Tuesday - American Association for Thoracic Surgery

Transcription

TH
95
AATS
DAI LY
NEW S
2015
A PRIL 25-29, 2015 • W ASHINGTON S TATE C ONVENTION C ENTER • S EATTLE , WA
TUESDAY EDITION
TUESDAY
7:00 a.m. – 8:40 a.m.
Cardiac Surgery Forum
7:00 a.m. – 8:40 a.m.
General Thoracic Surgery Forum
7:00 a.m. – 8:40 a.m.
Adult Cardiac Emerging Technology and
Techniques Forum NEW!
7:00 a.m. – 8:40 a.m.
General Thoracic Emerging Technology and
Techniques Forum NEW!
7:00 a.m. – 8:40 a.m.
Video Session
7:00 a.m. – 8:40 a.m.
VAD/ECMO Session NEW!
8:45 a.m. – 12:30 p.m.
Plenary Scientific Session
11:40 p.m. – 12:30 p.m.
HONORED GUEST LECTURE
Three Ideas About Changing Things
Col. Casey Haskins
12:30 p.m. – 2:00 p.m.
President del Nido Counsels Pragmatist Approach
W
hile applauding the progress
in technology and innovation
that the cardiothoracic surgery
community has made until now,
Pedro J. del Nido, MD, used his presidential address “Technological Innovation in Cardiothoracic Surgery:
A Pragmatist’s Approach” to ask the
question: How can we do better?
Certainly, the AATS has made
excellent strides so far, he said,
pointing out how, through the work
of the Scientific Affairs and Government Relations Committee (SAGR),
“CT surgery has achieved one of
the highest levels of representation
within the Study Sections of NIH in
the Committee’s history, including
CT surgical representation both at
the Center for Scientific Review, and
now finally within the review panels
of the National Cancer Institute.”
“We can take great pride in these
accomplishments, along with the
successes of the Cardiac Surgery
Clinical Trials Network and Pediatric Heart Network,” he added.
Of particular import toward the
development of new research and
innovation opportunities has also
been the work of David Sugarbaker, MD, and the AATS Graham
Foundation, which has been able to
provide educational and research
opportunities to residents, fellows
and young faculty members, providing alternative funding opportunities for young investigators through
seed and early career grants.
Continued on page 3
Pedro J. del Nido, MD, gave his presidential
address stressing the need for innovation.
Lunch in the Exhibit Hall
12:45 p.m. – 2:00 p.m.
Moderated Poster Competition
Continued on page 4
Honored Guest Lecturer:
Col. Casey Haskins
Tuesday, 11:40
Colonel Casey Haskins will bring his
expertise on helping leaders build innovative, creative
environments and
attitudes. In his
army career, he
has commanded
at every level from
platoon through
brigade and has
served in staff positions from battalion
COL. HASKINS
through theater
army. An accomplished military officer, faculty member
at West Point Academy and founder
of the consulting firm, BLK SHP INNOVATIONS, Col. Haskins will speak
about strategies that facilitate the discovery and reinvention of solutions to
challenging problems.
M
Monday’s Plenary: Improving Outcomes
onday’s Plenary Session featured
presentations on assessing and
improving outcomes in some of
the most complex cardiothoracic surgery procedures. Topics ranged from
dealing with open thoracoabdominal
aneurysm repairs to using concomitant
tricuspid annuloplasty during mitral
valve repair. The session was moderated by AATS President Pedro J. del
Nido, MD, of Boston Children’s Hospital, and Marc R. Moon, MD, of Washington University School of Medicine.
Outcomes of Thoracoabdominal
Aortic Aneurysm Repair
Joseph S. Coselli, MD, presented the
results of the study he and his colleagues at Baylor College of Medicine
in Houston conducted, analyzing data
from 3309 open TAAA repairs performed between October 1986 and
December 2014. Their series showed
that open TAAA repair produced respectable early outcomes, although
preoperative and intraoperative factors
were found to influence risk.
Joseph S. Coselli, MD, presented data
from the largest ever TAAA series.
The results showed an operative
mortality rate of 7.5% and a 30-day
death rate of 4.8, with the adverse
event outcome occurring among
around 14% of repairs.
The statistically significant predictors
of operative death were rupture, renal
insufficiency, symptoms, procedures
targeting visceral vessels, increasing
age, and increasing clamp time, while
extent IV repair (the least extensive
form of TAAA repair) was inversely
associated with death. Their analysis
showed that the significant predictors
of adverse event were use of HCA, renal insufficiency, rupture, extent II repair, visceral vessel procedures, urgent
or emergent repair, increasing age, and
increasing clamp time.
Outcomes differed by extent of repair,
with the risk being greatest in extent II
repair. Actuarial survival was 63.6% at 5
years, 36.8% at 10 years and 18.3% at 15
years. Freedom from repair failure was
nearly 98% at 5 years, around 95% at 10
years and 94% at 15 years.
“Along with respectable early outcomes, after repair, patients have acceptable long-term survival, and late
repair failure was uncommon. Notably,
there are several subgroups of patients
that do exceedingly well. Paraplegia in
young patients with connective tissue
Continued on page 4
DELIVERING MORE INNOVATION
CoreValve®
TRANSCATHETER AORTIC VALVE REPLACEMENT (TAVR) PLATFORM
Driving the future of TAVR.
The CoreValve Platform is now indicated for patients
with a failed bioprosthetic aortic valve.
Stop by Medtronic booth 537 to learn more
about the CoreValve Platform.
Innovating for life.
CAUTION: Federal law (USA) restricts these devices to sale by or on the order of a physician.
For a listing of indications, contraindications, warnings, precautions and adverse events,
please review the Brief Statement Documents available at the Medtronic booth.
201506322EN.indd 1
CoreValve is a registered trademark of Medtronic CV Luxembourg S.a.r.l.
©2015 Medtronic. All rights reserved. UC201506322 EN 03/2015
4/2/15 9:04 AM
A PRIL 25-29, 2015
•
W ASHINGTON S TATE C ONVENTION C ENTER
Continued from page 1
He was pleased to note that “In the
past year, in partnership with leaders in
industry, the Graham Foundation has
begun to offer specialized fellowships
in fields such as esophageal, arrhythmia
and robotic surgery, and plans for several other similar opportunities for our
Fellows and young faculty.”
“But AATS has not achieved the high
status that it enjoys today by resting
on its laurels or by focusing on its past
achievements,” said Dr. del Nido. The
remainder of his presentation outlined
his vision of how the Association
should proceed.
From a review of the history of the
field, Dr. del Nido revealed a definitive
conclusion: “I contend that the relentless advance of technology and new
concepts in our specialty over the last
50 to 70 years is largely a result of our
approach to innovation, which exemplifies the pragmatist philosophy.”
He cited the Pragmatist School and
its leading thinker, William James,
who said “Theories thus become instruments, not answers to enigmas in
which we can rest.”
This translates, according to Dr. del
Nido, to the position that “the meaning
of an idea can be found in its practical consequences.” This has obvious
implications for the development of
new knowledge, including in the field
of cardiothoracic surgery. “The importance of this philosophical approach to
the advancement of our specialty and
the advancement of medicine in general cannot be overestimated,” he said.
“The pragmatist approach leaves us
‘I contend that the relentless
advance of technology
and new concepts in our
specialty over the last 50
to 70 years is largely a
result of our approach to
innovation, which exemplifies
the pragmatist philosophy.’
open to new ideas and new solutions
to problems that may be better than
old solutions. This is the mindset at
the core of innovation. It drives the
innovator’s desire for generating better
solutions and the willingness to try
something new, not for the sake of
novelty, but for a better result.”
Cardiothoracic surgery progressed
from the 1930s to the 1970s through a
period of rapidly changing and exciting
times, developing new technologies at an
unprecedented pace.
But in 1976, Congress passed the
Medical Device Amendment to the
•
S EATTLE , WA
AATS 95TH ANNUAL MEETING
federal Food, Drug, and Cosmetic Act,
expanding the role of the Food and
Drug Administration, and thereafter
medical devices required review and
approval prior to marketing. This had a
major impact on industry.
Ultimately, the process of bringing
technological advances to patients
became more structured and along
with regulatory and financial pressures
on the health care environment, the
process of developing a novel therapy
became much more complex, often
requiring resources that are not readily
available to the practicing surgeon.
“However, this does not mean we
should wait for new technology or
therapies to reach us,” counseled Dr.
del Nido. “History has shown us that a
passive approach will virtually guarantee our obsolescence.”
To prevent this requires forging
partnerships with others outside the
field, whether they are engineers, basic
scientists, or even experts in the areas
of public policy, regulatory matters,
and commercialization. This very often
means interactions with industry.
