatic potential of non-small cell lung carcinoma (NSCLC), the prognostic implications of these molecules are poorly defined. The aim of this study was to determine whether expression of these molecules correlates with differences in survival among patients with adenocarcinoma of the lung. RESULTS: Significant differences in DFS were observed among lesions with respect to CXCR4 expression, depending upon the subcellular location of the molecule (see figure): nuclear expression was associated with improved survival, while cytoplasmic expression was associated with worse survival. Tumors with a high ratio of nuclear-to-cytoplasmic CXCR4 exhibited a particularly favorable prognosis (panel C of figure). These differences were observed * AATS Member 141 TUESDAY Morning METHODS: We examined 134 primary adenocarcinoma lesions resected from 101 patients, using immunohistochemical (IHC) staining intensity as a semi-quantitative measure of expression. Lesions were divided into high-expression or low-absent expression categories based on staining intensity. CXCL12 was detected in the cytoplasm and cell membrane but not in the nucleus; since CXCR4 was detected in the nucleus and cytoplasm, these two compartments were scored separately. Staining intensity was compared with clinicopathologic features including TNM stage and survival. Kaplan-Meier disease-free survival (DFS) curves were generated and compared using a log-rank test (significance, p < 0.05). 6295_AATS.book Page 142 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY among Stage I lesions, indicating that the association of CXCR4 expression with survival is stage-independent. Expression of CXCL12 did not correlate with survival. CONCLUSION: Cytoplasmic expression of the chemokine receptor CXCR4 by lung adenocarcinomas is associated with poorer disease-free survival, whereas nuclear expression confers a survival benefit. These findings are consistent with a model in which CXCR4 promotes tumor progression when present in the cytoplasm or cell membrane, while localization of this molecule in the nucleus prevents it from exerting its effects associated with poorer survival. By contrast, expression of the chemokine ligand for this receptor, CXCL12, does not have significant prognostic implications. 142 6295_AATS.book Page 143 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California F19. Overexpression of Cyclooxygenase-2 Is Associated with Chemoradiotherapy Resistance and Prognosis In Esophageal Squamous Cell Carcinoma Patients Huang Weizhao2, Fu Jianhua1, Hu Yi1, Liu Mengzhong1, Yang Hong1, Zheng Bin1, Wang Geng1, Rong Tiehua1 1Cancer Center, Sun Yat-Sen University, Guangzhou, China; 2Cancer Center and ZhongShan Hospital, Sun Yat-Sen University, Zhongshan, China Invited Discussant: Ross M. Bremner OBJECTIVE: To investigate whether Cyclooxygenase-2 (COX-2) expression can predict the prognosis and response to chemoradiotherpy in esophageal squamous cell carcinoma. RESULTS: COX-2 positive immunostaining was detected in 111 (99.1%) patients including overexpressed in 54 (48.2%) patients and low expressed in 58 (51.8%) patients. The 1, 3 years overall survival rate of cohort was 65.0% and 32.2% respectively. Response rate of tumors with a low level expression of COX-2 (70.7%, 41/58) was significantly higher than that of tumors with COX-2 overexpression (42.6%, 23/54; P = 0.003). Patients with low level COX-2 expression had a higher downstaged rate than those with high level COX-2 expression (9/13 VS. 2/8), but no statistical significance (P = 0.08). Univariate analysis showed that tumor length, M-stage (nonregional node metastasis), response, and level of COX-2 expression were correlated to prognosis of patients with esophageal squamous cell carcinoma received definitive chemoradiotherpy (91 cases)and Multivariate analysis showed only tumor length, M-stage, and response were independent prognosis factors. CONCLUSION: The assessment of COX-2 status could provide additional information in order to identify esophageal squamous cell carcinoma patients with poor chance of response to chemoradiotherpy and potentially candidates for more individualized treatment. 143 TUESDAY Morning METHODS: The clinicopathologic and follow-up data of 112 patients with esophageal squamous cell carcinoma, underwent chemoradiotherpy from Jan. 2001 to Jun. 2006, were analyzed retrospectively. The immunohistochemical expression level of COX-2 was examined for all biopsy specimens of primary tumors and the correlation of COX-2 expression with response to chemoradiotherpy and prognosis was examined. 6295_AATS.book Page 144 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY F20. Detergent-Enzymatic Bioengineered Pig Tracheal Tubular Matrices Lack of Immunogenicity and Maintain Their Structural Integrity When Implanted Heterotopically In an Allo- and Xeno-Transplantation Model Philipp Jungebluth1, Tetsuhiko Go1, Silvia Bellini2, Chiara Calore2, Luca Urbani2, Tatiana Chioato2, Michaela Turetta2, Adelaide M. Asnaghi3, Sara Mantero3, Maria T. Conconi2, Paolo Macchiarini1 1Department of General Thoracic Surgery, Hospital Clinic, University of Barcelona, Barcelona, Spain; 2Department of Pharmaceutical Sciences, University of Padua, Padua, Italy; 3Department of Bioengineering, Politecnico di Milano, Milano, Italy Invited Discussant: Sebastien Gilbert OBJECTIVE: To bioengineer a non-immunogenic tracheal tubular matrix of 6 cm in length, and test its structural, function and immunological properties in vitro and in vivo. METHODS: Tracheal segments of 12 cm in length were harvested from six male Yorkshire pigs (weighing 42.4 ± 3.3 kg). Each segment was divided into two of 6 cm each to be bioengineered with a detergent-enzymatic method (DEM; contained alternately Sodium deoxycholate/DNase lavations) for 17th cycles or used as a control (native, maintained in PBS at 4°C). Bioengineered and control tracheas were then implanted in HLA-unmatched pigs and mice heterotopically (either inguinal groin) during 30 days. Structural, functional analysis and immunostaining were performed after each DEM-cycle, and at 2, 7, and 30 days post transplantation. RESULTS: Compared to control tracheas, tracheal matrices showed complete removal of major histocompatibility complex class I and II antigens after 17th DEM-cycles, being only few nuclei of chondrocytes left from the decellularization process, and no significant (p 0.05) differences in their strain ability (trachea rupture force: 56.1 ± 3.3 vs. 55.5 ± 2.4 newtons; point of tracheal rupture: 12.2 ± 0.8 vs. 12 ± 0.5 cm). Seven days after implantation, the matrices showed in both models a significant (p < 0.05) lower inflammatory reaction compared to their control trachea (392 vs. 15 macrophages/mm2, 874 vs. 167 T-lymphocytes/mm2) and P-selectin expression (1/6 vs. 6/6). There was no development of anti-swine leukocyte antigen (SLA) antibodies or deposits of both IgM and IgG in mice. CONCLUSION: We created a completely antigenicity-free tracheal matrix of 6 cm length with structural characteristics similar to native tracheas. 144 6295_AATS.book Page 145 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California TUESDAY MORNING, MAY 13, 2008 9:00 a.m. PLENARY SCIENTIFIC SESSION (8 minutes presentation, 12 minutes discussion) Ballroom 20 A–C, San Diego Convention Center Moderators: D. Craig Miller Thoralf M. Sundt 29. OBJECTIVE: This study examined results after endovascular Talent® Thoracic stent-graft treatment in patients with acute or chronic aortic dissection. METHODS: 180 patients were treated for acute or chronic dissection (mean age = 59 ± 13 yr). Thirty-seven (21%) patients had acute aortic complications with rupture, distal malperfusion or persistent pain; the remainder were stable. Aortic diameter was 54 ± 14 (range 26–136) mm, the distance from the left subclavian artery to proximal entry tear was 44 ± 42 (range 0–220) mm, and dissection extended beyond the celiac axis in 88%. Length of covered aorta was 139 (range 28–380) mm; one stent-graft unit was used in 125 (69%) of cases. RESULTS: Procedural success was 98%. Eight patients died early for an in-hospital mortality rate of 4.4% (14% for those with acute complications vs. 2% for elective cases [p = 0.003]). In-hospital complications, including fatal and non-fatal major adverse events, also occurred more frequently in patients with acute aortic complications (41 vs. 11%, p < 0.001), especially neurological complications (16% vs. 4.2%, p = 0.01). Acute patients with a smaller aortic diameter had fewer secondary endoleaks. Multivariate logistic regression analysis showed that age 75 ≥ years (OR 4.9; 95% CI 1.6–15.1; p = 0.006), ASA class IV/V (OR 2.8; 95% CI 1.0–7.5; p = 0.04) and emergency status (OR 3.5; 95% CI 1.3–8.9; p = 0.01) were independent predictors of in-hospital adverse events. 145 TUESDAY Morning Mid-Term Results of Endovascular Treatment of Acute and Chronic Aortic Dissection: The Talent Thoracic Retrospective Registry (TTR) Marek P. Ehrlich1, Stephan Kische2, Herve Rousseau3, Robin Heijmen4, Philippe Piquet5, Jean-Paul Beregi6, Christoph A. Nienaber2, Rossella Fattori7 1Department Cardiothoracic Surgery, University Hospital Vienna, Vienna, Austria; 2Division of Cardiology, University Hospital Rostock, Rostock, Germany; 3Department of Radiology, Hopital de Rangueil, Toulouse, France; 4Department Cardiothoracic Surgery, St. Antonius Hospital, Nieuwegein, Netherlands; 5Hopital Sainte Marguerite, Marseille, France; 6Hopital Cardiologique CHRU, Lille, France; 7Cardiovascular Radiology, University Hospital S. Orsola, Bologna, Italy Invited Discussant: R. Scott Mitchell 6295_AATS.book Page 146 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY Average follow-up for hospital survivors was 22.3 ± 17 (1–71) months. Overall Kaplan-Meier survival estimate was 95 ± 2% at 30 days, 91 ± 2% at 12 months, 91 ± 2% at 24 months, and 82 ± 5% at 36 months. For patients with acute complications, survival was 86 ± 6% at 30 days, 83 ± 6% at 12 months, and 83 ± 6% at 3 years. Survival estimate for elective patients were 97 ± 1% at 30 days, 93 ± 2% at 12 months, and 82 ± 6% at 3 years (Figure). Follow-up imaging revealed a lower rate of progressive aortic enlargement in acute vs. chronic dissections (3.2% vs. 23%, p = 0.001). CONCLUSION: Endovascular treatment for aortic dissection is associated with reasonably low morbidity and mortality rates. Longer-term surveillance is crucial to define more comprehensively the durability of stent-graft treatment of aortic dissection and to determine which patients are appropriate candidates for stent-graft therapy. 146 6295_AATS.book Page 147 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California 30. Mechanical Valves Versus Ross Procedure for Aortic Valve Replacement In Children: Propensity-Adjusted Comparison of Long-Term Outcomes Bahaaldin Alsoufi1, Cedric Manlhiot2, Brian McCrindle2, Mamdouh Al-Ahmadi1, Ahmed Sallehuddin1, Charles Canver*1, Ziad Bulbul1, Mansoor Joufan1, Ghassan Siblini1, Zohair Al-Halees1, Bahaa Fadel1 1King Faisal Heart Institute, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia; 2Hospital for Sick Children and University of Toronto, Toronto, ON, Canada Invited Discussant: Vaughn A. Starnes METHODS: From 1983–2004, 346 children underwent AVR (215 Ross, 131 mechanical). Factors found to be associated with procedure choice (gender, age, pathology, hemodynamic manifestation, previous and concomitant surgeries) were used to construct a propensity score to adjust for non-randomization. Propensity-adjusted logistic and survival regression models were created to determine the effect of procedure type on operative mortality, longterm survival and cardiac reoperation. * AATS Member 147 TUESDAY Morning OBJECTIVE: Aortic valve replacement (AVR) in children is problematic and all options are associated with major limitations. We compared outcomes in children who underwent AVR using mechanical prostheses versus pulmonary autografts (Ross procedure). 6295_AATS.book Page 148 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY RESULTS: Patients undergoing Ross procedure were younger (p < 0.01), more likely to have congenital etiology (p < 0.01) or require annular enlargement (p < 0.01). Patients undergoing mechanical AVR were more likely to have rheumatic or connective tissue etiology (p < 0.01), aortic regurgitation (p < 0.01), and concomitant cardiac surgery (p < 0.01). Unadjusted 1 and 10 year survival was stable at 98% for Ross vs. 94% and 83% for mechanical. Younger age was the most significant factor for operative (OR 1.3 per year, p < 0.01) and late death (HR 1.2 per year, p < 0.01) for mechanical valves but was neutralized as a risk factor for Ross. Unadjusted 1 and 10 year freedom from aortic valve reoperation was 99% and 77% for Ross vs. 100% and 92% for mechanical. After propensity-adjustment, mechanical valves were associated with greater odds of operative (OR 10.5, p = 0.001) and late death (OR 9.3, p < 0.01). Smaller mechanical sizes were associated with higher risk of death (RR 1.7 per mm, p = 0.02) and valve reoperation (RR 1.8 per mm, p = 0.001). Ross was associated with greater odds of aortic (OR 6.6, p < 0.01) and cardiac reoperation (OR 3.0, p = 0.03). Although children with mechanical valves had more valve-related thromboembolic/bleeding complications, those events were too few to reach statistical significance. Adjusted comparison showed no significant difference in functional classification at last follow up with >99% of patients in NYHA functional class I (91%) or II (9%). CONCLUSION: Analysis indicates excellent functional status and acceptable complication rate with both valve choices. Given significantly increased risk of early and late death in younger children receiving smaller mechanical valves, Ross procedure confers survival advantage in this age group at the expense of increased reoperation risk. 148 6295_AATS.book Page 149 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California 31. How Does the Use of PTFE Neochordae for Posterior Mitral Valve Prolapse (Loop Technique) Compare with Leaflet Resection? Results of a Prospective Randomized Trial Volkmar Falk1, Markus Czesla1, Joerg Seeburger1, Thomas Kuntze1, Patrick Perrier2, Fitsum Lakev2, Joerg Ender1, Nicolas Doll1, Franka Nette1, Michael A. Borger1, Friedrich W. Mohr*1 1Heartcenter Leipzig, Leipzig, Germany; 2Cardiovascular Center Bad Neustadt, Bad Neustadt, Germany Invited Discussant: Tirone E. David METHODS: One-hundred and ten patients with severe MV regurgitation (MR), with a mean MR grade of 3.0 ± 0.6, underwent minimal-invasive MV surgery through a right lateral minithoracotomy. Mean age was 58 ± 12 years, 90 patients were male, mean preoperative EF was 65 ± 8%, and mean NYHA functional class was 2.1 ± 0.7. Ninety-five patients were diagnosed with isolated PML prolapse and 15 had bileaflet prolapse. Randomization was performed preoperatively (with an intention-to-treat analysis) and crossover was allowed if the surgeon deemed it medically necessary. In 9 patients crossover from resection to loops occurred, in 3 patients crossover from loops to resection occurred, and 6 patients received both treatment modalities. RESULTS: MV repair was accomplished in all patients (n = 110, 100%). The mean number of loops implanted on the PML was 3.2 ± 0.9 with a mean length of 13.3 ± 2.2 mm. Mitral ring annuloplasty was performed in all patients. Intraoperative transesophageal echocardiography showed a significantly longer line of coaptation following implantation of loops (7.6 ± 3.6 mm) than following resection (5.9 ± 2.6 mm; p = 0.03). Postoperative echocardiography showed no significant difference in mitral orifice area (3.6 ± 1.0 vs 3.7 ± 1.1 cm2, p = 0.4). Mean duration of CPB was 135 ± 37 min and mean aortic crossclamp time was 82 ± 26 min in all patients, with no significant difference between groups. Thirty-day mortality was 1.8% for the entire group (2 out of 110), with both deaths occuring in the loop group. Cause of death was massive pulmonary embolism in one and acute right heart failure in the other patient. Early and mid-term echocardiographic follow-up revealed excellent valve function in the vast majority of patients. CONCLUSION: Both repair techniques for PML prolapse are associated with excellent results. The loop technique, however, results in a significantly longer line of coaptation and may therefore be more durable. In addition, we feel the loop technique is more reproducible, particularly in patients with extensive PML or bileaflet prolapse. 10:00 a.m. AWARD PRESENTATIONS Ballroom 20 A–C, San Diego Convention Center 10:15 a.m. INTERMISSION—VISIT EXHIBITS Exhibit Hall GH * AATS Member 149 TUESDAY Morning OBJECTIVE: Mitral valve (MV)surgery for posterior mitral leaflet (PML) prolapse consists mostly of leaflet resection, but implantation of premeasured PTFE neochoardae (i.e., loops) is another option. The aim of this prospectively randomized trial was to compare if preservation of leaflet structure in combination with premeasured neochordae can favourably compare to the widely adopted technique of leaflet resection. 6295_AATS.book Page 150 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY NOTES 150 6295_AATS.book Page 151 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California 11:00 a.m. PLENARY SCIENTIFIC SESSION 32. OBJECTIVE: The International Association for the Study of Lung Cancer (IASLC) recently proposed a revision to the current UICC-6 staging system for non-small cell lung cancer (NSCLC). The T descriptors and stage groupings have been redefined while the nodal descriptors remain unchanged. The goal of this study was to apply the proposed changes to a cancer center population undergoing surgery for NSCLC and directly compare the proposed IASLC and UICC-6 staging systems to determine if one system is superior in its ability to classify operable patients based on stage. METHODS: Pathologic stages in 1,154 patients undergoing R0 surgical resection from a prospectively collected database over a 9-year period were analyzed. Each patient was assigned a stage based on both IASLC and UICC-6 staging systems. The effectiveness of each staging system was evaluated statistically using a log-rank trend test. Statistically meaningful differences between the two staging systems were evaluated with a computationally intensive log-rank test. RESULTS: Ordering and separation of stages in our patient population is visually comparable to the IASLC test and validation sets. The IASLC staging system is significantly more effective in differentiating between low, mid, and high stage patients compared to the UICC-6 system (p = 0.006). Reassigning patients to the IASLC system resulted in 202 (17.5%) patients being reassigned to a different stage (p = 0.012), with the most common shifts occurring from IB to IIA and IIIB to IIIA (Table). Three patients were downstaged from stage IV to IIIA (n = 2) and IIIB (n = 1). The five-year and median survivals of the IIIA patients in the IASLC system including those shifted from the UICC-6 IIIB was 37% and 35 months, respectively. Reclassifying UICC-6 IIIB to IASLC IIIA did not reduce survival for operable patients. * AATS Member 151 TUESDAY Morning Application of the Revised Lung Cancer Staging System (IASLC Staging Project) to a Cancer Center Population Edmund S. Kassis1, Ara A. Vaporciyan*1, Stephen G. Swisher*1, Arlene M. Correa1, Neby Bekele2, Jeremy J. Erasmus3, Wayne L. Hofstetter1, Ritsuko Komaki4, Reza J. Mehran1, Cesar A. Moran5, Katherine M. Pisters6, David C. Rice1, Garrett L. Walsh*1, Jack A. Roth*1 1The University of Texas MD Anderson Cancer Center, Department of Thoracic and Cardiovascular Surgery, Houston, TX; 2The University of Texas MD Anderson Cancer Center, Department of Bioinformatics & Computational Biology, Houston, TX; 3The University of Texas MD Anderson Cancer Center, Department of Radiology, Houston, TX; 4The University of Texas MD Anderson Cancer Center, Department of Radiation Oncology, Houston, TX; 5The University of Texas MD Anderson Cancer Center, Department of Pathology, Houston, TX; 6The University of Texas MD Anderson Cancer Center, Department of Thoracic/Head and Neck Medical Oncology, Houston, TX Invited Discussant: Bryan F. Meyers 6295_AATS.book Page 152 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY CONCLUSION: Our data confirms that the proposed IASLC staging system is more effective at differentiating prognostic stage groupings than the UICC-6 system. Use of this system will help to identify those patients at higher risk for recurrence and will facilitate adjuvant treatment decisions and research. Reclassifying patients from UICC-6 IIIB to IASLC IIIA will shift some patients from a stage previously considered unresectable to a stage frequently offered surgical resection. Further study and validation of the IASLC system are warranted. IA IB IIA IIB IIIA IIIB IV UICC-6, N(%) 358 (31) 305 (26.4) 74(6.4) 160 (13.9) 153 (13.3) 66 (5.7) 38 (3.3) IASLC, N (%) 358 (31) 242 (21.1) 185 (16) 110 (9.5) 216 (18.7) 8 (0.69) 35 (3) Patients were assigned a pathologic stage based on the UICC-6 and IASLC staging systems. Reclassification of patients between systems resulted in a statistically significant shift of patients between stage groupings (p = 0.012). 152 6295_AATS.book Page 153 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California 33. Selective Antegrade Cerebral Perfusion Via Right Axillary Artery Cannulation Reduces Morbidity and Mortality After Proximal Aortic Surgery Michael E. Halkos, Faraz Kerendi, Richard Myung, Patrick D. Kilgo, John D. Puskas*, Edward P. Chen Emory University, Atlanta, GA Invited Discussant: Joseph E. Bavaria OBJECTIVE: Selective antegrade cerebral perfusion (SCP) utilizing axillary artery cannulation is a well-described neuroprotective technique during hypothermic circulatory arrest (HCA) in proximal aortic surgery (Ao). This study investigated whether SCP was associated with improved survival and neurologic outcome in both emergent (EM) and elective (EL) settings. Outcome Operative mortality Composite Outcome Re-intubation LOS >7 days ICU >48 hrs. Vent. >24 hrs. Non-emergent SCP vs. emergent SCP (AOR) 0.25 (0.08, 0.73)a 0.25 (0.11, 0.56)a 0.15 (0.05, 0.44)a 0.26 (0.13, 0.50)a 0.42 (0.22, 0.81)a 0.30 (0.15, 0.58)a Non-emergent No-SCP vs. emergent No-SCP (AOR) 1.63 (0.45, 5.91) 1.00 (0.32, 3.20) 0.51 (0.09, 2.91) 0.27 (0.09, 0.79)a 0.29 (0.09, 0.91)a 0.31 (0.10, 0.97)a a p < 0.05 * AATS Member 153 Non-emergent SCP vs. Non-emergent No-SCP (AOR) 0.17 (0.05, 0.64)a 0.32 (0.11, 0.93)a 0.48 (0.09, 2.69) 1.13 (0.46, 2.77) 1.00 (0.42, 2.35) 0.95 (0.36, 2.51) Emergent SCP vs. emergent No-SCP (AOR) 1.14 (0.39, 3.34) 1.29 (0.51, 3.24) 1.70 (0.53, 5.39) 1.18 (0.47, 2.94) 0.70 (1.25, 1.91) 0.99 (0.40, 2.47) TUESDAY Morning METHODS: A single institution retrospective review was performed for all cases of Ao involving HCA between January 2004 and May 2007. Of these 272 patients, 106 presented EM with acute dissection or hematoma, and 166 patients underwent EL operation for other ascending aortic pathology. Patients were classified according to whether SCP was used and EM status. Measured outcomes included operative mortality, a composite of operative mortality, stroke, and temporary neurological dysfunction (composite outcome), re-intubation, length of stay (LOS), post-operative ventilator hours, and ICU hours. Potential selection bias was controlled by calculating each patient’s probability of being assigned to SCP based on 26 pre-operative risk factors using propensity score (PS) methods. Multivariable logistic regression analysis was used to model adverse outcomes as a function of SCP, EM status and their interaction, adjusted for the PS. Adjusted odds ratios (AOR) were formulated along with 95% confidence intervals. 6295_AATS.book Page 154 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY RESULTS: Operative mortality occurred in 33 patients (12.1%); 8.8% in patients with SCP vs. 22.1% in those without SCP. Overall, transient neurologic dysfunction occurred in 21 (7.7%) patients; 5.9% in patients with SCP vs. 13.2% in patients without SCP. Stroke occurred in 12 (4.4%) patients; 3.4% in patients with SCP vs. 7.4% in patients without SCP. In patients with SCP, EM procedures were associated with increases in operative risk and neurologic injury compared with EL. Without SCP, there was no difference between EM and EL. In the EL setting alone, SCP was associated with significant decreases in operative mortality and neurologic injury compared with no-SCP (see table). CONCLUSION: Use of SCP confers superior neurologic protection and a survival advantage during Ao that is most apparent in the EL operative setting. A risk reduction was also observed in patients having SCP in EL vs. EM surgery that was not observed in the no-SCP patients. These data suggest that use of SCP as a means of neurologic protection during HCA in Ao may be beneficial in EL as well as EM operative settings. 11:40 a.m. ADDRESS BY HONORED SPEAKER 50 Years of Cardiothoracic Surgery Through the Looking Glass and What the Future Holds Marko I. Turina, M.D. University Hospital, Zurich, Switzerland Introduced By: D. Craig Miller 12:20 p.m. ADJOURN FOR LUNCH—VISIT EXHIBITS Exhibit Hall GH, San Diego Convention Center ACADEMIC LEADERSHIP LUNCHEON Room 23 AB, San Diego Convention Center TSRA LUNCHEON Room 29 AB, San Diego Convention Center 154 6295_AATS.book Page 155 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California NOTES TUESDAY Morning 155 6295_AATS.book Page 156 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY TUESDAY AFTERNOON, MAY 13, 2008 2:00 p.m. SIMULTANEOUS SCIENTIFIC SESSION— ADULT CARDIAC SURGERY (8 minutes presentation, 12 minutes discussion) Ballroom 20 A–C, San Diego Convention Center Moderators: Joseph F. Sabik Andrew S. Wechsler 34. Equivalent Patencies of the Radial Artery, Right Internal Thoracic Artery and Saphenous Vein Beyond 5 Years: Surprising Results From the Radial Artery Patency and Clinical Outcomes Trial Philip Hayward1, Mark Horrigan2, David L. Hare2, Ian Gordon3, George Matalanis2, Brian F. Buxton*2 1Cardiothoracic Surgery, Essex Cardiothoracic Centre, Basildon, United Kingdom; 2Austin Hospital, Melbourne, VIC, Australia; 3University of Melbourne Statistical Consulting Centre, Melbourne, VIC, Australia Invited Discussant: Stephen E. Fremes OBJECTIVE: To investigate the optimum conduit for coronary targets other than the left anterior descending artery, long-term patencies of the radial artery, right internal thoracic artery and saphenous vein were evaluated, in parallel with clinical data, through the Radial Artery Patency and Clinical Outcomes (RAPCO) trial. METHODS: As part of a 10-year prospective, randomised, single-centre trial, patients undergoing primary coronary surgery were allocated to radial artery (n = 198) or free right internal thoracic artery (n = 196), if aged less than 70 years (Group 1), or radial artery (n = 112 or saphenous vein (n = 112) if aged at least 70 years (Group 2). All patients received a left internal thoracic artery graft to the LAD, and the randomised conduit was used to graft the second largest target. Protocol-directed angiography has been performed at randomly assigned intervals weighted towards the end of the study period, with an additional optional restudy at 5 and 10 years. All angiograms are independently reported by 3 assessors. Grafts are defined as failed if there was occlusion, string sign, or <80% stenosis. Analysis is by study conduit utilised, rather than by intention. RESULTS: At mean follow up of 5.2 and 5.4 years, protocol angiography has been performed in groups 1 and 2 in 212 and 102 patients respectively. There are no significant differences within each group in preoperative comorbidity, age or urgency. The Figure shows similar patencies for either of the 2 conduits in each group (log rank analysis, p = 0.70 for group 1, p = 0.40 for group 2). Alternative analysis by intention to treat does not influence this finding. * AATS Member 156 6295_AATS.book Page 157 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California TUESDAY Afternoon CONCLUSION: At mean 5-year angiography in largely asymptomatic patients, the selection of arterial or venous conduit for the second graft has not impacted on patency. This finding from the most comprehensive assessment of the radial artery offers surgeons, for now, enhanced flexibility in planning revascularisation. 157 6295_AATS.book Page 158 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY 35. Efficacy of Add Mitral Valve Restrictive Annuloplasty to CABG In Patients with Moderate Ischemic Mitral Valve Regurgitation Khalil Fattouch, Francesco Guccione, Marco Muscarelli, Emiliano Navarra, Davide Calvaruso, Giuseppe Speziale, Giovanni Ruvolo Cardiac Surgery, University of Palermo, Palermo, Italy Counterpoint: Alfredo Trento Open Discussion OBJECTIVE: Surgical management of moderate ischemic mitral valve regurgitation (I-MR) is still debated. In this study, we evaluate prospectively and randomly the early and midterm results of patients with moderate IMR underwent CABG or CABG + mitral valve repair (MVR). METHODS: Between February 2003 and May 2007, 102 patients with moderate IMR were prospectively and randomly enrolled to undergo CABG + MVR (48 pts/47%) or CABG alone (54 pts/53%). Standard CABG procedures was performed in all patients. Restrictive mitral valve annuloplasty using a Carpentier-Edwards phisio ring was applied for MVR. Preoperative demographics and clinical data, intraoperative characteristics, postoperative outcomes, postoperative mitral valve regurgitation grade, NYHA functional class at follow-up, in-hospital and late survival, left ventricular remodeling and pulmonary arterial pressure (PAP) were recorded. Exercise tolerance was performed for all survivors. There was one late cardiac related death. The mean follow-up was 28 ± 6 months. RESULTS: Overall in-hospital mortality was 3% (3 pts). One patient dead in CABG group (1.8%) and 2 pts in CABG + MVR group (4.1%). Predictors of early mortality were, preoperative poor LVEF % and age. The 2 groups were similar with regard to pre- and intraoperative data, excluding for CPB time (p < 0.05). At follow-up, in CABG group we showed a residual postoperative moderate to severe MR in 40 pts (75%). This data suggests that in only 25% of patients the CABG alone could be effective to decrease the severity of MR. In the CABG + MVR group, trivial MR was found in only 4 pts (8%). At follow-up, significant statistical difference was observed between groups respect to NYHA functional class, to left ventricular functionand remodelling, and to mean pulmonary arterial pressure. Patients in CABG group need more re-hospitalization, medical therapies and have decrease in exercise tolerance respect to CABG + MVR group. CONCLUSION: In patients with moderate IMR, combined CABG and MV restrictive annuloplasty have slightly high mortality respect to CABG alone in elderly patients and in those with poor left ventricular function without statistical difference. On the other hand, add MVR to CABG improve postoperative NYHA functional class, ventricular remodeling and function, decrease postoperative PAP, that leads to less in medical therapeutics administration, rehospitalization and tolerance to exercise. 158 6295_AATS.book Page 159 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California 36. A Long Term Analysis of Percutaneous Fenestration and Stenting for Acute Type B Dissection with Malperfusion— Implications for Thoracic Aortic Endovascular Repair Himanshu J. Patel, David M. Williams, Meir Meerkov, Narasimham L. Dasika, G. M. Deeb* University of Michigan Cardiovascular Center, Ann Arbor, MI Invited Discussant: Roy K. Greenberg METHODS: 89 consecutive patients presented with suspected B-AD with malperfusion (1997–2007). All patients underwent angiography, and were treated with a combination of flap fenestration, true lumen and branch vessel stenting where appropriate. Outcomes were analyzed for the cohort of 60 patients identified as having impaired organ perfusion on angiography (100% followup; mean 43.3 months). RESULTS: Mean age was 58.2 years. Comorbidities included CAD (7), hypertension (46), COPD (9), and stroke (2). Identified malperfused vascular beds included spinal cord (4), mesenteric (31), renal (46), and lower extremity (36). Median length of stay was 10 days. While in-hospital mortality was seen in 16.7% (multisystem organ failure n = 6; aortic rupture n = 4), no mortality was directly attributed to the interventional procedure. Permanent paralysis was seen in 1 who presented with cord ischemia. Complications from malperfusion included need for dialysis (6), and post-procedural stroke (1). Mean Kaplan-Meier survival was 85.2 months, with a crude late mortality rate of 31.7%. Though late mortality was associated with both age (p = 0.01) and discharge creatinine (p = 0.03), neither the type nor the number of malperfused vascular beds correlated with vital status at last follow-up (p > 0.5). Freedom from subsequent aortic repair or aortic rupture at 1, 5, and 8 yrs was 80.3%, 68.7%, and 51.5% respectively. CONCLUSION: Presentation with acute type B dissection with malperfusion carries a significant risk for early mortality. Percutaneous based approaches allow for rapid restoration of end-organ perfusion with acceptable early and late results. These long term data should be considered a benchmark against which to evaluate TEVAR as a primary therapeutic modality for B-AD. * AATS Member 159 TUESDAY Afternoon OBJECTIVE: Open aortic repair to resolve malperfusion in acute type B dissection (B-AD) is associated with a high risk for major morbidity. Thoracic aortic endovascular repair (TEVAR) has emerged as a less invasive therapeutic alternative for B-AD. Benefits of this strategy include the potential for false lumen thrombosis and prevention of rupture. However, its risks include both early morbidity (stroke, spinal cord ischemia, conversion to type A dissection), and the uncertain late results in the setting of potentially unstable landing zones. Accordingly, we present a contemporary long term appraisal of an alternative endovascular approach consisting of percutaneous flap fenestration with branch vessel stenting to restore end-organ perfusion in B-AD. 6295_AATS.book Page 160 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY 37. Hybrid Endovascular Aortic Arch Repair Using Branched Endoprosthesis: The Second Generation “Branched” Open Stent Grafting Technique Kazuo Shimamura1, Toru Kuratani2, Yukitoshi Shirakawa2, Mugiho Takeuchi1, Hiroshi Takano3, Goro Mastumiya1, Yoshiki Sawa1 1Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine, Osaka, Japan; 2Department of Advanced Cardiovascular Therapeutics,Osaka University Graduate School of Medicine, Osaka, Japan; 3Department of Cardiovascular Surgery, Osaka General Medical Center, Osaka, Japan Invited Discussant: Heinz G. Jakob OBJECTIVE: Open stent grafting (OSG) is an emerging technique of aortic arch repair which involves stent grafting to the descending aorta in traditional surgical method. We advanced this technique using a branched stent graft, which reconstructs simultaneously the cervical branch and descending aorta under direct visualization (branched OSG). This procedure could complete arch replacement in single process during deep hypothermic circulatory arrest (DHCA). In this study, we evaluated the efficacy of this new technique and assessed the early and mid-term results. METHODS: From January 1994 to September 2007, aortic arch repair with OSG was performed in 195 patients. Among them, branched OSG was underwent from 2004 in 69 cases (55 male, average age 66.2 years, 36 degenerative aneurysms and 33 aortic dissections, 13 [18.8%] in emergency, 7 [10.1%] re-do cases). Under DHCA, the branched stent graft was delivered through the opened aorta and aortic arch repair was completed as the figure. To avoid cerebral embolism, retrograde cerebral perfusion was performed at the end of DHCA. RESULTS: Average time of operation/cardiopulmonary bypass/DHCA was 417/130/36 minutes respectively. Total 124 cervical stent grafts was involved, and successfully delivered in 121 (97.6%). Operative mortality within 30 days was 3 (4.3%). The major postoperative complications involved 4 (5.8%) strokes, 2 (2.9%) spinal cord injuries. Median follow up was 20.3 month (1–41 months). No aortic related death was observed after discharge from 160 6295_AATS.book Page 161 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California hospital, and the survival rate was 90.9%, 88.8%, 88.8% at 1, 2, and 3 years respectively. Six (5.0%) cervical stent grafts showed endoleak, however all these cases were successfully treated by additional endovascular repair. Freedom from endoleak was 92.0%, 92.0% and 84.4% at 1, 2 and 3 years respectively. CONCLUSION: Aortic arch repair with branched open stent grafting is an effective technique with satisfactory early and mid-term results. Although long term results would confirm its efficacy, this technique could be an attractive alternative to conventional aortic arch repair. 