“The major benefits of these partnerships include a greater focus on practical application of the discovery and
access to the technology, regulatory,
and commercial resources of industry,
which are often not available in an academic laboratory,” Dr. del Nido said.
But he also pointed out that it is not
just on the individual level that innovation must be pursued. “Our professional societies can also participate in this
process. Indeed they must,” he stated.
The AATS plays a critical role in
supporting young investigators with
grants or special fellowships and advocating for surgical scientists with
the National Institutes of Health and
other government entities. And an
especially important role for AATS is
the dissemination of new technology
through educational programs such
as the Mitral Conclave and the Aortic
Symposium.
These are all significant activities that
it is important for the AATS to continue and expand “to support our specialty in its pursuit of the innovation
imperative,” said Dr. del Nido.
“And, if you have any doubts as to
whether the spirit and pragmatist philosophy is still part of our specialty,
I simply ask you to look around and
take in what is being presented at this
meeting.
“If you do, you will find a wealth of
new ideas, jam-packed with novel concepts and exciting new technologies.
What we need now is for all of us to
join forces, reach outside the boundaries of our profession, with a common
goal to improve the lives of our patients,” Dr. del Nido concluded.
CoreValve® Transcatheter Aortic Valve Replacement (TAVR) Platform
INDICATIONS The Medtronic CoreValve system is indicated for use in patients with symptomatic heart disease due to severe
native calcific aortic stenosis or failure (stenosed, insufficient, or combined) of a surgical bioprosthetic aortic valve who are
judged by a heart team, including a cardiac surgeon, to be at high or greater risk for open surgical therapy (i.e., Society of Thoracic
Surgeons operative risk score ≥8% or at a ≥15% risk of mortality at 30 days).
CONTRAINDICATIONS The CoreValve system is contraindicated for patients presenting with any of the following conditions:
• known hypersensitivity or contraindication to aspirin, heparin (HIT/HITTS) and bivalirudin, ticlopidine, clopidogrel, Nitinol
(Titanium or Nickel), or sensitivity to contrast media, which cannot be adequately premedicated • ongoing sepsis, including active
endocarditis • preexisting mechanical heart valve in aortic position.
WARNINGS General Implantation of the Medtronic CoreValve system should be performed only by physicians who have received
Medtronic CoreValve training. This procedure should only be performed where emergency aortic valve surgery can be performed
promptly. Mechanical failure of the delivery catheter system and/or accessories may result in patient complications. Transcatheter
Aortic Valve (Bioprosthesis) Accelerated deterioration of the bioprosthesis may occur in patients presenting with an altered calcium
metabolism.
PRECAUTIONS General The safety and effectiveness of the Medtronic CoreValve system have not been evaluated in the pediatric
population. The safety and effectiveness of the bioprosthesis for aortic valve replacement have not been evaluated in the following
patient populations: • with a native valve lesion which does not meet the criteria for severe aortic stenosis (Aortic valve area ≤1.0
cm2 or aortic valve area index ≤0.6 cm2/m2, a mean aortic valve gradient of ≥40 mm Hg, or a peak aortic-jet velocity ≥4.0 m/s) •
who are at moderate or low surgical risk (predicted perioperative mortality risk of <15%) • with untreated, clinically significant
coronary artery disease requiring revascularization • with a preexisting prosthetic heart valve with a rigid support structure in
either the mitral or pulmonic position if either the preexisting prosthetic heart valve could affect the implantation or function
of the bioprosthesis or the implantation of the bioprosthesis could affect the function of the preexisting prosthetic heart valve •
with cardiogenic shock manifested by low cardiac output, vasopressor dependence, or mechanical hemodynamic support • The
safety and effectiveness of a CoreValve bioprosthesis implanted within a failed preexisting transcatheter or surgical bioprosthesis
have not been demonstrated. • Implanting a CoreValve bioprosthesis in a degenerated surgical bioprosthesis (transcatheter aortic
valve in surgical aortic valve [TAV in SAV]) should be avoided in the following conditions. The degenerated surgical bioprosthesis
presents with a: • Significant concomitant perivalvular leak (between the prosthesis and the native annulus), is not securely
fixed in the native annulus, or is not structurally intact (eg, wireform frame fracture) • Partially detached leaflet that in the aortic
position may obstruct a coronary ostium • Stent frame with a manufacturer’s labeled inner diameter <17 mm • The safety and
effectiveness of the bioprosthesis for aortic valve replacement have not been evaluated in patient populations presenting with
the following: • blood dyscrasias as defined: leukopenia (WBC <1000 cells/mm3), thrombocytopenia (platelet count <50,000 cells/
mm3), history of bleeding diathesis or coagulopathy, or hypercoagulable states • congenital bicuspid or unicuspid valve verified
by echocardiography • mixed aortic valve disease (aortic stenosis and aortic regurgitation with predominant aortic regurgitation
[3-4+]) • moderate to severe (3-4+) or severe (4+) mitral or severe (4+) tricuspid regurgitation • hypertrophic obstructive
cardiomyopathy • new or untreated echocardiographic evidence of intracardiac mass, thrombus, or vegetation • native aortic
annulus size <18 mm or >29 mm per the baseline diagnostic imaging or surgical bioprosthetic aortic annulus size <17 mm or
>29 mm • transarterial access not able to accommodate an 18-Fr sheath • sinus of valsalva anatomy that would prevent adequate
coronary perfusion • moderate to severe mitral stenosis • severe ventricular dysfunction with left ventricular ejection fraction
(LVEF) <20% as measured by resting echocardiogram • end-stage renal disease requiring chronic dialysis or creatinine clearance
<20 cc/min • symptomatic carotid or vertebral artery disease • severe basal septal hypertrophy with an outflow gradient
Prior to Use Exposure to glutaraldehyde may cause irritation of the skin, eyes, nose, and throat. Avoid prolonged or repeated
exposure to the vapors. Damage may result from forceful handling of the catheter. Prevent kinking of the catheter when removing
it from the packaging. This device was designed for single patient use only. Do not reuse, reprocess, or resterilize this product.
Reuse, reprocessing, or resterilization may compromise the structural integrity of the device and/or create a risk of contamination
of the device, which could result in patient injury, illness, or death. The bioprosthesis size must be appropriate to fit the patient’s
anatomy. Proper sizing of the device is the responsibility of the physician. Refer to Instructions for Use for available sizes. Failure
to implant a device within the sizing matrix could lead to adverse effects such as those listed in below. Patients must present with
access vessel diameters of ≥6 mm or an ascending aortic (direct aortic) access site ≥60 mm from the basal plane. Implantation
of the bioprosthesis should be avoided in patients with aortic root angulation (angle between plane of aortic valve annulus and
horizontal plane/vertebrae) of >30° for right subclavian/axillary access or >70° for femoral and left subclavian/axillary access. Use
caution when using the subclavian/axillary approach in patients with a patent LIMA graft or patent RIMA graft.
During Use Adequate rinsing of the bioprosthesis with sterile saline, as described in the Instructions for Use, is mandatory before
implantation. During rinsing, do not touch the leaflets or squeeze the bioprosthesis. If a capsule becomes damaged during loading
or the capsule fails to close, replace the entire system (bioprosthesis, catheter, and CLS). Do not use a catheter with a damaged
capsule. After a bioprosthesis has been inserted into a patient, do not attempt to reload that bioprosthesis on the same or any
other catheter. During implantation, if resistance to deployment is encountered (e.g., the micro knob starts clicking or is tight or
stuck), apply upward pressure to the macro slider while turning the micro knob. If the bioprosthesis still does not deploy, remove
it from the patient and use another system. While the catheter is in the patient, ensure the guidewire is extending from the tip. Do
not remove the guidewire from the catheter while the catheter is inserted in the patient. Once deployment is initiated, retrieval of
201506322EN.indd 2
3
the bioprosthesis from the patient (e.g., use of the catheter) is not recommended. Retrieval of a partially deployed valve using the
catheter may cause mechanical failure of the delivery catheter system, aortic root damage, coronary artery damage, myocardial
damage, vascular complications, prosthetic valve dysfunction (including device malposition), embolization, stroke, and/or
emergent surgery. During deployment, the bioprosthesis can be advanced or withdrawn as long as annular contact has not been
made. Once annular contact is made, the bioprosthesis cannot be advanced in the retrograde direction; if necessary, and the frame
has only been deployed ≤2/3 of its length, the bioprosthesis can be withdrawn (repositioned) in the antegrade direction. However,
use caution when moving the bioprosthesis in the antegrade direction. Use the handle of the delivery system to reposition the
bioprosthesis. Do not use the outer catheter sheath. Once deployment is complete, repositioning of the bioprosthesis (e.g., use
of a snare and/or forceps) is not recommended. Repositioning of a deployed valve may cause aortic root damage, coronary artery
damage, myocardial damage, vascular complications, prosthetic valve dysfunction (including device malposition), embolization,
stroke, and/or emergent surgery. Do not attempt to retrieve a bioprosthesis if any one of the outflow struts is protruding from
the capsule. If any one of the outflow struts has deployed from the capsule, the bioprosthesis must be released from the catheter
before the catheter can be withdrawn. Ensure the capsule is closed before catheter removal. If increased resistance is encountered
when removing the catheter through the introducer sheath, do not force passage. Increased resistance may indicate a problem
and forced passage may result in damage to the device and/or harm to the patient. If the cause of resistance cannot be determined
or corrected, remove the catheter and introducer sheath as a single unit over the guidewire, and inspect the catheter and confirm
that it is complete. Clinical long-term durability has not been established for the bioprosthesis. Evaluate bioprosthesis performance
as needed during patient follow-up. Postprocedure, administer appropriate antibiotic prophylaxis as needed for patients at
risk for prosthetic valve infection and endocarditis. Postprocedure, administer anticoagulation and/or antiplatelet therapy per
hospital protocol. Excessive contrast media may cause renal failure. Preprocedure, measure the patient’s creatinine level. During
the procedure, monitor contrast media usage. Conduct the procedure under fluoroscopy. The safety and efficacy of implanting
a second CoreValve bioprosthesis within the initial CoreValve bioprosthesis have not been demonstrated. However, in the event
that a second CoreValve bioprosthesis must be implanted within the initial CoreValve bioprosthesis to improve valve function,
valve size and patient anatomy must be considered before implantation of the second CoreValve bioprosthesis to ensure patient
safety (e.g., to avoid coronary obstruction). In the event that valve function or sealing is impaired due to excessive calcification or
incomplete expansion, a postimplant balloon dilatation of the bioprosthesis may improve valve function and sealing. To ensure
patient safety, valve size and patient anatomy must be considered when selecting the size of the balloon used for dilatation. The
balloon size chosen for dilatation should not exceed the diameter of the native aortic annulus or, for surgical bioprosthetic valves,
the manufacturer’s labeled inner diameter. Refer to the specific balloon catheter manufacture’s labeling for proper instruction on
the use of balloon catheter devices. Note: Bench testing has only been conducted to confirm compatibility with NuMED Z-MED IITM
Balloon Aortic Valvuloplasty catheters where CoreValveTM bioprosthesis device performance was maintained after dilation. Data
on File.
POTENTIAL ADVERSE EVENTS Potential risks associated with the implantation of the Medtronic CoreValve transcatheter aortic
valve may include, but are not limited to, the following: • death • cardiac arrest • coronary occlusion, obstruction, or vessel spasm
(including acute coronary closure) • emergent surgery (e.g., coronary artery bypass, heart valve replacement, valve explant)
• multi-organ failure • heart failure • myocardial infarction • cardiogenic shock • respiratory insufficiency or respiratory failure •
cardiovascular injury (including rupture, perforation, or dissection of vessels, ventricle, myocardium, or valvular structures that
may require intervention) • ascending aorta trauma • cardiac tamponade • cardiac failure or low cardiac output • prosthetic valve
dysfunction including, but not limited to, fracture; bending (out-of-round configuration) of the valve frame; under-expansion of
the valve frame; calcification; pannus; leaflet wear, tear, prolapse, or retraction; poor valve coaptation; suture breaks or disruption;
leaks; mal-sizing (prosthesis-patient mismatch); malposition (either too high or too low)/malplacement; regurgitation; stenosis •
thrombosis/embolus (including valve thrombosis) • valve migration/valve embolization • ancillary device embolization • emergent
percutaneous coronary intervention (PCI) • emergent balloon valvuloplasty • major or minor bleeding that may or may not require
transfusion or intervention (including life-threatening or disabling bleeding) • allergic reaction to antiplatelet agents, contrast
medium, or anesthesia • infection (including septicemia and endocarditis) • stroke, TIA, or other neurological deficits • permanent
disability • renal insufficiency or renal failure (including acute kidney injury) • mitral valve regurgitation or injury • tissue erosion •
vascular access related complications (e.g., dissection, perforation, pain, bleeding, hematoma, pseudoaneurysm, irreversible nerve
injury, compartment syndrome, arteriovenous fistula, stenosis) • conduction system disturbances (e.g., atrioventricular node block,
left-bundle branch block, asystole), which may require a permanent pacemaker
Please reference the CoreValve Instructions for Use for more information regarding indications, warnings,
precautions and potential adverse events.
CAUTION Federal law (USA) restricts this device to sale by or on the order of a physician.
CoreValve is a registered trademark of Medtronic CV Luxembourg S.a.r.l.
© 2015 Medtronic, Inc. All rights reserved. UC201506322 EN
4/2/15 9:04 AM
4 AATS 95TH ANNUAL MEETING
disorders, even in the most extensive
repair (extent II), is remarkably rare –
these patients do extremely well across
the board,” Dr. Coselli concluded.
Comparing Norwoods: SANO vs. BT
Early survival advantages of using the
Norwood procedure with the Sano
shunt (SANO) over the standard
Norwood-BT shunt (BT) are confounded by concerns surrounding
delayed right ventricular dysfunction
Travis J. Wilder, MD, presented data
showing SANO bested the BT shunt.
2:00 p.m. – 5:35 p.m.
Adult Cardiac Surgery
Simultaneous Scientific Session
2:00 p.m. – 5:35 p.m.
Congenital Heart Disease Surgery
2:00 p.m. – 5:35 p.m.
General Thoracic Surgery
2:00 p.m. – 5:35 p.m.
Aortic/Endovascular Surgery
5:35 p.m. – 6:15 p.m
Executive Session (AATS Members only)
7:00 p.m. – 10:00 p.m.
AATS Attendee Reception at
The Museum of Flight
WEDNESDAY
7:00 a.m. – 9:35 a.m.
Adult Cardiac Surgery
7:00 a.m. – 9:35 a.m.
Congenital Heart Disease
7:00 a.m. – 9:35 p.m.
General Thoracic Surgery
9:45 a.m. – 11:15 a.m.
Adult Cardiac Masters
of Surgery Video Session
9:45 a.m. – 11:15 a.m.
Congenital Heart Disease
Masters of Surgery Video Session
9:45 a.m. – 11:15 a.m.
General Thoracic Masters
of Surgery Video Session
A PRIL 25-29, 2015
seen after SANO. “In children with
hypoplastic left heart syndrome
(HLHS), we compared trends in
long-term RV dysfunction and tricuspid regurgitation (TR) between these
strategies and incorporated survival
differences. Our registry results were
favorable for SANO over BT across
several parameters, a difference from
what has been seen in clinical trials,”
according to Travis J. Wilder, MD, of
the Congenital Heart Surgeons’ Society Data Center in Toronto.
Dr. Wilder presented the results
that he and his colleagues obtained
from an inception cohort of neonates
with HLHS who were managed by
Norwood palliation, using propensity
matching to pair SANO with BT patients.
Propensity-adjusted survival was
significantly worse with BT and this
remained throughout follow-up with
no evidence of convergence as late as
5 years, according to Dr. Wilder.
“In our analysis, for comparable
neonates with HLHS undergoing Norwood operation, SANO offers better
late (greater than 3-year) survival,
less late TR and possibly less late RV
dysfunction than BT. The results from
a research registry differ from randomized comparisons between the two
strategies,” concluded Dr. Wilder.
•
Sebastien Gilbert, MD, compared
analog and digital pleural monitoring.
Digital vs. Analog Pleural Drainage
Digital pleural drainage devices are a new
and promising tool for optimizing chest
tube management after lung resection
presumably because of their ability to
continuously monitor and record parenchymal air leak flow, and regulate intra-pleural pressure. However, it remains
unknown whether or not this technology
can benefit all patients or mainly those
who have a postoperative air leak, according to Sebastien Gilbert, MD, University
of Ottawa, and his colleagues.
Dr. Gilbert reported on their study
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to examine the impact of using a digital pleural drainage device on time to
chest tube removal and on length of
stay, stratified according to the presence or absence of an air leak after
lung resection. Although they found
no significant improvement in these
outcomes, they did find a significant
decrease in chest tube clamping trials,
with use of the digital device.