3:30 p.m. INTERMISSION—VISIT EXHIBITS Exhibit Hall GH, San Diego Convention Center TUESDAY Afternoon 161 6295_AATS.book Page 162 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY NOTES 162 6295_AATS.book Page 163 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California 4:00 p.m. SIMULTANEOUS SCIENTIFIC SESSION Ballroom 20 A–C, San Diego Convention Center Moderators: Joseph F. Sabik Andrew S. Wechsler 38. Cardiovascular Magnetic Resonance Assessment of Myocardial Scarring Predicts Recurrence of Functional Ischemic Mitral Regurgitation After Anuloplasty Tomislav Mihaljevic, Michael Flynn, Ronan Curtin, Edward R. Nowicki, Jeevanantham Rajeswaran, Scott D. Flamm, Eugene H. Blackstone* Cleveland Clinic, Cleveland, OH Invited Discussant: Robert A. E. Dion METHODS: From January 2001 to November 2006, 29 patients with ≥3+ ischemic MR had preoperative CMR prior to CABG and anuloplasty. Wall motion abnormality was graded for 17 standard myocardial segments (0 = none, 1+ = hypokinesis, 2+ = severe hypokinesis, 3+ = akinesis, 4+ = dyskinesis). Within each of these segments, degree of hyperenhancement, interpreted as scar, was graded as 0 = 0%, 1 = 1–25%, 2 = 26–50%, 3 = 51–75%, 4 = 76–100%. Postoperative recurrence of MR was assessed by 71 transthoracic echocardiograms and graded 0–4+. * AATS Member 163 TUESDAY Afternoon OBJECTIVE: The aims of this pilot study were to investigate the relation of cardiovascular magnetic resonance (CMR)-derived segmental wall motion and myocardial scarring to recurrence of mitral regurgitation (MR) following CABG and anuloplasty for ischemic MR. 6295_AATS.book Page 164 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY RESULTS: Left ventricular ejection fraction ranged from 10–45% (mean 22 ± 8.4%). Wall motion abnormalities grade ≥2+ were present in the majority of myocardial segments (median 13 of 17 segments). Scar >25% was present in a median of 3 segments, but in 44% of those in the territory of the posteromedial papillary muscle. Nearly all segments (95%) with >25% scar had ≥2+ wall motion abnormality. Although 90% of patients had no MR at hospital discharge, by 6 months, 30% had recurrent MR ≥2+. There was little association between wall motion abnormality and recurrence of MR (P > .1). However, in the territory of the posteromedial papillary muscle, 70% of patients with scar >25% had recurrent MR of ≥2+ by 6 months, compared with 15% of those with score ≤25% (P = .05; Figure). CONCLUSION: This pilot study suggests that CMR assessment of scar burden more accurately predicts recurrent MR following CABG and anuloplasty for ischemic MR than do wall motion abnormalities. Routine preoperative CMR-derived scar burden may identify patients for whom alternative modes of treatment of ischemic MR should be considered. 164 6295_AATS.book Page 165 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California 39. Prosthesis-Patient Mismatch Is Irrelevant for Patients Greater than 70 Years of Age Undergoing Bioprosthetic Aortic Valve Replacement Marc R. Moon*, Jennifer S. Lawton, Nabil A. Munfakh, Nader Moazami, Kristen A. Aubuchon, Kelly A. Baker, Michael K. Pasque*, Ralph J. Damiano* Cardiothoracic Surgery, Washington University School of Medicine, Saint Louis, MO Counterpoint: Christopher M. Feindel Open Discussion METHODS: Between 1992 and 2007, 1,399 patients underwent bioprosthetic AVR, including 518 patients ≤70 years of age and 881 patients > 70 years of age. PPM was defined as severe (prosthetic effective orifice area/body surface area <0.65 cm2/m2), moderate (0.65 to 0.85 cm2/m2), or absent (>0.85 cm2/m2). For patients ≤70 yo, PPM was severe in 62 (12%), moderate in 251 (48%), and absent in 205 (40%). For patients >70 yo, PPM was severe in 109 (12%), moderate in 451 (51%), and absent in 321 (37%). * AATS Member 165 TUESDAY Afternoon OBJECTIVE: The purpose of this investigation was to examine the impact of prosthesispatient mismatch (PPM) following bioprosthetic AVR on long-term survival in patients greater than 70 years of age compared to those less than 70 years of age. 6295_AATS.book Page 166 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY RESULTS: For patients ≤70 yo, PPM was associated with impaired long-term survival (Figure top). Survival at 5 and 10 years was 61 ± 7% and 28 ± 12% for severe PPM (mean survival 77 months), 65 ± 3% and 40 ± 5% for moderate PPM (92 months), and 73 ± 5% and 46 ± 9% for no PPM (98 months) (p = 0.015). In contrast, for patients > 70 yo, PPM did not impact long-term survival (Figure bottom). Survival at 5 and 10 years was 62 ± 5% and 42 ± 6% for severe PPM (mean survival 96 months), 62 ± 2% and 30 ± 5% for moderate PPM (87 months), and 53 ± 4% and 29 ± 5% for absent PPM (77 months) (p = 0.25). CONCLUSION: Thus, following bioprosthetic AVR, PPM had a negative impact on late survival for patients younger than 70 years of age, but for patients greater than 70 years of age, PPM did not influence late survival. 5:00 p.m. EXECUTIVE SESSION (MEMBERS ONLY) Ballroom 20 A–C, San Diego Convention Center 166 6295_AATS.book Page 167 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California NOTES TUESDAY Afternoon 167 6295_AATS.book Page 168 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY TUESDAY AFTERNOON, MAY 13, 2008 2:00 p.m. SIMULTANEOUS SCIENTIFIC SESSION— GENERAL THORACIC SURGERY (8 minutes presentation, 12 minutes discussion) Room 25, San Diego Convention Center Moderators: Alec Patterson W. Roy Smythe 40. Does Reperfusion Injury Still Cause Significant Mortality After Lung Transplantation? Gorav Ailawadi, Christine L. Lau, Lynn M. Fedourk, Philip W. Smith, Courtney Kuhn, Benjamin D. Kozower, John A. Kern*, Benjamin B. Peeler, Irving L. Kron*, David R. Jones* TCV Surgery, University of Virginia, Charlottesville, VA Invited Discussant: Shaf Keshavjee OBJECTIVE: Severe reperfusion injury (RI) is a major cause of early mortality following lung transplantation (LTX) with mortality rates of 40%. The purpose of this investigation was to identify if our improved 1-year survival of following LTX is related to better treatment of reperfusion injury. METHODS: The records of consecutive adult LTX recipients (N = 291) from January 1990 to August 2006 were reviewed. LTX recipients prior to March 2000 (early era, N = 136) were compared to recipients after March 2000 (current era, N = 155) when we reported selective early institution of ECMO (extracorporeal membrane oxygenation) can improve survival with RI defined by oxygenation index >7 (where oxygenation index = (percent inspired oxygen) * (mean airway pressure)/(partial pressure of oxygen). Risk factors for RI, treatment of RI, and 30-day mortality were compared between time periods using X2 or Fisher’s where appropriate. RESULTS: 30-day mortality following LTX improved from 11.8% in the early era to 3.9% in the current era (P = .02). In patients without RI, mortality was low and did not change in the two eras. Although the incidence of RI did not change between the eras, patients with RI had less mortality in the current era (11.4% vs. 38.2 %, P = .02). Primary pulmonary hypertension was more common in the early era (10% [14/136] vs. 2% [3/155], P = .005). Double lung transplantation was more common in the current era (26% [41/155] vs. 16% [22/136], P = .05). Mean ischemic time increased from 205.6 + 78.5 minutes in the early time period to 286.32 + 88.3 minutes in the later time period (P = .0001). Other variables were not different between the early and current eras including the utilization of ECMO, nitric oxide, and epoprostenol (11.0% [15/136] vs. 10.3% [16/155]). The mortality of RI patients requiring ECMO significantly improved in the current era (25.0% vs. 80.0%, P = .03). The median duration of ECMO was significantly shorter in the current era (30.6 ± 8.0 vs. 89 ± 29.8, P = .02). * AATS Member 168 6295_AATS.book Page 169 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California Outcome Early Mortality (30-day) Incidence of RI Mortality with RI Mortality of RI treated with ECMO Duration of ECMO Early Era (n = 136) 11.8% (16/136) 25% (34/136) 38.2% (13/35) 80.0% (8/10) 89 ± 29.8 hrs Current Era (n = 151) 3.9% (6/136) 22.6%(35/136) 11.4% (4/35) 25.0% (3/12) 30.6 ± 8.0 hrs P-Value 0.02 0.73 0.02 0.03 0.02 Data listed as %(n). ECMO duration listed as mean ± S.D. CONCLUSION: Improved early survival following lung transplantation is due to improvements in the treatment of severe reperfusion injury including better survival with ECMO. TUESDAY Afternoon 169 6295_AATS.book Page 170 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY 41. Does Endobronchial Ultrasonography Have a Place In the Thoracic Surgeon’s Armamentarium? Sebastien Gilbert1, David O. Wilson2, Neil A. Christie1, James D. Luketich*1, Matthew J. Schuchert1 1Heart, Lung, and Esophageal Surgery Institute, University of Pittsburgh Medical Center, Pittsburgh, PA; 2The Division of Pulmonary, Allergy, and Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA Invited Discussant: Stephen Swisher OBJECTIVE: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUSTBNA) is a promising tool in the evaluation of the mediastinum. To remain key players in this field, surgeons should acquire the skills and critically appraise this new technology. METHODS: Retrospective analysis of EBUS-TBNA experience in an academic thoracic surgery unit. RESULTS: Over 7 months, 23 patients (median age = 70; male = 15; female = 8) had EBUSTBNA. Diagnoses included: lung cancer or mass (14; 61%), mediastinal lymphadenopathy (ML) (4; 17%), and other (5; 22%). Nineteen patients (83%) had a PET scan and the mediastinum was positive in 18 (95%). Indications for EBUS-TBNA were positive PET scan (18; 78%) or ML alone (5; 22%). EBUS-TBNA was negative for cancer in 13 (56%), positive in 5 (22%), and non-diagnostic in 5 (22%). Among 18 PET-positive cases, EBUS-TBNA was negative in 10 (56%; 1/10 false negative), positive in 4 (22%), and non-diagnostic in 4 (22%). Of 14 patients with suspected lung cancer, 8 (57%) were either diagnosed with small cell cancer or downstaged from radiologic stage IIIa lung cancer. Mediastinoscopy was performed in 5 cases (22%) after a non-diagnostic (n = 2) or negative EBUS-TBNA (n = 3). The diagnostic yield was not operator dependent (pulmonologist vs surgeon; p > 0.05). Mediastinoscopy was not clinically required in 15 patients. There were no complications and all patients were discharged within 24 hours (91% same day). CONCLUSION: EBUS-TBNA provided clinically relevant data in 74% (17/23) overall and 72% (13/18) of patients with abnormal PET scans. EBUS-TBNA may be a useful, minimally invasive adjunct or alternative to mediastinoscopy. * AATS Member 170 6295_AATS.book Page 171 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California 42. Tailored Cricoplasty—An Improved Modification for Reconstruction In Subglottic Tracheal Stenosis Moishe Liberman, Douglas J. Mathisen* Thoracic Surgery, Massachusetts General Hospital, Boston, MA Invited Discussant: Erino A. Rendina OBJECTIVE: Stenosis of the subglottic larynx is the most challenging part of the airway to reconstruct. When the laryngeal ventricle is adequate, chance for success is good. When the ventricle is small and especially narrowed from side to side, success is limited and not thought to be achievable in many patients. This study consists of a retrospective chart review and telephone questionnaire follow-up of consecutive patients with subglottic stenosis at a single institution. Follow-up study questionnaires used Likert Scales (ratings: 1–10) to describe pre- and post-operative symptomatology, satisfaction, and perceived effectiveness. A score of zero signified extreme dissatisfaction/ therapy ineffective, and a score of ten signified extreme satisfaction/effectiveness. Results are reported as means, ranges and standard deviations. The Paired Sample T-test was used to compare means prior to surgery and at follow-up. Symptoms Pre- and Post-Cricoplasty Symptom Pre-Operative Post-Operative P-Value Dyspnea at rest 6.1 ± 2.4 0.5 ± 0.8 <0.001 Dyspnea with activity 8.6 ± 1.3 1.0 ± 2.0 <0.001 Wheezing severity 7.3 ± 2.2 0.4 ± 1.2 <0.001 Coughing severity 6.8 ± 2.1 1.0 ± 1.4 <0.001 Noisy breathing 7.8 ± 2.2 0.5 ± 1.1 <0.001 Stridor severity 2.9 ± 4.2 0 0.010 Inability to clear secretions 3.0 ± 4.0 0.1 ± 0.2 0.007 Difficulty swallowing / lump in throat 1.8 ± 3.3 1.1 ± 2.4 0.226 Impact of disability on day-to-day Activity 7.6 ± 2.4 1.5 ± 2.5 <0.001 Impact of disability on profession activity 7.0 ± 3.0 0.6 ± 1.3 <0.001 Impact of disability on social activity 5.9 ± 3.4 0.6 ± 1.1 <0.001 Number of blocks patient can walk without 1.2 ± 2.0 23.9 ± 17.6 <0.001 dyspnea Number of stairs patient can climb without 1.6 ± 2.4 85.1 ± 192.7 0.102 dyspnea * AATS Member 171 TUESDAY Afternoon METHODS: A modification of the standard technique of anterior cricoid resection was developed. Once the anterior cricoid is removed, a submucosal resection of thickened tissue is performed. The inner third to half of the cricoid cartilage is carefully excised. The exposed cricoid cartilage is resurfaced by advancing the preserved mucosa over the cricoid with interrupted 5-0 chromic sutures. This results in an additional horizontal enlargement of the luminal diameter of the airway of 4–5 mm. 6295_AATS.book Page 172 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY RESULTS: Eighteen patients (17 females) underwent tailored cricoplasty over a 15 month period. Three resections were performed for post-intubation tracheal stenosis and 15 for idiopathic subglottic stenosis. Mean age was 51 (range = 20–75), average number of tracheal rings resected (excluding cricoid) was 2.5 (range = 1–4), and mean follow-up was 9.1 ± 1.2 (range = 2–17) months. All patients were extubated in the operating room and mean duration of hospital stay was 8.3 ± 1.6 days. There were six complications in five patients. The table below compares symptoms before and after tailored cricoplasty. All patients reported that they were satisfied and would undergo surgery again. Overall satisfaction was rated at 9.5 ± 1.0 and satisfaction with resting and exertional dyspnea were 9.7 ± 0.5 and 9.5 ± 1.0, respectively. Symptoms of recurrence at follow-up were rated as 0.6 ± 1.4 out of 10. CONCLUSION: Tailored cricoplasty is an effective technique to improve the outcome of reconstructive subglottic stenosis. It offers reconstructive possibilities for patients previously excluded from surgical reconstruction. 3:00 p.m. INTERMISSION—VISIT EXHIBITS Exhibit Hall GH, San Diego Convention Center 172 6295_AATS.book Page 173 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California NOTES TUESDAY Afternoon 173 6295_AATS.book Page 174 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY 3:35 p.m. SIMULTANEOUS SCIENTIFIC SESSION— GENERAL THORACIC SURGERY Room 25, San Diego Convention Center Moderators: Alec Patterson W. Roy Smythe 43. Analysis of Surgical Results Leads to Improved Post-Operative Algorithms and Fast-Tracking of High Risk Patients After Pulmonary Resection Ayesha Bryant, Robert J. Cerfolio* Surgery, University of Alabama at Birmingham, Birmingham, AL Invited Discussant: K. Robert Shen OBJECTIVE: To identify our results with changes to our fast-tracking protocol in selected high-risk patients. METHODS: A retrospective study of a prospective database. Using multi-variate regression we identified several patient characteristic that predicted failure to fast-track secondary to increased morbidity. We modified our fast-tracking algorithm: in the elderly (>70 years) by substituting pain pumps for epidurals and avoiding narcotics. Patients with a BMI >40 had increased aspiration precautions. Patients with poor pulmonary function (FEV1% <45%) underwent increased respiratory treatments and more aggressive ambulation. Outcomes were compared. RESULTS: There were 2,895 patients who underwent elective pulmonary resection before the algorithm modification (1/1997–12/2001) and 3252 patients after (1/2002–7/2007). The length of stay was reduced by the protocol changes from 6.7 to 4.9 days (p = 0.024) in the elderly, from 5.7 to 4.8 days in the obese and from 6.2 to 4.3 days (p = 0.008) in those with FEV1<45%. The morbidity was reduced from 26% to 17% in the elderly (p = 0.046), from 29% to 20% (p = 0.027) in the obese and from 45% to 23% in those with a FEV 1 <45%. Overall mortality was also reduced 4.0% to 2.1% (p = 0.014). CONCLUSION: Critical review of surgical results can lead to improve patient care. High risk patients such as the elderly, the obese and those with poor pulmonary function can safely undergo pulmonary resection and a short hospital stay. Further identification of other specific modifications in other groups of patients is needed to continue to decrease surgical morbidity and mortality and maximizing patient and family satisfaction. * AATS Member 174 6295_AATS.book Page 175 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California 44. VATS Lobectomy Versus Thoracotomy for Lung Cancer – Results In 741 Patients Raja M. Flores, Bernard J. Park, Joseph Dycoco, Anna Arnova, Yael Hirth, Nabil P. Rizk, Manjit Bains*, Robert J. Downey*, Valerie W. Rusch* Thoracic Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY Invited Discussant: Scott J. Swanson OBJECTIVE: The optimal surgical technique for lobectomy in lung cancer is controversial. Proponents of VATS hypothesize that less trauma leads to quicker recovery while those who advocate thoracotomy claim it as an oncologically superior operation. However, a well balanced comparison of the two procedures is lacking in the literature. p value 0.738 0.652 0.142 141(43%) 54 (16%) 6 (2%) 1 204 (49%) 69 (16%) 13 (3%) 2 214 (65%) 61 (19%) 17 (5%) 9 (3%) 21 (6%) 6 (3%) 260 (63%) 70 (17%) 19 (5%) 18 (4%) 29 (7%) 17 (4%) 132 (40%) 150 (46%) 4 (1%) 35 (11%) 7 (2%) 2 cm 92 73 (22%) 5 78% 149 (36%) 174 (53%) 14 (3%) 65 (16%) 11 (3%) 2 cm 88 128 (31%) 7 76% 0.987 0.050 0.010 0.001 0.080 Survival: Cox Model VATS FEV1 Tumor Size Nodal Stage HR .67 .98 1.34 3.3 CI .40,1.11 .97,.99 1.14,1.66 1.58,6.71 p value 0.122 0.008 0.001 0.001 Complications: Logistic Regression Age VATS Tumor Size OR 1.04 .64 1.20 CI 1.02,1.06 .45,.89 1.03,1.40 p value 0.001 0.010 0.019 0.410 0.072 * AATS Member 175 TUESDAY Afternoon Variable Age (mean) Female Gender number of comorbidities 1 2 3 4 Pathological stage IA IB IIA IIB IIIA IIIB Histology Adenocarcinoma Adeno w/ BAC BAC Squamous Large Cell Tumor size (mean) FEV1 % predicted Complications LOS (days) 5-year survival (adjusted) Patient Characteristics VATS Lobectomy Thoracotomy n = 328 n = 413 67 years 67 years 206(63%) 266(64%) 6295_AATS.book Page 176 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY METHODS: All patients were selected for VATS or thoracotomy by a surgeon at initial evaluation at a single institution. Two surgeons exclusively performed thoracotomy lobectomy while 4 surgeons performed VATS lobectomy. All patients who underwent lobectomy for clinical stage 1A non-small cell lung cancer by CT and PET were identified from a prospective database. Variables recorded included age, sex, comorbidities, pulmonary function, tumor size, nodal status, and histology. Complications were classified and graded by the Cancer Institute Common Toxicity Criteria for Adverse Events version 3.0 (http://ctep.cancer.gov/reporting/ ctc.html). Patient characteristics were compared by student’s t-test, Pearson chi squared, and Fisher’s exact test. Survival was assessed by Kaplan-Meier and Cox proportional hazards analysis. Complications were assessed by a multivariate logistic regression model. A p value of less than 0.05 was considered statistically significant. RESULTS: From May 2002 to August 2007, 328 patients underwent VATS lobectomy and 413 underwent thoracotomy. There was 1 postoperative death in each group. Survival by Cox model was no different for VATS versus thoracotomy and logistic regression demonstrated fewer complications in the VATS lobectomy group. CONCLUSION: VATS lobectomy and thoracotomy demonstrated similar 5-year survival. However, VATS lobectomy was associated with fewer complications and shorter length of hospital stay. 176 6295_AATS.book Page 177 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California 45. Operative Risk of Pneumonectomy: Influence of Preoperative Induction Therapy Henning A. Gaissert*, Dong Yoon Keum, Cameron D. Wright*, Marek Ancukiewicz, Dean M. Donahue, John C. Wain*, Michael Lanuti, Noah C. Choi, Douglas J. Mathisen* MGH, Boston, MA Counterpoint: Mark J. Krasna Open Discussion OBJECTIVE: Prior studies reporting increased perioperative mortality of pneumonectomy for lung cancer after induction therapy may influence patient selection and limit the candidacy for pneumonectomy. A single institution experience was reviewed to evaluate our results. RESULTS: Between 1994 and 2005, 232 patients underwent pneumonectomy for lung cancer, including completion (35; 15.1%), carinal (17; 7.3%) and with chest wall (23; 9.9%) resections. One hundred fifty-one patients (65%) underwent pneumonectomy only. Seventy-three patients received induction therapy (combined XRT/chemo 59, XRT only 6; chemotherapy only 8; 31.5%) or remote mediastinal radiation (8 patients, 3.5%). Indications for induction therapy were stage IIIA disease in 48, IIIB in 15, IIB in 5, and VI in 4 patients. Patients receiving preoperative therapy were younger (mean age 56.8 vs. 62.6 years; p = 0.0003), had less heart disease (9.9 vs. 29.1%; p = 0.0008), higher preoperative FEV1 (2.38 vs. 2.10L; p = 0.0019), lower preoperative hematocrit (35.2 vs. 37.9%; p < 0.0001), and a higher proportion of right pneumonectomy (59.3 vs. 42.4%; p = 0.0189). Hospital mortality was 7.4 % (6/81) after preoperative therapy and 10.6% (16/151) after resection only (p = 0.49). Hospital mortality was greater after right pneumonectomy (right 13.4 vs. left 5.8%; p = 0.0713). Five preoperative predictors of mortality identified during multivariable analysis (Table) did not include induction therapy. Differences in individual or combined cardiopulmonary morbidities between those who did or did not receive induction therapy were not significant (combined morbidity: induction 42.5%, resection only 42.0%; p = 1.0). FVC% by 10% CAD or CHF Steroid usage Carinal procedure Completion procedure Odds Ratio 0.69 5.37 12.43 3.72 3.41 95% CI 0.52–0.93 1.64–17.55 2.54–60.91 0.80–17.16 1.05–11.02 p-Value 0.0142 0.0055 0.0019 0.0926 0.0407 CI = Confidence interval; FVC = Forced vital capacity; CAD = Coronary artery disease; CHF = Congestive heart failure CONCLUSION: The risk of pneumonectomy is not increased by preoperative radiation or chemotherapy. Patient selection, in particular the exclusion of patients with heart disease, may account for this finding. The operative mortality of right pneumonectomy, though higher than after left-sided procedures, should not preclude its use in carefully selected patients. 5:00 p.m. EXECUTIVE SESSION (MEMBERS ONLY) Ballroom 20 A–C, San Diego Convention Center * AATS Member 177 TUESDAY Afternoon METHODS: A retrospective study was performed to determine the impact of induction therapy on operative risk. 6295_AATS.book Page 178 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY NOTES 178 6295_AATS.book Page 179 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California TUESDAY AFTERNOON, MAY 13, 2008 2:00 p.m. SIMULTANEOUS SCIENTIFIC SESSION— CONGENITAL HEART DISEASE (8 minutes presentation, 12 minutes discussion) Room 28 A–C, San Diego Convention Center Moderators: Charles D. Fraser, Jr. James S. Tweddell Surgery for Adults with Congenital Heart Disease Should Be Performed by Congenital Heart Surgeons Pro: Joseph A. Dearani Con: Michael A. Acker 179 TUESDAY Afternoon 46. 6295_AATS.book Page 180 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY 47. Optimal Dose of Aprotinin for Neuroprotection and Renal Function In a Piglet Model Yusuke Iwata, Toru Okamura, David Zurakowski, Richard A. Jonas* Children’s National Heart Institute, Children’s National Medical Center, Washington, DC Invited Discussant: Ross M. Ungerleider OBJECTIVE: Efficacy of aprotinin in reducing blood loss after CPB is well established, however its neuroprotective potential is less well known. Furthermore, there is controversy regarding optimal dosing and possible renal complications. METHODS: 54 piglets were randomly assigned to three CPB groups at risk for post-op cerebral and renal dysfunction: circulatory arrest at 25°C, ultra-low flow (10 ml/kg/min) at 25°C or 34°C. Animals were randomized to: control (no aprotinin), low dose (30,000 KIU/kg into prime only), full dose (30,000 KIU/kg bolus IV into prime plus 10,000 KIU/kg infusion), and double full dose. Tissue oxygenation index (TOI) was monitored by near-infrared spectroscopy. Neurologic functional and histological scores, creatinine and blood urea nitrogen (BUN) were outcomes of interest. RESULTS: Aprotinin significantly improved neurological scores on postoperative day 1 after ultra-low flow bypass at 25°C or 34°C (p < .01), but not after HCA (P = .57). Linear regression indicated a strong dose-response relationship with higher aprotinin doses having the best neurological scores. During LF, a higher TOI was correlated with a higher aprotinin dose (p < .05). Use of aprotinin and dose had no significant effect on creatinine, BUN, or BUN-tocreatinine ratio on day 1. Low body weight was the only predictor of high BUN (r = –0.39, p < .01). CONCLUSION: Aprotinin significantly improves neurologic recovery without impairing renal function. Future studies are needed to examine the safety and efficacy of a double usual full dose strategy. * AATS Member 180 6295_AATS.book Page 181 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California 48. Functional Health Status In an Inception Cohort of Adult Survivors with Tetralogy of Fallot Edward J. Hickey, Gruschen Veldtman, Timothy Bradley, Aungkana Gengsakul, Gary Webb, William G. Williams*, Cedric Manlhiot, Brian W. McCrindle The Hospital for Sick Children, Toronto, ON, Canada Invited Discussant: John J. Lamberti OBJECTIVE: We have recently demonstrated the late hazard for death to be very low (<0.5% per year) in adult survivors with tetralogy of Fallot. Therefore efforts to assess and improve quality of late survivorship will be more important than efforts to further improve late survival. We therefore aimed to determine the long-term functional health status in the growing population of adult survivors with tetralogy of Fallot (TOF). RESULTS: Cardiorespiratory symptomatology was denied in more than half (55%). Chest pain (15%) was associated with late pulmonary valve replacement (PVR). Exertional dyspnoea (23%) was associated with older age at follow-up, associated cardiovascular anomalies and PVR. Palpitations (32%) were more common in older patients at the time of follow-up, women and following open surgical re-intervention. SF-36 scores were significantly below normal for physical domains, particularly physical functioning and general health (table). However, vitality was the only psycho-social domain that was significantly abnormal. Physical Functioning Role Physical Body Pain General Health Vitality Social Functioning Role Emotion Mental Healthy SF36 Functional Health Scores of Survivors (N = 396) z-Score Scale Z Score SEM P Value Predictors Physical –0.59 .07 <.001 Older age at follow-up Associated lesions Palliative shunt Physical –0.15 .05 <.01 Older age at follow-up Associated lesions Re-operation Physical +0.20 .05 <.001 Older age at follow-up Associated lesions Physical –0.84 .07 <.001 Associated lesions Mental Mental –0.26 –0.06 .06 .05 <.001 .27 Mental –0.01 .05 .86 — Mental –0.10 .06 .09 — * AATS Member 181 Palliative shunt — TUESDAY Afternoon METHODS: Of 1693 patients diagnosed with TOF at our institution and born prior to 1984, current known vital status for 1333 yielded 840 (63%) adult survivors to age 18 years. Current cross-sectional follow-up was achieved by interview (n = 707), or chart review (n = 133). SF-36 health status questionnaire was completed by 396 of these survivors and compared with age- and gender-matched norms. 6295_AATS.book Page 182 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY Older age at follow-up and associated cardiovascular lesions were consistent independent predictors of worse physical scores compared to age-matched norms. CONCLUSION: Despite a low late hazard for death, characterization of functional health status from an inception cohort of adult survivors with TOF shows a high prevalence of symptomatology (45%) with decrements in physical functioning. Older patients exhibit lower scores (relative to age-matched norms), which may reflect late deterioration with advancing age or cohort effects related to historical management. Interestingly, psycho-social well-being was comparable to norms, despite the burden of re-operations and impaired physical capacity. 