After stratification according air
leak status on the first postoperative
day, randomization to the new pleural
drainage technology did not significantly reduce the duration of chest
tube drainage or hospital stay, according to Dr. Gilbert. However, chest
tube clamping trials were significantly
reduced in digital device patients with
an air leak (23% vs. 50%) and in those
without an air leak (0% vs. 16%).
“Based on the results, we cannot
recommend the use of digital devices
as an intervention to reduce length
of hospital stay after lung resection.
Despite the absence of a clear-cut
benefit in our study, we still think
that the technology presents opportunities to improve efficiency, refine
evidence-based practice in chest tube
management, and gain a more fundamental understanding of pleural space
mechanics after pulmonary resection,”
Dr. Gilbert concluded.
Biological Engineering–Basic Science Lecture
0
ffering a “glimpse of things to
come,” Donald Ingber, MD, PhD,
of the Wyss Institute for Biologically Inspired Engineering, outlined
an exciting new world on the edge of
science fiction – human organs on a
chip, robotic insects that can fly, and a
miniature human body made of chips.
These are not just interesting curiosities, but in fact are proving to be
powerful study tools, with not only the
potential to replace animal testing of
new human drugs, but providing the
ability to mimic human physiology
and genetics to the point of identifying
new drug and therapeutic targets and
the very people who are most likely to
benefit from them.
Part of the goal of the Wyss Institute
is to foster the fusion of biology and
engineering, of life and non-life, to
create new forms of research tools and
instrumentation straddling the boundaries of both. The Institute has been
so successful that since its inception, it
has been producing an article a month
in either Science or Nature and has
around 1000 patents already.
The current drug development model is essentially failing, according to Dr.
Ingber. Its costs are skyrocketing, with
a price tag of over $2 million to test a
Donald Ingber, MD, spoke of the new
interface between life and non-life.
single candidate in animals. The use of
organs on a chip has the potential to
replace this with far more relevance,
since these have the opportunity to
mimic the authentic metabolic and
physiological behavior of human organs, something that animal models
often fail to do.
A good example of this breakthrough
technology is the human breathing
lung on a chip. This consists of 3 channels – an air channel above, a layer
of human lung cells and a circulating
blood channel. The cells are made
to “breathe” by side chambers that
expand and contract to change their
configuration.
So successful is this model that they
have found it capable of imitating the
behavior of smog air pollutants as they
naturally affect real human lungs, and
also capable of mimicking pulmonary
edema when appropriately triggered,
said Dr. Ingber.
Similarly, researchers at the Institute
have developed a human gut on a chip
which with proper stimulation actually forms human villi-like structures
capable of mimicking the behavior of
disease and probiotic bacteria. There is
also a beating heart on a chip, a human
kidney chip that “pees” and even a
spleen capable of clearing toxins from
human blood.
Remarkably all of these new chips
can be linked to create an integrated
human in a ‘body’ that is capable of
passing materials (including drugs)
from organ chip to organ chip in a
manner that simulates authentic physiological pathways.
Ultimately, there is even the opportunity to personalize these chips using
individualized patient cells to get
unique genomic behaviors, Dr. Ingber
concluded.
T
A PRIL 25-29, 2015
•
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Evaluating Techniques in Congenital Heart Surgery
he Ross operation has acceptable
outcomes in selected pediatric
patients with biventricular circulation. However, there are little data
concerning outcomes in patients with
univentricular circulation undergoing
biventricular conversion, according to
Alejandra Bueno, MD, of Boston Children’s Hospital and her colleagues.
In Monday’s Congenital Heart Surgery Symposium, Dr. Bueno reported
on their study that reviewed the outcomes before and after Ross operations, including patients undergoing
AATS Council
biventricular conversion with the Damus-Kaye-Stansel (DKS) takedown.
They performed a retrospective review
on 62 consecutive patients who underwent simple and complex Ross operations at a single institution from March
2000 to October 2014, including eight
patients who underwent biventricular
conversion with Ross operation and
DKS takedown with or without reversal of the cavopulmonary connection
(defined as complex).
The Ross procedure has good
similar short-term results in simple
and complex patients and should be
considered for use in those undergoing biventricular conversion and
DKS takedown. Moreover, the study
shows that native PV size should not
be a contraindication for the Ross
Left to right sitting: Secretary: Marc R. Moon, Washington University;
President-Elect: Joseph S. Coselli, Baylor College of Medicine; President:
Pedro J. del Nido, Boston Children’s Hospital; Vice President: Thoralf M.
Sundt, III, Massachusetts General Hospital; Treasurer: Duke E. Cameron,
Johns Hopkins Hospital
Standing Councilors: David J. Sugarbaker, Baylor College of Medicine; David
R. Jones, Memorial Sloan Kettering Cancer Center; David H. Adams, Mount
Sinai Medical Center; J. William Gaynor, Children’s Hospital of Philadelphia;
José Pomar, Hospital Clinico de Barcelona; Lars G. Svensson, Cleveland
Clinic
Alejandra Bueno, MD, presented a
study of the Ross procedure.
Richard Dobson, MD, reported on adult
survivors of tetralogy of Fallot repair.
procedure,” Dr. Bueno concluded.
Richard Dobson, MD, of the Scottish Adult Congenital Cardiac Service,
discussed a study that he and his
colleagues performed to examine the
long-term outcomes of adult survivors
of surgical repair of tetralogy of Fallot
with respect to survival, functional
capacity, and adverse events, as well as
the effect of pulmonary valve replacement (PVR). They found that these
patients had excellent long-term survival; although PVR did not convey a
survival benefit, despite improvements
in functional outcomes.
Dr. Dobson reported on a retrospective cohort analysis of 376 adult survivors
of repaired tetralogy of Fallot enrolled
through a national adult congenital cardiac database. They found that at 40-year
follow-up from the date of repair that
freedom from death was 83%, from atrial
arrhythmia was 60%, from ventricular
arrhythmia was 73%, from pacemaker/
ICD insertion was 70%, and from surgical/percutaneous reintervention was
27%. In a multivariate model, the risk
of death was significantly increased by
older age at repair, atrial arrhythmia by
older age at repair, device insertion by
the presence of a genetic syndrome,
and reintervention by any non-classical
form of tetralogy of Fallot and the use
of a transannular patch repair.
At follow-up, the vast majority of
patients were NYHA class 1.The mean
QRS duration was 147 milliseconds
(ms). Each ms increase raised the risk
of all-cause mortality in a univariate
model. There were nearly 35% of
patients with moderate or greater pulmonary regurgitation (PR) at latest follow-up, with mean PR fraction 25%.
“In adult patients with repaired tetralogy of Fallot, long-term survival
remains excellent. However morbidity,
arrhythmias and repeat intervention
are frequent,” Dr. Dobson concluded.
A PRIL 25-29, 2015
•
Top Gun Contest
During the Welcome Reception on Sunday, the top five resident finalists
showcased their technical skills as they competed for the designation of the
2015 Resident Top Gun in the Cardiothoracic Surgery Resident “Top Gun”
Competition. The winner will be announced on Tuesday morning.
AATS Resident Poster Competition
The AATS Cardiothoracic Resident Poster Competition provides an opportunity
for senior cardiothoracic surgery residents and/or congenital heart surgery
fellows to represent their institution in a competition against one another
by presenting a scientific poster of their clinical/investigative research. The
winners will be announced on Tuesday.
•
S EATTLE , WA
AATS 95TH ANNUAL MEETING
7
H
•
•
S EATTLE , WA
Monday’s Adult Cardiac Surgery Simultaneous Session
ow well do benchmarks and selection criteria predict outcomes for
surgical aortic valve replacement
(AVR) surgery in elderly, high-risk
patients?
Results from the arm of the PARTNER-I trial of transcatheter AVR
(TAVR) for severe aortic stenosis suggest
that benchmarks may do poorly in discriminating across high-risk populations.
In fact, despite surgical AVR being
performed in institutions whose results
generally outperform national bench-
Wilson Szeto, MD, spoke on selection
criteria for TAVR outcomes.
marks, high-risk, operable (PARTNER-IA) patients experienced only
average early results and prolonged
hospitalization, according to Wilson
Szeto, MD, who presented an analysis
of the PARTNER patient selection criteria and outcomes at Sunday’s Adult
Cardiac Surgery Symposium.
Dr. Szeto of the University of Pennsylvania Medical Center, discussed
how the PARTNER-1 trial provided
the unique opportunity to ask some
crucial questions: First, whether outcomes after surgical AVR in an elderly,
high-surgical-risk population are accurately predicted by contemporary
Society of Thoracic Surgeons (STS)
benchmarks; and second, whether
their intermediate-term survival was
commensurate with that of the gen-
Bring the AATS
Annual Meeting Home
M
A PRIL 25-29, 2015
ost presentations from the
2015 AATS Annual Meeting will be available on the
AATS website, www.aats.org, immediately following the meeting.
Re-visit a session, share with
your colleagues, or view a presentation you may have missed.
eral population. Dr. Szeto and his
colleagues also examined the data to
determine whether there was an identifiable subset of these patients whose
observed risk after surgical AVR was
higher than those patients deemed
inoperable in the trial (PARTNER-IB),
which would indicate a less-than-optimal selection criteria.
Observed operative mortality was
not significantly different from the
expected. Nor was there a significant
difference in the rate of observed
stroke or sternal wound infection as
compared with expected. However,
the observed renal failure (lower
than expected) and the observed
prolonged length of stay (higher than
expected) were both significantly
different. Dr. Szeto did note a caveat, that the calibration of observed
events across the spectrum of expected risk was poor.
In terms of survival, the 1-, 2-, 3-,
and 4-year rates were substantially lower than those seen in the matched U.S.
population, but higher than those seen
in the PARTNER-IB cohort.
Risk factors for death included smaller body mass index, lower albumin,
history of cancer, longer aortic clamp
time, and severe prosthesis-patient
mismatch. Only the 10% of patients
with a poor risk profile based on preoperative comorbidity had an estimat-
George L. Zorn, III, MD, spoke on PPM
in SAVR and TAVR.
ed 1-year survival less than that of the
standard therapy patients.
Unlike past surgical series, in which
survival of elderly patients was commensurate with a matched U.S. population, PARTNER-IA patients had
worse survival, suggesting that they
were a less highly selected population.
However, after a period of higher
early mortality, most PARTNER-IA
patients experienced better mid-term
survival than inoperable PARTNER-IB
patients, suggesting that PARTNER
selection criteria for surgical AVR, with
a few caveats, may be more appropriate
for improving survival than previous
practice, according to Dr. Sveto.
Prosthesis-patient mismatch may
be a factor with implications for left
Anelechi Anyanwu, MD, reported on
stratifying valve repairs.
ventricular mass regression in patients
undergoing either surgical aortic valve
replacement (SAVR) or transcatheter
aortic valve replacement (TAVR). In patients at increased surgical risk and with
severe aortic stenosis, prosthesis-patient
mismatch (PPM) is more common
and more severe in those treated with
SAVR than in those treated with TAVR,
according to George L. Zorn, III, MD,
of the University of Kansas Hospital.
Dr. Zorn reported that despite this difference, left ventricular mass regression
was observed in both TAVR and SAVR
treatment groups.
Dr. Zorn and his colleagues compared the incidence of PPM between
TAVR using a self-expanding prosthesis and SAVR in the high-risk arm of
the CoreValve US Pivotal Trial. They
also evaluated the impact of mismatch
on left ventricular mass (LVM) regression. “Although LVMI regression was
observed in both TAVR and SAVR
treatment groups, there was a greater
magnitude of regression in the SAVR
treatment arm,” Dr. Zorn concluded.
Although degenerative valve repairs
vary in complexity, depending on
lesions encountered, guidelines and
publications on process and outcomes
of valve repair for degenerative disease
generally group patients as a single cohort. Anelechi Anyanwu, MD, and his
colleagues at Mount Sinai Medical Center attempted to deal with this disparity
by developing a complexity score to
allow stratification of valve repairs, and
to evaluate the impact of complexity on
operative process and outcomes.
Dr. Anyanwu reported on their
study, which retrospectively analyzed
data on 668 consecutive mitral valve
operations for degenerative disease.
“We developed a lesion score and
graded valves based on intraoperative
valve analysis and categorized valves
into three complexity groups based
on the total complexity score,” he
said, describing lesion scores of 1:
simple (244 patients); 2-4: intermediate (260 patients); 5 or more: complex (164 patients). The researchers
compared the results from these
three groups.
“Despite longer and more technically involved repairs, we observed
extremely high repair rates and excellent results in patients with complex
lesions,” said Dr. Anyanwu.
“Our study shows that lesion scoring can facilitate preoperative planning if applied echocardiographically.
A surgeon should be able to predict
reparability of a particular valve in
their practice. Particularly for asymptomatic patients, surgeons should
consider other options if they are not
likely to predictably repair the valve
based on its complexity. Where the
complexity score is high, the surgeon
should be facile with a blend of repair techniques and be prepared to
commit to a longer operative time
and to use multiple techniques to
effect a durable repair. A surgeon
taking on Complex Valves should be
well versed in advanced surgical tech-
Daniel Enter, MD, discussed risk
factors in mitral valve patients.
niques as these were required in half
of our complex cases,” Dr. Anyanwu
concluded.
Daniel Enter, MD, of Northwestern
University, spoke on pulmonary hypertension in patients having mitral valve
surgery. He explored the question of
hypertension as a 30-day risk factor in
these patients.
A PRIL 25-29, 2015
•
•
S EATTLE , WA
2015 AATS Annual Meeting Exhibitors
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AATS Exhibit Hall Hours
SCIENTIFIC SESSIONS
N9
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WELCOME
CENTER
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TO FIRE
E XITS
Tuesday April 28
9:00 a.m. – 4:30 p.m.
N13
C YBER C AF E
N12
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NO BOO THS
THIS AR EA
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G AT E 5
G AT E 7
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F&B
140
138
136
134
132
FUTURE
MEETINGS
343
Edwards
Lifesciences
Medtronic
MAQUET
Medical
337 Systems
TOP G UN
9'
POSTERS
537
737
531
431
Medtronic
Customer
Experience
Center
On-X Life
Technologies
333
331
F& B
S TAGE
SYMPOSIA
WALL
FHC
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THE ATER # 1
142
LEARNING
CENTER
ENTRANCE
144
Association Booths
LE
TO SOUTH LOB B Y
CHARGING
STATION
730
831
Medtronic
Customer
Experience
Center
931
48 POSTER BOARDS
128
C WF
P UB LIC
P HO NE S
RO O M 401
2016
BOOTH
S ELEC TION
723
520
1023
1123
WO MEN
1017 1116
1117
1011 1110
1111
919
516
Companies highlighted in orange are
advertisers of the AATS Daily News
C WF
WO MEN
917
MEN
P UB LIC
P HO NE S
ME N
617
517
Kapp
Surgical
512
512Instrument
817
717
1016
COFFEE
813
511
611
711
709
508
810
808
811
809
910
909
1008
907
1006
908
Admedus
DO WN
UP
706
505
E XIT
604
605
704
705
804
805
904
COFFEE
501 600 601 603 700
ENTRANCE
P UB LIC
P HO NE S
504
2310 S Miami Blvd., Suite 240,
Durham, NC 27703
www.aemedical.com
Abbott Vascular
Acelity (KCI)
1325
12930 IH 10 W., San Antonio, TX 78249
www.acelity.com
A&E Medical products include MYO/
Wire® temporary pacing wires, MYO/Wire
II sternum wires, MYO/Punch rotating
surgical punch, MYO/Lead disposable patient cable and DoubleWire high strength
sternal closure system.
511
3200 Lakeside Drive, Santa Clara, CA 95054
www.abbottvascular.com
MitraClip is the world’s first transcatheter
mitral valve repair therapy available, providing an option for select patients with
degenerative mitral regurgitation.
1105
1005 1104
1213 1312
1313
1211 1310
1311
1209 1308
1309
1207 1306
1307
1205 1304
1305
504
C OATS
A & E Medical Corporation
1325
THE ATER # 2
G AT E 9
E XIT
1225 1324
S TAGE
523
1327
C OFFEE
S HOW
MAN AG EMENT
O FF IC E
1227 1326
Acelity provides a trusted and complementary portfolio of advanced wound therapeutics and regenerative medicine from
KCI, LifeCell and Systagenix.
Acute Innovations
21421 NW Jacobson Road, Suite 700,
Hillsboro, OR 97124
www.acuteinnovations.com
1017
Furthering their reputation as a leader in
the thoracic industry, ACUTE Innovations® continues to make advancements in
chest-wall stabilization technology. Stop by
our training booth #1017 to learn about
ACUTE’s NEW and exciting cutting-edge
products: the RibLoc® U Plus Chest Wall
ENTRANCE
P UB LIC
P HO NE S
F
Plating System and the AcuTie® II Sternum
Closure System.
Admedus
1105
8400 Normandale Lake Blvd, Suite 920,
Minneapolis, MN, 55437
www.admedus.com
Admedus, a global healthcare group, is working with renowned medical leaders to bring
new medical technologies to market. CardioCel®, a cardiovascular scaffold, is the first of
our ADAPT® tissue engineered bio-implants
and is being used by surgeons to repair simple
and complex cardiac defects.