3:10 p.m. INTERMISSION—VISIT EXHIBITS Exhibit Hall GH, San Diego Convention Center 182 6295_AATS.book Page 183 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California NOTES TUESDAY Afternoon 183 6295_AATS.book Page 184 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY 3:45 p.m. SIMULTANEOUS SCIENTIFIC SESSION— CONGENITAL HEART DISEASE Room 28 A–C, San Diego Convention Center Moderators: Charles D. Fraser, Jr. James S. Tweddell 49. Ventricular Performance In Long-Term Survivors After Fontan Operation Yuki Nakamura, Toshikatsu Yagihara, Kouji Kagisaki, Ikuo Hagino, Shuichi Shiraishi, Junjiro Kobayashi, Soichiro Kitamura* Cardiothoracic Surgery, National Cardiovascular Center, Suita, Osaka, Japan Invited Discussant: Charles D. Fraser, Jr. OBJECTIVE: Long-term ventricular performance after Fontan operation has not been elucidated in detail. This study evaluated ventricular function and arrhythmia in patients with Fontan circulation for more than 15 years. METHODS: We retrospectively reviewed 110 patients who underwent Fontan operation from 1979 to 1992. Forty eight patients in survivors who have been able to be followed up for more than 15 years were included in this study. Atriopulmonary connection (APC) was performed in 26 patients, and total cavopulmonary connection (TCPC) in 22 patients. We divided patients into 3 groups based on ventricular morphology: right ventricle (RV) group (n = 21), left ventricle (LV) group (n = 24), and biventricle group (n = 3). Follow-up cardiac catheterization was carried out routinely 1, 5, 10, and 15 years after the operation, and cardiac index (CI [l/min/m2]), ejection fraction (EF [%]), end-diastolic volume (EDV [% of normal]), and end-diastolic pressure (EDP [mmHg]) were employed for the assessment. Mean age at Fontan operation was 6.1 ± 4.3 years. Three patients who required APC conversion to TCPC within 15 years were excluded for the comparison between the groups. CI (l/min/m2) EF (%) EDV (% of normal) EDP (mmHg) Postoperative cardiac catheterization 1 year 5 years 10 years 15 years (n = 47) (n = 41) (n = 41) (n = 40) 2.55 ± 0.67 2.59 ± 0.78 2.31 ± 0.55 2.32 ± 0.69 55 ± 13 57 ± 13 54 ± 12 55 ± 10 105 ± 52* 78 ± 17** 72 ± 21** 73 ± 23** 3.4 ± 2.1# 6.5 ± 2.4## 8.2 ± 3.4## 7.5 ± 2.9## p = .125 p = .785 p < .05; * vs ** p < .001; # vs ## RESULTS: Mean follow-up was 18.5 ± 3.2 years (15 ~ 27.8): 20.1 ± 3.4 years (15.8 ~ 27.8) in APC group and 16.5 ± 1.4 years (15 ~ 19.7) in TCPC group. The table below indicates data of postoperative cardiac catheterization. EDV at 1 year was significantly larger than at 5, 10, 15 years (p < .05). EDP at 1 year was significantly lower than at 5, 10, 15 years (p < .001). CI was significantly higher in TCPC group than in APC group at 10 years (p = .045) and 15 years (p = .040). EF was higher in LV group than in RV group at 1 year (p = .042), 5 years (p = .007), 10 years (p = .136), and 15 years (p = .061). Beyond 15 years after * AATS Member 184 6295_AATS.book Page 185 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California Fontan operation, six patients suffered from ventricular tachycardia (VT) (12.5%): four in APC group at 15, 22, 22 and 24 years (3 of tricuspid atresia, 1 of double inlet LV), and two in TCPC group at 16 and 19 years (both of right isomerism heart). In comparison between the patients with and without VT, VT group revealed significantly higher operative age (10.5 ± 4.3 vs. 5.5 ± 4.0, p = 0.003). CONCLUSION: Long-term follow-up of Fontan operation demonstrated stability of hemodynamic parameters after 5 years. The advent of VT was recognized 15 years after the operation in higher age patients at the procedure, which might become a key event in further longer periods. TUESDAY Afternoon 185 6295_AATS.book Page 186 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY 50. How Size Matters: The Complex Relationship Between Pediatric Cardiac Surgical Case Volumes and Mortality Rates In a National Clinical Database Karl F. Welke1, Sean M. O’Brien2, Eric D. Peterson2, Ross M. Ungerleider*1, Marshall L. Jacobs*3, Jeffery P. Jacobs*4 1Surgery, Oregon Health and Science Univerisity, Portland, OR; 2Outcomes Research and Assessment Group, Duke Clinical Research Institute, Durham, NC; 3St. Christopher Hospital for Children, Philadelphia, PA; 4The Congenital Heart Institute of Florida (CHIF), Saint Petersburg and Tampa, FL Invited Discussant: J. William Gaynor OBJECTIVE: An inverse relationship exists between volume and mortality for a variety of surgical procedures. However, in pediatric cardiac surgery, where such investigations have employed older risk models and state level data, the results have been mixed. We sought to determine the association between hospital pediatric cardiac surgical volume and mortality using sophisticated case-mix adjustment and a national clinical database. Volume Category Association Between Annual Case Volume and Mortality Adjusted Odds Ratio N Deaths (95% CI) P-value 350+ 250–349 150–249 <150 10570 11978 6051 3681 All Procedures 346 (reference) 450 1.05 ( 0.86, 1.29) 250 1.14 ( 0.84, 1.55) 148 1.51 ( 1.19, 1.90) 0.004* 0.63 0.41 0.0005 350+ 250–349 150–249 <150 8663 10252 5104 3229 Low Difficulty Procedures 188 (reference) 295 1.16 ( 0.87, 1.53) 148 1.08 ( 0.76, 1.52) 86 1.21 ( 0.87, 1.69) 0.29* 0.31 0.68 0.26 350+ 250–349 150–249 <150 1855 1636 894 406 High Difficulty Procedures 135 (reference) 138 0.89 ( 0.69, 1.15) 79 1.22 ( 0.81, 1.84) 54 2.41 ( 1.89, 3.06) 0.0008* 0.38 0.35 <0.0001 350+ 250–349 150–249 <150 479 418 194 63 Norwood Procedures 81 (reference) 95 1.43 ( 1.06, 1.95) 47 1.59 ( 1.09, 2.32) 23 2.91 ( 1.98, 4.28) <0.0001* 0.020 0.016 <0.0001 * = P for linear trend METHODS: Patients 18 years of age or less who had a cardiac operation between 2002 and 2006 were identified in the STS National Congenital Heart Surgery Database (32,413 patients from 48 hospitals). After analyzing volume as a continuous variable, hospitals were grouped by yearly pediatric cardiac surgical volume (small <150, medium 150–249, large 250–349, * AATS Member 186 6295_AATS.book Page 187 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California very large >350). Volume categories were created to assure adequate sample size in each group. Logistic regression adjusted mortality rates for volume, surgical case mix (Aristotle and RACHS-1 categories), patient risk factors, and year of surgery. CONCLUSION: There was an inverse association between pediatric cardiac surgical volume and mortality that became increasingly important as case complexity increased. Although volume was not associated with mortality for low complexity cases, lower volume programs underperformed larger programs as case complexity increased. For one of the most complex procedures (Norwood), the largest programs had results that were significantly better than all other groups. Since overall, unadjusted, mortality rates do not accurately reflect this complex relationship, institutional comparisons must employ methodology that takes into account both patient risk factors and surgical case mix. 187 TUESDAY Afternoon RESULTS: Overall, raw mortality rates were similar across volume groups (range 3.3% [346/ 10603] to 4.0% [148/3715], p = 0.24). However, the mortality rate for difficult operations (Aristotle technical difficulty component score 4–5) decreased as volume increased, from 17.3% (54/312) at small programs to 9.9% (135/1368) at very large programs, p = 0.009. The same was true for the subgroup of patients who underwent Norwood procedures (36.5% [23/63] versus 16.9% [81/479], p < 0.0001). After adjustment for surgical case mix and patient risk factors, all groups performed similarly for low difficulty operations. (Table) Conversely, for difficult procedures, small programs performed significantly worse than all other volume groups. For Norwood procedures, very large programs outperformed all other groups. 6295_AATS.book Page 188 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY 51. What Is the Optimal Timing of Cardiac Transplantation for Failed Fontan: A Single Institution Experience Ryan R. Davies1, Jonathan Yang1, Robert Sorabella1, Mark Russo1, Ralph S. Mosca*1, Jonathan M. Chen2, Jan M. Quagebeur*1 1Columbia University Medical Center, New York, NY; 2Weill Medical College of Cornell University, New York, NY Invited Discussant: Charles B. Huddleston OBJECTIVE: An increasing number of patients are presenting with failure following the Fontan procedure. Cardiac transplantation provides one option for treating these patients, but which patients will benefit from it, and the optimal timing have not been determined. We examined our own institutional experience with transplantation for failed Fontan. METHODS: The records of 163 patients transplanted for congenital heart disease (CHD) at a single institution from 6/84–9/07 were reviewed. Of these 40 patients had a previous Fontan procedure (25 m, 15 f) (median age: 14.5 yrs, range: 1–47). Predictors of short- and longterm survival were evaluated and Fontan patients were compared to all other patients with CHD (n = 123: 79 m, 44 f) (median age: 12.8 yrs, range: 0–56). RESULTS: Among patients with a previous Fontan, 21 were classic Fontans, 11 were lateral tunnel, 3 had been revised back to shunts, and 1 was not specified. The most common indications for transplantation included: protein-losing enteropathy (25.9%), chronic heart failure (53.7%), and pulmonary arteriovenous malformations (7.4%). Transplants performed in Fontan patients were more likely to require pulmonary artery reconstruction (odds ratio 12.7, 95% CI 3.7–44.3) and had longer cardiopulmonary bypass times (205 vs. 280 min, p < 0.0001). Thirty-day mortality was higher in the Fontan group (25.0% vs. 13.0%) (2.2, 0.9– 5.4), but among patients surviving 30-days, long-term outcomes were similar (p = 0.7581) (1-yr: 83.2% vs 90.3%, 5-yr: 78.3% vs. 82.1%, 10-yr: 69.6% vs. 64.4%, p = 0.7581). Risk Factors for 30-day Mortality Among Failed Fontan Patients Risk Factor Mortality Odds Ratio (95%CI) Creatinine > 1.5 4/6 (66.7%) 10.8 (1.5–75.7) Extracorporeal membrane oxygenation 3/5 (60.0%) 5.6 (0.8–40.1) Mechanical ventilation 3/7 (42.9%) 5.0 (0.7–34.3) Less than 30-days since Fontan 2/4 (50.0%) 4.0 (0.5–34.5) Age > 18 years 5/13 (38.5%) 2.8 (0.6–12.1) Within the Fontan group no correlation between the time from Fontan to transplantation and mortality was observed. Predictors of 30-day mortality within the Fontan group are shown in the table. Renal failure was a strong predictor of early mortality (10.8, 1.5–75.7). CONCLUSION: Transplantation is an acceptable treatment for patients with a failed Fontan. Clinical factors (rather than the indication for transplantation) appear to have the highest correlation with early mortality. This suggests that patients with failed Fontans should be transplanted prior to the onset of renal failure or the need for additional physiologic support (mechanical ventilation or circulatory support). 5:00 p.m. EXECUTIVE SESSION (MEMBERS ONLY) Ballroom 20 A–C, San Diego Convention Center * AATS Member 188 6295_AATS.book Page 189 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California NOTES TUESDAY Afternoon 189 6295_AATS.book Page 190 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY WEDNESDAY MORNING, MAY 14, 2008 7:00 a.m. EMERGING TECHNOLOGIES AND TECHNIQUES FORUM (7 Minutes Presentation, 6 Minutes Discussion) Room 25, San Diego Convention Center Moderators: Michael A. Acker Lars G. Svensson T1. Inflammation Is Reduced Using the Resting Heart Mini-Cardiopulmonary Bypass System In a Prospective Randomized Study Bob Kiaii, Kelly Summers, Stephanie Fox, Stuart A. Swinamer, Reiza Rayman, Andrew Cleland, Philip Fernandes, James MacDonald, Wojciech Dobkowski, Richard J. Novick* London Health Sciences Centre, London, ON, Canada Invited Discussant: John D. Puskas OBJECTIVE: To compare the systemic inflammatory response of the Resting Heart miniaturized cardiopulmonary bypass (CPB) System (Medtronic, Minneapolis, MN) to two groups utilizing a standard extracorporeal circulation system during on-pump coronary artery bypass grafting (CABG) surgery. METHODS: 60 consecutive patients requiring CABG were prospectively randomized to undergo on-pump CABG using Group A: Conventional CPB without cardiotomy suction; Group B: Conventional CPB Group with cardiotomy suction; or Group C: Resting Heart System. Blood samples were collected at 5 time points: immediately pre-CPB, 30-minutes into CPB, end of CPB, 30-minutes post-CPB, 1-hour post-CPB. Blood was analyzed for changes in plasma levels of (1) the inflammatory cytokines IL-6, IL-8, TNF-alpha, and chemokines MIG and MCP-1 using multiplexed immunoassays, (2) troponin I using ELISA, (3) glucose using a bioanalyzer, plus (4) leukocyte and thrombocyte numbers RESULTS: MIG secretion was significantly less in Group C than Groups A and B (p = .002). IL-8 (p = .006) and MCP-1 (p = .05) secretion was significantly less in Groups C and A, than Group B. IL-6 (p = .208) and TNF (p = .206) production tended to be lower in Groups C and A, than Group B. Troponin release was significantly less in Groups C and A, compared to Group B (p = .007). Glucose levels were unchanged in all groups. Median leukocyte numbers were similarly increased in all groups. Median thrombocyte numbers increased in Group C, but decreased in Groups A and B (p = .05). CONCLUSION: The Medtronic Resting Heart mini-cardiopulmonary bypass System induced less systemic inflammation than Conventional CPB systems, particularly when cardiotomy suction was used. * AATS Member 190 6295_AATS.book Page 191 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California T2. Is Transcatheter Based Aortic Valve Implantation Really Less Invasive Than Minimal Invasive Aortic Valve Replacement? Mirko Doss, Sven Martens, Stephan Fichtelscherer, Thomas Trepels, Gerhard Wimmer Greinecker, Anton Moritz, Volker Schächinger Thoracic and Cardiovascular Surgery, J. W. Goethe University Frankfurt, Frankfurt am Main, Germany Invited Discussant: Eric E. Roselli OBJECTIVE: Transcatheter valve implants currently draw their justification for use from reduction of perioperative risk. However, patient age and comorbidities are independent predictors of adverse outcome after aortic valve replacement, regardless of prostheses. Therefore, it is unclear, whether in high risk patients, transcatheter based aortic valve implants really improve perioperative outcomes. METHODS: We included a total of 51 high risk patients with severe aortic valve stenosis. Patients were allocated to transcatheter aortic valve implantation, via transapical approach (n = 21) or minimal invasive aortic valve replacement, via partial upper sternotomy (n = 30), in a non randomized fashion. RESULTS: After a mean follow up of 12 ± 4 months, there were 5 deaths (23.8%) in the transcatheter group versus 3 deaths (10%) in the surgery group. Only 2 deaths were procedure related in each group respectively. There was 1 intraoperative death in the transcatheter group versus none in the surgery group. In the transcatheter group, there were 2 rethoracotomies for bleeding, 2 intraoperative conversions, 1 prosthesis migration and 2 impairments of coronaries. In the surgery group, there was 1 rethoracotomy and 3 cases of atrial fibrillation. There were no cases of endocarditis, stroke or atrio-ventricular block in any of the groups. CONCLUSION: Early outcomes after transcatheter aortic valve implantation, in high risk patients, match those of minimal invasive aortic valve surgery. 191 WEDNESDAY Morning Patient age and perioperative risk, expressed as logistic Euroscore, were comparable between the groups (38 ± 14 vs 35 ± 9). 6295_AATS.book Page 192 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY T3. Sutureless Perceval S Aortic Valve Replacement: Multicentric, Prospective, Pilot Trial Malakh Shrestha1, Thierry Folliguet2, Paul Herijgers3, Alain Debie2, Christoph Bara1, Marie-Christin Herregods3, Nawid Khaladj1, Christian Hagl1, Willem Flameng*3, Franscois Laborde2, Axel Haverich*1 1Cardiothoracic Surgery, Hannover Medical School, Hannover, Germany; 2Institut Mutualiste Montsouris, Paris, France; 3U.Z. Gasthuisberg, Leuven, Belgium Invited Discussant: George J. Magovern, Sr. OBJECTIVE: A European, multicentric, prospective, non-randomized, clinical pilot trial was designed to evaluate the safety (mortality and morbidity at 30 days) of the Perceval S prosthesis in 30 high surgical risk patients requiring aortic valve replacement with standard surgical procedure. Perceval S is a bovine pericardium tri-leaflet prosthetic valve fixed in a selfexpanding Nitinol stent. The exclusive shape of the stent provides a reliable anchoring of the prosthesis within the patient aortic root. This prosthesis is available in two sizes, 21 and 23 mm. Mortality, morbidity and echocardiographic haemodymanic performance evaluation is planned at discharge, 1, 3, 6 and 12 months. METHODS: The valve is implanted following sternotomy, extracorporeal circulation, aortic cross clamping, cardioplegic arrest and removal of the native valve. No suture is required. Optimal annular sealing is obtained with brief low pressure balloon dilation. When indicated, distal coronary anastomoses were performed before valve deployment. RESULTS: From April to September 2007, 23 patients (5 males, mean age: 78 ± 4 years, 76–88) have undergone aortic valve replacement. Pure aortic stenosis prevalence was 82.6%, while a mixed lesion was present in 17.4%. Mean Logistic Euroscores was 12.2% and NYHA class was III and IV in 91.3%, 8.7% respectively. Implanted valve size was 21 and 23 mm in 39.1% and 60.9% respectively. 9 (39.1%) patients received CABGs (9 IMAs, 3 vein grafts). Mean aortic cross clamp time and cardiopulmonary were 38 min and 61 min, respectively. There were no failures of deployment. One trivial paravalvular leakage (4.3%) was noticed peri-operatively at TEE; no new onset of paravalvular leakages. Tamponade was the cause of early surgical revision in 1 (4.3%) patient, a sternal wound infection (4.3%) required debridement in another one and there was a peripheral thromboembolic event (4.3%). One (4.3%) patient required PM implantation because of III° AVBlock. One (4.3%) in hospital death and one (4.3%) late death, both not-valve related. Mean length of stay was 9 days. Mean follow-up is 80 days: 18, 12 Pts. have respectively reached 1 and 3 month follow-up. No migration or dislodgement occurred. CONCLUSION: The preliminary results of this trial confirmed the safety and efficacy of this sutureless aortic valve. In this high risk subset of patients, the reduction of the aortic clamping and CPB time among other advantages has proven to reduce the mortality and morbidity related to the surgical procedure. * AATS Member 192 6295_AATS.book Page 193 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California T4. Efficacy of Intramyocardial Injection of Angiogenic Cell Precursors for Dilated Cardiomyopathy: A Case Match Study Kitipan V. Arom*, Permyos Ruengsakulrach, Vibul Jotisakulratana Cardiovascular Surgery, Bangkok Heart Hospital, Bangkok, Thailand Invited Discussant: Richard D. Weisel OBJECTIVE: The objective is to determine efficacy of intramyocardial angiogenic cell precursors (ACPs) injection in dilated cardiomyopathy (DCM). METHODS: Thirty five DCM patients (cell group) underwent intramyocardial ACPs injection. Seventeen DCM patients (control group) from heart failure database treated by medical means were matched with the cell group. There was no statistically significant different between cell and control groups in relation to age, preoperative left ventricular ejection fraction (LVEF) and NYHA Class. In the cell group, mean age was 56.7 ± 14.3 years. Mean LVEF was 23.9 ± 6.5%. NYHA Class was 3.0 ± 0.6. The ACPs were obtained from autologous blood and culture in vitro. ACPs express CD34, CD133, CD144, CD31Bright and secrete interleukin-8, vascular endothelial growth factor and angiogenin. The number of cells prior to injection was 20.7 ± 17.9 million cells. The cells were injected into all areas of the left ventricle in the cell group. CONCLUSION: Intramyocardial ACPs injection is safe and effective in the DCM patients. The NYHA class, LVEF and quality of life were significantly improved in the cell group. Large randomized control trials are needed to confirm these results. * AATS Member 193 WEDNESDAY Morning RESULTS: In the cell group: there was no new ventricular arrhythmia. NYHA class was improved by 1.1 ± 0.7 (P < 0.001) at 284.7 ± 136.2 days. Six-minute walk test improved (preop 369.5 ± 122.4 vs postop 425 ± 218.5 meters, P = 0.2) at 3 months follow up. The quality of life assessed by Short Form 36 demonstrated improving of physical function (P = 0.004), role-physical (P = 0.02), general health (P < 0.001) and vitality domains (P = 0.007) at 3 months follow up. The LVEF was improved in 71.4% of patients (25/35). The LVEF improved by 4.4 ± 10.6 points % (P = 0.02) (from 23.9 ± 6.5% to 28.3 ± 10.7%) at 192.7 ± 135.1 days. In the control group: there was no significant improvement of LVEF (preop LVEF 25.0 ± 8.9 vs postop LVEF 27.6 ± 7.6). The NYHA class was improved by 0.6 ± 0.8 (from 2.45 ± 0.9 to 1.9 ± 0.5) (P = 0.052). 6295_AATS.book Page 194 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY T5. Radiofrequency Ablation for Cure In Medically Inoperable Stage I Lung Cancer: A Single Institution Experience Michael Lanuti, Amita Sharma, Subba R. Digumarthy, Cameron D. Wright*, John C. Wain*, Douglas J. Mathisen*, JoAnne O. Shepard Thoracic Surgery, MGH, Boston, MA Invited Discussant: Neil A. Christie OBJECTIVE: To evaluate the long term results of radiofrequency ablation as primary treatment for medically inoperable early stage lung cancer. METHODS: Thirty-one consecutive patients with biopsy proven non-small cell lung cancer (NSCLC) underwent 37 treatments of CT-guided radiofrequency ablation (RFA) over a 4-year period. All patients were carefully selected after multidisciplinary evaluation and were deemed medically unresectable by a thoracic surgeon. Assessment included pulmonary function, CT-PET within 60 days from diagnosis, and mediastinoscopy for enlarged or FDG-avid lymph nodes. RFA was performed with curative intent using a single or cluster cool-tip F electrode (Radionics). Procedures were conducted primarily under conscious sedation and patients were hospitalized for 23-hour observation. RESULTS: Treatment was successfully completed in all patients with no 30-day mortality. Local recurrence was confirmed radiographically via CT and/or PET in 13% (4/31) of patients. Two patients were successfully re-treated for technical failures due to pneumothorax and one patient failed re-treatment requiring external beam radiotherapy (XRT) with stable disease. Another patient failed lung RFA and XRT. The mean maximal diameter of the 34 tumors treated was 1.9 ± 1 cm (range 0.8 – 4.4cm). Eighty-one percent (25/31) of patients were alive after a median follow-up of 12.2 ± 10 months. Three patients died of metastatic disease and 3 patients succumbed to pneumonia. The overall 2 and 4-year survival was 60% and 30%, respectively. Median overall and progression free survival was 30 months. There was no significant difference in pulmonary function measured 6 months after ablation. Complications included pneumothorax (9/37), fever (3/37), pneumonia (6/37), mild hemoptysis (8/37), small hemothorax (2/37) and pleural effusion (5/37). Two patients with upper lobe lesions developed transient nerve palsies involving the recurrent laryngeal nerve and ulnar nerve, respectively. Patient Characteristics RFA Treatments Lung Tumors Median Age Local Failure Repeat Treatment Clinical Stage T1NO T2NO Median Follow-up Disease Progression Disease Free Median Progression Free Survival (4 Years) * AATS Member 194 37 34 70 13% (4/31) 3 28 6 12 ± 10 Months 19% (6/31) 88% (22/25 Alive) 30 Months 6295_AATS.book Page 195 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California CONCLUSION: Radiofrequency ablation of medically inoperable early stage lung cancer in carefully selected patients yields encouraging mid-term to long-term results without significant loss of pulmonary function. Local tumor progression appears to be related to RFA treatment of >3 cm lung tumors. The incidence of major complications remains low. CT-PET needs further validation in the early detection of local failure of RFA-treated NSCLC. WEDNESDAY Morning 195 6295_AATS.book Page 196 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY T6. Transapical Transcatheter Aortic Valve Implantation One Year Follow-Up In 19 Patients Jian Ye, Anson Cheung, John G. Webb, Daniel R. Wong, Ronald G. Carere, Christopher R. Thompson, Samuel V. Lichtenstein Surgery, University of British Columbia, Vancouver, BC, Canada Invited Discussant: Lars G. Svensson OBJECTIVE: Added life expectancy has caused a growing elderly population often presenting with aortic stenosis (AS). Elderly patients are not referred/declined for conventional aortic valve replacement (AVR) due to age and/or significant co-morbidities. Transcatheter aortic valve implantation (AVI) without cardiopulmonary bypass could become an alternative treatment for patients who are at too high a risk for AVR. METHODS: Between 2005–2006, 19 patients (11 male) underwent transapical transcatheter AVI with 23 or 26 mm Edwards transcatheter aortic bioprostheses through a left mini-thoracotomy. Mean follow-up was 8.8 ± 7.4 months. These patients were noncandidates for transfemoral AVI because of diseased and/or small ilio-femoral arteries, or had failed the transfemoral approach. Clinical and Echo follow-up was performed at discharge, at 1 and 6 months, and then yearly after the procedure. We used matched data from 12 patients who survived over 12 months for comparisons of preoperative baseline, 1-, 6-, and 12-month follow-up Echo results. RESULTS: Mean age was 79 ± 10 yrs and the predicted operative mortality by Logistic EuroScore was 34 ± 21%. Valves were successfully deployed and well seated in the aortic annulus in 18 patients. In 1 patient, a second valve was implanted at the same time. Five patients died within 30 days from pneumonia, sepsis, ischemic bowel, and possible left main obstruction by a displaced native calcified valve. 30-day mortality was 26%. Two patients died from noncardiovascular diseases after 30 days. Overall 12-month survival was 63% (12). If patients survived 30 days postoperatively, 12-month survival was 86%. There were no late valverelated complications. NYHA class decreased significantly in all patients during follow-up. Aortic valve area (AVA) and mean gradient (MG) of the aortic bioprostheses remain stable at 1-, 6- and 12-month follow-up (AVA: 1.7 ± 0.4, 1.6 ± 0.4, & 1.6 ± 0.4 cm2; MG: 8.5 ± 4.0, 8.7 ± 4.8, and 9.5 ± 5.0 mm Hg, respectively). Trivial-mild paravalvular leaks were common and remain unchanged during the follow-up. Left ventricular ejection fraction improved from 53.3 ± 13.4% preoperatively to 54.5 ± 9.6%, 60.0 ± 9.3%, and 61.8 ± 10.2% at 1-, 6- and 12-month follow-up, respectively. CONCLUSION: Pre-existing comorbidity and postoperative sepsis are the main causes of early mortality. Transapical AVI improves quality of life by eliminating cardiac symptoms in most patients, and valve- or cardiovascular-related late mortality or morbidity is rare. 196 6295_AATS.book Page 197 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California T7. A Multicenter Prospective Randomized Trial of a 2nd Generation Anastomotic Device In Coronary Artery Bypass Surgery Lars Wiklund3, Marek Setina2, Robert J. Cusimano1, Katherine Tsang1, Terrence M. Yau*1 1Division of Cardiovascular Surgery, Toronto General Hospital, Toronto, ON, Canada; 2University Hospital FN Motol, Prague, Czech Republic; 3Sahlgrenska University Hospital, Gothenburg, Sweden Invited Discussant: Joseph F. Sabik OBJECTIVE: We performed a prospective randomized trial to evaluate the clinical and angiographic outcomes of a 2nd generation anastomotic device used for saphenous vein grafts. METHODS: This multinational randomized trial was performed at 3 centers from August 2003 to December 2004. Patients undergoing elective isolated CABG with at least 2 saphenous vein grafts were consented. Patient demographics, intraoperative data, hospital outcomes and followup data were collected. One-year study graft patency was evaluated by coronary angiography, MRI or CT, and analyzed on an intent-to-treat basis. RESULTS: 151 patients (65 ± 9 yrs, 87% male) who met inclusion/exclusion criteria and were enrolled into the study were analyzed. 489 grafts were constructed (3.2 ± 0.5 grafts per patient), including 327 vein grafts randomized to the connector (N = 162) or suture (N = 165). There were 140 LITA grafts and 22 vein grafts which were not randomized (some patients had 3 or more vein grafts, but only 2 vein grafts were randomized). In 162 connector grafts, 151 devices were successfully implanted. 11 devices had technical issues requiring explantation. A second device was used in 6 of these grafts, and the other 5 were sutured. There were 2 early (≤30 days) deaths and 1 late death. At 1 year, patients reported a mean CCS angina class of 1.01 ± 0.2. Patency was evaluated in 120 patients (81%) with 260 study grafts. 74 patients with 161 grafts were evaluated by coronary angiography, 31 patients with 69 grafts by MRI and 15 patients with 30 grafts by CT. The mean interval from surgery to angiographic/MRI/CT follow-up was 418 ± 83 days. The one-year patency rate for study grafts constructed with the anastomotic connector was 92.2% (118/128), and for hand-sutured grafts was 91.7% (121/132). CONCLUSION: This prospective multicenter randomized controlled trial demonstrated good in-hospital and late clinical outcomes and excellent one-year patency for vein grafts constructed both by the St. Jude Medical second generation aortic connector system and hand-sutured grafts. The patency of the connector grafts did not differ from that of the hand-sutured grafts. * AATS Member 197 WEDNESDAY Morning Intraoperatively, the proximal vein graft segments were sized and appropriate sizes of a second-generation aortic connector system (St. Jude Medical) were recorded. The proximal anastomoses were then randomized, within each patient, to be constructed by the connector or by suture. Each patient was randomized to receive at least one connector study graft and one sutured study graft. 6295_AATS.book Page 198 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY T8. Minimally Invasive Surgical Pulmonary Vein Isolation for Atrial Fibrillation: A Multicenter Experience James R. Edgerton*1, James McClelland2, David Duke2, Marc Gerdisch3, Bryan Steinberg4, Scott H. Bronleewe5, Tara A. Weaver6, Syma L. Prince6, Michael J. Mack*1 1Medical City Dallas Hospital, Dallas, TX; 2Endovascular Research, Eugene, OR; 3Central Dupage Hospital, Winfield, IL; 4Washington Adventist Hospital, Takoma Park, MD; 5University Community Hospital, Tampa, FL; 6CRSTI, Dallas, TX Invited Discussant: Takashi Nitta OBJECTIVE: The development of enabling technologies has allowed surgical ablation of atrial fibrillation (AF) to be accomplished in a minimally invasive manner. We conducted a prospective five center registry of patients undergoing minimally invasive surgical ablation of AF by a standardized technique to determine if the procedure is effective. METHODS: The study consisted of 150 consecutive patients, treated at 5 centers. The mean age was 60.83 (range 32–82) years with the duration of AF > one year in 87.3%. Sixty-six percent were male. Paroxysmal AF was present in 83 (55.3%), persistent in 30 (20.0%), and long-standing persistent in 37 (24.7%) Surgical indications included failure of antiarrhythmic drug (AAD) therapy (46.7%), Coumadin intolerance or noncompliance (20.0%), and failure of previous catheter ablation (24.0%). The procedure consisted of bilateral pulmonary vein antral electrical isolation with a bipolar radiofrequency clamp, targeted autonomic denervation of the left atrium, and selective left atrial appendectomy (LAA) performed through small bilateral thoracotomy incisions. Patients were followed for six months and outcomes reported using Heart Rhythm Society guidelines. Follow-up at six months included ECG and longer term monitoring (LTM). Longer term monitoring consisted of pacemaker interrogation (16 patients) or 14–30 day event monitors (72 patients). When patient circumstances dictated, a 24 hour Holter monitor was used (33 patients). NSR by ECG NSR by LTM On or off AAD NSR by LTM Off AAD Six Month Follow-Up Persistent/Long-Standing Paroxysmal Persistent Patients Patients (n = 71) (n = 50) 65 (91.5%) 38 (76.0%) 61 (85.9%) 27 (54.0%) 50 (70.4%) 20 (40.0%) All Patients (n = 121) 103 (85.1%) 88 (72.7%) 70 (57.9%) RESULTS: There were two (1.3%) operative mortalities and one (0.7%) late unrelated mortality. The LAA was excised or excluded in 134 (89.4%) patients. Mean hospital stay was 4.8 (range 0–34) days. Other complications included new heart block in 4 (2.7%) and phrenic nerve palsy in two (1.3%) patients. Six-month follow up was complete in 121 (80.7%) patients. Normal sinus rhythm (NSR) at six months by LTM was 88/121 (72.7%) with 70/121 (57.9%) off of AADs. NSR was 61/71 (85.9%) in paroxysmal and 27/50 (54.0%) in persistent/long-standing persistent patients. * AATS Member 198 6295_AATS.book Page 199 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California CONCLUSION: Minimally invasive surgical ablation of atrial fibrillation is effective treatment of paroxysmal AF with less optimal results in persistent/long-standing persistent AF. Rhythm analysis by ECG alone overestimates success by approximately 15%. WEDNESDAY Morning 199 6295_AATS.book Page 200 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY 8:45 a.m. CONTROVERSIES IN CARDIOTHORACIC SURGERY PLENARY SESSION Ballroom 20 A–C, San Diego Convention Center Live Surgery at National and Regional Cardiothoracic Surgical Meetings Should Be Outlawed Moderator: D. Craig Miller Pro: Duke Cameron Con: Hugo K.I. Vanermen CONTROVERSIES IN CARDIOTHORACIC SURGERY GENERAL THORACIC CONTROVERSIES Ballroom 20 A–C, San Diego Convention Center Should the Certifying Authority Provide Two Certificates: One for Cardiac Surgery and One for Thoracic Surgery? Moderator: Bruce W. Lytle Pro: Walter Klepetko Con: Douglas J. Mathisen 10:45 a.m. ADJOURN 200 6295_AATS.book Page 201 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California NOTES WEDNESDAY Morning 201 6295_AATS.book Page 252 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY AMERICAN ASSOCIATION FOR THORACIC SURGERY 2008 NECROLOGY Ivan D. Baronofsky, M.D., San Diego, California Ronald Belsey, M.D., Bath, England Charles A. Beskin, M.D., Atlanta, Georgia Mortimer J. Buckley, M.D., Ostertville, Massachusetts Roy H. Clauss, M.D., New York, New York Morley Cohen, M.D., Winnepeg, Canada Stephen B. Colvin, M.D., New York, New York Frederick S. Cross, M.D., Hudson, Ohio Paul Field, M.D., Victoria, British Columbia, Canada M. Judah Folkman, M.D., Boston, Massachusetts Edward J. Hurley, M.D., El Macero, California Frank E. Johnson, M.D, St. Louis, Missouri Ellis L. Jones, M.D., Atlanta, Georgia 252 6295_AATS.book Page 253 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California James A. Magovern, M.D., Pittsburgh, Pennsylvania Clifton F. Mountain, M.D., San Diego, California Eoin O’Malley, M.D., Dublin, Ireland Robert J. Schramel, M.D., New Orleans, Louisiana Richard D. Schultz, M.D., Omaha, Nebraska Edward A. Stemmer, M.D., Long Beach, California James H. Walker, M.D., Charleston, West Virginia John Y. Templeton, III, M.D., Bryn Mawr, Pennsylvania 253 6295_AATS.book Page 254 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY AMERICAN ASSOCIATION FOR THORACIC SURGERY 2007 – 2008 GEOGRAPHICAL ROSTER (Current as of February, 2008) NORTH AMERICA UNITED STATES ALABAMA ARKANSAS Birmingham Athanasuleas, Constantine L Cerfolio, Robert J Holman, William L Kahn, Donald R Kirklin, James K McGiffin, David C Indian Springs Pacifico, Albert D Montgomery Simmons, Earl M ALASKA Little Rock Campbell, Gilbert S Read, Raymond C CALIFORNIA Anchorage Misbach, Gregory A ARIZONA Carefree Michaelis, Lawrence Green Valley McClenathan, James E Phoenix Pearl, Jeffrey M Vaughn, Cecil C Scottsdale Fisk, R. Leighton Pluth, James R Shields, Thomas W Trastek, Victor F Tempe Cornell, William P Tucson Copeland, Jack G Sanderson, Richard G Sethi, Gulshan K Alameda Ecker, Roger R Bonita Gonzalez-Lavin, Lorenzo Capistrano Beach Flynn, Pierce J Carmel Iverson, Leigh I Clovis Bolton, J. W. Randolph Coronado Silver, Arthur W Duarte Kernstine, Kemp El Macero Andrews, Neil C Fallbrook Swain, Julie A Granite Bay Ebert, Paul A Hillsborough Thomas, Arthur N Ullyot, Daniel J Indian Wells Salyer, John M Irvine Kirsh, Marvin M La Canada Penido, John R. F.. 254 La Jolla DeLaria, Giacomo A Hutchin, Peter West, John B Lakeside Aaron, Benjamin L Loma Linda Bailey, Leonard L Razzouk, Anees J Wareham, Ellsworth E Los Angeles Allen, Bradley S Ardehali, Abbas Benfield, John R Buckberg, Gerald D Chaux, Aurelio Cohen, Robbin G DeMeester, Tom R Fontana, Gregory P Holmes, E. Carmack Kay, Jerome H Laks, Hillel Maloney, James V Matloff, Jack M McFadden, P. Michael McKenna, Robert J Shemin, Richard J Sintek, Colleen F Starnes, Vaughn A Trento, Alfredo Wells, Winfield J Lynwood Lee, Myles E Martinez Guernsey, James M Mendocino Kerth, William J Montebello Lui, Alfred H. F. 6295_AATS.book Page 255 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California San Jose Oakes, David D San Marino Tsuji, Harold K San Rafael Roe, Benson B Santa Ana Gazzaniga, Alan B Santa Barbara Jahnke, Edward J Love, Jack W Santa Cruz Fishman, Noel H Santa Monica Fonkalsrud, Eric W Morton, Donald L Robertson, John M Sausalito Zaroff, Lawrence I Stanford Fann, James I Hanley, Frank L Mark, James B. D. Miller, D. Craig Mitchell, R. Scott Oyer, Philip E Reddy, V. Mohan Reitz, Bruce A Robbins, Robert C Whyte, Richard I Tiburon Heydorn, William H Torrance Carey, Joseph S Moore, Thomas C State, David Ventura Brandt, Berkeley Dart, Charles H Walnut Creek May, Ivan A COLORADO Aurora Fullerton, David A Lacour Gayet, Francois Pomerantz, Marvin Beulah Bartley, Thomas D Denver Campbell, David N Eiseman, Ben Clarke, David R Grover, Frederick L Hopeman, Alan R 255 Paton, Bruce C Rainer, W. Gerald Greenwood Village Pappas, George Parker Olinger, Gordon N Snowmass Village Mills, Lawrence J Steamboat Springs Greenberg, Jack J CONNECTICUT Bridgeport Rose, Daniel M Essex Jaretzki, Alfred New Haven Detterbeck, Frank C Elefteriades, John A Hammond, Graeme L Kopf, Gary S Shinoka, Toshiharu Tellides, George North Haven Adams, Peter X Norwalk Okinaka, Arthur J Old Greenwich Brodman, Richard F Waterbury Sanchez, Juan A Woodbridge Stern, Harold DELAWARE Dover Mannion, John D Greenville Norwood, William