Advanced Cardiothoracic
Consultants, LLC
1310
12155 Golden Bluff Court, Indianapolis, IN
46236
www.actc4solutions.com
1200 1201 1300 1301 1400 1303
F
U P TO 5
Utilizing over 40 years of clinical expertise
in cardiothoracic, thoracic transplant/
organ replacement, and advanced heart
failure ACTC can evaluate financial and
clinical aspects for programs to increase
efficiencies. Whether a new or well established program, hospital, or insurer let
ACTC assist you in maintaining financial
viability and sustaining growth in today’s
challenging healthcare market.
AtriCure, Inc.
817
6217 Central Park Drive, West Chester, OH
45069
www.atricure.com
AtriCure is intent on reducing the global
Afib epidemic and healing the lives of those
affected through clinical science, education
and innovation. We are a leading Afib solu-
A PRIL 25-29, 2015
•
tions partner with the only FDA-approved
surgical treatment for Afib and most widely implanted occlusion device for left atrial
appendage management.
Bard Davol
617
100 Crossings Boulevard, Warwick, RI 02886
www.davol.com
BARD is the market leader in comprehensive soft tissue reconstruction. In addition
to this extensive suite of products, or BioSurgery franchise is delivering a growing
line of sealants and hemostatic products
to complement surgical techniques across
thoracic, cardiovascular, and other surgical
specialties.
BFW, Inc.
917
2307 River Road, #103, Louisville, KY 40206
www.bfwinc.com
Surgical headlight innovation is BFW.
From its new Ambrose™ and Montauk™
portable LED systems, to introducing solid-state plasma fiber-optic illumination, to
pioneering coaxial High-Definition headlight video imaging, BFW’s universal reputation for quality, personalized service and
hi-tech leadership is second to none.
Biomet Microfixation
804
1520 Tradeport Drive, Jacksonville, FL 32218
www.biomet.com/microfixation
Biomet Microfixation is a leading global
healthcare provider of orthopedic products.
Our thoracic portfolio includes the Pectus
Bar for repair of Pectus Excavatum and
the SternaLock Blu Primary Closure System for sternal closure. The Blu System
aligns and stabilizes the sternum after
sternotomy and enables easier closure after
minimally invasive access.
Bolton Medical Inc.
1213
799 International Pkwy, Sunrise, FL 33325
www.boltonmedical.com
Bolton Medical is a subsidiary of the WerfenLife Company. WerfenLife is an international company that manufactures and
distributes medical diagnostic solutions
and medical devices worldwide. Bolton
Medical sells endovascular therapies for
thoracic repair, such as Relay Thoracic
Stent-Graft in both U.S. and International
markets and Relay NBS (non-bare stent)
in International markets.
CardiacAssist, Inc.
1207
240 Alpha Drive, Pittsburgh, PA 15238
www.cardiacassist.com
CardiacAssist, inventor of the TandemHeart® Extracorporeal Circulatory
Support System, offers versatile MCS treatment options. While we’re best known for
our Left Ventricular Support platform, we
recently launched a line of Arterial Cannulae, and the PROTEK Duo™ Veno-Venous
dual lumen cannula. Stop by our booth to
learn more.
Cardiovascular Research
Foundation
111 East 59th Street, 11th floor
New York, NY 10022-1202
www.crf.org
142
CRF is a global leader at the forefront of
today’s treatments and technologies in the
fight against heart disease. Since its inception in 1991, CRF has played a pivotal
role in advancing the understanding and
treatment of cardiovascular disease, realizing dramatic improvements by establishing
the safe use of new technologies, drugs, and
therapies in the field of interventional cardiovascular procedures.
ClearFlow, Inc.
809
1630 S. Sunkist St., Suite E, Anaheim, CA
92806
www.clearflow.com
The PleuraFlow® Active Clearance Technology™ System from ClearFlow, Inc. offers
a safe way to proactively prevent clot from
accumulating in a completely sterile system,
thus minimizing Retained Blood Syndrome
(RBS) complications that can result from
ineffective evacuation of blood after surgery.
New! Distributed in the US by Maquet
Medical Systems.
Cormatrix Cardiovascular, Inc.
1327
1100 Old Ellis Road, Roswell, GA 30076
www.cormatrix.com
CorMatrix® Cardiovascular markets its
ECM® Bioscaffold devices for vascular
repair, pericardial repair and reconstruction, cardiac tissue repair, and CanGaroo
ECM Envelope and is currently conducting preclinical studies to evaluate future
applications in other cardio and vascular
applications.
Covidien
1123
555 Long Wharf Drive, New Haven, CT
06511
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/surgical to learn more.
CRC Press - Taylor &
Francis Group LLC
1106
6000 Broken Sound Parkway NW., Suite 300,
Boca Raton, FL 33487
www.crcpress.com
CRC Press – Taylor & Francis Group is
a global publisher of print and electronic
books for medical, scientific and technical
communities. Visit our booth to browse
our new and bestselling publications in
cardiothoracic surgery and take advantage
of convention discounts. Register for email
alerts at www.crcpress.com.
CryoLife, Inc.
523
1655 Roberts Blvd NW., Kennesaw, GA 30144
www.cryolife.com
CryoLife® is one of the world’s leading
contemporary medical device companies
providing preserved human cardiac and
vascular tissues, surgical adhesives and
sealants, and cardiac lasers for treatment
of refractory angina. CryoLife® is committed to partnering with academic training
programs and cardiac surgical societies and
associations through their new Thoracic
Surgery Education Reform Initiative.
•
AATS 95TH ANNUAL MEETING 11
S EATTLE , WA
CTSNet
140
633 N. St Clair, Chicago, IL
www.ctsnet.org
CTSNet (www.ctsnet.org), headquartered
in Chicago, Illinois, USA, is the leading
international source of online resources
related to cardiothoracic surgery, as well as
the major hub of the international online
community of cardiothoracic surgeons and
allied health care professionals.
CureVentions
1312
595 N. Dobson Rd Suite B-32
Chandler, AZ 85224
www.cureventions.com.
Cure Ventions’ Sternal Vest is the only
compression vest designed specifically to
meet the needs of the cardiothoracic heart
patient. For more than a decade, we have
consistently delivered a superior quality
product with unsurpassed results--maintaining incision stability, reducing pain,
improving respiration, and quicker mobilization. With improved patient comfort,
prescribed therapies are more likely to
be followed. Nurses and surgeons attest
to the significant improvement Cure
Ventions’ Sternal Vest makes in patients
recovery.
De Soutter Medical USA
1324
224 Rolling Hill Road, Suite 12A, Mooresville,
NC 28117
www.de-soutter.com
DeSoutter Medical is a world leader in
orthopedic power tools. The Sternudrive
Cardiothoracic saw has a unique active
damping system that reduces vibration by
30%. Lithium Ion sterile battery technology assures a class leading power to weight
ratio and a wrench less micro adjustable
blade guard provides optimum control.
Designs For Vision, Inc.
431
760 Koehler Avenue, Ronkonkoma, NY, 11779
www.designsforvision.com
Just Se It™ with Designs for Vision’s lightweight custom-made surgical Telescopes
- See It Even Better™ with the L.E.D.
Daylite® or Twin Beam®, L.E.D. Daylite®
providing the brightest and safest un-tethered illumination. Introducing the L.E.D.
Daylite® Nano Cam HD video from your
prospective.
EACTS
128
EACTS House, Madeira Walk Windsor, SL4
1EU, United Kingdom
www.eacts.org
EACTS is the largest European Association
devoted to the practice of Cardio-thoracic
surgery. The main objective of the Association is to advance education in the field of
cardio-thoracic surgery and to promote, for
the public benefit, research into cardiovascular and thoracic physiology and therapy and
to correlate and disseminate the useful results
thereof. Visit booth 124 for information on:
membership, future meetings and all activities of EACTS. Journals: EJCTS (European
Journal of Cardio-Thoracic Surgery) ICVTS
(Interactive Cardiovascular and Thoracic
Surgery) and MMCTS (Multimedia Manual of Cardiothoracic Surgery).
Edwards Lifesciences
737
One Edwards Way, Irvine, CA 92614
www.edwards.com
Edwards Lifesciences is the global leader
in the science of heart valves and hemodynamic monitoring. Driven by a passion to
help patients, the company partners with
clinicians to develop innovative technologies in the areas of structural heart disease
and critical care monitoring, enabling them
to save and enhance lives. Additional company information can be found at www.
edwards.com.
Elsevier Inc.
508
1600 JFK Blvd., Ste 1800, Philadelphia, PA
19103
www.elsevierclinicalsolutions.com
ELSEVIER is a leading publisher of
health science publications, advancing
medicine by delivering superior reference information and decision support
tools to doctors, nurses, health practitioners and students. With an extensive
media spectrum — print, online and
handheld, we are able to supply the
information you need in the most convenient format.
Enova Illumination
1326
1839 Buerkle Road, St. Paul, MN 55110
http://www.enovaillumination.com
Introducing Enova’s newest and brightest
LED surgical headlight, model XLT-225.
It is designed for deep cavity surgery and is
the brightest LED surgical headlight in the
world!5 year warranty on LED. Made in
USA since 2005.
ESTS
144
1 The Quadrant, Exeter, Devon, ex2 4le,
United Kingdom
www.ests.org
ESTS is the largest international general
thoracic surgery organization with over
1350 members from all Continents. Our
mission is to improve quality in our specialty: from clinical and surgical management
of patients to education, training and credentialing of thoracic surgeons worldwide.
ETHICON
904
190 Lexington Road, Glastonbury, CT 06033
www.ethicon.com
Ethicon US LLC , a Johnson & Johnson
company, commercializes a broad range of
innovative surgical products, solutions and
technologies used to treat some of today’s
most prevalent medical issues, such as:
colorectal and thoracic conditions, women’s
health conditions, hernias, cancer and obesity. Learn more at www.ethicon.com, or
follow us on Twitter @Ethicon.
Fehling Instruments GmbH
& Co. KG
Hanauer Landstr. 7A, 63791, Karlstein,
Germany
www.fehlingsurgical.com
331
FEHLING SURGICAL INSTRUMENTS features Minimally Invasive Valve
Sets including NEW Retractor designs for
unmatched Atrial Exposure. Stop by and
take our new MICS Simultator for a spin
Continued on page 12
to refine your manual/tactile skills on a
“Dummy”! CERAMO® surface means high
efficiency through enhanced performace,
increased endurance and minimal maintenance.
G & N Medical
1308
Maydwell Ave, Off Stane St., Horsham, United
Kingdom
www.gandn.com
G+N Medical is a British medical device
company which was established in 1974
originally selling laboratory consumables.
Today they are the UK market leaders
in DVT prevention and have a range of
specialist cardiothoracic products. G+N is
an independent company which is proud to
supply the highest quality, best value products to customers around the world.
Genesee BioMedical, Inc.
711
700 West Mississippi Avenue, Denver, CO
80223-3408
www.geneseebiomedical.com
Design Beyond Standard. Genesee BioMedical, Inc. provides unique devices for
cardiothoracic surgery including sternal/
thoracic valve retractors for adult, adult
congenital and pediatric cardiac surgery,
instruments for MICS, coronary graft
markers, suture guards, retraction clips and
aortic valve repair. Now available “PHOTOFIX” Bovine Pericardial Patch. Denver, CO USA www.geneseebiomedical.com.
Gore & Associates, Inc. 1008
1505 N. Fourth Street, Flagstaff, AZ 86004
www.goremedical.com
At Gore, we have provided creative therapeutic solutions to complex medical problems for more than 35 years. During that
time, more than 35 million innovative Gore
Medical Devices have been implanted,
saving and improving the quality of lives
worldwide. Our extensive family of products includes vascular grafts, endovascular
and interventional devices, surgical meshes
for hernia and soft tissue reconstruction,
staple line reinforcement materials, and
sutures for use in vascular, cardiac, and
general surgery. We are one of a select few
companies to appear on all of the US “100
Best Companies to Work For” lists since
the rankings debuted in 1984. For more
information, visit www.goremedical.com.
Hawaiian Moon
1313
321 S. Missouri Ave., Clearwater, FL 33756
Heart Hugger/Gen’l Cardiac
Technology
704
6489 Comden Ave. #106, San Jose, CA 95120
www.hearthugger.com
Heart Valve Society
132
500 Cummings Center, Suite 4550, Beverly,
MA 01915
www.HeartValveSociety.org
An International Heart Team. Leaders in
Evaluation, Management and Research.
HeartWare, Inc
910
500 Old Connecticut Path, Framingham, MA
01701
www.heartware.com
A PRIL 25-29, 2015
HeartWare is dedicated to delivering
safe, high-performing and transformative
therapies that enable patients with heart
failure to get back to life. The company’s
breakthrough innovations begin with the
HVAD® Pump, designed to be implanted
in the pericardial space avoiding the more
invasive surgical procedures required with
older LVAD technologies. The HVAD
Pump is commercially available around
the world.
Integrated Sensing Systems
1205
391 Airport Industrail Dr., Ypsilanti, MI 48198
www.mems-issys.com
Integrated Sensing Systems, Inc. (ISS) is
a technology company that has built and
maintained a state of the art manufacturing
facility that supplies innovative MEMS
based solutions to each of its independent
business units to empower the business units
to deliver breakthrough products that are focused on both large and emerging markets.
International BioPhysics Corporation
1110
2101 E. Elmo St. Suite 275, Austin, TX 78744
www.biophysicscorp.com
SternaSafe is an active adjustable stability
sternum support brace (patents pending)
which give patients hand-free mobility.
The SternaSafe is made from comfortable,
soft, breathing materials developed for sternotomy patients. The brace is worn by the
patient after their sternotomy operation.
The SternaSafe can be worn during their
hospital stay and subsequently at home.
The average use time at home is 21 days.
International Society of Minimally
Invasive Cardiac Surgery
1311
500 Cummings Center, Suite 4550, Beverly,
MA 01915
www.ismics.org
ISMICS: Innovation, Technologies, and
Techniques in Cardiothoracic and Cardiovascular/Vascular Surgery. 2015 ISMICS
Annual Scientific Meeting, 3-6 June 2015,
InterContinental Hotel, Berlin, Germany
www.ismics.org.
Intuitive Surgical, Inc.
723
•
Kapp Surgical Instrument Inc.
512
4919 Warrensville Center Road, Cleveland,
Ohio 44128
www.kappsurgical.com
Kapp Surgical is a custom design shop which
designs surgical instruments and implants,
manufactures them, and sells as well as
distributes domestically and internationally.
Kapp’s exclusive products are: The Cosgrove
Heart Retractor, Strip T’s surgical organizer,
and countless surgical devices all FDA approved with several pending approvals.
Karl Storz EndoscopyAmerica, Inc.
604
2151 E. Grand Ave., Suite 100, El Segundo, CA
90245
www.karlstorz.com
KARL STORZ, a leader in endoscopic
technologies for over 70 years, offers solutions for video-assisted thoracic surgery.
Among our mediastinoscopy products is
the SLIM Distending Mediastinoscope, an
ideal solution for advanced procedures at
the mediastinum. Our EndoCAMeleon®
Laparoscope enables surgeons to adjust the
scope’s viewing direction from 0° to 120°.
KLS Martin, LP
705
PO Box 16369, Jacksonville, FL 32245
www.klsmartinnorthamerica.com
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.
Lara Tape Labs, LLC
1211
8777 N. Gainey Center Drive, Suite 136,
Scottsdale, AZ 85258
www.laratapelabs.com
Lara Tape Labs is a designer and manufacturer of high performance expanded
PTFE films and membranes designed to
solve medical applications.
LifeNet Health
810
1864 Concert Dr. Virginia Beach, VA 23453
www.lifenethealth.org
Intuitive Surgical is the global leader in minimally invasive, robotic-assisted surgery. Its
da Vinci® Surgical System – with a 3D-HD
vision system and EndoWrist® instrumentation – enables surgeons to offer a minimally
invasive approach for a range of complex
procedures. da Vinci is used in more than
2,500 hospitals around the world.
LifeNet Health helps save lives, restore
health, and give hope to thousands of patients each year. We are the world’s most
trusted provider of transplant solutions,
from organ procurement to new innovations in bio-implant technologies and
cellular therapies—a leader in the field of
regenerative medicine, while always honoring the donors and healthcare professionals
that allow the healing process.
JACE Medical
LoupeCam by VizVOCUS inc.
1020 Kifer Road Sunnyvale, CA 94086
www.intuitivesurgical.com
1104
17020 Duck Lane, Haymarket, VA 20169
www.jacemed.com
JACE is a medical device development
company pioneering a fully integrated,
re-sequencing technology + application for
sternal resection and closure. We innovate
with an eye toward providing definitive
benefits across the entire five-sided healthcare spectrum of Patient, Physician, Provider, Payer and Regulator.