I Newark Banbury, Michael K Gardner, Timothy J DISTRICT OF COLUMBIA Washington Jonas, Richard A Katz, Nevin M Keshishian, John M Simmons, Robert L Trachiotis, Gregory D FLORIDA Atlantic Beach Stranahan, Allan ROSTER Geographical Murrieta Wakabayashi, Akio Oakland Harken, Alden H Orange Blanche, Carlos Connolly, John E Milliken, Jeffrey C Ott, Richard A Pacific Palisades Mulder, Donald G Palm Desert Fosburg, Richard G Palm Springs Gundry, Steven R Palo Alto Burdon, Thomas A Champsaur, Gerard L Palos Verdes Estates Cukingnan, Ramon A Nelson, Ronald J Stiles, Quentin R Pebble Beach Miller, George E Portola Valley Fogarty, Thomas J Rancho Palos Verdes Mandal, Ashis K Rancho Santa Fe Daily, Pat O Geha, Alexander S Sacramento Berkoff, Herbert A Follette, David M Harlan, Bradley J Mainwaring, Richard D Young, J. Nilas San Diego Dembitsky, Walter P Jamieson, Stuart W Lamberti, John J Miller, Fletcher A Moreno-Cabral, Ricardo J Thistlethwaite, Patricia A Trummer, Max J San Francisco Ellis, Robert J Hill, J. Donald Jablons, David M Karl, Tom R Merrick, Scot H Ratcliffe, Mark B Yee, Edward S 6295_AATS.book Page 256 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY Aventura Bregman, David Bal Harbour Grondin, Pierre R Belleair Lasley, Charles H Boca Raton Kiser, Joseph C Coconut Grove Center, Sol Coral Gables Reis, Robert L Delray Beach Rosensweig, Jacob Fernandina Beach Malm, James R Gainesville Alexander, James A Spotnitz, William D Tribble, Curt G Jacksonville Edwards, Fred H Koster, J. Kenneth Jupiter Gerbasi, Francis S Lake Wales Bender, Harvey W Lakeland Brown, Ivan W Largo Wheat, Myron W Miami Beach Spear, Harold C Miami Bolooki, Hooshang Jude, James R Kaiser, Gerard A Kurlansky, Paul A Pham, Si Mai Ricci, Marco Salerno, Tomas A Subramanian, S Thurer, Richard J Wilder, Robert J Naples Cox, James L Gonzalez, Luis L Linberg, Eugene J MacGregor, David C Smyth, Nicholas P. D. Orlando Accola, Kevin D DeCampli, William M Palm City Timmis, Hilary H Ponte Vedra Beach Barnhorst, Donald A Gilbert, Joseph Saint Petersburg Daicoff, George R Jacobs, Jeffrey P Tallahassee Kraeft, Nelson H Lambert, Cary J Tamarac Friedlander, Ralph Tampa Angell, William W Robinson, Lary A GEORGIA Atlanta Craver, Joseph M Gott, John P Guyton, Robert A Hatcher, Charles R Kanter, Kirk R Kessler, Charles R Lee, Arthur B Mansour, Kamal A Miller, Daniel L Miller, Joseph I Puskas, John D Symbas, Panagiotis Vega, J. David Williams, Willis H Augusta Landolfo, Kevin P Chickamauga Hall, David P Dunwoody Rivkin, Laurence M Evans Zumbro, G. Lionel Macon Dalton, Martin L Van De Water, Joseph M Savannah Yeh, Thomas J HAWAII Honolulu Ching, Nathaniel P Gebauer, Paul W McNamara, J. Judson Kailua Young, William P 256 Kihei Smeloff, Edward A IDAHO Boise Herr, Rodney H ILLINOIS Burr Ridge Blakeman, Bradford P Chicago Amato, Joseph J Backer, Carl L Barker, Walter L Breyer, Robert H Campbell, Charles D Faber, L. Penfield Ferguson, Mark K Goldin, Marshall D Hanlon, C. Rollins Higgins, Robert S. D. Jeevanandam, Valluvan Kittle, C. Frederick Massad, Malek G Mavroudis, Constantine McCarthy, Patrick M Montoya, Alvaro Najafi, Hassan Raffensperger, John Raman, Jaishankar Replogle, Robert L Snow, Norman J Tatooles, Constantine J Vanecko, Robert M Warren, William H Zajtchuk, Rostik Elk Grove Village Sullivan, Henry J Evanston Head, Louis R Glencoe Rubenstein, L. H. Lake Forest Weinberg, Milton Maywood Love, Robert B Pifarre, Roque Oak Brook Jensik, Robert J Nigro, Salvatore L Oak Lawn Ilbawi, Michel N Oak Park Hartz, Renee S River Forest Mason, G. Robert 6295_AATS.book Page 257 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California Springfield Hazelrigg, Stephen R Western Springs Thomas, Paul A Willowbrook Leininger, Bernard J Winnetka Fry, Willard A Mackler, S. Allen INDIANA Anderson Scott, Henry E Bloomington O’Neill, Martin J Fort Wayne Ladowski, Joseph S Indianapolis Brown, John W Kesler, Kenneth A King, Harold King, Robert D Mahomed, Yousuf Mandelbaum, Isidore Rodefeld, Mark D Shumacker, Harris B Siderys, Harry Turrentine, Mark W IOWA Kansas City Reed, William A Lawrence Miller, Don R Mission Hills Ashcraft, Keith W Piehler, Jeffrey M KENTUCKY Lexington Crutcher, Richard R Ferraris, Victor A Todd, Edward P Zwischenberger, Joseph B Louisville Austin, Erle H Dowling, Robert D Gray, Laman A Mahaffey, Daniel E LOUISIANA Alexandria Webb, Watts R Baton Rouge Berry, B. Eugene Nathitoches Bloodwell, Robert D New Orleans Blalock, John B DeCamp, Paul T DeLeon, Serafin Y Hewitt, Robert L Lindsey, Edward S Moulder, Peter V Ochsner, John L VanMeter, Clifford H Shreveport Mancini, Mary C MAINE Cape Elizabeth Bredenberg, Carl E Lewiston Cochran, Richard P Portland Morton, Jeremy R Rome Tarnay, Thomas J Sedgwick Siewers, Ralph D Yarmouth Hiebert, Clement MARYLAND Baltimore Attar, Safuh Baker, R. Robinson Battafarano, Richard J 257 Baumgartner, William A Cameron, Duke Ed Conte, John V Gott, Vincent L Greene, Peter S Griffith, Bartley P Haller, J. Alex McLaughlin, Joseph S Pierson, Richard N Watkins, Levi Yang, Stephen C Bethesda Horvath, Keith A Nguyen, Dao M Schrump, David S Glen Arm Turney, Stephen Z Lutherville Salomon, Neal W Parkville Hankins, John R Reisterstown Heitmiller, Richard F Towson Krasna, Mark J Worton Walkup, Harry E MASSACHUSETTS Amherst Levine, Frederick H Boston Akins, Cary W Allan, James S Aranki, Sary F Austen, W. Gerald Bacha, Emile A Bolman, R. Morton Bueno, Raphael Burke, John F Cohn, Lawrence H Collins, John J Colson, Yolonda L Couper, Gregory S Daggett, Willard M Daly, Benedict D. T. DeCamp, Malcolm M del Nido, Pedro J Ellis, F. Henry Gaissert, Henning A Hilgenberg, Alan D Jaklitsch, Michael T Lazar, Harold L Levitsky, Sidney Madsen, Joren C Mathisen, Douglas J Mayer, John E Mentzer, Steven J ROSTER Geographical Cedar Rapids Levett, James M Council Bluffs Sellers, Robert D Des Moines Zeff, Robert H Iowa City Behrendt, Douglas M Ehrenhaft, Johann L Iannettoni, Mark D Richenbacher, Wayne E Rossi, Nicholas P Stanford, William Urbandale Phillips, Steven J KANSAS Prairie Village Holder, Thomas M Shawnee Mission Killen, Duncan A Padula, Richard T 6295_AATS.book Page 258 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY Pigula, Frank A Rosengard, Bruce R Sellke, Frank W Sugarbaker, David J Thurer, Robert L Torchiana, David F Urschel, John D Vlahakes, Gus J Wain, John C Warner, Kenneth G Weintraub, Ronald M Wright, Cameron D Boylston Okike, Okike N Brookline Berger, Robert L Cambridge Malcolm, John A Neirotti, Rodolfo Centerville Lefemine, Armand A Chestnut Hill Bougas, James A Concord Norman, John C Falmouth McElvein, Richard B Framingham Bernhard, William F Medford Desforges, Gerard North Andover Cook, William A Plymouth Moran, John M Salem Vander Salm, Thomas J Springfield Engelman, Richard M Rousou, John A Sudbury Shahian, David M Wayland Moncure, Ashby C West Newton Neptune, Wilford B West Roxbury Barsamian, Ernest M Khuri, Shukri F Westborough Schuster, Samuel R Weston Rheinlander, Harold F Westwood Black, Harrison Williamstown Wilkins, Earle W Worcester Conlan, A. Alan Harrison, Lynn H MICHIGAN Ann Arbor Bartlett, Robert H Bolling, Steven F Bove, Edward L Deeb, G. Michael Gago, Otto Greenfield, Lazar J Neerken, A. John Ohye, Richard G Orringer, Mark B Pagani, Francis D Prager, Richard L Sloan, Herbert E Detroit Arbulu, Agustin Baciewicz, Frank A Delius, Ralph E Mentzer, Robert M Silverman, Norman A Stephenson, Larry W Walters, Henry L Wilson, Robert F Grand Rapids Harrison, Robert W Rasmussen, Richard A Taber, Rodman E Tomatis, Luis A Grasse Pointe Farms Javid, Hushang West Bloomfield Arciniegas, Eduardo MINNESOTA Coon Rapids Joyce, Lyle D Hopkins Garamella, Joseph J Minneapolis Foker, John E Gannon, Paul G Helseth, Hovald K Kelly, Rosemary Maddaus, Michael A Shumway, Sara J Ward, Herbert B 258 New Brighton Molina, J. Ernesto Rochester Allen, Mark S Bernatz, Philip E Daly, Richard C Danielson, Gordon K Dearani, Joseph A Deschamps, Claude McGregor, Christopher G. A. Mullany, Charles J Orszulak, Thomas A Pairolero, Peter C Park, Soon J Puga, Francisco J Schaff, Hartzell V Sundt, Thoralf M Saint Paul Emery, Robert W Stillwater Kaye, Michael P Waubun DeNiord, Richard N MISSISSIPPI Carriere Mills, Noel L Carthage Logan, William D Clinton McPhail, Jasper L Jackson Johnston, J. Harvey McMullan, Martin H MISSOURI Chesterfield Bergmann, Martin Columbia Curtis, Jack J Silver, Donald Walls, Joseph T Frontenac Strevey, Tracy E Kansas City Allen, Keith B Borkon, A. Michael Hopkins, Richard A Lofland, Gary K Van Way, Charles W Saint Louis Barner, Hendrick B Codd, John E Connors, John P Damiano, Ralph J Ferguson, Thomas B 6295_AATS.book Page 259 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California Fiore, Andrew C Flye, M. Wayne Gandhi, Sanjiv K Gay, William A Huddleston, Charles B Johnson, Robert G Kouchoukos, Nicholas T Lewis, J. Eugene Meyers, Bryan F Moon, Marc R Naunheim, Keith S Pasque, Michael K Patterson, Alec Penkoske, Patricia A Roper, Charles L Sasser, William F Willman, Vallee L Webster Groves Kaiser, George C MONTANA Columbia Falls Myerowitz, P. David Missoula Duran, Carlos Gomez Stevensville Oury, James H NEBRASKA Bennington Fleming, William H Lincoln Northrup, William F NEVADA Hanover Plume, Stephen K Lebanon Nugent, William C Sanders, John H Stratham Gaensler, Edward A NEW JERSEY Alpine Holswade, George R Basking Ridge Lewis, Ralph J Belleville Gerard, Franklyn P Browns Mills McGrath, Lynn B Neptune Roberts, Arthur J New Brunswick Mackenzie, James W Scholz, Peter M Newark Donahoo, James McBride, Lawrence R Parsonnet, Victor Paramus Korst, Robert J Pittstown Garzon, Antonio A South Orange Gielchinsky, Isaac Swan, Kenneth G Tenafly Gerst, Paul H Wallsh, Eugene Wyckoff Adler, Richard H NEW MEXICO Albuquerque Dietl, Charles A Wernly, Jorge A Alto Sutherland, R. Duncan Buena Vista Thal, Alan P Santa Fe Davila, Julio C NEW YORK Albany Moores, Darroch W. O. Bronx Attai, Lari A Ford, Joseph M 259 Hirose, Teruo Veith, Frank J Bronxville Frater, Robert W. M. Brooklyn Acinapura, Anthony J Cunningham, Joseph N Lahey, Stephen J Levowitz, Bernard S LoCicero, Joseph Sawyer, Philip N Buffalo Demmy, Todd L Hoover, Eddie L Canandaigua Craver, William L Chappaqua Fell, Stanley C Dewitt Parker, Frederick B East Amherst Bhayana, Joginder N Fishers Island Baue, Arthur E Floral Park Crastnopol, Philip Garden City Hines, George L Germantown Reed, George E Larchmont Steichen, Felicien M New York Adams, David H Altorki, Nasser K Anagnostopoulos, C. E. Bains, Manjit S Boyd, Arthur D Culliford, Alfred T Downey, Robert J Filsoufi, Farzan Flores, Raja M Galloway, Aubrey C Girardi, Leonard N Green, George E Griepp, Randall B Grossi, Eugene A Hochberg, Mark S Isom, O. Wayne King, Thomas C Kirschner, Paul A Krieger, Karl H Litwak, Robert S Michler, Robert E Moggio, Richard A ROSTER Geographical Las Vegas Carter, P. Richard NEW HAMPSHIRE Camden Camishion, Rudolph C Englewood Ergin, M. Arisan Fort Lee Conklin, Edward F Jersey City Demos, Nicholas J Moorestown DelRossi, Anthony J Fernandez, Javier Morristown Parr, Grant V. S. 6295_AATS.book Page 260 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY Mosca, Ralph S Naka, Yoshifumi Oz, Mehmet C Pass, Harvey I Quaegebeur, Jan Modest Redo, S. Frank Rose, Eric A Rusch, Valerie W Smith, Craig R Sonett, Joshua R Spencer, Frank C Spotnitz, Henry M Subramanian, Valavanur A Swanson, Scott J Tice, David A Waters, Paul F Wichern, Walter Wolff, William I NorthPort Soroff, Harry S Plattsburgh Potter, Robert T Rochester DeWeese, James A Hicks, George L Schwartz, Seymour I Stewart, Scott Roslyn Thomson, Norman B Wisoff, George Stony Brook Bilfinger, Thomas V Rosengart, Todd K Syracuse Kohman, Leslie J Meyer, John A Valhalla Lansman, Steven L Voorheesville Foster, Eric D White Plains McCormack, Patricia M Williamsville Andersen, Murray N NORTH CAROLINA Asheville Hill, Ronald C Kroncke, George M Takaro, Timothy Biltmore Forest Watson, Donald C Chapel Hill Bowman, Frederick Egan, Thomas M Feins, Richard H Keagy, Blair A Mill, Michael R Oldham, H. Newland Sink, James D Starek, Peter J Wilcox, Benson R Charlotte Robicsek, Francis Selle, Jay G Durham Anderson, Robert W D’Amico, Thomas A Davis, R. Duane Glower, Donald D Harpole, David H Jaggers, James Jones, Robert H Lowe, James E Milano, Carmelo A Sabiston, David C Smith, Peter K Wolfe, Walter G Gastonia Dyke, Cornelius M Greensboro Van Trigt, Peter Greenville Chitwood, W. Randolph Elbeery, Joseph R Ferguson, T. Bruce High Point Mills, Stephen A Highlands Mullen, Donald C Winston-Salem Cordell, A. Robert Hammon, John W Hudspeth, Allen S Kon, Neal D Meredith, Jesse H OHIO Chagrin Falls Ankeney, Jay L Cincinnati Albers, John E Callard, George M Flege, John B Helmsworth, James A Hiratzka, Loren F Ivey, Tom D Manning, Peter B Merrill, Walter H Wilson, James Miller Wolf, Randall K Wright, Creighton B 260 Cleveland Blackstone, Eugene H Cobanoglu, Adnan Cosgrove, Delos M Duncan, Brian W Gillinov, A. Marc Greenberg, Roy K Lytle, Bruce W Murthy, Sudish C Pettersson, Gosta B Rice, Thomas W Sabik, Joseph F Smedira, Nicholas G Svensson, Lars G Van Heeckeren, Daniel W Columbus Davis, J. Terrance Kakos, Gerard S Meckstroth, Charles Williams, Thomas E Dayton DeWall, Richard A Little, Alex G Grove City Kilman, James W Lyndhurst Loop, Floyd D Toledo Gold, Jeffrey P Willoughby Groves, Laurence K OKLAHOMA Oklahoma City Elkins, Ronald C Felton, Warren L Fisher, R. Darryl Zuhdi, M. Nazih Tulsa LeBeck, Martin B OREGON Ashland Campbell, Daniel C Days Creek Miller, Arthur C Florence Turley, Kevin Medford Lupinetti, F.. Mark Portland Furnary, Anthony P Handy, John R Krause, Albert H Lemmer, John H Okies, J. Edward 6295_AATS.book Page 261 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California Poppe, J. Karl Starr, Albert Ungerleider, Ross M PENNSYLVANIA Providence Moulton, Anthony L Singh, Arun K SOUTH CAROLINA Charleston Bradham, R. Randolph Bradley, Scott M Crawford, Fred A Ikonomidis, John S Kratz, John M Reed, Carolyn E Rubin, Joseph W Sade, Robert M Spinale, Francis G Swenson, Orvar Columbia Almond, Carl H Greenwood Lajos, Thomas Z Hilton Head Island Humphrey, Edward W TENNESSEE Johnson City Pennington, D. Glenn Jonesborough Bryant, Lester R Knoxville Blake, Hu Al Brott, Walter H Memphis Pate, James W Robbins, S. Gwin Shochat, Stephen J Weiman, Darryl S 261 Nashville Alford, William Byrne, John G Drinkwater, Davis C Gobbel, Walter G Nesbitt, Jonathan C Putnam, Joe B, Randolph, Judson G Rankin, J. Scott Sawyers, John L Stoney, William S Thomas, Clarence S TEXAS Austin Tyson, Kenneth R. T. Wukasch, Don C Dallas Adam, Maurice DiMaio, J. Michael Estrera, Aaron S Holland, Robert H Jessen, Michael E Mack, Michael J Mendeloff, Eric N Meyer, Dan M Platt, Melvin R Ring, W. Steves Urschel, Harold C Dilley Hood, Richard H Galveston Conti, Vincent R Henly, Walter S Houston Cooley, Denton A Coselli, Joseph S DeBakey, Michael E Espada, J. Rafael Fraser, Charles D Frazier, O. Howard Hallman, Grady L Lawrie, Gerald M LeMaire, Scott A Letsou, George V Mattox, Kenneth L Ott, David A Overstreet, John W Reardon, Michael J Reul, George J Roth, Jack A Safi, Hazim J Swisher, Stephen G Vaporciyan, Ara A Walker, William E Walsh, Garrett L Kemp Davis, Milton V ROSTER Geographical Abington Addonizio, V. Paul Berwyn Edie, Richard N Camp Hill Pennock, John L Carlisle DeMuth, William E Hershey Campbell, David B Midgley, Frank M Myers, John L Pae, Walter E Pierce, William S Huntingdon Valley Lemole, Gerald M Johnstown Kolff, Jacob Lancaster Bonchek, Lawrence I Lemoyne Waldhausen, John A Philadelphia Acker, Michael A Bavaria, Joseph E Bowles, L. Thompson Cooper, Joel D Diehl, James T Edmunds, L. Henry Friedberg, Joseph S Gaynor, J. William Gorman, Joseph H Gorman, Robert C Guerraty, Albert J Hargrove, W. Clark Jacobs, Marshall L Kaiser, Larry R MacVaugh, Horace Samuels, Louis E Shrager, Joseph P Spray, Thomas L Wechsler, Andrew S Whitman, Glenn J. R. Woo, Y. Joseph Pittsburgh Hardesty, Robert L Hattler, Brack G Keenan, Robert J Kormos, Robert L Landreneau, Rodney J Luketich, James D Magovern, George J Magovern, George J McCurry, Kenneth R Pontius, Robert G Rams, James J Zehr, Kenton J Rydal Goldberg, Melvyn Sewickley Clark, Richard E West Chester DiSesa, Verdi J Wilkes-Barre Cimochowski, George E Wynnewood Goldman, Scott M McKeown, John J Wallace, Herbert W RHODE ISLAND 6295_AATS.book Page 262 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY Lubbock Baldwin, John C Bricker, Donald L Feola, Mario Hood, R. Maurice Montgomery Jones, James W Plano Edgerton, James R San Antonio Calhoon, John H Cohen, David J Dooley, Byron N Treasure, Robert L Temple Smythe, W. Roy UTAH Bountiful Doty, Donald B Murray Jones, Kent W Park City Hughes, Richard K Salt Lake City Hawkins, John A Karwande, Shreekanth V Liddle, Harold V McGough, Edwin C Nelson, Russell M VERMONT Burlington Leavitt, Bruce J Hartland Marrin, Charles A. S. Richford Grondin, Claude M VIRGINIA Alexandria Speir, Alan M Altavista Pierucci, Louis Charlottesville Crosby, Ivan Keith Dammann, John F Daniel, Thomas M Jones, David R Kern, John A Kron, Irving L Minor, George R Muller, William H Nolan, Stanton P Wellons, Harry A Falls Church Ad, Niv Burton, Nelson A Lefrak, Edward A Fredericksburg Armitage, John M McLean Conrad, Peter W Pecora, David V Wallace, Robert B Norfolk Baker, Lenox D Reston Boyd, Thomas F Richmond Bosher, Lewis H Brooks, James W Lower, Richard R Springfield Mills, Mitchell WASHINGTON Issaquah Gentsch, Thomas O Mercer Island Li, Wei-i Manhas, Dev R Seattle Aldea, Gabriel S Allen, Margaret D Anderson, Richard P 262 Cohen, Gordon A Mansfield, Peter B Merendino, K. Alvin Miller, Donald W Mulligan, Michael S Sauvage, Lester R Thomas, George I Verrier, Edward D Wood, Douglas E Silverdale Malette, William G Spokane Berg, Ralph WEST VIRGINIA Morgantown Graeber, Geoffrey M Gustafson, Robert A Murray, Gordon F WISCONSIN Altoona McEnany, M. Terry Brookfield Johnson, W. Dudley Madison Chopra, Paramjeet S Weigel, Tracey L Marshfield Myers, William O Milwaukee Almassi, G. Hossein Haasler, George B Litwin, S. Bert Tector, Alfred J Tweddell, James S West Bend Gardner, Robert J WYOMING Evanston Kaunitz, Victor H Shell Scott, Meredith L 6295_AATS.book Page 263 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California CANADA ALBERTA Calgary Bharadwaj, Baikunth Miller, George E Edmonton Gelfand, Elliot T Koshal, Arvind Rebeyka, Ivan M Ross, David B Sterns, Laurence P BRITISH COLUMBIA Vancouver Ashmore, Phillip G Jamieson, W. R. Eric Tyers, G. Frank O Victoria Stenstrom, John D MANITOBA Winnipeg Barwinsky, Jaroslaw Menkis, Alan H Unruh, Helmut W NOVA SCOTIA Halifax Hirsch, Gregory M Johnston, Michael R Kingsburg Murphy, David A ONTARIO 263 Waubaushene Mickleborough, Lynda L Westbrook Lynn, R. Beverley QUEBEC Montreal Blundell, Peter E Carrier, Michel Chartrand, Claude C. C. Chiu, Chu-Jeng (Ray) Dobell, Anthony R. C. Duranceau, Andre C. H. MacLean, Lloyd D Morin, Jean E Mulder, David S Pelletier, L. Conrad Perrault, Louis P Shum-Tim, Dominique Tchervenkov, Christo I Pointe-Claire Shennib, Hani Rosemere Cossette, Robert Saint-Laurent DesLauriers, Jean SASKATCHEWAN Saskatoon Casson, Alan G ROSTER Geographical Almonte Todd, Thomas R. J. Collingwood Heimbecker, Raymond Hamilton Kirby, Thomas J London Guiraudon, Gerard M McKenzie, F. Neil Novick, Richard J Mansfield Pearson, F. Griffith Oakville Allen, Peter Ottawa Hendry, Paul J Keon, Wilbert J Mesana, Thierry G Ruel, Marc Sundaresan, R. Sudhir Sebright Trimble, Alan S Toronto Baird, Ronald J Christakis, George T Coles, John G David, Tirone E Feindel, Christopher M Fremes, Stephen E Goldman, Bernard S Keshavjee, Shaf McKneally, Martin F Scully, Hugh E Trusler, George A Van Arsdell, Glen Weisel, Richard D Williams, William G Yau, Terrence M 6295_AATS.book Page 264 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY AMERICAN ASSOCIATION FOR THORACIC SURGERY 2007 – 2008 GEOGRAPHICAL ROSTER (Current as of February, 2008) OTHER COUNTRIES ARGENTINA Buenos Aires Kreutzer, Guillermo O Schlichter, Andres J AUSTRALIA QUEENSLAND Main Beach O’Brien, Mark F SOUTH AUSTRALIA Beaumont Sutherland, H D’Arcy Nurioopta Aberg, Torkel H VICTORIA Parkville Tatoulis, James Richmond Buxton, Brian F Williams Town Mee, Roger B. B. AUSTRIA Salzburg Unger, Felix H Thumersbach Bruecke, Peter E Vienna Klepetko, Walter Wolner, Ernst BELGIUM Aalst Casselman, Filip P Vanermen, Hugo K. I. Genk Dion, Robert A Leuven Flameng, Willem J Lerut, Antoon E.M.R. Sergeant, Paul T Van Raemdonck, Dirk E. M. Linden Daenen, Willem J BRAZIL Rio de Janeiro Meier, Milton A Sao Paulo DaSilva, Jose Pedro Jatene, Adib D Oliveira, Sergio A SaoJose do RioPreto Braile, Domingo M CHINA Beijing Wu, Qingyu ENGLAND Amersham Bucks Khaghani, Asghar Bristol Angelini, Gianni D Cambridge Wallwork, John Wells, Francis C Harefield Dreyfus, Gilles D Yacoub, Magdi Herts Lennox, Stuart C Liverpool Corno, Antonio F London Braimbridge, Mark V 264 de Leval, Marc R Elliott, Martin J Goldstraw, Peter Lincoln, Christopher R Ross, Donald N Stark, Jaroslav F Taylor, Kenneth M Tsang, Victor T Newcastle upon Tyne Dark, John H Oxford McCord, Colin W Taggart, David P Westaby, Stephen Somerset Abbey-Smith, R Southampton Hants Monro, James L Suffolk Kennedy, John H Worcestershire Landymore, Roderick W FINLAND Grankulla Mattila, Severi P Helsinki Harjula, Ari L. J. FRANCE Bordeaux-Pessac Roques, Xavier F Bordeaux Fontan, Francis M Creteil Loisance, Daniel Le Plessis Robinson Binet, Jean-Paul Dartevelle, Philippe G 6295_AATS.book Page 265 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California Planche, Claude Serraf, Alain Lyon Jegaden, Olivier J. L. Obadia, Jean F Marseille Metras, Dominique R Montpellier Thevenet, Andre A Paris Blondeau, Philip Cabrol, Christian E. A. Carpentier, Alain F Chachques, Juan C Chauvaud, Sylvain M Grunenwald, Dominique H Khonsari, Siavosh Menasche, Philippe Piwnica, Armand H Pessac Baudet, Eugene M Couraud, Louis GERMANY Athens Palatianos, George M Sarris, George E Guatemala City Castaneda, Aldo R Herrera-Llerandi, Rodolfo HONG KONG Shatin, NT He, Guo-Wei Yim, Anthony P INDIA Mogappair, Chennai Cherian, K. Mammen ISRAEL Jerusalem Shapira, Oz M ITALY Bergamo Parenzan, Lucio Catania Calafiore, Antonio M Milan Alfieri, Ottavio R Peracchia, Alberto Naples Cotrufo, Maurizio Rocco, Gaetano Padova Bortolotti, Uberto Gerosa, Gino Stellin, Giovanni Palermo Marcelletti, Carlo Rome Di Donato, Roberto Rendina, Erino Angelo Venuta, Federico San Donato Milanese Menicanti, Lorenzo A JAPAN Fukuoka Yasui, Hisataka Handa City, Aicki Bando, Ko Kanazawa Iwa, Takashi Kitakyushushi Miyamoto, Alfonso T Kobe Matsuda, Hikaru Okita, Yutaka 265 Kyoto Wada, Hiromi Minoo City Kawashima, Yasunaru Okayama City Sano, Shunji Okayama Date, Hiroshi Osaka Kitamura, Soichiro Kobayashi, Junjiro Sapporo Abe, Tomio Kazui, Teruhisa Sendai Fujimura, Shigefumi Mohri, Hitoshi Tabayashi, Koichi Shinjuku-ku Imai, Yasuharu Tokyo Koyanagi, Hitoshi Kurosawa, Hiromi Nitta, Takashi Suma, Hisayoshi Takamoto, Shinichi Wada, Juro J Toyohashi, Aichi Komeda, Masashi KOREA Seoul Chang, Byung-Chul MONACO Monaco Cedex Dor, Vincent NETHERLANDS Amsterdam Brutel De La Riviere, Aart Utrecht Jansen, Erik W. L. POLAND Szczecin Grodzki, Tomasz PORTUGAL Carnaxide Melo, Joao Queiroze Coimbra Antunes, Manuel J Leca Da Palmeira Gomes, Mario N ROSTER Geographical Aachen Messmer, Bruno J Bad Oeynhausen Korfer, Reiner Berlin Alexi-Meskishvili, Vladimir Hetzer, Roland Freiburg Beyersdorf, Friedhelm Hannover Haverich, Axel Homburg/Saar Schafers, Hans-Joachim Leipzig Mohr, Friedrich W Loiching Sebening, Fritz Munich Borst, Hans G Malec, Edward J Munster Daebritz, Sabine H Neuss Bircks, Wolfgang H GREECE GUATEMALA 6295_AATS.book Page 266 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY REPUBLIC OF KOREA Seoul Cho, Bum-Koo ROMANIA Targu-Mures Deac, Radu C RUSSIA Moscow Bockeria, Leo A SAUDI ARABIA Riyadh Al-Halees, Zohair Y Canver, Charles C SCOTLAND Bearsden Glasgow Wheatley, David J SINGAPORE Singapore Lee, Chuen-Neng SPAIN Barcelona Aris, Alejandro Macchiarini, Paolo Mestres, Carlos A Murtra, Marcos Pomar, Jose L Madrid Comas, Juan V Rivera, Ramiro Santander Revuelta, Jose Manuel Valencia Otero Coto, Eduardo SWEDEN Turina, Marko I Weder, Walter SYRIA Stockholm Bjork, Viking SWITZERLAND Abu Dhabi Bachet, Jean E UNITED KINGDOM Berne Carrel, Thierry-Pierre Bottmingen Hasse, Joachim T. W. Geneva Kalangos, Afksendiyos Lausanne vonSegesser, Ludwig K Pully Naef, Andreas P Zurich Pretre, Rene 266 Damascus Kabbani, Sami S THAILAND Bangkok Arom, Kit V U.A.E. London Keogh, Bruce E VENEZUELA Caracas Bello, Alexis G Tricerri, Fernando E WALES Cardiff Butchart, Eric G 6295_AATS.book Page 267 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California AMERICAN ASSOCIATION FOR THORACIC SURGERY CHARTER MEMBERS E. Wyllis Andrews Arthur A. Law John Auer William Lerche Edward R. Baldwin Howard Lilienthal Walter M. Boothby William H. Luckett William Branower Morris Manges Harlow Brooks Walton Martin Lawrason Brown Rudolph Matas Kenneth Bulkley E. S. McSweeney Alexis Carrel Samuel J. Metzler Norman B. Carson Willy Meyer (Founder) J. Frank Corbett James Alexander Miller Armistead C. Crump Robert T. Miller Charles N. Dowd Fred J. Murphy Kennon Dunham Leo S. Peterson Edmond Melchior Eberts Eugene H. Pool Max Einhorn Walter I. Rathbun Herman Fischer Martin Rehling Albert H. Carvin B. Merrill Ricketts Nathan W. Green Samuel Robinson John R. Hartwell Charles I. Scudder George J. Heuer William H. Stewart Chevalier Jackson Franz Torek H. H. Janeway Martin W. Ware James H. Kenyon Abraham O. Wilensky Adrian V. S. Lambert Sidney Yankauer 267 6295_AATS.book Page 268 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY AMERICAN ASSOCIATION FOR THORACIC SURGERY THE BY-LAWS ARTICLE 1. NAME The name of this Corporation is The American Association for Thoracic Surgery (hereinafter the “Association”). ARTICLE II. PURPOSE The purposes of the Association shall be: To associate persons interested in, and carry on activities related to, the science and practice of thoracic surgery, the cure of thoracic disease and the related sciences. To encourage and stimulate investigation and study that will increase the knowledge of intrathoracic physiology, pathology and therapy, and to correlate and disseminate such knowledge. To hold scientific meetings featuring free discussion of problems and developments relating to thoracic surgery, and to sponsor a journal for the publication of scientific papers presented at such meetings and other suitable articles. To succeed to, and continue to carry on the activities formerly conducted by The American Association for Thoracic Surgery, an unincorporated association. ARTICLE III. MEMBERSHIP Section 1. There shall be three classes of members: Honorary, Senior, and Active. Admission to membership in the Association shall be by election. Membership shall be limited, the limits on the respective classes to be determined by these By-Laws. Only Active and Senior Members shall have the privilege of voting or holding office, except as provided by these By-Laws. Honorary members shall have the privilege of voting but shall not be eligible to hold office. Section 2. Honorary Membership shall be reserved for such distinguished persons as may be deemed worthy of this honor by the Council with concurrence of the Association. Section 3. The number of Senior Members shall be unlimited. Active Members automatically advance to Senior Membership at the age of seventy years or upon request after the age of sixty-five. In addition, a younger Active Member may be eligible for Senior Membership by petition to and approval by the Council. Section 4. Active Membership shall be limited to seven hundred. A candidate to be eligible must be a physician and shall have achieved distinction in the thoracic field or shall have made a meritorious contribution to knowledge pertaining to thoracic disease or its surgical treatment. Section 5. Election to Honorary, Senior or Active Membership shall be for life, subject to the provisions of Section 8 following. All new members shall be elected directly to Honorary or Active status. Section 6. Candidates for membership in this Association must be formally nominated and seconded, in an approved manner, by not less than three Active, Senior or Honorary Members. Such nomination must have been in the hands of the Membership Committee for not less than four months, and the name of the candidate must have been distributed to all members of the Association before final action may be taken on any new candidate for election to Active Membership. Provided the foregoing 268 6295_AATS.book Page 269 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California requirements have been met and the candidates have been approved by the Membership Committee and by the Council, their names shall be presented to the Association at a future regularly convened annual meeting for final action. A three-fourths vote of those present and voting shall be required to elect. Any candidate for membership in the Association who has failed of election three times shall automatically cease to be a candidate and may not be renominated until after a lapse of three years. Section 7. The report of the Membership Committee shall be rendered at the second executive session of each annual meeting of the Association. Candidates shall be presented in groups in the following order: Candidates for Honorary Membership; retirement of Active Members to Senior Membership; Candidates for Active Membership; members dropped from the rolls of the Association. Section 8. Membership may be voluntarily terminated at any time by members in good standing. The Council, acting as Board of Censors, may recommend the expulsion of any member on the grounds of moral or professional delinquency, and submit his/her name, together with the grounds of complaint, to the Association as a whole at any of the regularly convened meetings, after giving such member ample opportunity to appear in his/her own behalf. Section 9. The Council shall recommend that any Active Member whose dues are in arrears for two years shall have his/her membership terminated. ARTICLE IV. Board of Directors (“Council”) Section 1. The Board of Directors of the Association shall be called the Council and shall be composed of the President, President-Elect, Vice-President, Secretary, Treasurer, six Councilors and the Editor of the Association who shall be a member ex-officio without vote. All members of the Council must be Active or Senior Members of the Association, except that the Editor may be an Honorary Member. Section 2. The Council shall be the governing body of the Association, and shall have full power to manage and act on all affairs of the Association, except as follows: a. It may not levy any general assessments against the membership but it may, in individual cases, waive annual dues or assessments. b. It may not change the Articles of Incorporation or By-Laws. c. It may neither elect new members nor alter the status of existing members, other than to apply the provisions of Article III, Section 8. Section 3. At the conclusion of the annual meeting, the retiring President shall automatically become a Councilor for a one-year term office. One of the other five Councilors shall be elected at each annual meeting of the Association to serve for a four-year term of office in the place of the elected Councilor whose term expires at such meeting. When appropriate, one of the Councilors shall be elected from among the non-North American members of the Association to serve for a three-year term of office. No Councilor may be reelected to succeed himself/herself. Any Councilor so elected shall take office upon the conclusion of the annual meeting at which he/she is elected. ARTICLE V. Officers Section 1. The officers of the Association shall be President, a President-Elect, a Vice-President, a Secretary, and a Treasurer. All officers must be Active or Senior Members of the Association. Said officers shall be ex-officio members of the Council of the Association. Section 2. The Council may, for the purposes of Article IV, give status as officers of the Association to the individual members of an ad hoc Committee appointed by the Council. 269 Constitution and By-Laws Section 4. Vacancies in the office of Councilor shall be temporarily filled by the Council subject to approval of the Association at the next annual meeting of the Association. 6295_AATS.book Page 270 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY Section 3. The President, President-Elect, Vice-President, Secretary and Treasurer shall be elected at the annual meeting of the Association and shall take office upon conclusion of the meeting. The President, President-Elect, and the Vice-President shall be elected for a one-year term of office. The Secretary and the Treasurer shall be elected for a one-year term of office and may be reelected for not more than four additional terms. Section 4. The President of the Association shall perform all duties customarily pertaining to the office of President. He/she shall preside at all meeting of the Association and at all meetings of the Council. Section 5. The President-Elect of the Association shall, in the absence or inability of the President to serve, perform all duties customarily pertaining to the office of President. In this instance the Council shall advance the Vice-President to the office of the President-Elect and appoint an interim Vice-President as necessary. Section 6. The Secretary of the Association shall perform all duties customarily pertaining to the office of Secretary. He/she shall serve as Secretary of the Association and as Secretary of the Council. When deemed appropriate an Active or Senior Member may be elected to serve as an understudy to the Secretary in anticipation of the latter’s retirement from office. Section 7. The Treasurer of the Association shall perform all duties customarily pertaining to the office of Treasurer. He/she shall serve as Treasurer of the Association. When deemed appropriate an Active or Senior Member may be elected to serve as an understudy to the Treasurer in anticipation of the latter’s retirement from office. Section 8. The Editor of the Association is not an officer of the Association. The Editor shall be appointed by the Council at its annual meeting; provided, however, that such appointment shall not become effective until approved by the Association at the annual meeting of the Association. The Editor shall be appointed for a five-year term and may be reappointed to no more than two additional one-year terms. The Editor shall serve as the Editor of the Official Journal and shall be ex officio the Chair of the Editorial Board and a member of the Council of the Association without vote. Section 9. Vacancies occurring among the officers named in Section I or a vacancy in the position of Editor shall be temporarily filled by the Council, subject to approval of the Association at the next meeting of the Association. ARTICLE VI. Committees Section 1. The Council is empowered to appoint a Membership Committee, a Program Committee, a Necrology Committee and such other committees as may in its opinion be necessary or desirable. All such committees shall render their reports at an executive session of the Association, except that no ad hoc committee need report unless so directed by the Council. Section 2. The Membership Committee shall consist of seven Active or Senior Members. The Council may appoint not more than one of its own members to serve on this Committee. The duties of the Membership Committee are to investigate all candidates for membership in the Association and to report its findings as expeditiously as possible to the Council through the Secretary of the Association. This Committee is also charged with searching the literature of this and other countries to the end that proper candidates may be presented to the Association for consideration. Appointment to this Committee shall be for a period of one year, and not more than five of the members may be reappointed to succeed themselves. Section 3. The Program Committee shall consist of at least 14 members: the President, the President-Elect, the Vice President, the Secretary and the Editor and at least 9 members-at-large, three each representing the areas of adult cardiac, pediatric cardiac and general thoracic surgery. The President or his/her designee shall serve as the Chair of this Committee. Three of these members-at-large shall be appointed each year by the President for a three-year term. Additional Committee members shall be appointed for one or two-year terms. The duties of this Committee shall be to arrange, in conformity with instructions from the Council, the scientific program for the annual meeting. 270 6295_AATS.book Page 271 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California Section 4. The Necrology Committee shall consist of one or more Active or Senior Members. Appointments to this Committee shall be for a one-year term of office. Any or all members of this committee may be reappointed to succeed themselves. The Chair shall serve as Historian and the Council may, if it so desires, appoint one of its own members to serve as Chair of this Committee. The duties of the Necrology Committee shall be to prepare suitable resolutions and memorials upon all deaths of members of the Association and to report such deaths at every annual meeting. Section 5. The Nomination Committee shall consist of the five (5) immediate Past Presidents of the Association. The most senior Past President shall serve as Chair. This Committee shall prepare a slate of nominees for Officers and Councilors upon instruction from the Council as to the vacancies which are to be filled by election and shall present its report at the second Executive Session of the Annual Meeting. Section 6. The Association as a whole may authorize the Council to appoint Scientific or Research Committees for the purpose of investigating thoracic problems and may further authorize the Council to support financially such committees to a limited degree. When Scientific or Research Committees are authorized by the Association, the Council shall appoint the Chairs of these Committees, with power to organize their committees in any way best calculated to accomplish the desired object, subject only to the approval of the Council. Financial aid rendered to such Committees shall not exceed such annual orspecial appropriations as may be specifically voted for such purposes by the Council. Members are urged to cooperate with all Scientific or Research Committees of the Association. Section 7. The Evarts A. Graham Memorial Traveling Fellowship Committee shall consist of eight members: two cardiac surgeons, two general thoracic surgeons, two transplant surgeons, and two pediatric heart surgeons, two to be appointed each year for four year terms with the senior two members of the Committee serving as Co-Chairs. The duties of the Committee shall be to recommend Fellowship candidates to the Graham Education and Research Foundation, and to carry out other business pertaining to the Fellowship and Fellows, past, present and future. Additionally, the Committee shall recommend Research Scholar candidates to the association, and carry out other business pertaining to the Research Scholarship and Research Scholars, past, present, and future. Section 8. The Editorial Board shall be appointed by the Editor, subject only to the approval of the Council. The Editor shall be, ex officio, the chairman of this board and shall be privileged to appoint and indefinitely reappoint such members of the Association, regardless of class of membership, and such non-members of the Association as in his/her opinion may be best calculated to meet the editorial requirements of the Association. Section 9. The Ethics Committee shall consist of five members appointed by the Council. The Ethics Committee shall advise the Council concerning alleged breaches of ethics. Complaints regarding alleged breaches of ethics shall be received in writing by the Ethics Committee and shall be investigated by it. In addition, the Ethics Committee may investigate on its own initiative. Section 11. The Education Committee shall consist of six (6) members with two (2) members being appointed each year by the Council for a three (3) year term. At least two (2) members shall represent the areas of adult cardiac, pediatric cardiac and general thoracic surgery. In addition, a chair shall be appointed by the Council for a three (3) year term. The committee shall be responsible for identifying areas within the specialty for which additional training and education are necessary and the selection of topics and chairs for postgraduate activity to address these areas. 271 Constitution and By-Laws Section 10. The Thoracic Surgical Workforce Committee shall be a Joint Committee of this Association and The Society of Thoracic Surgeons. The Committee shall consist of two members of this Association, two members of The Society of Thoracic Surgeons, and a Chair who shall be a member of this Association and The Society of Thoracic Surgeons. The duties of this Committee, and the manner of appointment and term of its members and chairman, shall be determined jointly by the Council of this Association and the Board of Directors of The Society of Thoracic Surgeons. 6295_AATS.book Page 272 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY Section 12. The Committee on Publications shall consist of the Secretary as Chair, the PresidentElect, the Vice President, the Treasurer, and the Executive Director. The Committee shall oversee the business relationships between the Association and the publisher of its journal maintain liaison among the publisher, the Editor, and the Council, and shall have advisory oversight for all official scientific publications of the Association and make recommendations to the Editor and the Council. Section 13. The Cardiothoracic Residents Committee shall consist of eight members appointed by the Council. Two members shall be appointed each year for a four-year term with the senior two members of the Committee serving as Co-Chairs. At least two members shall represent adult cardiac surgery, general thoracic surgery, congenital heart surgery, and the Editorial Advisory Board of THE JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY. The duties of the committee shall include the development of educational activities specifically directed at cardiothoracic residents, the review of scientific material submitted for any resident award program and the selection of any such awardees and the responsibility for recommending to the Council the generation of new programs of interest to cardiothoracic residents. Section 14. The Scientific Affairs and Government Relations Committee shall consist of a Chair, appointed by the Council who shall serve a term of three (3) years, the Secretary who shall serve ex-officio and such members as the Council may deem appropriate to fulfill the responsibilities of the committee who shall serve for one (1) year. The committee shall be responsible for identifying and interacting with the various Federal agencies and institutions which affect research activities and funding in cardiothoracic surgery. It shall serve as a resource to the membership in the development of programmatic activities appropriate to research efforts in the specialty. ARTICLE VII. Finances Section 1. The fiscal year of the Association shall begin on the first day of January and end on the last day of December each year. Section 2. Members shall contribute to the financial maintenance of the Association through initiation fees, annual dues, and special assessments. The amount of the annual dues and the initiation fees shall be determined by the Council. If, at the end of any fiscal year, there is a deficit in the current funds of the Association, the Council may send out notices to that effect and invite Active members to contribute the necessary amount so that no deficit is carried over from one fiscal year to another. The Association may, in any regularly convened meeting, vote a special assessment which shall become an obligatory charge against the classes of members affected thereby. Section 3. To meet the current expenses of the Association, there shall be available all revenue derived by the Association. ARTICLE VIII. Meetings Section 1. The time, place, duration, and procedure of the annual meeting of the Association shall be determined by the Council and the provisions of the By-Laws. Section 2. Notice of any meeting of the Association shall be given to each member of the Association not less than five nor more than forty days prior to any annual meeting and not less than thirty nor more than forty days prior to any special meeting by written or printed notice delivered personally or electronically by mail, by or at the direction of the Council, the President or the Secretary. Such notice shall state the place, day and hour of the meeting and in the case of a special meeting shall also state the purpose or purposes for which the meeting is called. Section 3. A special meeting of the Association may be called by the Council or on the written request of fifteen members delivered to the Council, the President or the Secretary. The specific purposes of the meeting must be stated in the request. 272 6295_AATS.book Page 273 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California Section 4. Attendance at annual meetings and participation in the scientific programs shall be optional for all Honorary and Senior Members, but it shall be expected from all Active Members. Section 5. Each annual meeting shall have at least two executive sessions. Section 6. When the Association convenes for its annual meeting, it shall immediately go into the first executive session, but the business at this session shall be limited to: 1. Appointment of necessary committees. 2. Miscellaneous business of an urgent nature. Section 7. The second executive session of the Association shall be held during the afternoon of the second day of the meeting. The business at this session shall include, but is not limited to: 1. Reading or waiver of reading of the minutes of the preceding meetings of the Association and the Council. 2. Report of the Treasurer of the last fiscal year. 3. Audit Report. 4. Report of the Necrology Committee. 5. Report of the Program Committee. 6. Action on amendments to the Articles of Incorporation and By-Laws, if any. 7. Action on recommendations emanating from the Council. 8. Unfinished Business. 9. New Business 10. Report of the Membership Committee. 11. Election of new members. 12. Report of Nominating Committee. 13. Election of officers. Section 8. Except where otherwise required by law or these By-Laws, all questions at a meeting of the members shall be decided by a majority vote of the members present in person and voting. Voting by proxy is not permitted. Section 9. Fifty voting members present in person shall constitute a quorum at a meeting of members. Section 10. While the scientific session of the annual meeting is held primarily for the benefit of the members of the Association, it may be open to non-members who are able to submit satisfactory credentials, who register in a specified manner, and who pay such registration fee as may be determined and published by the Council from year to year. Section 11. There shall be an annual meeting of the Council held during the annual meeting of the Association. Additional meetings of the Council may be called on not less than seven days’ prior written or telephonic notice by the President, the Secretary or any three members of the Council. Section 13. Whenever any notice is required to be given to any member of the Council, a waiver thereof in writing, signed by the member of the Council entitled to such notice, whether before or after the time state therein, shall be deemed equivalent thereto. Section 14. Any action which may be or is required to be taken at a meeting of the Council may be taken without a meeting if a consent in writing, setting forth the action so taken, shall be signed by all of the members of the Council. Any such consent shall have the same force and effect as a unanimous vote at a duly called and constituted meeting. 273 Constitution and By-Laws Section 12. Six members of the Council shall constitute a quorum for the conduct of business at any meeting of the Council, but a smaller number may adjourn any such meeting. 6295_AATS.book Page 274 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY ARTICLE IX. Indemnification and Directors and Officers Section 1. The Association shall indemnify any and all of its Councilors (hereinafter in this Article referred to as “directors”) or officers or former directors or officers, or any person who has served or shall serve at the Association’s request or by its election as a director or officer of another corporation or association, against expenses actually and necessarily incurred by them in connection with the defense or settlement of any action, suit or proceeding in which they, or any of them, are made parties, or a party, by reason of being or having been directors or officers of the Association, or of such other corporation or association, provided, however, that the foregoing shall not apply to matters as to which any such director or officer or former director or officer or person shall be adjudged in such action, suit or proceeding to be liable for willful misconduct in the performance of duty or to such matters as shall be settled by agreement predicated on the existence of such liability. Section 2. Upon specific authorization by the Council, the Association may purchase and maintain insurance on behalf of any and all of its directors or officers or former directors or officers, or any person who has served or shall serve at the Association’s request or by its election as a director or officer of another corporation or association, against any liability or settlement based on asserted liability, incurred by them by reason of being or having been directors or officers as director or officer of the Association or of such other corporation or association, whether or not the Association would have the power to indemnify them against such liability or settlement under the provisions of Section 1. ARTICLE X. Papers Section 1. All papers read before the Association shall become the property of the Association. Authors shall provide original or electronic copies of their manuscripts to the Editor, prior to the time of presentation, for consideration for publication in the official Journal. Section 2. When the number of papers makes it desirable, the Council may require authors to present their papers in abstract, and may set a time limit on discussions. ARTICLE XI. Initiation Fees, Dues and Assessments Section 1. Honorary Members of the Association are exempt from all initiation fees, dues, and assessments. Section 2. Annual dues for Active Members shall be established by the Council and shall include a year’s subscription to THE JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY. Section 3. Senior Members are exempt from dues. Section 4. The initiation fee for those elected directly to Active Membership shall be established by the Council. Section 5. Active Members must subscribe to THE JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY to retain their membership status. Section 6. Subscription to THE JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY is optional for Senior Members. Section 7. Bills for membership dues and for subscriptions to THE JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY will be mailed to members by the Treasurer at the beginning of the fiscal year. 274 6295_AATS.book Page 275 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California ARTICLE XII. Parliamentary Procedure Except where otherwise provided in these By-Laws or by law, all parliamentary proceedings at the meetings of this Association and its Council and Committees shall be governed by the then current Sturgis Standard Code of Parliamentary Procedure. ARTICLE XIII. Amendments Section 1. These By-Laws may be amended by a two-thirds vote of the members present and voting at an executive session of a properly convened annual or special meeting of the Association provided that the proposed amendment has been moved and seconded by not less than three members at a prior executive session of that meeting or a prior meeting of the Association. Section 2. These By-Laws may be suspended in whole or in part for a period of not more than twelve hours by a unanimous vote of those present and voting at any regularly convened meeting of the Association. As amended, May, 2006 Constitution and By-Laws 275 6295_AATS.book Page 276 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY GRAHAM EDUCATION AND RESEARCH FOUNDATION President Irving L. Kron, M.D. Charlottesville, VA Vice President David J. Sugarbaker, M.D. Boston, MA Secretary-Treasurer Elizabeth Dooley Crane, CAE, CMP Beverly, MA Directors Robert L. Kormos, M.D. Pittsburgh, PA John C. Wain, Jr., M.D. Boston, MA The Graham Education and Research Foundation supports the Evarts A. Graham Memorial Traveling Fellowship program. Since the inception of the program in 1951, fifty-five young surgeons from twenty-nine countries have completed their training at thoracic surgery centers throughout North America. Planned Gifts to the Foundation Dr. and Mrs. Roger R. Ecker, Alameda, CA Charitable Remainder Trust For more information about planned giving, please contact the Foundation at 900 Cummings Center, Suite 221-U, Beverly, Massachusetts, 01915, or by phone at (978) 927-8330. 276 6295_AATS.book Page 277 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California EVARTS A. GRAHAM MEMORIAL TRAVELING FELLOWSHIPS The Evarts A. Graham Memorial Traveling Fellowship was established in 1951 by The American Association for Thoracic Surgery. Administered through the Graham Education and Research Foundation, it provides grants to young surgeons from abroad who have completed their formal training in general, thoracic, and cardiovascular surgery. The award allows the recipient to study a year to intensify his training in a program of special interest and to travel to several sites to broaden his overall training and increase his contacts with thoracic surgeons internationally. Awards are made to surgeons of unique promise who have been regarded as having potential for later international thoracic surgical leadership. Since the inception of the Graham Fellowship, 53 young surgeons from 27 countries have completed their training at thoracic surgical centers. 1. 1951-52 2. 1953-54 3. 1954-55 4. 1955-56 5. 1956-57 6. 1957-58 7. 1958-59 8. 1960-61 9. 1961-62 10. 1962-63 11. 1963-64 12. 1963-64 13. 1964-65 14. 1964-65 15. 1965-66 L.L. Whytehead, M.D., F.R.C.S. Canada W.B. Ferguson, M.B., F.R.C.S. England Lance L. Bromley, M., Chir, F.R.C.S. England Raymond L. Hurt, F.R.C.S. England Mathias Paneth, F.R.C.S. England Peter L. Brunnen, F.R.C.S. Scotland N.G. Meyne, M.D. Holland Godrej S. Karai, M.D. India Fritz Helmer, M.D. Austria Theodor M. Scheinin, M.D. Finland Masahiro Saigusa, M.D. Japan Adar J. Hallen, M.D. Sweden Stuart C. Lennox, M.D. England Elias Carapistolis, M.D., F.A.C.S. Greece Gerhard Friehs, M.D. Austria 277 6295_AATS.book Page 278 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY 16. 1965-66 17. 1966-67 18. 1966-67 19. 1967-68 20. 1969-70 21. 1970-71 22. 1971-72 23. 1972-73 24. 1973-74 25. 1974-75 26. 1975-76 27. 1976-77 28. 1977-78 29. 1978-79 30. 1981-82 31. 1981-82 32. 1982-83 33. 1983-84 34. 1984-85 35. 1985-86 36. 1986-87 37. 1987-88 Ary Blesovsky, M.D. England C. Peter Clarke, F.R.A.C.S. Australia G.B. Parulkar, M.D. India Claus Jessen, M.D. Denmark Peter Bruecke, M.D. Austria Michel S. Slim, M.D. Lebanon Severi Pellervo Mattila, M.D. Finland Yasuyuki Fujiwara, M.D. Japan Marc Roger deLeval, M.D. England J. J. DeWet Lubbe, M.D. South Africa Mieczyslaw Trenkner, M.D. Poland Bum Koo Cho, M.D. Korea Alan William Gale, M.D., F.R.A.C.P., F.R.A.C.S. Australia Eduardo Otero Coto, M.D. Spain Richard Firmin, M.D. England Claudio A. Salles, M.D. Brazil Yasuhisa Shimazaki, M.D. Japan Georg S. Kobinia, M.D. Austria Aram Smolinsky, M.D. Israel Florentino J. Vargas, M.D. Argentina Ari L. J. Harjula, M.D. Finland Byung-Chul Chang, M.D. Korea 278 6295_AATS.book Page 279 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California 38. 1988-89 39. 1989-90 40. 1991-92 41. 1992-93 42. 1993-94 43. 1995-96 44. 1996-97 45. 1997-98 46. 1998-99 47. 1999-00 48. 2000-01 49. 2001-02 50. 2002-03 51. 2003-04 52. 2004-05 53. 2005-06 54. 2006-07 55. 2007-08 56. 2008-09 Wang Cheng, M.D. P R China Christopher Knott-Craig, M.D. South Africa Ko Bando, M.D., Ph.D. Japan Timothy E. Oaks, M.D. United States Alain Serraf, M.D. Morocco Cornelius McKown Dyke, M.D. United States Monica Robotin-Johnson, M.D. France Jun Wan, M.D. P. R. of China Christian Kreutzer, M.D. Argentina Anders Franco-Cereceda, M.D. Sweden Albertus M. Scheule, M.D. Tuebingen, Germany Anna Maria Ciccone, M.D. Rome, Italy Cliff K. C. Choong, M.D. Auckland, New Zealand Edvin Prifti, M.D. Tirana, Albania Smruti Ranjan Mohanty, M.D. Bangalore, Karnataka, India Zsolt Tóth, M.D. Pécs, Hungary Ari Mennander, M.D. Tampere, Finland Ioannis Toumpoulis, M.D. Athens, Greece Sachin Talwar, M.D. New Delhi, India 279 6295_AATS.book Page 280 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY AMERICAN ASSOCIATION FOR THORACIC SURGERY RESEARCH SCHOLARSHIP RECIPIENTS The American Association for Thoracic Surgery Research Scholarship was established by the Association in 1985. Funded by the Association and individual contributions, the Research Scholarship provides opportunity for research, training and experience for North American surgeons committed to pursuing an academic career in cardiothoracic surgery. Administered by the Graham Education and Research Foundation, the program is undertaken within the first three years after completion of an approved cardiothoracic residency and is about two years in duration. EDWARD D. CHURCHILL RESEARCH SCHOLARSHIP 1986-1988 Mark K. Ferguson, M.D. University of Chicago, Department of Surgery ALFRED BLALOCK RESEARCH SCHOLARSHIP 1988-1990 Gus J. Vlahakes, M.D. Massachusetts General Hospital and Harvard Med School JOHN H. GIBBON, JR., RESEARCH SCHOLARSHIP 1990-1992 Donald D. Glower, M.D. Duke University Medical Center ALTON OCHSNER RESEARCH SCHOLARSHIP 1992-1994 David H. Adams, M.D. Brigham and Women’s Hospital ROBERT E. GROSS RESEARCH SCHOLARSHIP 1994-1996 Mehmet C. Oz, M.D. Columbia Presbyterian Medical Center Thoralf Mauritz Sundt, III, M.D. Washington University School of Medicine JOHN ALEXANDER RESEARCH SCHOLARSHIP 1996-1998 Richard Norris Pierson, III, M.D. Vanderbilt University Medical Center ANDREW G. MORROW RESEARCH SCHOLARSHIP 1997-1999 Stephen C. Yang, M.D. Johns Hopkins University School of Medicine DWIGHT HARKEN RESEARCH SCHOLARSHIP 1998-2000 Bruce Rosengard, M.D. University of Pennsylvania THE SECOND EDWARD D. CHURCHILL RESEARCH SCHOLARSHIP 1999-2001 Joseph B. Shrager, M.D. University of Pennsylvania 280 6295_AATS.book Page 281 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California SECOND ALFRED BLALOCK RESEARCH SCHOLARSHIP 2000-2002 Abbas Ardehali, M.D. UCLA School of Medicine Thomas K. Waddell, M.D, MSc, Ph.D. University of Toronto and Toronto General Hospital SECOND JOHN H. GIBBON, JR. RESEARCH SCHOLARSHIP 2001-2003 Richard J. Battafarano, M.D., Ph.D. Washington University School of Medicine Carmelo A. Milano, M.D. Duke University Medical Center SECOND ALTON OCHSNER RESEARCH SCHOLARSHIP 2002-2004 Yolonda Lorig Colson, M.D. Brigham & Women’s Hospital Michael S. Mulligan, M.D. Seattle, Washington SECOND ROBERT E. GROSS RESEARCH SCHOLARSHIP 2003-2005 Ross M. Bremner, M.D., Ph.D. University of Southern California Vivek Rao, M.D., Ph.D. Toronto General Hospital SECOND JOHN ALEXANDER RESEARCH SCHOLARSHIP 2004-2006 King F. Kwong, M.D. University of Maryland SECOND ANDREW G. MORROW RESEARCH SCHOLARSHIP 2005-2007 Marc de Perrot, M.D. University of Toronto/Toronto General Hospital Frederick Y. Chen, M.D. Brigham & Women’s Hospital JOHN W. KIRKLIN RESEARCH SCHOLARSHIP 2006-2008 Daniel Kreisel, M.D. Washington University Christine Lau, M.D. University of Michigan SECOND DWIGHT HARKEN RESEARCH SCHOLARSHIP 2007-2009 Shu S. Lin, M.D., Duke University Medical Center NORMAN E. SHUMWAY RESEARCH SCHOLARSHIP 2008-2010 Alexander S. Krupnick, M.D. Washington University Michael P. Fischbein, M.D. Stanford University 281 6295_AATS.book Page 282 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY C. WALTON LILLEHEI RESIDENT FORUM Through a generous unrestricted educational grant from St. Jude Medical, Inc., this Forum recognizes the extraordinary contributions to our specialty by a great innovator in congenital and vascular disease. Selected by the Cardiothoracic Residents Committee, the recipient receives a $5,000 award. Winners: 2007 Leo M. Gazoni, Charlottesville, NC Timing Is Everything. Pretreatment of Donor Lungs with the Adenosine 2A Receptor Agonist ATL-313 Results in Superior Protection From Lung Ischemia Reperfusion Injury Versus Administration During Reperfusion 2006 Jae Y. Kim, San Francisco, CA WNT Inhibitory Factor Inhibits Lung Cancer Cell Growth Amir M. Sheikh, Durham, NC Proteomics of Brain Injury in a Neonatal Model of Deep Hypothermic Circulatory Arrest 2005 Paul W. Fedak, Toronto, ON Canada Cell Transplantation Preserves Matrix Homeostasis: A Novel Paracrine Mechanism 2004 Filiberto Rodriguez, Palo Alto, CA Alterations of Transmural Strains In the Ischemic Border Zone During Acute Mid-Circumflex Occlusion Mark F. Berry, Philadelphia, PA Targeted Overexpression of Leukemia Inhibitory Factor Preserves Myocardium In Postinfarction Heart Failure 2003 Sunil Singhal, Philadelphia, PA Preoperative Viral Gene Transfer of Interferon-Beta Prevents Recurrence and Improves Survival In Advanced Thoracic Malignancies 2002 Subhasis Chatterjee, Philadelphia, PA Viral Gene Transfer of the Anti-Apoptotic Factor ARC Protects Against Post Ischemic Heart Failure 2001 Tomasz A. Timek, Palo Alto, CA Septal-Lateral Annular Cinching Abolishes Acute Ischemic Mitral Regurgitation In Sheep 282 6295_AATS.book Page 283 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California 2000 Allan S. Stewart, Philadelphia, PA Gene Transfer of Bcl-2 Does Not Affect Myocardial Stunning But Ameliorates the Deleterious Effects of Chronic Remodeling 1999 Andrew I. Campbell, Toronto, ON, Canada Angiogenic Therapy with Vascular Endothelial Growth Factor Reverses Pulmonary Hypertension 1998 Stephen D. Cassivi, Toronto, ON, Canada Transgene Expression Following Adenoviral-Mediated Retransfection of Rat Lungs Is Increased and Prolonged by Transplantation-Level Immunosuppression 283 6295_AATS.book Page 284 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY AMERICAN ASSOCIATION FOR THORACIC SURGERY SCIENTIFIC ACHIEVEMENT AWARD The American Association for Thoracic Surgery Scientific Achievement Award was established by the Association in 1994. The award serves to honor individuals who have achieved scientific contributions in the field of thoracic surgery worthy of the highest recognition the Association can bestow. Honorees receive a Medallion for Scientific Achievement from the Association presented by the president at the Annual Meeting and the honoree’s name and biography is printed in the Journal of Thoracic and Cardiovascular Surgery. RECIPIENTS 1995 John W. Kirklin, Birmingham, Alabama 1998 Norman E. Shumway, Stanford, California 1999 Michael E. DeBakey, Houston, Texas 2000 Denton A. Cooley, Houston, Texas 2005 Alain F. Carpentier, Paris, France 2007 Gerald D. Buckberg, Los Angeles, CA 2008 Andrew S. Wechsler, Philadelphia, Pennsylvania LIFETIME ACHIEVEMENT AWARD The American Association for Thoracic Surgery established the Lifetime Achievement Award in 2003. The Award serves to recognize individuals for their significant contributions to cardiothoracic surgery in the areas of patient care, teaching, research, or community service. Honorees receive a plaque for Lifetime Achievement from the Association presented by the president at the Annual Meeting. RECIPIENT 2004 2007 F. Griffith Pearson, Toronto, ON, Canada Frank C. Spencer, New York, NY 284 6295_AATS.book Page 285 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California INTERNATIONAL TRAVELING FELLOWSHIP The AATS Traveling Fellowship was established in 1997 by the American Association for Thoracic Surgery. Administered through the Graham Education and Research Foundation, it provides grants to young North American Cardiothoracic Surgeons who are within two years of the completion of their formal cardiothoracic surgery training. The award allows the recipient to study abroad for one year to intensify training in different disciplines and to travel to several sites to broaden the overall training and increase contacts with thoracic surgeons internationally. Awards are made to surgeons of unique promise who have been regarded as having potential for later international thoracic surgical leadership. 1998-99 Lishan Aklog, West Roxbury, MA 285 6295_AATS.book Page 286 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY THE THORACIC SURGERY FOUNDATION FOR RESEARCH AND EDUCATION YOUR FOUNDATION FOR RESEARCH AND EDUCATION Unlike other organizations to which you make philanthropic contributions, the Thoracic Surgery Foundation for Research and Education works directly for your specialty. TSFRE supports research and education initiatives to increase knowledge and enhance treatment of patients with cardiothoracic diseases; develops the skills of cardiothoracic surgeons as surgeon-scientists and health policy leaders; and, strengthens society’s understanding and trust in the profession. TSFRE is making a difference in cardiothoracic surgery. This is possible only because of your support. TSFRE is entirely supported through private donations. If you have not yet made your annual gift to TSFRE, now is the time! If you make an annual gift of appreciated stocks, bonds or mutual funds, you avoid capital gains tax and earn an income tax deduction by donating rather than selling these assets. This may be better for you than a gift of cash. If you have been thinking of making a charitable contribution to TSFRE, this may be the time to consider a planned gift. Often, this type of giving enables an individual to give a larger gift at a cost that is actually lower than if the gift were to be made outright. You may also find that planned giving enables you to meet other personal financial goals while making significant charitable gifts. You may give to TSFRE through a revocable instrument, such as a bequest in your will, or through an irrevocable instrument like a charitable lead trust or a charitable remainder trust. You may also give through a life insurance policy or your retirement plan. For more information about your annual gift or a deferred gift, contact the Thoracic Surgery Foundation for Research and Education at 900 Cummings Center, Suite 221-U, Beverly, Massachusetts, 01915 or by phone at (978) 927-8330. 286 6295_AATS.book Page 287 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California THE THORACIC SURGERY FOUNDATION FOR RESEARCH AND EDUCATION 2008 BOARD OF DIRECTORS Michael J. Mack, M.D., President Edward D. Verrier, M.D., Vice President Thomas A. D’Amico, M.D., Secretary Alec Patterson, M.D., Treasurer John H. Calhoon, M.D. W. Randolph Chitwood, Jr., M.D. Lawrence H. Cohn, M.D. Fred A. Crawford, M.D. Richard H. Feins, M.D. Robert A. Guyton, M.D. Larry R. Kaiser, M.D. James K. Kirklin, M.D. Douglas J. Mathisen, M.D. Joseph I. Miller, M.D. Craig R. Smith, M.D. Daniel J. Ullyot, M.D. Donna S. Kohli Executive Director 900 Cummings Center, Suite 221-U Beverly, MA 01915 978-927-8330 Fax 978-524-0461 [email protected] 287 6295_AATS.book Page 288 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY 2008 TSFRE RESEARCH AWARD RECIPIENTS TSFRE RESEARCH FELLOWSHIPS provide support of up to $35,000 a year for up to 2 years for surgical residents who have not yet completed cardiothoracic surgical training. Jane Yanagawa, M.D., University of California, Los Angeles “The Role of Snail in the Regulation of the Invasive Phenotype in Non-Small Cell Lung Cancer” TSFRE RESEARCH GRANTS provide operational support of original research efforts by cardiothoracic surgeons who have completed their formal training, and who are seeking initial support and recognition for their research program. Awards of up to $30,000 a year for up to 2 years are made each year to support the work of an early-career cardiothoracic surgeon (within 5 years of first faculty appointment). Juan A. Crestanello, M.D., Ohio State University “Post Conditioning, Free Oxygen Radical Generation and Mitochondrial Function” Gorav Ailawadi, M.D., University of Virginia “The Effects of IL-1 Beta on Smooth Muscle Cell Phenotype during Experimental Aortic Aneurysm Formation” NINA STARR BRAUNWALD AWARD provides a biennial award of $110,000 for two years to support the research career development of a woman cardiac surgeon who holds a full-time faculty appointment and who is within 10 years of completion of thoracic surgery residency. Kimberly L. Gandy, M.D., Ph.D., Medical College of Wisconsin “The Use of Autologous Hematopoietic Stem Cells in Tolerance Induction for Organ Transplantation” 288 6295_AATS.book Page 289 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California PREVIOUS RESEARCH AWARD RECIPIENTS Your contributions to THE THORACIC SURGERY FOUNDATION FOR RESEARCH AND EDUCATION have supported the following awards: THE TSFRE RESEARCH FELLOWSHIP provides support to surgeons and surgical trainees who wish to acquire investigational skills. Edward M. Boyle, Jr., M.D., The University of Washington Allen Cheng, M.D., Stanford University Madison C. Cuffy, M.D., Yale University School of Medicine Seth Force, M.D., The University of Pennsylvania Julie R. Glasson, M.D., Stanford University School of Medicine Joseph H. Gorman, III, M.D., Hospital of the University of Pennsylvania Andrew J. Kaufman, M.D., Memorial Sloan-Kettering Cancer Center Richard W. Kim, M.D., Yale University School of Medicine Samuel S. Kim. M.D., University of Pennsylvania Hospital Daniel Kreisel, M.D., University of Pennsylvania Baiya Krishnadasan, M.D., University of Washington John Langenfeld, M.D., Robert Wood Johnson Paul C. Lee, M.D., University of Pittsburgh Sang H. Lee, M.D., University of California, San Diego Medical Center Raja S. Mahidhara, M.D., University of Pittsburgh Tom C. Nguyen, M.D., Ph.D., Stanford University Mark D. Peterson, M.D., Toronto General Hospital Steffen Pfeiffer, M.D., Vanderbilt University Medical Center Robert S. Poston, Jr., M.D., Stanford University Medical Center Danny Ramzy, M.D., University of Toronto Nathalie Roy, M.D., Children’s Hospital, Boston Hisasha Sahara, M.D., Massachusetts General Hospital, Harvard Medical School Andrew J. Sherman, M.D., Northwestern University Medical School Christopher L. Skelly, M.D., The University of Chicago Michael A. Smith, M.D., Washington University William E. Stansfield, M.D., University of North Carolina at Chapel Hill Wilson Y. Szeto, M.D., Hospital of the University of Pennsylvania Mohan Thanikachalam, M.D., University of Miami Vinod H. Thourani, M.D., Emory University School of Medicine Tomasz A. Timek, M.D., Stanford University Edward Yiming Woo, M.D., University of Pennsylvania 289 6295_AATS.book Page 290 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY TSFRE RESEARCH GRANT provides operational support of original research projects by cardiothoracic surgeons who have completed their formal training and who are certified or eligible by The American Board of Thoracic Surgery or its equivalent. James S. Allan, M.D., Massachusetts General Hospital Richard J. Battafarano, M.D., Ph.D., Washington University Anthony Caffarelli, M.D., Stanford University Yolanda Lorig Colson, M.D., Ph.D., Brigham and Women’s Hospital Peter S. Dahlberg, M.D., Ph.D., University of Minnesota Richard P. Embrey, M.D., The Medical College of Virginia Lorenzo E. Ferri, M.D., McGill University Paul M. Kirshbom, M.D., Children’s Hospital of Pennsylvania Robert J. Korst, M.D., Memorial Sloan-Kettering Cancer Center Joren C. Madsen, M.D., Massachusetts General Hospital John D. Mannion, M.D., Thomas Jefferson University Marc R. Moon, M.D., Washington University School of Medicine Alfred C. Nicolisi, M.D., Medical College of Wisconsin Si M. Pham, M.D., University of Pittsburgh Robert S. Poston, M.D., University of Maryland Todd K. Rosengart, M.D., The New York Hospital, Cornell Medical Center David S. Schrump, M.D., National Cancer Institute Ara A. Vaporciyan, M.D., University of Texas, M.D. Anderson Cancer Center Thomas K. Waddell, Ph.D., M.D., Toronto General Hospital and The University of Toronto TSFRE CAREER DEVELOPMENT AWARD provides support for applicants who have completed their residency training and who wish to pursue investigative careers in thoracic surgery. Michael Argenziano, M.D., Columbia-Presbyterian Mark S. Bleiweis, M.D., University of Florida Paul Kirshbom, M.D., Emory University Kenneth McCurry, M.D., University of Pittsburgh Amit N. Patel, M.D., University of Pittsburgh NINA S. BRAUNWALD CAREER DEVELOPMENT AWARD provides a biennial award of $100,000 for two years to support the research career development of a women cardiac surgeon who holds a full-time faculty appointment and who is within 10 years of completion of thoracic surgery residency. Margaret D. Allen, M.D., University of Washington School of Medicine Rosemary F. Kelly, M.D., University of Minnesota Jennifer S. Lawton, M.D., Washington University Mary C. Mancini, M.D., Louisiana State University Medical Center Lynne A. Skaryak, M.D., University of Massachusetts Medical Center Patricia A. Thistlethwaite, M.D., University of California – San Diego 290 6295_AATS.book Page 291 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California NINA S. BRAUNWALD RESEARCH FELLOWSHIP provides salary support to women in academic cardiothoracic surgery who wish to acquire investigational skills. Leora Balsam, M.D., Stanford University Kathryn Quadracci Flores, M.D., Brigham and Women’s Hospital Tara Karamlou, M.D., Oregon Health Sciences University Melina R. Kibbe, M.D., University of Pittsburgh Elizabeth N. Morgan, M.D., University of Washington Meena Nathan, M.B.B.S., Brigham and Women’s Hospital Bao-Ngoc Nguyen, M.D., University of Maryland DuyKhan Pham, M.D., Duke University Medical Center Barbara L. Robinson, M.D., M.S., Boston Children’s Hospital Elaine E. Tseng, M.D., Johns Hopkins Hospital Jennifer Dale Walker, M.D., Medical University of South Carolina THE THORACIC SURGERY FOUNDATION FOR RESEARCH AND EDUCATION and the NATIONAL HEART, LUNG, AND BLOOD INSTITUTE Jointly Sponsored MENTORED CLINICAL SCIENTIST DEVELOPMENT AWARD (K08 or K23) provides support for the development of outstanding clinician research scientists for a 5-year period in the early stages of their research careers. Shahab A. Akhter, M.D., University of Cincinnati Anthony Azakie, M.D., University of California Daniel Kreisel, M.D., Washington University Scott A. LeMaire, M.D., Baylor College of Medicine Michael J. Mann, M.D., University of California, San Francisco Kenneth R. McCurry, M.D., University of Pittsburgh Michael S. Mulligan, M.D., University of Washington Y. Joseph Woo, M.D., University of Pennsylvania THE THORACIC SURGERY FOUNDATION FOR RESEARCH AND EDUCATION and the NATIONAL CANCER INSTITUTE Jointly Sponsored MENTORED CLINICAL SCIENTIST DEVELOPMENT AWARD (K08 or K23) provides support for the development of outstanding research scientists. This mechanism provides support for clinically trained professionals who are committed to a career in laboratory or fieldbased research and have the potential to develop into independent investigators. Malcolm V. Brock, M.D., Johns Hopkins University 291 6295_AATS.book Page 292 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY EDUCATION AWARD RECIPIENTS TSFRE offers Alley-Sheridan tuition scholarships for cardiothoracic surgeons to pursue a year of study in health care policy at Harvard University. The following individuals have received this award: William Berry, M.D., Napa, CA Vladimir Birjiniuk, M.D., West Roxbury, MA David J. Cohen, M.D., Fort Sam Houston, TX Edward J. Dunn, M.D., Milwaukee, WI Edgar L. Feinberg, III, M.D., Lafayette, LA Peter P. McKeown, M.D., Tampa, FL Joseph J. McNamara, M.D., Honolulu, HI Stancel M. Riley, Jr., M.D., Huntsville, AL Juan A. Sanchez, M.D., Lexington, KY Alan J. Spotnitz, M.D., New Brunswick, NJ Paul N. Uhlig, M.D., Wichita, KS ALLEY-SHERIDAN EXECUTIVE COURSE SCHOLARS. The Alley-Sheridan Fund was established within the Thoracic Surgery Foundation for Research and Education by Mr. David Sheridan on behalf of his lifelong friend and collaborator, Dr. Ralph Alley, to provide educational opportunities, especially in health care policy matters for cardiothoracic surgeons. This fund has been used to support the Health Policy Leadership Program offered in the past in partnership with Harvard University and more recently with Brandeis University. This initiative provides a comprehensive, weeklong program that focuses on the changing nature of the nation’s health care system, its management and how physicians can impact that system. To date, TSFRE has named 117 individuals to receive Alley-Sheridan Scholarships to attend this course. 292 6295_AATS.book Page 293 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California THE THORACIC SURGERY FOUNDATION FOR RESEARCH AND EDUCATION DONOR ROSTER Donations to TSFRE for the period January 1, 2006 – June 30, 2007 PARTNERS Gifts of $1,000,000 or more cumulatively American Association for Thoracic Surgery Eugene Braunwald, M.D. Datascope Corporation Edwards Lifesciences David S. Sheridan The William J. von Liebig Foundation GRAND BENEFACTORS Gifts of $500,000 to $999,999 Lazlo N. Tauber Charitable Foundation, Inc. The Graham Foundation The Society of Thoracic Surgeons The Starr Foundation BENEFACTORS Gifts of $100,000 to $499,999 Frederick Cross, M.D. The Cross-Jones Research & Education Fund Foundation for Advancement of Cardiac Therapies, Inc. Genetech, Inc. Richard D. Jones, Ph.D. Dr. & Mrs. Martin F. McKneally Medtronic, Inc. St. Jude Medical, Inc. PATRONS Gifts of $50,000 to $99,999 Bristol-Myers Squibb Company CHMC Cardiovascular Surgical Foundation Richard E. Clark, M.D. Roy H. Clauss, M.D. Lawrence H. Cohn, M.D. Ethicon, Inc. W.L. Gore & Associates, Inc. The Heart & Lung Surgery Foundation Robert W. Jamplis Charitable Trust Dr. & Mrs. Jack M. Matloff Dr. & Mrs. W. Gerald Rainer Southern Thoracic Surgical Association Sulzer Carbomedics, Inc. Synovis Life Technologies Dr. & Mrs. Robert Wallace The Western Thoracic Surgical Association 293 6295_AATS.book Page 294 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY SPONSORS Gerald Buckberg, M.D. John Burkholder, M.D. David Campbell, M.D. Cardiovascular and Thoracic Surgeons, Inc. Robert Cerfolio, M.D. Dr. & Mrs. W. Randolph Chitwood Jr. John V. Conte, M.D. Vincent R. Conti, M.D. Denton A. Cooley, M.D. Coordinating Committee for Continuing Education in Thoracic Surgery A. Robert Cordell, M.D. Joseph Coselli, M.D. Delos Cosgrove, M.D. James Cox, M.D. Fred Crawford Jr., M.D. Harry DePan, M.D. Dr. & Mrs. James DeWeese Richard N. Edie, M.D. Robert G. Ellison, M.D. Elsevier Science, Inc. Dr. & Mrs. Richard Engelman L. Penfield Faber, M.D. Thomas B. Ferguson, M.D. Victor Ferraris, M.D. Thomas J. Fogarty, M.D. Gregory P. Fontana, M.D. Richard Fosburg, M.D. Dr. & Mrs. William H. Frist Timothy Gardner, M.D. J. William Gaynor, M.D. Farid Gharagozloo, M.D. Glaxo Wellcome, Inc. Scott Goldman, M.D. L. Michael Graver, M.D. Frederick Grover, M.D. John Hammon, M.D. Frank L. Hanley, M.D. Bradley Harlan, M.D. Alan Hartman, M.D. Hovald Helseth, M.D. Dr. & Mrs. George L. Hicks Jr. Alan Hilgenberg, M.D. O. Wayne Isom, M.D. Leigh I. Iverson, M.D. Jeffrey P. Jacobs, M.D. Stuart Jamieson, M.D. G. Gilbert Johnston, M.D. The Joyce Foundation Lyle Joyce, M.D. George Kaiser, M.D. P. V. Kamat, M.D. Kirk Kanter, M.D. The Kealy Family Foundation Paul Kelly Jr., M.D. A. Hassan Khazei, M.D. Shukri F. Khuri, M.D. The Larry King Cardiac Foundation Marvin Kirsh, M.D. Nicholas Kouchoukos, M.D. Gifts of $25,000 to $49,000 Dr. & Mrs. John H. Bell John R. Benfield, M.D. Drs. Lawrence I. & Rita Boncheck Columbia University, Department of Cardiothoracic Surgery Edgar L. Feinberg, II, M.D. Dr. Kathryn Quadracci Flores & Dr. Raja M. Flores J. William Gaynor, M.D. Richard A. Jonas, M.D. Harold V. Liddle, M.D. George J. Magovern, M.D. Mary C. Mancini, M.D. Constantine Mavroudis, M.D. Northern Illinois Heart Institute Respironics, Inc. David B. Skinner, M.D. Alfred Tector, M.D. Dr. & Mrs. Harold C. Urschel, Jr. James M. Wilson, M.D. James L. Zellner, M.D. HERITAGE SOCIETY Members have made provisions for an estate gift John R. Benfield, M.D. Eugene Braunwald, M.D. Richard E. Clark, M.D. Vincent R. Conti, M.D. David A. Fullerton, M.D. Dr. & Mrs. Robert W. Jamplis Dr. & Mrs. Martin F. McKneally Dr. & Mrs. W. Gerald Rainer David S. Sheridan Dr. & Mrs. Harold C. Urschel, Jr. Dr. & Mrs. Robert B. Wallace James M. Wilson, M.D. LIFE MEMBERS Cumulative Gifts of $10,000 to $24,999 Abbott Laboratories Fund David Adams, M.D. Arvind Agnihotri, M.D. Cary Akins, M.D. William Alford, Jr., M.D. The American Board of Thoracic Surgery Richard P. Anderson, M.D. Atrium Medical Corporation W. Gerald Austen, M.D. Dr. & Mrs. Carl L. Backer Lenox D. Baker, M.D. Hendrick Barner, M.D. William Baumgartner, M.D. Joseph E. Bavaria, M.D. David P. Blake, M.D. Edward L. Bove, M.D. 294 6295_AATS.book Page 295 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California Irving Kron, M.D. Hillel Laks, M.D. John Lamberti, M.D. James Levett, M.D. Sidney Levitsky, M.D. Ralph Lewis, M.D. George G. Lindesmith, M.D. Joseph LoCicero III, M.D. Bruce Lytle, M.D. Thomas E. MacGillivray, M.D. James Mackenzie, M.D. Joren Madsen, M.D. James Malm, M.D. Christopher T. Maloney, M.D. William T. Maloney Dr. & Mrs. James B. D. Mark Douglas Mathisen, M.D. P. Michael McFadden, M.D. Joseph S. McLaughlin, M.D. Roger B. Mee, M.D. Robert M. Mentzer, Jr., M.D. Bertrand W. Meyer, M.D. Lynda Mickleborough, M.D. D. Craig Miller, M.D. Joseph Miller Jr., M.D. Gregory A. Misbach, M.D. Robert L. Mitchell, M.D. Steve Mourning, FAHP Gordon Murray, M.D. John L. Myers, M.D. Hassan Najafi, M.D. Stanton P. Nolan, M.D. The Northern Trust Company William Nugent, M.D. John Ochsner, M.D. Gordon N. Olinger, M.D. Mark Orringer, M.D. Peter Pairolero, M.D. Grant V. S. Parr, M.D. Alec Patterson, M.D. Patricia A. Penkoske, M.D. D. Glann Pennington, M.D. Dr. & Mrs. Gosta B. Pettersson Dr. & Mrs. Richard N. Pierson, III Edward J. Planz, Jr., M.D. Marvin Pomerantz, M.D. Richard L. Prager, M.D. Pratt Surgical Associates, Inc. Walter Purcell Joseph B. Putnam, Jr., M.D. Ronald Quinton, M.D. Michael J. Reardon, M.D. Stancel M. Riley, Jr., M.D. W. Steves Ring, M.D. Eric A. Rose, M.D. Jack Roth, M.D. Valerie Rusch, M.D. Robert M. Sade, M.D. Francis L. Shannon, M.D. Baljit K. Sharma, M.D. Thomas Sharp, M.D. Richard J. Shemin, M.D. Dr. & Mrs. Peter M. Sidell Mark Slaughter, M.D. Herbert E. Sloan, M.D. Frank Spencer, M.D. Thomas Spray, M.D. Quentin R. Stiles, M.D. Valavanur Subramanian, M.D. Thoralf M. Sundt, M.D. Francis P. Sutter, M.D. James Symes, M.D. Stanley K. C. Tam, M.D. Christo I. Tchervenkov, M.D. Thoracic & Cardiovascular Surgery at University of Virginia David Torchiana, M.D. Gregory D. Trachiotis, M.D. Bernard L. Tucker, M.D. Donald A. Turney James Tweddell, M.D. U.S.C. Cardiothoracic Surgeons University of Iowa Hospitals & Clinics Vascutek, Ltd., a Terumo Company Gus Vlahakes, M.D. John Waldhausen, M.D. Jennifer D. Walker, M.D. William Wallace Henry L. Walters, III., M.D. Andrew S. Wechsler, M.D. Benson R. Wilcox, M.D. Women in Thoracic Surgery NEW CENTURY SOCIETY SUMMA CUM LAUDA Gifts of $5,000 to $9,999 E. Pendleton Alexander, M.D. Leonard L. Bailey, M.D. William R. Berry, M.D. Thomas V. Bilfinger, M.D. R. Morton Bolman III, M.D. Edward L. Bove, M.D. Frederick Bowman Jr., M.D. John H. Calhoon, M.D. CIMIT Richard P. Cochran, M.D. Stephen B. Colvin, M.D. Willard M. Daggett, M.D. Thomas M. Daniel, M.D. Tirone E. David, M.D. Anthony P. Furnary, M.D. Otto Gago, M.D. Thomas E. Gaines, M.D. Joseph J. Garamella, M.D. Marshall D. Goldin, M.D. Alden H. Harken, M.D. Charles B. Huddleston, M.D. Michel N. Ilbawi, M.D. 295 6295_AATS.book Page 296 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY Shukri F. Khuri, M.D. Leslie J. Kohman, M.D. Theodore C. Koutlas, M.D. Alex G. Little, M.D. Robert S. Litwak, M.D. Michael J. Mack, M.D. Yousuf Mahomed, M.D. Patrick M. McCarthy, M.D. Richard B. McElvein, M.D. J. Judson McNamara, M.D. Keith S. Naunheim, M.D. Carolyn E. Reed, M.D. Bruce A. Reitz, M.D. Robert M. Sade, M.D. Frank W. Sellke, M.D. Craig R. Smith, M.D. William S. Stoney, M.D. Thoralf M. Sundt, M.D. Julie A. Swain, M.D. Alfredo Trento, M.D. Paul N. Uhlig, M.D. Thomas J. Vander Salm, M.D. Jennifer Dale Walker, M.D. Paul H. Werner, M.D. Douglas E. Wood, M.D. James L. Zellner, M.D. George L. Zorn Jr., M.D. Kenneth G. Warner, M.D. Ronald M. Weintraub, M.D. James Miller Wilson, M.D. J. Nilas Young, M.D. NEW CENTURY SOCIETY CUM LAUDE Gift of $1,000 to $2,499 Herbert D. Adams, M.D. Lishan Aklog, M.D. James S. Allan M.D. Margaret D. Allen, M.D. G. Hossein Almassi, M.D. Emile A. Bacha, M.D. Charles A. Beskin, M.D. Vladimir Birjiniuk, M.D. Scott M. Bradley, M.D. Laurence Brinckerhoff, M.D. John W. Brown, M.D. Nora L. Burgess, M.D. Andrea J. Carpenter, M.D. Thomas L. Carter, M.D. Chalit Cheanvechai, M.D. Wen Cheng, M.D. George E. Cimochowski, M.D. Neri M. Cohen, M.D., PhD. Joel D. Cooper, M.D. Pedro J. del Nido, M.D. Robert A. Dion, M.D. Donald B. Doty, M.D. Fred H. Edwards, M.D. Afshin Ehsan, M.D. John A. Elefteriades, M.D. Gregory P. Fontana, M.D. David A. Fullerton, M.D. Elliot T. Gelfand, M.D. Myles S. Guber, M.D. Robert A. Gustafson, M.D. Steven W. Guyton, M.D. Robert A. Guyton, M.D. W. Clark Hargrove III, M.D. Daniel P. Harley, M.D. Cynthia Herrington, M.D. Keith A. Horvath, M.D. Frederick M. Howden, M.D. Marshall L. Jacobs, M.D. John G. Jacobson, M.D. James Jaggers, M.D. Robert J. Jensik, M.D. Shreekanth V. Karwande, M.D. Thomas L. Kilgore, M.D. Christopher J. Knott-Craig, M.D. James D. Luketich, M.D. James C. MacMillan, M.D. Ambrish P. Mathur, M.D. Michael C. Mauney, M.D. John E. Mayer Jr., M.D. Martin H. McMullan, M.D. NEW CENTURY SOCIETY MAGNA CUM LAUDE Gifts of $2,500 to $4,999 Mark S. Allen, M.D. Joseph E. Bavaria, M.D. Seth Bekoe, M.D. John H. & Amy Bowles Lawrence Foundation Michael H. Buch, M.D. John V. Conte, M.D. Vincent R. Conti, M.D. Benedict D. T. Daly, M.D. Davis C. Drinkwater Jr., M.D. Bartley P. Griffith, M.D. Jeffrey P. Jacobs, M.D. Forrest L. Junod, M.D. Larry R. Kaiser, M.D. Edward A. Lefrak, M.D. Peter P. McKeown, M.D. Kathleen W. McNicholas, M.D. Roger C. Millar, M.D. Hassan Rastegar M.D. Robert T. Reichman, M.D. Stancel M. Riley Jr., M.D. David C. Sabiston Jr., M.D. Edward B. Savage, M.D. Hartzell V. Schaff, M.D. William D. Spotnitz, M.D. Clifford H. VanMeter, Jr., M.D. Edward D. Verrier, M.D. John C. Wain Jr., M.D. 296 6295_AATS.book Page 297 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California Gregory A. Misbach, M.D. David S. Mulder, M.D. John L. Myers, M.D. Yoshifumi Naka M.D. Eduardo Otero Coto, M.D. Richard A. Ott, M.D. Richard K. Parker, M.D. Si Mai Pham, M.D. Steven J. Phillips, M.D. Frank A. Pigula, M.D. Ito Puruhito, M.D. Robert J. Rizzo, M.D. Bruce R. Rosengard, M.D. Todd K. Rosengart, M.D. Richard G. Rouse, M.D. John A. Rousou, M.D. Rosalyn P. Scott, M.D. Mark M. Sherman, M.D. Kwang-Hyun Sohn, M.D. Vaughn A. Starnes, M.D. Scott Strongfellow Lars G. Svensson, M.D. Scott J. Swanson, M.D. Michael F. Teodori, M.D. Ann Toran M.D. Philip W. Wright, M.D. Peter L. Birnbaum, M.D. Eugene H. Blackstone, M.D. Arie Blitz, M.D. John D. Blizzard, M.D. Rachael Boches Dave & Dawn Bond Edward M. Boyle Jr., M.D. Berkeley Brandt III, M.D. Charles O. Brantigan, M.D. William I. Brenner, M.D. Rafael A. Brito Arache, M.D. Lewis W. Britton, M.D. Robert S. Brooks, M.D. Eric Bross Aart Brutel De La Riviere, M.D. F. Curtis Bryan, M.D. Raphael Bueno, M.D. David A. Bull, M.D. Joshua H. Burack, M.D. Thomas A. Burdon, M.D. Denise Bussel Brian F. Buxton Antonio M. Calafiore, M.D. Thomas R. Calhoun, M.D. Samuel J. Camarata, M.D. Michel Carrier, M.D. Marianne L. Casey Filip P. Casselman, M.D., Ph.D Alan G. Casson, M.D. Michele T. Cerino, M.D. Gerard L. Champsaur, M.D. Woon Ha Chang, M.D., Ph.D K. Mammen Cherian, M.D. Bum-Koo Cho, M.D. Modassir S. Choudhry, M.D. John E. Codd, M.D. Gordon A. Cohen, M.D. Larry Cohler, M.D. John G. Coles, M.D. George J. Collins Jr., M.D. Yolonda L. Colson, M.D. John E. Connolly, M.D. Antonio F. Corno, M.D. John D. Crouch, M.D. Kenneth Cruze, M.D. Willem J. Daenen Richard C. Daly, M.D. Thomas A. D’Amico, M.D. John H. Dark Charles H. Dart Jr., M.D. Philippe G. Dartevelle, M.D. Jose Pedro DaSilva, M.D. Hiroshi Date, M.D. R. Duane Davis Jr., M.D. Malcolm M. DeCamp, M.D. Giacomo A. DeLaria, M.D. Anthony J. DelRossi, M.D. Walter P. Dembitsky, M.D. Claude Deschamps, M.D. Jean DesLauriers, M.D. CONTRIBUTORS Gifts up to $999 St. Thomas UCC Ark Builders Kevin D. Accola, M.D. Barry & Kelly Ackerman Niv Ad, M.D. Peter X. Adams, M.D. David H. Adams, M.D. Belhhan Akpinar, M.D. Ottavio R. Alfieri, M.D. Zohair Y. Al-Halees, M.D. Bradley S. Allen, M.D. Keith B. Allen, M.D. C. E. Anagnostopoulos, M.D. Sary F. Aranki, M.D. Georgio Aru M.D. James W. Asaph, M.D. Erle H. Austin III, M.D. Salim Aziz, M.D. Gaetano Azzolina, M.D. Manjit S. Bains, M.D. Ko Bando, M.D. Robert H. Bartlett, M.D. John & Kathleen Basehore Renata B. Bastos, M.D. Richard J. Battafarano, M.D. Eugene M. Baudet, M.D. Carol A. Beck Stanley J. Berman, M.D. Albert Bernstein, M.D. Friedhelm Beyersdorf, M.D. David P. Bichell, M.D. 297 6295_AATS.book Page 298 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY Frank C. Detterbeck, M.D. Jatinder S. Dhillon, M.D. Gregory Di Russo ,M.D. Don & Linda Dickinson Edward B. Diethrich, M.D. Wadih R. Dimitri, M.D. Dimitrios Dougenis, M.D. James M. Douglas Jr., M.D. Emery C. Douville, M.D. Barbara Downs Gilles D. Dreyfus, M.D. Cornelius M. Dyke, M.D. Esther S. Eckenroth Nanette M. Eisenhuth Coyness L. Ennix Jr., M.D. Bharam Erfan, M.D. M. Arisan Ergin, M.D. Barry C. Esrig, M.D. Aaron S. Estrera, M.D. Anthony L. Estrera, M.D. James I. Fann, M.D. Henry J. Fee, M.D. Christopher M. Feindel, M.D. Andrew C. Fiore, M.D. Keith D. Flachsbart, M.D. John E. Foker, M.D. David M. Follette, M.D. Fabrizio M. Follis, M.D. Robert W. M. Frater, M.D. Joseph S. Friedberg, M.D. Donna Friedrich Angela Fulginiti Alex J. Furst, M.D. Henning A. Gaissert, M.D. Anthony A. Garson, M.D. Antonio A. Garzon, M.D. Richard N. Gates, M.D. Alan B. Gazzaniga, M.D. Gino Gerosa, M.D. Ali Gheissari, M.D. A. Marc Gillinov, M.D. Michael Gingerich Jeffrey P. Gold, M.D. Gerry Goldstein Adalberto C. Gonzalez, M.D. Allan H. Goodman, M.D. Robert C. Gorman, M.D. John P. Gott, M.D. Earl & Mildred Graeff Pam Graeff Mark T. Grattan, M.D. Laman A. Gray Jr., M.D. Roy K. Greenberg, M.D. Mary G. Gregg, M.D. Tomasz Grodzki M.D. Cynthia Grossman Steven R. Gundry, M.D. Jeffrey & Andrea Hardick Violet Hartman Joachim T. W. Hasse, M.D. John A. Hawkins, M.D. Paul J. Hendry, M.D. Albert & Ann Herman William H. Heydorn, M.D. Dave & Penny Himmelberger Gregory M. Hirsch, M.D. Janet Hollen David & Roxanne Hollen Alan R. Hopeman, M.D. Yasuyuki Hosoda, M.D. Leland B. Housman, M.D. Ryan & Wendy Hoyer Ming Lu Huang, M.D. Kathleen A. Huddy Manly R. Hyde, M.D. Mark D. Iannettoni, M.D. Timothy B. Icenogle, M.D. Michael T. Ingram, M.D. Hiroshi Inoue, M.D. David M. Jablons, M.D. George A. Jackson Erik W. L. Jansen, M.D. Olivier J. L. Jegaden, M.D. James H. Jewell, M.D. Robert G. Johnson, M.D. Robert P. Jones Jr., Ed.D. Jane Kadlubkiewicz George Kafrouni, M.D. Gerard S. Kakos, M.D. Afksendiyos Kalangos, M.D. Riyad C. Karmy-Jones, M.D. Robert M. Kass, M.D. James A. Kaufman, M.D. Yasunaru Kawashima, M.D. Marvin & Grace Kaylor Teruhisa Kazui, M.D. Robert J. Keenan, M.D. Jan Keeney Fraser M. Keith, M.D. Kenneth A. Kesler, M.D. Randolph M. Kessler, M.D. Fareed A. Khouqeer, M.D. Teresa M. Kieser, M.D. Linda Killian Sang Hyung Kim, M.D. Robert C. King, M.D. James K. Kirklin, M.D. Kim Kissling Soichiro Kitamura, M.D. Gerald M. Klain Robert R. Klingman, M.D. Wolf-Peter Kloevekorn, M.D. Ronald W. Knight, M.D. Gary S. Kochamba, M.D. Tadasu Kohno, M.D. Masashi Komeda, M.D. Argiris N. Kontaxis, M.D. Reiner Korfer, M.D. Robert J. Korst, M.D. Arvind Koshal, M.D. 298 6295_AATS.book Page 299 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California Guillermo O. Kreutzer, M.D. Hiromi Kurosawa, M.D. Joseph S. Ladowski, M.D. Stephen J. Lahey, M.D. Thomas Z. Lajos, M.D. Steven L. Lansman, M.D., Ph.D Louis A. Lanza, M.D. Gordon L. Larsen, M.D. Jeffrey M. Lau, M.D. Gerald M. Lawrie, M.D. Chuen-Neng Lee, M.D. Lorraine M. Leeman, M.D. Scott A. LeMaire, M.D. Michael & Diane Leonard Frederick H. Levine, M.D. Kevin A. Linkus, M.D. James W. Long, M.D. Edwin T. Long, M.D. James Longoria, M.D. Donald E. Low, M.D. Robert C. Lowery, M.D. Brian & Nancy Luckenbill Erica Lyon S. Allen Mackler, M.D. Michael P. Macris, M.D. Gyaandeo S. Maharajh, M.D. David Malave, M.D. Frank Manetta, M.D. Marshall V. Marchbanks, M.D. Daniel Marelli, M.D. Carol Mason Hikaru Matsuda M.D., Ph.D Thomas L. Matthew, M.D. Carole L. Maynard Sanjay & Tara Mehta Eric N. Mendeloff, M.D. Lorenzo A. Menicanti, M.D. Ed & Dot Meredith Thierry G. Mesana, M.D. Dominique R. Metras, M.D. Dan M. Meyer, M.D. Pat Miller J. Scott Millikan, M.D. Jeffrey C. Milliken, M.D. Rodrigo M. Miranda, M.D. Richard A. Moggio, M.D. Friedrich W. Mohr, M.D. Hitoshi Mohri, M.D. William H. Moncrief Jr., M.D. Rainer Moosdorf, M.D. Shigeki Morita, M.D. Ralph S. Mosca, M.D. A. C. Moulijn, M.D. Meena Nathan, M.D. Ricardo A. Navarro, M.D. Dao M. Nguyen, M.D. Hiep Nguyen M.D. Tuan Nguyen-Duy, M.D. Takashi Nitta, M.D. William F. Northrup III, M.D. Richard J. Novick, M.D. Chukumere E. Nwogu, M.D. Jean F. Obadia, M.D. Richard G. Ohye, M.D. Yukikatsu Okada, MD Okike N. Okike, M.D. Yutaka Okita, M.D. Bassam O. Omari, M.D. David A.Ott, M.D. Albert D. Pacifico, M.D. Antonio C. Panebianco, M.D. Soon J. Park, M.D. Dale N. Payne, M.D. Mike & Linda Pendleton Lester C. Permut, M.D. Louis P. Perrault, M.D. Armand H. Piwnica, M.D. Jose L. Pomar M.D., Ph.D. Mario F. Pompili, M.D. Francisco J. Puga, M.D. John D. Puskas, M.D. Jan Modest Quaegebeur, M.D. Jaishankar Raman, M.D. James J. Rams, M.D. J. Scott Rankin, M.D. Mark B. Ratcliffe, M.D. Anees J. Razzouk, M.D. Ivan M. Rebeyka, M.D. Sreenath V. Reddy, M.D. Mark & Karen Reichley Jose Manuel Revuelta, M.D. Costante Ricci, M.D. David & Michelle Rice Robert C. Robbins, M.D. Peter F. Roberts, M.D. John M. Robertson, M.D. Gaetano Rocco, M.D. Mark D. Rodefeld, M.D. Xavier F. Roques, M.D. Eric E. Roselli, M.D. David B. Ross, M.D. Stephen J. Rossiter, M.D. Ty & Meredith Rost John R. Rowlis, M.D. Ali M. Sadeghi, M.D. Tohru Sakamoto, M.D. Rawn Salenger, M.D. Louis E. Samuels, M.D. Shunji Sano, M.D. Craig R. Saunders, M.D. Louis J. Scerra, Jr. Hans-Joachim Schafers M.D. Clark & Susan Schenck Andres J. Schlichter, M.D. Paul T. Sergeant, M.D. Alain Serraf, M.D. Suvro S. Sett, M.D. Hezekiah Shani, M.D. Franklin & Lucille Shearer Barry B. Sheppard, M.D. 299 6295_AATS.book Page 300 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY Taguchi Shinichi, M.D. Toshiharu Shin’oka, M.D., Ph.D Yuji Shiraishi, M.D. Joseph P. Shrager, M.D. Dominique Shum-Tim M.D. Sara J. Shumway, M.D. Alan Siegel Norman A. Silverman, M.D. Sri Krishna Sirivella, M.D. Nicholas G. Smedira, M.D. Wendel J. Smith, M.D. W. Roy Smythe, M.D. Rolf Sommerhaug, M.D. Charlotte M. Spadafora Alan M. Speir, M.D. Francis G. Spinale, M.D. Henry M. Spotnitz, M.D. Richard D. Stahl, M.D. William & Judy Stamey Joanne P. Starr, M.D. Robert A. Steedman, M.D. Felicien M. Steichen, M.D. Giovanni Stellin, M.D. James R. Stewart, M.D. Clifford J. Straehley, M.D. Vita Sullivan, M.D. Henry J. Sullivan, M.D. Hisayoshi Suma, M.D. Takaaki Suzuki, M.D. Stephen G. Swisher, M.D. Koichi Tabayashi, M.D. David P. Taggart, M.D. Shinichi Takamoto, M.D. Oguz Tasdemir, M.D. James Tatoulis, M.D. Jacquelyn E. Tellier Vasken K. Tenekjian, M.D. Paul A. Thomas Jr., M.D. J. Kent Thorne, M.D. Richard J. Thurer, M.D. Theodor Tirilomis, M.D. Thomas R. J. Todd, M.D. Luis A. Tomatis, M.D. Eric E. Toselli, M.D. Kenneth G. Traverse Victor T. Tsang, M.D. Marko I. Turina, M.D. J. Jeffrey Tyner M.D. Ross M. Ungerleider, M.D. Helmut W. Unruh, M.D. Peter G. Vajtai, M.D. Eric Vallières, M.D. Glen Van Arsdell, M.D. Dirk E. M. Van Raemdonck, M.D. Paul Van Schil, M.D. Hugo K. I. Vanermen, M.D. Ara A. Vaporciyan, M.D. G. Dennis Vaughan III, M.D. Steve & Mary Verdelli Hiromi Wada, M.D. E. Lance Walker, M.D. Garrett L. Walsh, M.D. Nan Wang, M.D. Ellsworth E. Wareham, M.D. Levi Watkins Jr., M.D. Chris J. Wehr, M.D. Tracey L. Weigel, M.D. Darryl S. Weiman, M.D., JD Gina West Stephen Westaby, M.D. David J. Wheatley, M.D. Grayson H. Wheatley III, M.D. Glenn J. R. Whitman, M.D. William G. Williams, M.D. Scott & Jessica Wise Don & Louise Wolf Randall K. Wolf, M.D. Ernst Wolner, M.D. Y. Joseph Woo, M.D. Ronald K. Woods, M.D. David W. Wormuth, M.D. Robert A. Wynbrandt, J.D. Richard & Betty Jane Wyrick Stephen C. Yang, M.D. Hisataka Yasui, M.D. Terrence M. Yau, M.D. Anthony P. Yim ,M.D. Kwok L. Yun, M.D. Edward R. Zech, M.D. Kenton J. Zehr, M.D. Every effort has been made to insure accuracy, and we sincerely regret any errors or omissions. If an error has been made, please contact TSFRE so we may correct our records. 300 6295_AATS.book Page 301 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California AATS AUTHORS INDEX Last Name First Name Paper # Last Name First Name Paper # Abate Abbas Adams Ailawadi Ajani Al Chare Al-Ahmadi Alghamdi Al-Halees Allen Alsoufi Alster Altorki Ancukiewicz Anderson Angelini Arnova Arom Ascione Asnaghi Astarci Aubuchon Awais Ayazi Bacha Badve Badzioch Bains Baker Baker Baldwin Bank Bara Baumbach Baumgartner Bavaria Bekele Bellini Bellizzi Beregi Beyer Bhutani Bianchi Bianco Bin Bivona Blackstone Blansfield Blom Bolton Boodhwani Borger Bosco Bothe Emmanuele Ghulam David H Gorav Jaffer A Walid Mamdouh Abdullah A Zohair Mark S Bahaaldin Joan M Nasser K Marek Jennifer Gianni D Anna Kitipan V Raimondo Adelaide M Parla Kristen A Omar Shahin Emile Sunil Michael Manjit Scott Kelly A William M Farazaneh Christoph Andreas William A Joseph E Neby Silvia Andrew M Jean-Paul Erik AK Banoop Cesario Giuseppe Zheng Antonio Eugene H Joseph Aaron S William D Munir Michael A Paolo Wolfgang 19 17 F7 40 20 F6 30 L8 30 6 30 15 21, F18 45 F13 10 44 T4 10 F20 13 39 17 19 23 F15 24 44 F8 39 F14 19 T3 10 F14 9 32 F20 L2 29 8 20 L3 5 F19 11 12, 15, 38 F12 F1 16, 20 7 31 11 L1 Bradley Brinks Brock Bronleewe Bryant Budev Bueno Bulbul Buxton Calafiore Caldarone Callahan Calore Calvaruso Canver Carere Carpentier Carrel Carroll Cattaneo Cerfolio Chachques Champion Chan Chan Chedrawy Chen Chen Cheung Chioato Cho Choi Christakis Christie Clancy Cleland Cleuziou Cohen Colson Conconi Connolly Contini Cook Corrado Correa Coselli Crabtree Croft Culliford Curtin Cusimano Czesla Damiano Dasika Timothy Henriette L Malcolm V Scott H Ayesha Marie M Raphael Ziad Brian F Antonio M Christopher A John Chiara Davide Charles Ronald G Alain Thierry P David Stephen M Robert J JuanCarlos Hunter C Nadia Frandics P Edgar G Jonathan M Edward P Anson Tatiana Sandy Noah C George T Neil A Robert R Andrew Julie Gideon Yolonda L Maria T Heidi M Marco Noah Egle Arlene M Joseph S Traves D Laura R Lucy Ronan Robert J Markus Ralph J Narasimham L 48 F4 14 T8 43 15 3 30 34 11 L6 L6 F20 35 30 T6 F6 F4 F17 14 43 F6 F14 19 26 2 51 33 T6 F20 24 45 1 41 4, 24 T1 27 1 F11 F20 9 11 24 5 16, 20, 32 9 18 F7 10 38 T7 31 39 36 301 6295_AATS.book Page 302 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY Last Name First Name Paper # Davies de Kerchove Debie Deeb Del Nido DeMeester DeMeester Di Mauro Dibardino Dietz Digumarthy Dioguradi Dobkowski Doll Donahue Doss Downey Ducko Duke Dycoco Edgerton Eghtesady Ehrlich El Khoury Emani Ender Ennis Eperjesi Erasmus Fadel Falk Fattori Fattouch Feder-Elituv Fedourk Fernandes Fernandez Fichtelscherer Flameng Flamm Flores Flynn Folliguet Fox Francis Fremes French Fynn-Thompson Gagliardi Gaissert Gallina Garcia-Rinaldi Gay Gaynor Gaynor Gazoni Ryan R Laurent Alain G. M. Pedro Steven R Tom R Michele Daniel J Harry C Subba R Pietro Wojciech Nicolas Dean M Mirko Robert J Christopher T David Joseph James R Pirooz Marek P Gébrine Sirisha Joerg Daniel B Thomas J Jeremy J Bahaa Volkmar Rossella Khalil Randi Lynn M Philip Lucas G Stephan Willem Scott D Raja M Michael Thierry Stephanie Ashleigh Stephen E Brent A Francis Massimo Henning A Sabina Raul F William A J. William J. William Leo M 51 13 T3 36 23 19 19 11 25 9 T5 5 T1 31 45 T2 44 3 T8 44 T8 F8 29 13 L3 31 L1 F1 16, 20, 32 30 31 29 5, 35 1 40 T1 L2 T2 T3 38 44 38 T3 T1 20 1 F5 23 11 45 11 L5 2 4 24 L2 302 Last Name First Name Paper # Geng Gengsakul Gerdisch Gilbert Giraud Glineur Go Gokaslan Goldman Goodyear Gordon Gorman Gorman Grab Grinstaff Guccione Hagen Hagino Hagl Halkos Hamilton Hammoud Hanley Hare Haverich Hayward Heijmen Herijgers Herregods Heude Hickey Hirakawa Hirth Hoashi Hoercher Hofstetter Hoganson Holper Hong Honjo Hörer Horrigan Hu Hussain Iaco' Ingels Itoh Iwata Jack Jacobs Jacobs Jaklitsch Jarvik Jerri Jianhua John Wang Aungkana Marc Sebastien Marie-Noelle David Tetsuhiko Ziya Bernard S Adam Ian Robert C Joseph H Joshua D Mark W Francesco Jeffrey A Ikuo Christian Michael E Mark Zane Frank L David L Axel Philip Robin Paul Marie-Christin Didier Edward J Koujirou Yael Takaya Katherine J Wayne L David M Klaus Yang Osami Jürgen Mark Sheng Shou Mustafa Angela L Neil B Akinobu Yusuke Robert Marshall L Jeffery P Michael T Gail Hilshorst Fu Lombardi F19 48 T8 41 F4 13 F20 16 1 16 34 F1 F1 6 F11 35 19 49 T3 33 10 F15 26 34 T3 34 29 T3 T3 F6 48 F3 44 F2 12 16, 20, 32 F13 27 F19 L8 27 34 28 F12 11 L1 L1 47 17 50 50 3 24 F8 F19 F8 6295_AATS.book Page 303 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California Last Name First Name Johnson Jonas Jones Jotisakulratana Joufan Joyner Jungebluth Kagisaki Kaku Kang Karck Kassis Kaza Kerendi Kern Kesler Keum Khaladj Kiaii Kilgo Kilic Kim Kim Kische Kitamura Kobayashi Komaki Kozower Kreisel Krishnamurthy Kron Krupnick Kucharczuk Kuhn Kuklinski Kuntze Kuratani Laborde Lakev Lam Lam Landreneau Landreneau Landreneau Lange Lanuti Lau Laubach Lawton Lecarpentier Lee Lee Lee Leers Lele LeMaire Bruce E Richard A David R Vibul Mansoor Campbell D Philipp Kouji Eiichi Chang H Matthias Edmund S Aditya K Faraz John A Kenneth Dong Yoon Nawid Bob Patrick D Arman Joo H Young T Stephan Soichiro Junjiro Ritsuko Benjamin D Daniel Gaurav Irving L Alexander S John C Courtney Daniela Thomas Toru Franscois Fitsum B-Khanh Christopher Rodney J Joshua P James R Rüdiger Michael Christine L Victor E Jennifer S Yves P. Richard Paul C Jessica M Himalaya Scott A Paper # 3 47 40 T4 30 1 F20 49 F3 F16 F10 32 25 33 40 F15 45 T3 T1 33 17 F16 F16 29 49 49 16, 20, 32 40 18 L1 L2, L4, F5, 40 18 6 40 F4 31 37 T3 31 8 F8 17 17 17 27 45, T5 40 L2, L4, F5 39 F6 F18 8 21 19 2 9 303 Last Name First Name Paper # Li Li Liberman Libutti Licht Lichtenstein Lim Lipham Lisle Liu Liu Loehfelm Louis-Tisserand Luketich Macchiarini MacDonald MacDonald Mack Malhotra Maniar Manlhiot Mantero Marshall Martens Maru Mason Massad Mastumiya Masuda Matalanis Mathisen Matsumiya Matsusaki Mayer McClelland McCrindle McElhinney McKellar Meerkov Meguid Meherally Mehran Mehta Mengzhong Merklinger Meyers Michelot Mihaljevic Milewicz Miller Miyagawa Moazami Mohr Montenegro Moon Moran Lang Shou Jun Moishe Steven K Daniel J Samuel V Hong-Gook John Turner C Rong Zhigang Amy Mariana James D Paolo James Ryan J Michael J Sunil P Hersh S Cedric Sara Audrey Sven Dipen David P Malek G Goro Esteban George Douglas J Goro Kanji John E James Brian W Doff B Stephen H Meir Robert A Danish Reza J Atul C Liu Sandra L Bryan F Robert Tomislav Dianna M D. Craig Shigeru Nader Friedrich W Lisa M Marc R Cesar A F15 28 42 F12 4 T6 23 19 L2 F11 28 F12 F6 17, 41 F20 T1 L5 T8 26 2 30, 48 F20 23 T2 20 15 2 37 F17 34 42, 45, T5 F2 F1 23, 25 T8 30, 48 25 L5 36 14 21 16, 20, 32 15 F19 L8 18 F6 38 9 L1, 9 F2 39 31 4 39 32 6295_AATS.book Page 304 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY Last Name First Name Paper # Moritz Mosca Moss Moussa Muehlfeld Mueller Munfakh Murphy Murthy Muscarelli Musick Myung Nakamura Nathan Navarra Nette Nguyen Nguyen Nicolson Nienaber Noirhomme Noma Novick Nowicki O'Brien Oezcelik Oka Okamura Okano Okita Orrick Otu Padala Palmero Panzarella Park Park Park Park Pasque Patel Patterson Paul Peeler Perrier Peterson Petrossian Pettersson Pettiford Pigula Piquet Pisters Pisters Plappert Poncelet Port Anton Ralph S Nancy C Fuad Christian Jordan Nabil A Gavin Sudish C Marco Joanne Richard Yuki Howard J Emiliano Franka Tom C Dao M Susan C Christoph A Philippe Mio Richard J Edward R Sean M Arzu Norihiko Toru Teruo Yutaka Brian Hasan Muralidhar Laura C Gaetano Gary Joo-yeon Sun J Bernard J Michael K Himanshu J G. Alexander Subroto Benjamin B Patrick Eric D Edwin Gosta B Brian L Frank Philippe Katherine Katherine M Theodore Alain Jeffrey L T2 51 L7 1 F4 3 39 10 15 35 18 33 49 7 35 31 L1 F12 4, 24 29 13 F1 T1 12, 38 50 19 L6 47 F2 F3 F13 L3 F7 9 5 F17 F16 F16 44 39 36 18 21 40 31 50 26 15 17 23 29 16 32 F1 13 21, F18 304 Last Name First Name Paper # Powell Prasad Prince Prodan Puskas Quagebeur Radovits Rajeswaran Ramlawi Rayman Reddy Redington Reeves Rhines Rice Richards Rieger Rizk Robbins Robert Roth Rothnie Rousseau Rubay Rubens Ruengsakulrach Rusch Russo Ruvolo Ryan Saito Sallehuddin Salomon Sampognaro Saqi Sawa Schächinger Schaff Schreiber Schrepfer Schuchert Schussler Seeburger Sehgal Sekiya Sellke Selzman Servais Setina Sever Shah Sharma Sharma Shepard Shera Shimamura Scott Sunil M Syma L Zsolt John D Jan M Tamás Jeevanantham Basel Reiza Vadiyala M Andrew Barney Laurence David C William G Karen Nabil P Robert Ferguson Jack A Christine Herve Jean Fraser D Permyos Valerie W Mark Giovanni Liam P Mitsuhiro Ahmed Dan Roberta A. Yoshiki Volker Hartzell V Christian Sonja Matthew J Olivier Joerg Shailen Naosumi Frank W Craig H Elliot L Marek Jeri Ashish S Amita Ashish K JoAnne O David M Kazuo F7 2 T8 27 33 51 F10 12, 38 L3 T1 26 L6 10 16 16, 20, 32 3 F15 44 F17 F8 16, 20, 32 F9 29 13 7 T4 44 51 5, 35 F1 F3 30 F6 5 F18 F2, F3, 37 T2 L5 27 F17 17, 41 F6 31 F12 F2 L3 L7 21 T7 1 F14 T5 L2, L4 T5 4 37 6295_AATS.book Page 305 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California Last Name First Name Paper # Shimizu Shiraishi Shirakawa Shrestha Siblini Silverman Smedira Smith Smith Snow Sorabella Speziale Spray Spring St. John-Sutton Stansfield Steinberg Stiles Sugarbaker Summers Sundt Sung Sussman Swanson Swinamer Swisher Szabó Tabbutt Takahashi Takano Takatani Takeuchi Tang Tarakji Taylor Taylor Tevaearai Thelitz Thomas Thompson Thompson Thourani Thuita Tiehua Tilleman Toth Trepels Tropek Tsang Tselentis Turetta Uchimura Ungerleider Urbani Vacanti Van Arsdell Tatsuya Shuichi Yukitoshi Malakh Ghassan Norman Nicholas G David Philip W Norman J Robert Giuseppe Thomas Denise J Martin G Bill Bryan Brendon M David J Kelly Thoralf M Sook W Marc S Julia C Stuart A Stephen G Gábor Sarah Hiroaki Hiroshi Setsuo Mugiho Ruhang Ahmed Vanessa Nicole G Hendrik Stephan Craig Jess L Christopher R Vinod H Lucy Rong Tamara R Erzsebet Thomas Michael Katherine Nicole Michaela Eiichirou Ross M Luca Joseph P Glen S F2 49 37 T3 30 26 12 10 40 2 51 35 24 F9 F1 L7 T8 21 3 T1 L5, 9 F16 14 L1 T1 16, 20, 32 F10 24 F3 37 L8 37 L7 2 F17 18 F4 26 F12 L5 T6 F7 15 F19 3 F9 T2 L6 T7 26 F20 F3 50 F20 F13 L8 305 Last Name First Name van de Locht Vaporciyan Vazquez Veeramachaneni Veldtman Velotta Veres Verhelst Verrier Vogt Volguina Vossough Wagner Wain WWalsh Wang Wang Weaver Weaver Webb Webb Weiss Weiss Weizhao Welke Wernovsky Wi Wiklund Williams Williams Williams Wilson Wilson Wilson Wimmer Greinecker Wolinsky Wong Wood Wozny Wright Yagihara Yang Yang Yang Yau Ye Yeh Yeow Yi Yoganathan Yoon Zagorski Zellos Zhao Zoole Zurakowski Andreas Ara A M Nirmal K Gruschen Jeffrey Gabor Robert Edward D Manfred Irina V Arastoo P. L. John C Garrett L Lixing Xing Li Jason Tara A Gary John G Eric C Eric S Huang Karl F Gil Hyun C Lars Jason A William G David M Gregory David O Heather-Marie P Gerhard Jesse Daniel R Malcolm Denise Cameron D Toshikatsu Jonathan Zequan Stephen C Terrence M Jian Joannie T Wen-Shuz Hu Ajit P Dustin Y Brandon Lambros Qianqian Jennifer B David Paper # F10 16, 20, 32 F18 18 48 F17 F10 13 F9 27 9 4 F18 45, T5 16, 20, 32 L6 9 16 T8 48 T6 14 F14 F19 50 4, 24 F16 T7 F14 48 36 L6 41 F9 T2 F11 T6 F6 7 6, 45, T5 49 51 L4, F5 14 T7 T6 2 F12 F19 F7 12 1 3 F15 18 47 6295_AATS.book Page 306 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY AATS PRESENTERS INDEX Last Name First Name Ailawadi Alsoufi Angelini Arom Beyer Bolton Boodhwani Brinks Bryant Calafiore Chen Cho Cohen Coselli Davies Dibardino Doss Edgerton Eghtesady Ehrlich El Khoury Falk Fattouch Flores Gaissert Gilbert Hammoud Hayward Hickey Hoganson Honjo Hörer Hu Itoh Iwata Jungebluth Kassis Kiaii Kim Lanuti Leers Gorav Bahaaldin Gianni D Kitipan V Erik A. K. William D Munir Henriette L Ayesha Antonio M Edward P Sandy Gideon Joseph S Ryan R Daniel J Mirko James R Pirooz Marek P Gébrine Volkmar Khalil Raja M Henning A Sebastien Zane Philip Edward J David M Osami Jürgen Sheng Shou Akinobu Yusuke Philipp Edmund S Bob Young T Michael Jessica M Final ID 40 30 10 T4 8 16, 20 7 F4 43 11 33 24 1 9 51 25 T2 T8 F8 29 13 31 5, 35 44 45 41 F15 34 48 F13 L8 27 28 L1 47 F20 32 T1 F16 T5 19 306 Last Name First Name Liberman Licht Lisle Liu Mason Matsusaki McKellar Meguid Mihaljevic Moon Moss Nakamura Oka Padala Patel Pigula Prasad Ramlawi Schuchert Schussler Sehgal Sekiya Shimamura Shrestha Stiles Szabó Takahashi Thelitz Tilleman Veeramachaneni Velotta Wagner Weiss Weizhao Welke Wiklund Wilson Wright Yang Ye Yoon Moishe Daniel J Turner C Rong David P Kanji Stephen H Robert A Tomislav Marc R Nancy C Yuki Norihiko Muralidhar Himanshu J Frank Sunil M Basel Matthew J Olivier Shailen Naosumi Kazuo Malakh Brendon M Gábor Hiroaki Stephan Tamara R Nirmal K Jeffrey P. L. Eric S Huang Karl F Lars Heather-Marie P Cameron D Zequan Jian Dustin Y Final ID 42 4 L2 F11 15 F1 L5 14 38 39 L7 49 L6 F7 36 23 2 L3 17 F6 F12 F2 37 T3 21 F10 F3 26 3 18 F17 F18 F14 F19 50 T7 F9 6 L4, F5 T6 12 6295_AATS.book Page 307 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California 2008 AATS EXHIBITORS EXHIBIT HOURS AND DATES Sunday, May 11, 2008 Monday, May 12, 2008 Tuesday, May 13, 2008 5:00 p.m. - 7:00 p.m. 9:00 a.m. - 4:30 p.m. 9:00 a.m. - 4:00 p.m. BOOTH NO. A & E MEDICAL CORPORATION ......................................................... 1520 2310 South Miami Boulevard, Suite 240, Durham, NC 27703 USA Products to be exhibited: MYO/Wire™ temporary pacing wires, MYO/Wire II sternum wires, PorterMed rotating aortic punch, Direct View Retractor (DVR2) for minimally invasive saphenous vein harvest and DoubleWire high strength sternal closure system. The high strength DoubleWire sternum closure system provides stable sternal fixation in large and COPD patients. www.aemedical.com ACCUMETRICS .................................................................................... 252 3985 Sorrento Valley Boulevard, San Diego, CA 92121 USA Accumetrics develops and manufactures the VerifyNow® System, a comprehensive system for the assessment of platelet function. VerifyNow provides doctors with an easy to use, automated, rapid and accurate way to monitor platelet function to optimize the effectiveness of antiplatelet therapies. Accumetrics markets VerifyNow® tests for aspirin, Plavix® and GPIIb/IIIa inhibitors. www.accumetrics.com ACUTE INNOVATIONS .......................................................................... 246 21421 NW Jacobson Road, Suite 700, Hillsboro, OR 97124 USA Acute Innovations Rib Fracture Plating System is a comprehensive system of implants and instruments specifically for repairing rib fractures. The plate’s unique U-shape with locking screw technology provides excellent fixation and allows a minimally invasive approach. The precise targeting and instrumentation provide straightforward insertion that reduces OR time. www.acuteinnovations.com AESCULAP, INC. ................................................................................. 1401 307 Exhibitors 3773 Corporate Parkway, Center Valley, PA 18034 USA Aesculap, Inc., is a member of the B. Braun family of healthcare companies and the world’s largest manufacturer of surgical instrumentation. For more than 138 years, Aesculap has provided customers with surgical instrumentation and implants for neurosurgery, ENT, plastic and reconstructive, thoracic, micro-vascular, cardiovascular, orthopedic and laparoscopic surgery. www.aesculapusa.com 6295_AATS.book Page 308 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY BOOTH NO. ALSIUS CORPORATION ....................................................................... 241 15770 Laguna Canyon Road #150, Irvine, CA 92618 USA ALSIUS is the worldwide leader in providing catheter-based intravascular patient temperature management for critically ill patients. The ALSIUS system and catheters deliver precise core patient cooling or warming therapy in an easy-to-use and costeffective system to achieve and maintain desired patient temperature. www.alsius.com AMERICAN ASSOCIATION FOR THORACIC SURGERY ..................... Lobby 1 900 Cummings Center, Suite 221-U, Beverly, Massachusetts 01915 USA Founded in 1917, the American Association for Thoracic Surgery is dedicated to excellence in research, education, and innovation in thoracic surgery and has become an international professional organization of more than 1100 of the world’s foremost cardiothoracic surgeons. The annual meeting, research grants, awards, educational symposia and courses, along with the AATS official journal, the Journal of Thoracic and Cardiovascular Surgery, all strengthen its commitment to science, education and research. Please visit www.aats.org or stop by the AATS booth for more information. www.aats.org ARROW INTERNATIONAL, A TELEFLEXMEDICAL COMPANY ............... 1406 4024 Stirrup Creek Drive, Durham, NC 27709 USA www.teleflexmedical.com ATRICURE, INC. .................................................................................. 913 6033 Schumacher Park Drive, West Chester, OH 45069 USA Expand your cardiac ablation instrumentarium to include the AtriCure® Isolator® ablation system. Connecting surgeons to a whole new range of patients, AtriCure Coolrail™ linear pen allows you to complete a full epicardial left atrial maze lesion set in a minimally invasive or thoracoscopic setting. www.atricure.com ATRIUM MEDICAL CORPORATION .................................................... 1407 5 Wentworth Drive, Hudson, NH 03051 USA Visit Atrium’s booth where you can see our Ocean, Oasis & Express chest drains, Pneumostat & Express Mini 500 mobile chest drains and Pleuraguide disposable chest tube kits. Learn about our continuing commitment to comprehensive education and support tools offered to you at no charge! www.atriummed.com 308 6295_AATS.book Page 309 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California BOOTH NO. ATS MEDICAL, INC. ............................................................................. 721 3905 Annapolis Lane, Suite 105, Minneapolis, MN 55447 USA ATS Medical features the ATS Open Pivot® Mechanical Heart Valves, ATS Simulus™ Annuloplasty Products, and ATS 3f® Bioprostheses. ATS is the leader in surgical cryoablation providing ATS CryoMaze™ probes and clamps for the treatment of cardiac arrhythmias. www.atsmedical.com BFW, INC. .......................................................................................... 1327 2307 River Road, Suite 103, Louisville, KY 40206 USA Recognized around the world for progressive engineering and straightforward, functional design in surgical headlights, from its Thru-the-Lens Headlight video system to its Maxenon™ Xi 300-Watt Xenon headlight system, BFW™ provides the most dependable and powerful headlight illumination available for the OR today. www.bfwinc.com BIOMET MICROFIXATION (Formerly W. Lorenz Surgical) ................... 535 1520 Tradeport Drive, Jacksonville, FL 32218 USA SternaLock “The New Gold Standard” Intended for primary sternal closure in “high risk” patients, SternaLock is proven to provide greater stability, decrease infection, promote earlier bone healing, and increase patient comfort while saving time and money. www.biometmicrofixation.com BIORING, SA ....................................................................................... 330 Chemin d’Etraz 2, CH-1027 LONAY Switzerland Bioring brings solutions made of biodegradable materials to surgeons and patients. The Kalangos Ring is the first subendocardial annuloplasty ring, easy to implant, that induces the formation of fibrous tissue while it degrades, preserving the atrioventricular annulus contractility and the native annulus growth potential. Indicated for adults and children. www.bioring.ch BOSS INSTRUMENTS, LTD. .................................................................. 342 395 Reas Ford Road, Suite 120, Earlysville, VA 22936 USA BOSS Instruments, Ltd. is a surgical instrument company which concentrates on the manufacture and continual development of specialty lines in the following areas: Bariatric, ENT, General Surgery, Laparoscopy, Neurosurgery, Obstetrics/Gynecology, Ophthalmic, Orthopedic, Plastic, Table-Mounted Retractors, and Vascular/Cardiovascular. www.bossinst.com Exhibitors 309 6295_AATS.book Page 310 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY BOOTH NO. BRONCUS TECHNOLOGIES, INC. ....................................................... 1525 1400 North Shoreline Boulevard, Building A8, Mountain View, CA 94043 USA Broncus Technologies is conducting the EASE Trial to investigate airway bypass, a minimally-invasive bronchoscopic procedure to treat emphysema. Airway bypass creates new pathways in the lung for trapped air to escape and may potentially reduce lung hyperinflation, improve pulmonary function and enhance quality of life in emphysema patients. www.broncus.com CALIFORNIA MEDICAL LABORATORIES, INC. .................................... 1234 1570 Sunland Lane, Costa Mesa, CA 92626 USA Manufacturer of cardiovascular cannuale, catheters, array of cardioplegia delivery products, suction and venting devices, accessories, and minimally invasive products. Please visit our booth in order to discuss recent developments in our Cannulae Line. www.calmedlab.com CARDICA, INC. .................................................................................... 935 900 Saginaw Drive, Redwood City, CA 94063 USA Anastomosis made fast & simple. Cardica designs and manufactures proprietary automated anastomosis systems used by cardiovascular surgeons to perform rapid, reliable and consistent anastomosis of the blood vessels during coronary artery bypass graft (CABG) surgery. In comparison with hand-sewn sutures, our systems offer mechanically governed repeatability and reduced procedural complexity. www.cardica.com CARDIMA, INC. ................................................................................... 248 47266 Benicia Street, Fremont, CA 94538 USA Cardima-Advancing Cardiac Ablation Techniques. Proven innovative technology incorporated into an ablation line of products used in an open (or closed) chest procedure safely and effectively; creating continuous, thin, deep, transmural lesions. Cardima has been dedicated to the diagnosis and treatment of arrhythmias for over 12 years. www.cardima.com CARDIOGENESIS CORPORTATION ...................................................... 335 11 Musick, Irvine, CA 92618 USA Cardiogenesis Corporation is a progressive medical device company specializing in the treatment of cardiovascular disease and a leader in therapies designed to stimulate cardiac angiogenesis (new blood vessel formation) and aid in complete revascularization in patients with ischemic heart disease. The company’s market-leading Holmium:YAG laser and disposable fiber-optic delivery systems are used to treat patients suffering from the debilitating pain of severe angina. www.cardiogenesis.com www.heartofnewlife.com www.learntmr.com 310 6295_AATS.book Page 311 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California BOOTH NO. CARDIOMEDICAL GMBH ..................................................................... 243 Industriestrasse 3A D-30855 Langenhagen Germany MIC-Instruments Laparoscopic Instruments Retractors and Accessories Coronary Instruments Cannulaes Program Blood Flow Measurement Xenon Headlight System Clip Technology Pacer Temporary Heartwires & Leads www.cardiomedical.de CAS MEDICAL SYSTEMS, INC. .............................................................. 835 44 East Industrial Road, Branford, CT 06405 USA CAS Medical Systems, a leader in vital signs monitoring systems, presents the FORESIGHT® Cerebral Oximeter, a compelling new technology for the continuous monitoring of absolute cerebral tissue oxygen saturation. This non-invasive device enables tailored patient management and a reduction in catastrophic desaturation events. Visit us at booth number Booth 835 or online at: www.CASMED.com/FORE-SIGHT THE CENTER FOR BIOMEDICAL CONTINUING EDUCATION (CBCE) .......245 1707 Market Place Boulevard, Suite 370, Irving TX 75063 The CBCE invites you to participate in our satellite symposium entitled Optimizing Adjuvant Chemotherapy in Non-Small Cell Lung Cancer. Faculty includes Eric Vallieres, MD an Associate Professor of Surgery from University of Washington and David Harpole, MD from the Department of Cardiovascular and Thoracic Surgery from Duke University Medical Center. Upon completion of this activity, physicians will be able to describe the biological mechanisms underlying the impact of various tumor molecular characteristics on patient prognosis or therapeutic response to adjuvant therapy in early-stage NSCLC, evaluate recent clinical data from studies investigating molecular approaches to predicting benefit to adjuvant chemotherapy in early-stage NSCLC, and summarize the specific issues that must be considered as targeted agents are increasingly used in the adjuvant setting in early-stage NSCLC. To Register, log-on to www.thecbce.com or call 214-260-9024. www.thecbce.com Exhibitors 311 6295_AATS.book Page 312 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY BOOTH NO. CEREMED, INC. ................................................................................ 1335 3643 Lenawee Avenue, Los Angeles, CA 90016 USA Ceremed manufactures and sells Ostene, a synthetic, water soluble, bone hemostasis material. Ostene achieves immediate hemostasis without interfering with bone healing, without causing an increase in infection rates and without causing chronic inflammation. www.ostene.com CHASE MEDICAL .............................................................................. 1025 1876 Firman Drive, Richardson, TX 75081 Chase Medical is a medical technology company focused on the diagnosis and treatment of heart failure. Products include the MannequinTM for physicians performing Surgical Ventricular Restoration (SVR) and MARISATM Cardiac MRI analysis technology. www.chasemedical.com COOK MEDICAL ................................................................................. 1506 750 Daniels Way, PO Box 489, Bloomington, IN 47402 USA Cook Medical was the first company to introduce interventional devices in the United States. Today, the company participates in all global markets, integrating device design, biopharma, gene and cell therapy and biotech to enhance patient safety and improve clinical outcomes. Cook won the prestigious Medical Device Manufacturer of the Year for 2006 from Medical Device and Diagnostic Industry magazine. For more information, visit www.cookmedical.com. www.cookmedical.com CORONEO, INC. .................................................................................. 518 9250 Park Avenue, Suite 514, Montreal, Quebec, Canada, H2N 1Z2 Featured will be the “Extra-Aortic” Annuloplasty Ring, a unique expansible ring to correct aortic insufficiency in valve-sparing surgery, while preserving the physiology of the aortic root. Surgical platforms for both sternotomy and intercostal approaches during valvular, CABG, OPCAB, and robotic surgery. Also featured will be pediatric titanium retractors with swivel blades. www.coroneo.com COVIDIEN ........................................................................................ 1221 150 Glover Ave, Norwalk, CT 06850 USA Covidien is a leading global healthcare products company that creates innovative medical solutions for better patient outcomes and delivers value through clinical leadership and excellence. Please visit www.covidien.com to learn more. www.covidien.com 312 6295_AATS.book Page 313 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California BOOTH NO. CRYOLIFE, INC. ................................................................................... 523 1655 Roberts Boulevard NW, Kennesaw, GA 30144 USA CryoLife®, Inc. is a leader in the development and implementation of advanced technologies associated with allograft processing and cryopreservation. Additionally, CryoLife continues to expand its protein hydrogel technology platform, which currently includes BioGlue® Surgical Adhesive. www.cryolife.com CTSNET ............................................................................................. 1517 3108 Queeny Tower, Barnes Jewish Hospital Plaza, Saint Louis, MO 63110 USA CTSNet is the premier electronic community and portal of information for cardiothoracic surgery, providing the most comprehensive, most heavily trafficked, and most reliable online source of information about cardiothoracic surgery available worldwide. www.ctsnet.org DATASCOPE CORPORATION ................................................................ 929 14 Phillips Parkway, Montvale, NJ 07645 USA Datascope Corp. provides counterpulsation and conduit harvest solutions for Cardiothoracic Surgeons. Featuring CS300® pump and Sensation® catheter. We are the leader in counterpulsation therapy. Our ClearGlide® EVH products offer flexible, efficient options for single, small incision conduit harvest. www.datascope.com DELACROIX-CHEVALIER ...................................................................... 635 c/o MED Alliance Group, Inc., 3825 Commerce Drive, St. Charles, IL 60174 USA Delacroix-Chevalier designs and manufactures World Class Instruments. D-C is best known for the Carpentier Mitral Valve Repair retractor and instrument set, Mammary Retractors, and Resano “Magic” Forceps. www.delacroix-chevalier.com DESIGNS FOR VISION, INC. ............................................................... 1400 760 Koehler Avenue, Ronkonkoma, NY 11779 USA Designs for Vision, Inc. manufactures the world’s finest Surgical Telescopes and headlights. Our lightweight custom-made Surgical Telescopes (2.5x, 3.5x, 4.5x and 6.0x) improve visual acuity and reduce back and neck pain. The Daylight Xenon 300™ and Daylight Metal Halide™ provide the brightest intensity at an affordable price. www.designsforvision.com DORNIER MEDTECH ........................................................................... 344 313 Exhibitors 1155 Roberts Boulevard N.W., Kennesaw, GA 30144 USA Dornier MedTech develops, manufactures, markets and services medical lasers, orthopedic shock wave devices, lithotripters and urotables worldwide, providing innovative therapeutic, diagnostic and service solutions for numerous health-care fields. www.dornier.com 6295_AATS.book Page 314 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY BOOTH NO. EACTS .............................................................................................. 1529 3 Park Street, Windsor, SL4 1LU, UK EACTS—the largest European Association devoted to Cardiothoracic surgery. Our mission is to raise standards in CT surgery through education and training. Visit the booth for information on membership, future meetings and all activities of EACTS. www.eacts.org EDWARDS LIFESCIENCES .................................................................. 1001 One Edwards Way, Irvine, CA 92614 USA Edwards Lifesciences is the leading heart valve company in the world. Edwards addresses advanced cardiovascular disease with its market-leading heart valve therapies, vascular disease treatments and critical care technologies. In 2008, Edwards is celebrating 50 years of partnering with clinicians to develop life-saving innovations. www.edwards.com ESTECH CARDIAC SURGERY SPECIALISTS ................................ 613 & 623 2603 Camino Ramon, Suite 100, San Ramon, CA 94583 USA ESTECH enables procedures Cardiac Surgeons specialize in: Ablations, CABG, and Valve—with COBRA® RF Ablation Products, Stabilizers and Positioners, Valve Exposure and Cannulation Systems for traditional and minimally invasive approaches. www.estech.com EXPERIMENTAL SURGICAL SERVICES ................................................. 237 420 Delaware St. SE, MMC 220, Minneapolis, MN 55455 USA Experimental Surgical Services at the University of Minnesota is more than just a contract research organization. From discovery to regulatory strategy to submission we are the industry leader in researching and testing pre-clinical medical devices and surgical techniques. We have 25 years experience in pre-clinical assessment for the medical industry. www.ess.umn.edu FEHLING SURGICAL INSTRUMENTS, INC. ............................................ 435 509 Broadstone Lane, Acworth, GA 30101 USA FEHLING SURGICAL INSTRUMENTS’ exhibit features the “Fehling CERAMO® Instrument Line,” “SUPERPLAST Coronary Probes,” and “Innovative Retractor Systems” including Instrumentation for Minimally Invasive Cardiac Surgery. Black CERAMO® surface means high efficiency through enhanced performance, increased endurance and minimal maintenance. See and feel the difference. www.fehlingsurgical.com 314 6295_AATS.book Page 315 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California BOOTH NO. GENESEE BIOMEDICAL, INC. ............................................................. 1513 1308 S. Jason Street, Denver, CO 80223 USA Innovation Changing Life through products for Cardiothoracic Surgery. Genesee BioMedical, Inc. develops and manufactures instruments and devices for cardiothoracic surgery. Unique Genesee products include sternal and thoracic retractors for adult/pediatric cardiac surgery, reusable cardiac positioners, coronary graft markers, myocardial temperature needles and suture guards. All products are CE marked. www.geneseebiomedical.com GORE & ASSOCIATES, INC. ................................................................ 1334 1505 North 4th Street, PO BOX 2400, Flagstaff, AZ 86001 USA The Gore Medical Products Division has provided creative therapeutic solutions to complex medical problems for three decades. During that time, more than 23 million innovative Gore Medical Devices have been implanted, saving and improving the quality of lives worldwide. The extensive Gore Medical family of products includes vascular grafts, endovascular and interventional devices, surgical meshes for hernia repair and sutures for use in vascular, cardiac and general surgery. For more information, please visit… www.goremedical.com HEART HUGGER/GENERAL CARDIAC TECHNOLOGY, INC. ................... 1512 15814 Winchester Blvd. #105, Los Gatos, CA 95030 USA HEART HUGGER Sternum Support Harness: Patient-controlled pain management post-op. Heart Hugger gives patients the confidence and security to be aggressive with RT, speeding recovery, while stabilizing their wound. Patients squeeze the handles together whenever they cough or move, tightening the chest strap, supporting the ribcage laterally with uniform encircling pressure. www.hearthugger.com HODDER ARNOLD PUBLISHERS ........................................................ 1514 198 Madison Avenue, New York, NY 10016 USA Please visit our booth featuring the latest titles from Hodder Arnold including Operative Thoracic Surgery, by Kaiser, which was awarded first prize in the surgery category of the 2007 BMA Medical Book Competition. www.oup.com/us/catalog/general/series/AHodderArnoldPublication/?view=usa HRA HOSPITAL RESEARCH ASSOCIATES ............................................ 1426 315 Exhibitors 400 Lanidex Plaza, Parsippany, NJ 07054 USA Our team of experienced interviewers will be distributing carefully developed questionnaires. We’ll be gathering the answers to vital marketing and clinical questions/answers that can affect the introduction of new products or the continuation of existing healthcare products and services. www.hraresearch.com 6295_AATS.book Page 316 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY BOOTH NO. I-FLOW CORPORATION ...................................................................... 729 20202 Windrow Drive, Lake Forest, CA 92630 USA ON-Q is labeled to significantly reduce pain better than narcotics and to significantly reduce narcotics intake after surgery. ON-Q was upheld as a best practice for postsurgical pain relief and its widespread use was encouraged as part of an independent study published in the prestigious Journal of American College of Surgeons. Medicare recognizes ON-Q as a payable covered benefit and therefore medically necessary. www.iflo.com INTERNATIONAL SOCIETY FOR MINIMALLY INVASIVE CARDIOTHORACIC SURGERY .............................................................. 508 900 Cummings Center, Suite 221-U, Beverly, MA 01915 USA ISMICS: Advancing new techniques and technologies in less invasive forms of cardiothoracic surgery, ISMICS offers cutting-edge scientific programs and hands-on demonstrations at its Annual Meeting and Winter Workshop. 11th Annual Meeting, 11–14 June 2008, Marriott Copley Place in Boston, MA. www.ismics.org INTUITIVE SURGICAL, INC. ................................................................. 327 1266 Kifer Road, Building 101, Sunnyvale, CA 94086 USA Intuitive Surgical, Inc. is the global technology leader in robotic-assisted, minimally invasive surgery. The Company’s da Vinci® Surgical System offers breakthrough capabilities that enable cardiac surgeons to use a minimally invasive approach and avoid sternotomy. www.intuitivesurgical.com JOHNSON & JOHNSON WOUND MANAGEMENT, A DIVISON OF ETHICON, INC. .......................................................... 1435 Route 22 West, Somerville, NJ 08876 USA Visit Johnson & Johnson Wound Management, a division of Ethicon, Inc. at Booth #1435 to view innovations in hemostasis, featuring EVITHROM* Thrombin, Topical (Human), and Effective, Safe, and Easy-to-Use human thrombin. Come experience the Human Advantage! www.biosurgicals.com KAPP SURGICAL INSTRUMENTS, INC. ............................................... 1135 4919 Warrensville Center Road, Cleveland, OH 44128 USA Kapp Surgical is a custom design house for surgical instrumentation. Kapp holds the original patent on the Cosgrove Valve Retractor, the gold standard. Kapp has other retractors and sterile products related to the OR, i.e., McCarthy Mini Sternotomy Retractor, Gillinov Maze Retractor, and several NEW custom cardiac devices. www.kappsurgical.com 316 6295_AATS.book Page 317 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California BOOTH NO. KLS MARTIN LP ................................................................................ 1235 PO Box 50249, Jacksonville, FL 32250 USA KLS-Martin, a responsive company, is focused on the development of innovative products for oral, plastic and craniomaxillofacial surgery. New product developments in our titanium osteosynthesis plating systems allow these products to be used for rapid sternal fixation and reconstruction. www.klsmartin.com KOROS USA INC. ............................................................................... 1521 610 Flinn Avenue, Moorpark, CA 93021 USA For the past 33 years Koros USA has manufactured and distributed state of the art surgical instruments such as our Swivel Mitral Valve, Swift, Pro (Ring), CAB and IMA Retractors. All our instruments are custom made from the finest quality and excellence. www.korosusa.com LIPPINCOTT/WILLIAMS & WILKINS ................................................... 1516 4750 Matty Court, La Mesa, CA 91941 USA www.lww.com LUNA INNOVATIONS ............................................................................ 239 3157 State St. Blacksburg, VA 24060 USA The EDAC® QUANTIFIER (Emboli Detection and Classification) blood circuit monitor uses sophisticated ultrasound technology to non-invasively count and measure gaseous emboli in the extracorporeal blood circuit. Unlike traditional emboli detectors, the EDAC® QUANTIFIER detects microemboli that may otherwise go unnoticed. What was previously unknown is now precisely measurable. www.lunamedicalproducts.com LUXTEC® PART OF INTEGRA SURGICAL ................................................ 334 99 Hartwell Street, West Boylston, MA 01583 USA Luxtec is the leading manufacturer of medical illumination systems including xenon light source and headlight systems, MicroLux® DLX Camera headlight systems, digital video recording system (nStream+™ DVD Recorder), fiber optic cables, surgical loupes and instruments (Jarit, Padgett, Ruggles…), video carts, Sony® monitors and color printers. www.luxtec.com MAQUET CARDIOVASCULAR ................................................................ 513 317 Exhibitors 170 Baytech Drive, San Jose, CA 95134 USA The MAQUET Group is a global market leader for Medical Systems and is comprised of three specialty divisions: Surgical Workplaces, Critical Care and Cardiovascular. The MAQUET Cardiovascular division includes MAQUET cardiopulmonary products along with proven Cardiac and Vascular Surgery solutions previously offered by Boston Scientific and its predecessor Guidant. www.maquet.com 6295_AATS.book Page 318 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY BOOTH NO. MARKET ACCESS PARTNERS ............................................................. 1528 3236 Meadowview Road, Evergreen, CO 80439 USA Market Access Partners provides market research consulting to the medical device and pharmaceutical industries. We use innovative qualitative and quantitative methodologies to research opinions of physicians, nurses and patients. We offer a management-oriented approach to product development and marketing. www.marketaccesspartners.com MEDELA HEALTHCARE ....................................................................... 735 1101 Corporate Drive, McHenry, IL 60050 USA Welcome to the age of digital thoracic drainage therapy. Medela introduces the Thopaz®, an electronic measuring and monitoring system developed for safe and effective patient ambulation following cardio-thoracic surgery. www.medelasuction.com MEDICALCV, INC. ............................................................................. 1404 9725 South Robert Trail, Inver Grove Heights, MN 55077 USA MedicalCV manufactures and markets its laser-based technology in both the ATRILAZE™ Surgical Ablation System and the SOLAR™ Automated Surgical Ablation System, which have been used in open, endoscopic, and robotic cardiac tissue ablation procedures. www.medcvinc.com MEDISTIM ......................................................................................... 629 10200 73rd Avenue North, Suite 112, Maple Grove, MN 55369 USA MediStim is the world’s leading provider of patency verification technologies helping cardiac surgeons deliver improved patient outcomes and verify quality care. Enhanced quality control is available intra-operatively, delivered through MediStim’s highly validated, easy-to-use transit time and Doppler ultrasound modalities. www.medistim.com MEDTRONIC ....................................................................................... 701 710 Medtronic Parkway NE, Minneapolis, MN 55432 USA Medtronic, global leader in medical technology, offers innovative adult/pediatric cardiac products for lifetime patient management in areas such as structural heart disease, endovascular and revascularization. Key technologies include valve repair/replacement, minimally invasive/off-pump techniques, aortic stent grafts, irrigated radio frequency ablation, CPB technology, transcatheter technology and skills-based EDGESM training programs. www.medtronic.com 318 6295_AATS.book Page 319 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California BOOTH NO. NCONTACT SURGICAL INC. ................................................................ 1124 1001 Aviation Parkway, Suite 400, Morrisville, NC 27560 nContact Surgical, Inc. is a medical device company whose technology is the integration of suction, perfusion, and RF energy. Its elegance is in its simplicity. nContact features the FDA cleared VisiTrax™ Systems for coagulation of cardiac tissue for traditional and minimally invasive approaches. www.ncontactsurgical.com NOVADAQ TECHNOLOGIES INC. .......................................................... 421 2585 Skymark Avenue, Suite 306, Mississauga, Ontario, Canada L4W 4L5 Novadaq Technologies develops medical imaging and image guided therapeutic systems for the operating room. Novadaq markets the SPY® Imaging System for the intraoperative assessment of coronary bypass grafts, the PINPOINT™ Autofluorescence Endoscopic System for use in the surgical management of lung cancer and the CO2 HEART LASER™ for Transmyocardial Revascularization. www.novadaq.com OLYMPUS SURGICAL AMERICA .......................................................... 1125 One Corporate Drive, Orangeburg, NY 10962 USA Olympus Surgical America is an important part of the global Olympus network, with responsibility for the sales and marketing of surgical endoscopy equipment. With a focus on innovation and quality, Olympus provides knowledge and solutions that enable healthcare professionals to achieve excellent clinical and financial outcomes across the continuum of care. www.olympussurgical.com ONCOTECH ....................................................................................... 1523 15501 Redhill Avenue, Tustin, CA 92780 USA Oncotech is a molecular oncology laboratory that provides reliable, diagnostic tumor specific information to physicians to assist them in the treatment planning process for their cancer patients. Available testing services include Oncotech’s proprietary Extreme Drug Resistance (EDR®) Assay, pathology consultations, immunohistochemistry, immunophenotyping, and Fluorescent In Situ Hybridization. www.oncotech.com ON-X LIFE TECHNOLOGIES, INC. ....................................................... 1207 319 Exhibitors 8200 Cameron Road, A-196, Austin, TX 78754 USA On-X0.0® Heart Valves: Patented natural design and On-X® Carbon offer reduced turbulence in a mechanical valve to rival the clinical and hemodynamic performance of prosthetic tissue valves. FDA approved PROACT (Prospective Randomized On-X® Anticoagulation Clinical Trial) in progress. Distributor of Flexigrip Sternal Closure, Cardima Surgical Ablation, CarbonAid C02 Diffusion. www.onxvalves.com www.heartvalvechoice.com 6295_AATS.book Page 320 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY BOOTH NO. PEAK SUGICAL, INC. ........................................................................... 244 2464 Embarcadero Way, Palo Alto, CA 94303 PEAK Surgical’s flagship product, the PEAK™ Surgery System, combines the PULSAR™ Generator, which supplies unrivaled pulsed plasma radiofrequency energy, with the PEAK PlasmaBlade™, a disposable cutting tool that offers the exacting control of a scalpel and the bleeding control of traditional electrosurgery without the extensive collateral damage. www.peaksurgical.com PENINSULA MEDICAL PRODUCTS, LLC. .............................................. 250 31330 Schoolcraft Road, Suite 200, Livonia, MI 48150 USA Sterna-Band™ Self-locking sternotomy sutures are a replacement for steel wires. A 4.5 mm width spreads the clamping force six times over wire and the breaking point is twice that of wires. The buckle is double-locked to eliminate slippage. Design prevents suture from cutting through the sternum and can reduce dihiscence. www.peninsulamedicalproducts.com PETERS SURGICAL .............................................................................. 829 c/o MED Alliance Group, Inc. 3825 Commerce Drive, St. Charles, IL 60174 USA Peters Surgical is proud to announce FDA clearance on the uniRing® Universal Annuloplasty System. Peters Surgical specializes in cardiovascular sutures. CardioNYL® is a monofilament suture for mitral valve repair and pediatric surgery. CardioFLON® and CardioXYL® are braided sutures for valves and rings. Corolene® is a monofilament suture for bypass surgery. www.peters-surgical.com PHILIPS HEALTHCARE ........................................................................ 240 22100 Bothell-Everett Highway, Bothell, WA 98021 Philips simplifies healthcare by focusing on patients and care providers in the care cycle. Our product line – including X-ray, ultrasound, and radiation oncology systems, as well as patient monitoring, information management and resuscitation products – supports open, minimally invasive, and hybrid surgical procedures. We also offer a wide range of services www.medical.philips.com/us/company/aboutus PIONEER SURGICAL TECHNOLOGY ................................................... 1526 375 River Park Circle, Marquette, MI 49855 USA The Pioneer Sternal Cable System consists of multi-strand stainless steel cable which is tensioned to a known degree and then crimped in place using a patented instrument. The cable is smooth, flexible, and remarkably strong, contributing to a consistently stable, secure closure. www.pioneersurgical.com 320 6295_AATS.book Page 321 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California BOOTH NO. POWER MEDICAL INTERVENTIONS, INC. ............................................. 901 2021 Cabot Boulevard West, Langhorne, PA 19047 USA POWER MEDICAL INTERVENTIONS® (PMI) is leading the development and commercialization of Intelligent Surgical Instruments™ for bariatric, cardiothoracic, colorectal and general surgical applications, which enable less invasive surgical techniques to benefit surgeons, patients, hospitals and healthcare networks, including minimizing medical waste. www.pmi2.com PRODUCTS FOR MEDICINE, INC. ......................................................... 434 1201 E. Ball Road, #H, Anaheim, CA 92805 USA Products for Medicine manufactures a complete and comprehensive line of bright and cool surgical headlights and xenon light source systems for every discipline in today’s Operating Rooms. Our no-nonsense pricing, industry leading illumination and warranty provide a fresh solution to other overpriced headlight systems. www.productsformedicine.com QUEST MEDICAL, INC. ........................................................................ 923 One Allentown Parkway, Allen, TX 75002 USA FEATURES MPS®2 SYSTEM PROVIDING FLEXIBILITY/control to optimize myocardial protection strategy w/Microplegia & cyclic flow (pulsatile) and pediatric protocols, including cardioplegia delivery catheters/accessories, Retract-O-Tape® silicone vessel loops; CleanCut™, PerfectCut®, and the bullet-nose rotating aortic punches. www.questmedical.com RICHARD WOLF INSTRUMENTS CORPORATION ................................... 338 353 Corporate Woods Parkway, Vernon Hills, IL 60061 USA Richard Wolf, a leading endoscopic manufacturer for over 100 years, offers many diagnostic and therapeutic products for use in otoscopy, sinuscopy/FESS, Stroboscopy, laryngoscopy, and bronchoscopy, including our Integrated Fiberoptic Bronchoscope known as the Texas Rigid Integrated Bronchoscope. Please visit us at Booth #338 to discover our innovative products. www.richardwolfusa.com RULTRACT/PEMCO ............................................................................ 1227 5663 Brecksville Road, Cleveland, OH 44131 USA Rultract®/Pemco established a medical industry standard for surgical retraction systems providing gentle and uniform lift and allows for maximum exposure for cardiac/ thoracic procedures. For further information contact Rultract® directly or visit our website. www.rultract.net Exhibitors 321 6295_AATS.book Page 322 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY BOOTH NO. SAUNDERS/MOSBY – ELSEVIER, INC. ................................................ 1501 1600 JFK Boulevard, Suite 1800, Philadelphia, PA 19103 USA ELSEVIER, proud publisher of the Journal of Thoracic and Cardiovascular Surgery, official publication of the AATS. Trust ELSEVIER to offer innovative resources to expand your knowledge in the healthcare field. ELSEVIER also publishes Saunders, Mosby and Churchill Livingstone titles. Browse through our complete selection of publications including books, periodicals and online solutions! www.elsevierhealth.com SCANLAN INTERNATIONAL, INC. ....................................................... 1301 One Scanlan Plaza, St Paul, MN 55107 USA Highest quality surgical products designed and manufactured by the Scanlan family since 1921. Offering instrumentation designs in stainless steel and titanium including VATS and MICS instruments, Never Shear™ Dual Guide™ titanium forceps, single-use products including Surg-I-Loop® PLUS, A/C Locator® and Radiomark® graft markers, Surgical Acuity magnification loupes featuring new Sport wrap-around frames. www.scanlanintemational.com SIEMENS MEDICAL SOLUTIONS USA, INC. ........................................ 1421 51 Valley Stream Parkway, Malvern, PA 19355 USA Artis zeego® is the revolutionary, multi-axis system that enables variable working height and delivers large-volume image results to meet your current and future imaging needs. www.medical.siemens.com SOCIETY OF THORACIC SURGEONS .................................................. 1531 633 North Saint Clair, Chicago, IL 60611 USA The Society of Thoracic Surgeons is a not-for-profit organization representing more than 5,600 surgeons, researchers, and allied health professionals worldwide who are dedicated to ensuring the best possible heart, lung, esophageal and other chest surgeries, including transplants. The STS 45th Annual Meeting & Exhibition, the Society’s pre-eminent educational event, will be held January 26–28, 2009, in San Francisco, California. The popular STS/AATS Tech-Con 2009 will be held just prior to the Annual Meeting, January 24–25, also in San Francisco. The Society offers a wide variety of member benefits, including a complimentary subscription to the prestigious The Annals of Thoracic Surgery, dynamic educational offerings, online patient information resources, and much more. Stop by Booth #1531 or visit the STS Web site, www.sts.org, to learn more about The Society of Thoracic Surgeons. www.sts.org SOMANETICS CORPORATION ............................................................ 1201 1653 East Maple Road, Troy, MI 48083 USA Somanetics’ INVOS® System helps detect site-specific tissue and cerebral ischemia so the cardiac OR team can intervene to prevent or lessen complications. Cerebral oximetry is now a collected metric in The STS Adult Cardiac Surgery Database. www.somanetics.com 322 6295_AATS.book Page 323 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California BOOTH NO. SONTEC INSTRUMENTS, INC. ............................................................ 1321 7248 South Tucson Way, Centennial, CO 80112 USA Sontec offers the most comprehensive selection of exceptional hand held surgical instruments available to the discriminating surgeon. There is no substitute for quality, expertise and individualized service. Sontec’s vast array awaits your consideration at our booth. www.sontecinstruments.com SORIN GROUP ................................................................................... 1213 14401 West 65th Way, Arvada, CO 80004 USA With a comprehensive portfolio and more than 30 years clinical experience, Sorin Group’s innovative prosthetic heart valves and repair devices deliver superior hemodynamic performance, implant flexibility and exceptional durability to surgeons and patients. Visit us at booth #1213 to see why Sorin Group is THE CHOICE of Cardiac Surgeons Worldwide. www.sorin.com ST. JUDE MEDICAL, INC. ................................................................... 1013 807 Las Cimas Parkway, Suite 400, Austin, TX 78746 USA St. Jude Medical is dedicated to making life better for patients worldwide through excellence in medical device technology and services. Visit booth 1013 to see our innovative solutions for the cardiac surgeon, featuring the Epic™ Stented Tissue Valve and the Epicor™ Cardiac Ablation System. www.sjm.com STS/AATS JOINT HEALTH POLICY ACTION CENTER ............................ 1535 633 North Saint Clair, Chicago, IL 60611 USA The STS/AATS Joint Health Policy Action Center (Booth #1535) is the best place to learn about STS/AATS government relations activities and to find out how you can help your practice and the future of the specialty. Start by helping to fight the proposed 16% reductions in your Medicare reimbursement fees. Stop by Booth #1535, where you can e-mail your Congressional representatives, discuss election-year healthcare policy issues, and explore options for grassroots advocacy in your home town. www.sts.org SUPERDIMENSION ............................................................................ 1229 323 Exhibitors 161 Cheshire Lane, Suite 100, Plymouth, MN 5441 USA superDimension, Inc. develops and manufactures software, hardware and disposables for the lung disease market. superDimension’s system is the total bronchial access and navigation system that provides a safe pathway to peripheral or central lung lesions, even for patients with procedure-restricting conditions. www.superdimension.com 6295_AATS.book Page 324 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY BOOTH NO. SURGE MEDICAL SOLUTIONS, LLC .................................................... 1328 3710 Sysco Court, SE, Grand Rapids, MI 49512 USA Surge Medical Solutions LLC, designs, manufactures, and distributes a full line of cardioplegia cannula and accessories, adapters for cardioplegia administration systems, and cardiovascular surgery accessories. www.surgemedical.com SURGITEL/GENERAL SCIENTIFIC CORPORATION .............................. 1428 77 Enterprise Drive, Ann Arbor, MI 48103 USA Lightweight digital video camera, the first loupe-mounted video camera (called SurgiCam), will be demonstrated which can record DVD-quality video on a personal laptop computer. SurgiTel’s ErgoVision loupes and headlights prevent or eliminate chronic neck pain. Many surgical professionals, who have been experiencing neck pain with the use of traditional fixed loupes, have switched to ErgoVision loupes. www.surgitel.com SYNCARDIA SYSTEMS INC. ................................................................. 340 1992 East Silverlake, Tucson, AZ 85713 USA The CardioWest® temporary Total Artificial Heart (TAH-t) is the only FDA and CE approved device that provides circulatory restoration in morbidly ill patients with irreversible bi-ventricular failure, bridging them to transplantation. At AATS, we will provide information about our upcoming clinical trial of the Companion driver, designed for use in the operating room, hospital room and at home. www.syncardia.com SYNTHEMED, INC. ............................................................................ 1429 200 Middlesex Essex Turnpike, Suite 210, Iselin, NJ 08830 USA REPEL-CV® Adhesion Barrier is a thin, transparent, bioresorbable membrane made from synthetic polymers that is placed over the epicardial surface during an open heart surgical procedure to reduce the severity of post-operative adhesions. REPEL-CV is CE Mark approved and marketed outside the US; FDA approval is pending. www.synthemed.com SYNTHES, INC. ................................................................................. 1329 1301 Goshen Parkway, West Chester, PA 19380 USA Synthes CMF develops, produces and markets instruments and implants for the surgical reconstruction of the human skeleton and soft tissues. Our product offering includes systems for primary or secondary closure and repair of the sternum following sternotomy or fracture to stabilize the sternum and promote healing. www.synthes.com 324 6295_AATS.book Page 325 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California BOOTH NO. TAPESTRY MEDICAL, INC. ................................................................... 235 1404 Concannon Boulevard, Livermore, CA 94550 USA Tapestry provides patients on warfarin therapy with services & products to test their INR at home. Tapestry uses the Roche CoaguChek XS® as the test platform, provides customized reimbursement support for both Medicare & private insurance, and is the only supplier providing Face-2-FaceSM training for each patient. www.tapestrymedical.com TERUMO CARDIOVASCULAR SYSTEMS ................................................. 713 6200 Jackson Road, Ann Arbor, MI 48103 USA Terumo’s cardiac and vascular companies will display the VirtuoSaph™ Endoscopic Vein Harvesting System, Vascutek® Gelweave™ Graft Geometries range of gelatin sealed woven grafts, DuraHeart™ Left Ventricular Assist System (not available in the U.S.), cannulae and perfusion systems. www.terumo-cvs.com THORACIC SURGERY FOUNDATION FOR ............................................ 1500 RESEARCH & EDUCATION (TSFRE) 900 Cummings Center, Suite 221-U, Beverly, MA 01915 USA The Thoracic Surgery Foundation for Research and Education (TSFRE) was established in 1992 to increase knowledge and enhance treatment of patients with cardiothoracic disease, to develop skills of cardiothoracic surgeons as surgeon-scientists and health policy leaders and to strengthen society’s understanding of the specialty. Physicians, corporate partners and patients are urged to contribute to TSFRE. Please stop by the TSFRE booth for your donor sticker and visit www.tsfre.org for more information on awards and giving opportunities that benefit you and our profession. www.tsfre.org THORAMET SURGICAL PRODUCTS, INC. ............................................ 1530 301 Route 17 North, Suite 800, Rutherford, NJ 07070 USA THORAMET offers the Lewis VATS Instruments, conventional ring-handled thorascopic instruments with a unique “switchback” feature designed for access and maneuverability in minimally invasive lung and chest procedures. See our new innovative pericardial pickup for your window procedures. www.thoramet.com THORATEC CORPORATION .................................................................. 734 325 Exhibitors 6035 Stoneridge Drive, Pleasanton, CA 94588 USA With over 11,000 patient implants and three decades of experience, Thoratec® Corporation offers the broadest portfolio of mechanical circulatory support devices. Thoratec’s product line includes the CentriMag® Acute Circulatory Support Device, HeartMate® LVAS, Thoratec PVAD™ and IVAD™, and the HeartMate II®, an investigational device in clinical trial. www.thoratec.com 6295_AATS.book Page 326 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY BOOTH NO. TRANSONIC SYSTEMS, INC. .............................................................. 1427 34 Dutch Mill Road, Ithaca, NY 14850 USA Fast, easy and reproducible intraoperative blood flow measurements with Transonic Surgical Flowmeters improve surgical outcomes. Flowbased assessment of coronary bypass grafts ensures surgical success by confirming their patency in Off-pump and On-pump cases, or by prompting the surgeon to re-examine an anastomoses while the patient is still in the OR. www.transonic.com USB MEDICAL, LTD. .......................................................................... 1326 2000 Pioneer Road, Huntingdon Valley, PA 19006 Introducing the World’s First Adjustable Heart Retractor for minimally invasive surgery—see the heart like never before! The MonoFib™ System is the World’s First Completely Disposable One-Handed Internal Defibrillation Delivery System. The Monofib™ System is completely disposable, lightweight, easy and safe to use! www.usbmedical.com VITALCOR, INC. & APPLIED FIBEROPTICS ........................................ 1420 100 E. Chestnut Avenue Chicago, IL 60559 Vitalcor Inc.: Introducing the Featherweight Vascular Clamps, replacing the Bulldog. Latex free coronary artery balloon cannulae with balloon. Titanium specialty instruments. Reusable stabilizer for beating heart surgery. Applied Fiberoptics new digital camera system incorporated with the Gemini Headlight & Sunbeam Light Source. Axiom wound drains. Applied Fiberoptics: Bringing the clarity of daylight into the surgical suite. The Gemini Headlight is lightweight & perfectly balanced, sleek, ultra-low-profile designed headlight. The Sunbeam 300 Watt Xenon light source delivers instant clean white light for superb tissue definition in hard-to-see cavities. www.vitalcor.com www.appliedfiberoptics.com VITALITEC .......................................................................................... 534 10 Cordage Park Circle, Plymouth, MA 02360 USA Vitalitec will be showing a full range of atraumatic Flexible and Ring Handled vascular clamps, inserts, delicate spring clips, Greyhound™ Bulldog adjustable spring clips as well as a line of unique manual load ligation clips, high quality titanium and stainless surgical instruments. www.vitalitec.com 326 6295_AATS.book Page 327 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California BOOTH NO. WEXLER SURGICAL SUPPLIES ............................................................ 1413 11333 Chimney Rock Road, #16, Houston, TX 77035 USA Wexler Surgical designs and manufactures a wide range of innovative, high quality surgical products, including titanium and stainless steel specialty instruments for Cardiovascular, Vascular, Microsurgical and Thoracic applications. Our instruments are handcrafted from the finest materials and our customer service is among the best in the industry. www.wexlersurgical.com THANK YOU EXHIBITORS & SUPPORTERS. AATS APPRECIATES YOUR SUPPORT! Exhibitors 327 6295_AATS.book Page 328 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY PRODUCT/SERVICE LISTINGS BOOTH NO. ABLATION DEVICES ATS Medical, Inc. 721 ANNULOPLASTY DEVICES Bioring, SA Coroneo Inc. Medtronic, Inc. ATS Medical, Inc. Peters Surgical Sorin Group Genesee BioMedical, Inc. 330 518 701 721 829 1213 1513 AORTIC PUNCHES BOSS Instruments, Ltd. Fehling Surgical Instruments, Inc. Maquet Cardiovascular Quest Medical, Inc. Scanlan International, Inc. Wexler Surgical Genesee BioMedical, Inc. 342 435 513 923 1301 1413 1513 ASSOCIATIONS, FOUNDATIONS, SOCIETIES American Association for Thoracic Surgery International Society of Minimally Invasive Cardiothoracic Surgery Thoracic Surgery Foundation for Education and Research Saunders/Mosby – Elsevier, Inc. Lippincott/Williams & Wilkins EACTS Society of Thoracic Surgeons STS/AATS Joint Health Policy Action Center Lobby 1 508 1500 1501 1516 1529 1531 1535 BALLOON PUMPING Datascope Corp. 929 BLOOD MONITORING SYSTEMS Luna Innovations Medtronic, Inc. Terumo Cardiovascular Systems Sorin Group Transonic Systems Inc. 239 701 713 1213 1427 328 6295_AATS.book Page 329 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California BOOTH NO. BLOOD RECOVERY SYSTEMS Sorin Group 1213 CANNULAE Boss Instruments, Ltd. Estech Cardiac Surgery Specialists Medtronic, Inc. Terumo Cardiovascular Systems Edwards Lifesciences Sorin Group California Medical Laboratories Wexler Surgical 342 613 & 623 701 713 1001 1213 1234 1413 CARDIAC SURGERY Maquet Cardiovascular St. Jude Medical 513 1013 CARDIOPLEGIA DELIVERY SYSTEMS Quest Medical, Inc. Sorin Group Surge Medical Solutions, LLC 923 1213 1328 CARDIOPULMONARY BYPASS PRODUCTS Luna Innovations Peninsula Medical Products Fehling Surgical Instruments, Inc. Maquet Cardiovascular Estech Cardiac Surgery Specialists MediStim Medtronic, Inc. Terumo Cardiovascular Systems Peters Surgical Sorin Group California Medical Laboratories Genesee BioMedical, Inc. 239 250 435 513 613 & 623 629 701 713 829 1213 1234 1513 CARDIOVASCULAR PRODUCTS 240 250 252 330 335 329 Exhibitors Philips Healthcare Peninsula Medical Products Accumetrics Bioring, SA Cardiogenesis Corp. 6295_AATS.book Page 330 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY BOOTH NO. Boss Instruments, Ltd. Fehling Surgical Instruments, Inc. Coroneo Inc. Cryolife Inc. Vitalitec Estech Cardiac Surgery Specialists MediStim Abiomed Delacroix-Chevalier Terumo Cardiovascular Systems Peters Surgical AtriCure, Inc. Quest Medical, Inc. Cardica St. Jude Medical Kapp Surgical Instrument Covidien California Medical Laboratories Scanlan International, Inc. Surge Medical Solutions, LLC Ceremed Inc. Aesculap, Inc. Atrium Medical Corp. Wexler Surgical Transonic Systems Inc. SyntheMed, Inc. Cook Medical Koros USA, Inc. 342 435 518 523 534 613 & 623 629 634 635 713 829 913 923 935 1013 1135 1221 1234 1301 1328 1335 1401 1407 1413 1427 1429 1506 1521 CATHETERS I-Flow Corporation Quest Medical, Inc. Datascope Corp. St. Jude Medical Kapp Surgical Instrument Covidien California Medical Laboratories Atrium Medical Corp. Cook Medical 729 923 929 1013 1135 1221 1234 1407 1506 330 6295_AATS.book Page 331 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California BOOTH NO. CHEST DRAINAGE PRODUCTS Medela Healthcare Kapp Surgical Instrument California Medical Laboratories Atrium Medical Corp. Cook Medical 735 1135 1234 1407 1506 COMPUTER SOFTWARE Terumo Cardiovascular Systems superDimension 713 1229 CORONARY ANGIOPLASTY Philips Healthcare 240 EDUCATION PROGRAMS Bioring, SA Medtronic, Inc. Edwards Lifesciences St. Jude Medical Covidien Synthes CMF 330 701 1001 1013 1221 1329 ELECTROSURGICAL DEVICES PEAK Surgical, Inc. Estech Cardiac Surgery Specialists Olympus Surgical Medical Covidien 244 613 & 623 1125 1221 ENDOSCOPIC SYSTEMS/PRODUCTS Philips Healthcare Luxtec® Part of Integra Surgical Richard Wolf Medical Instruments Boss Instruments, Ltd. Products For Medicine, Inc. Vitalitec Estech Cardiac Surgery Specialists Medtronic, Inc. Olympus Surgical Medical superDimension 240 334 338 342 434 534 613 & 623 701 1125 1229 Exhibitors 331 6295_AATS.book Page 332 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY BOOTH NO. HEADLIGHTS AND ACCESSORIES Luxtec® Part of Integra Surgical Products For Medicine, Inc. BFW, Inc. Designs for Vision Inc. Vitalcor, Inc. & Applied Fiberoptics SurgiTel/General Scientific Corporation 334 434 1327 1400 1420 1428 HEART VALVES ATS Medical (Bioprosthetic & Mechanical Heart Valves) 721 IMAGING SYSTEMS Philips Healthcare Intuitive Surgical, Inc. MediStim SurgiTel/General Scientific Corporation 240 327 629 1428 IMPLANTABLE DEVICES Peninsula Medical Products Bioring, SA Luxtec® Part of Integra Surgical SynCardia Systems, Inc. Coroneo Inc. Cryolife Inc. Vitalitec Medtronic, Inc. Peters Surgical St. Jude Medical Sorin Group Scanlan International, Inc. Ceremed Inc. SyntheMed, Inc Genesee BioMedical, Inc. Broncus Technologies, Inc. 250 330 334 340 518 523 534 701 829 1013 1213 1301 1335 .1429 1513 1525 INFECTION CONTROL PRODUCTS Boss Instruments, Ltd. I-Flow Corporation Designs for Vision Inc. 342 729 1400 LOUPES Scanlan International (Surgical Magnifying Loupes) 332 1301 6295_AATS.book Page 333 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California BOOTH NO. MARKET RESEARCH Market Access Partners 1528 MECHANICAL CIRCULATORY ASSISTANCE SynCardia Systems, Inc. Terumo Cardiovascular Systems 340 713 MINIMALLY INVASIVE CARDIAC SURGERY Philips Healthcare Intuitive Surgical, Inc. Cardiogenesis Corp. Boss Instruments, Ltd. Fehling Surgical Instruments, Inc. Maquet Cardiovascular Coroneo Inc. Vitalitec Estech Cardiac Surgery Specialists MediStim Delacroix-Chevalier Medtronic, Inc. Peters Surgical AtriCure, Inc. Cardica Edwards Lifesciences Covidien California Medical Laboratories Scanlan International, Inc. USB Medical, Ltd. MedicalCV, Inc. Genesee BioMedical, Inc. 240 327 335 342 435 513 518 534 613 & 623 629 635 701 829 913 935 1001 1221 1234 1301 1326 1404 1513 MINIMALLY INVASIVE LUNG SURGERY Broncus Technologies, Inc. 1525 MYOCARDIAL PROTECTION 713 923 1213 1328 1429 1513 333 Exhibitors Terumo Cardiovascular Systems Quest Medical, Inc. Sorin Group Surge Medical Solutions, LLC SyntheMed, Inc. Genesee BioMedical, Inc. 6295_AATS.book Page 334 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY BOOTH NO. NON-INVASIVE SURGICAL PRODUCTS Luna Innovations Philips Healthcare Luxtec® Part of Integra Surgical Peters Surgical Covidien Scanlan International, Inc. 239 240 334 829 1221 1301 OCCLUSION DEVICES Coroneo Inc. Vitalitec Scanlan International, Inc. Genesee BioMedical, Inc 518 534 1301 .1513 ONCOLOGY TESTING SERVICES Oncotech 1523 OPERATING ROOM EQUIPMENT Philips Healthcare Intuitive Surgical, Inc. Products For Medicine, Inc. MediStim AtriCure, Inc. Quest Medical, Inc. Olympus Surgical Medical Sorin Group Designs for Vision Inc. Vitalcor, Inc. & Applied Fiberoptics 240 327 434 629 913 923 1125 1213 1400 1420 PAIN PUMP I-Flow Corporation 729 PERFUSIONISTS Estech Cardiac Surgery Specialists MediStim 613 & 623 629 PUBLISHERS Saunders/Mosby–Elsevier Hodder Arnold 1501 1514 ROBOTICS Intuitive Surgical, Inc. 327 334 6295_AATS.book Page 335 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California BOOTH NO. STENTS Kapp Surgical Instrument Atrium Medical Corp. Cook Medical Broncus Technologies, Inc. 1135 1407 1506 1525 STERNAL CLOSURE/FIXATION Biomet Microfixation/W. Lorenz Surgical Synthes CMF 535 1329 STERNAL SUPPORT SYSTEMS Peninsula Medical Products Synthes CMF Genesee BioMedical, Inc. Pioneer Surgical Technology 250 1329 1513 1526 SURGICAL ADHESIVE Cryolife Inc. 523 SURGICAL INSTRUMENTS Luxtec® Part of Integra Surgical Richard Wolf Medical Instruments Boss Instruments, Ltd. Intuitive Surgical, Inc. Dornier MedTech Fehling Surgical Instruments, Inc. Coroneo Inc. Vitalitec Biomet Microfixation/W. Lorenz Surgical, Inc. Estech Cardiac Surgery Specialists Delacroix-Chevalier AtriCure, Inc. Olympus Surgical Medical Covidien Rultract/Pemco Scanlan International, Inc. Sontec Instruments, Inc. USB Medical, Ltd. 334 338 342 327 344 435 518 534 535 613 & 623 635 913 1125 1221 1227 1301 1321 1326 Exhibitors 335 6295_AATS.book Page 336 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY BOOTH NO. Aesculap, Inc. Wexler Surgical SurgiTel/General Scientific Corporation Genesee BioMedical, Inc. Koros USA, Inc. Thoramet Surgical Products 1401 1413 1428 1513 1521 1530 SUTURES AND NEEDLES Peninsula Medical Products Coroneo Inc. Estech Cardiac Surgery Specialists Peters Surgical Covidien Aesculap, Inc. Genesee BioMedical, Inc. 250 518 613 & 623 829 1221 1401 1513 TRANSMYOCARDIAL REVASCULARIZATION PRODUCTS Cardiogenesis Corp. 335 VALVES Bioring, SA Cryolife Inc. Estech Cardiac Surgery Specialists Medtronic, Inc. Quest Medical, Inc. Edwards Lifesciences St. Jude Medical On-X Life Technologies, Inc. Sorin Group 330 523 613 & 623 701 923 1001 1013 1207 1213 VASCULAR GRAFTS Maquet Cardiovascular Cryolife Inc. Medtronic, Inc. Terumo Cardiovascular Systems Kapp Surgical Instrument Atrium Medical Corp. Cook Medical 513 523 701 713 1135 1407 1506 VATS INSTRUMENTATION Scanlan Corporation 1301 336 6295_AATS.book Page 337 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California BOOTH NO. VIDEO EQUIPMENT, ANGIOSCOPES, TELESCOPES Philips Healthcare Luxtec® Part of Integra Surgical Richard Wolf Medical Instruments Products For Medicine, Inc. Olympus Surgical Medical BFW, Inc. Designs for Vision Inc. SurgiTel/General Scientific Corporation 240 334 338 434 1125 1327 1400 1428 WOUND SUPPORT SyntheMed, Inc. 1429 OTHER Blood Flow Measurement Transonic Systems Inc. 1427 Bronchoscopic Biopsy Tools superDimension 1229 Contract Lab Experimental Surgical Services 237 Cryopreserved Tissue Cryolife Inc. 523 Electromagnetic Navigation superDimension 1229 Graft Patency Verification MediStim 629 Lasers Dornier MedTech 344 Light Sources BFW, Inc. 1327 Monitoring System Somanetics Corporation 1201 Patient Temperature Management Alsius Corporation 241 Pediatrics Retractors Coroneo Inc. 518 Exhibitors 337 6295_AATS.book Page 338 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY BOOTH NO. Pre-Clinical Research Facility Experimental Surgical Services 237 Post-Operative Pain Management Cryolife Inc. 523 Robotics Intuitive Surgical, Inc. 327 Total Artificial Hearts SynCardia Systems, Inc. 340 Vessel Harvesting PEAK Surgical, Inc. 244 338 6295_AATS.book Page 339 Wednesday, March 12, 2008 3:28 PM 88TH ANNUAL MEETING • May 10–May 14, 2008 • San Diego, California AFFILIATE SYMPOSIA (As of February 2008) Friday, May 9 Looking to the Future in Thoracic Surgery Marina Ballroom F, San Diego Marriott Hotel & Marina 8:00 am – 5:00 pm Supported by Covidien Saturday, May 10 Heart Valve Surgery Forum 8:00 am – 12:00 pm Marina Ballroom D, San Diego Marriott Hotel & Marina (Symposium) Marina Ballroom E, San Diego Marriott Hotel & Marina (Breakfast) Supported by Edwards Lifesciences Sunday, May 11 Optimizing Adjuvant Chemotherapy in NSCLC Presented by The Center for Biomedical Continuing Education 6:00 am – 8:00 am, Breakfast Marina Ballroom FG, San Diego Marriott Hotel & Marina Supported by Genentech Cardiovascular Clinical Specialties – Collaboration Forum 7:00 pm – 9:00 pm, Reception Marina Ballroom DE, San Diego Marriott Hotel & Marina Supported by Medtronic, Inc. Expanding Treatment Options for the Cardiac Surgeon: Opportunities in Collaborative Care 7:00 pm – 9:00 pm, Dinner Hard Rock Hotel Supported by St. Jude Medical 339 6295_AATS.book Page 340 Wednesday, March 12, 2008 3:28 PM AMERICAN ASSOCIATION FOR THORACIC SURGERY Monday, May 12 25 Years Experience with Medtronic Hancock II Bioprosthesis 6:00 am – 8:00 am, Breakfast Marina Ballroom D, San Diego Marriott Hotel & Marina Supported by Medtronic, Inc. The Epicardial Frontier: Minimally Invasive Techniques to Treat a Broader Range of AF Patients 6:00 pm – 8:00 pm, Dinner Seaview Room, San Diego Marriott Hotel & Marina Supported by AtriCure, Inc. Techniques and Concepts – Thoracic-Aortic Hybrid Procedures Arch and Visceral De-Branching 7:00 pm – 10:00 pm, Dinner Marina Ballroom D, San Diego Marriott Hotel & Marina Supported by Vascutek Off-Pump Made Easy 7:45 pm – 10:00 pm, Dinner W Hotel Supported by Cardica, Inc. and Maquet Tuesday, May 13 How Do You Know? Compelling Evidence for the Routine Use of Transit Time Flow Technology During CABG 6:00 am – 8:00 am, Breakfast Room 29A, San Diego Convention Center Supported by MediStim 340