1225
10245 E. Via Linda Blvd, Suite 210, Scottsdale,
AZ 85258
www.loupecam.com
The ProHD LoupeCam® takes visualization and HD video recording to a complete
different level. This nickel-size camera, with
only 0.4 oz, offers a 3.0 MP sensor, a builtin microphone and HD video recording
1280x720p directly to your laptop with
full Mac or Windows options. Mounting
adapters available for all loupes models.
•
S EATTLE , WA
The Bluetooth Footpedals ensure a complete
hands-free experience. www.LoupeCam.com
LSI Solutions
1111
7796 Victor-Mendon Rd., Victor NY 14564
www.lsisolutions.com
COR-KNOT® delivers instant security
with automated knot placement and integrated suture trimming in one easy step.
COR-KNOT® may reduce cardiopulmonary bypass and cross-clamp time in your
OR. Visit LSI SOLUTIONS® at booth
1111 to learn more.
Magic Masseuse
1304
8056 17th Ave NE, Seattle, WA 98115
www.magicmasseuse.com
You have to try it, to believe it. Aching
back, neck pain, sore hips, knee or ankle
pain, sciatica, headaches, fibromyalgia,
blood circulation, plantar fascitis, arthritis, tennis elbow. Instant pain relief. Same
professional treatment you would get at the
doctor or chiropractor office. Easy to use,
safe and effective.
Mallinckrodt Pharmaceuticals
601
12481 High Bluff Drive #200, San Diego, CA
92130
www.mallinckrodt.com
Mallinckrodt is a global specialty biopharmaceutical and medical imaging business
that develops, manufactures, markets and
distributes specialty pharmaceutical products and medical imaging agents. Mallinckrodt is an industry leader in intravenous
analgesia for acute pain management. Visit
www.mallinckrodt.com to learn more.
MAQUET Medical Systems, USA 337
45 Barbour Pond Road, Wayne, NJ 7470
www.maquet.com
MAQUET Medical Systems is a market
leader focused on improving patient care
and quality of life. We offer a comprehensive
portfolio of innovative products designed
to meet the needs of clinical professionals in
the areas of: advanced hemodynamic monitoring, cardiothoracic and vascular surgery,
thoracic drainage, cardiac intervention, perfusion, anesthesia and ventilation.
MED Alliance Solutions, LLC
717
3825 Commerce Drive, St. Charles, IL 60174
www.medalliancesolutions.com
ISO 13485 certified medical device distributor committed to providing high quality
specialty devices for cardiothoracic surgery
worldwide. Exclusive US distributor of
French instruments manufacturer Delacroix-Chevalier and partner of Michigan
based Surge Cardiovascular for open heart
surgical products.
Medela, Inc.
1011
1101 Corporate Drive, McHenry, IL 60050
www.medela.com
Medela concentrates on two divisions:
“Breastfeeding”, leading in the development
and production of breastfeeding products, and
“Healthcare”, engineering and manufacturing
highly innovative medical vacuum technology
solutions. Medela has 18 subsidiaries, distributes its products in over 90 countries, and
employs 1,500 staff worldwide.
A PRIL 25-29, 2015
•
Medistim
517
14000 25th Ave. N. Ste. 108, Plymouth, MN
55447
www.medistim.com
Medistim is the standard of care in the operating room. With the unique combination
of transit time flow measurement (TTFM)
and high frequency ultrasound imaging
guidance to help reduce and minimize the
risk of negative postoperative outcomes,
Medistim’s quality assessment technology
offers surgeons quantifiable validation and
guidance during cardiovascular, vascular,
transplantation and neurosurgery.
Medtronic, Inc.
537
710 Medtronic Parkway MS-LS290,
Minneapolis, MN 55432
www.medtronic.com
602
PO Box 1378, Bellaire, TX, 77402
www.microsurgeryusa.com
1227
2207-33 Wood Street, Toronto, ON M4Y 2P8,
Canada
www.mtmedi.com
We offer Exceptional Spring Style and
Double Action Titanium Scissors, Forceps and Needle Holders with Tungsten
Carbide Inserts for Thoracic and Cardan
Surgery. We guarantee 20,000 cuts for our
Titanium Scissors and 5 years warranty
for Titanium Forceps and Titanium Needle
Holders with excellent grasping. Free of
charge Trial available.
Myriad Genetic Laboratories
611
320 Wakara Way, Salt Lake City, UT 84108
www.myriad.com
Myriad Genetics is a leading molecular
diagnostic company dedicated to making a
difference in patients’ lives through the discovery and commercialization of transformative
tests to assess a person’s risk of developing disease, guide treatment decisions and assess risk
of disease progression and recurrence. Myriad’s portfolio of molecular diagnostic tests are
based on an understanding of the role genes
play in human disease and were developed
with a commitment to improving an individual’s decision making process for monitoring
and treating disease. Myriad is focused on
811
7700 Equitable Drive, Suite 206, Eden Prairie,
MN 55344, USA
www.neochord.com
NeoChord, a U.S.A. medical device company, has developed a new minimally invasive technology that enables beating heart,
sternal sparing implantation of artificial
chord tendinae, for the treatment of degenerative mitral valve regurgitation. CE mark
was obtained in December, 2012, and
more than 200 patients have been treated
to date.
730
1300 E. Anderson Lane, Bldg. B, Austin, TX
78752
www.onxlti.com
On-X® Life Technologies, Inc., Product
Description On-X® Heart Valves: Patented
natural design and On-X® Carbon offer
reduced turbulence in a mechanical valve
to rival the clinical and hemodynamic
performance of bioprostheses. FDA IDE
approved PROACT (Prospective Randomized On-X® Anticoagulation Clinical
Trial) is in process. Chord-X PTFE suture
is available for mitral valve repair.
Orascoptic
Microsurgery Instruments is one of the
leading suppliers of surgical instruments
and loupes. Our instruments include:
titanium scissors, needle holders, and
debakey forceps. Our Super-Cut scissors
are the sharpest in the market, and our
newly designed surgical loupes offer up
to 130mm field of view, and up to 11x
magnification.
MT Medi Corp.
NeoChord, Inc.
On-X Life Technologies, Inc.
At Medtronic, we’re committed to Innovating for life by pushing the boundaries of
medical technology and changing the way
the world treats chronic disease. Medtronic’s breadth of solutions in structural heart
and aortic disease management includes:
tissue, mechanical and transcatheter valves;
irrigated RF and cryo surgical ablation
devices; aortic stent graft systems; and
OPCAB, MICS CABG, cannulae and perfusion products.
Microsurgery Instruments, Inc.
strategic directives to introduce new products,
including companion diagnostics, as well as
expanding internationally.
709
3225 Deming Way #190, Middleton, WI
53562
www.orascoptic.com
Orascoptic has been designing and manufacturing award-winning loupes, lights
and operator chairs for surgeons, dentists
and hygienists for more than 30 years. The
Orascoptic focus is superior visualization
coupled with oprimal clinical ergonomics.
We are recognized as the inovators in the
market, being the first company to bring
you a portable LED light, the first loupe
with a built-in cable-less headlight, and the
first loupe with adjustable magnification
(zoo) power.
Otto Trading, Inc.
1209
1921 Carengie Ave Suite C., Santa Ana, CA
92705
Manufacturer and distributor of hand-held
portable digital massager, TENS unit
Oxford University Press
808
198 Madison Ave., New York, NY 10016
Peters Surgical
831
42, Rue Benoit Frachon, Bobigny cedex,
93000, France
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Therapy Systems Together we make the
difference in minimally invasive treatment
to improve patient outcomes and save lives.
With our Live Image Guidance and Data
Integration Solutions we aim to remove
barriers to safer, more effective, and more
reproducible treatments, delivering relevant
clinical value where it’s needed most - at the
point of patient treatment.
and stainless steel precision instruments
including: VATS/MIS thoracoscopic
instruments, Scanlan® SUPER CUT™
Scissors, and Scanlan® LEGACY titanium
needle holders and forceps. Single-use
products include Aorta/Vein Punches,
VASCU-STATT® bulldog clamps and graft
markers.
Qualiteam s.r.l.
51 Valley Stream Parkway, Malvern, PA 19355
www.healthcare.siemens.com
1016
Casale Nassio Sopra 15A, Chiaverano, TO,
10010, Italy
www.qualiteam.com
Founded by a nurse Qualiteam focuses
100% on advancing recovery through
prevention of complications after surgery
(infections, dehiscence, pain, respiratory
issues). Our unique wound support products are patented, FDA-cleared and reimbursable. The high performance is clinically
proven in even the worst, post-surgery scenarios. Visit our booth for details.
Quest Medical Inc.
909
One Allentown Pkwy., Allen, TX 75002
www.questmedical.com
Quest Medical, Inc. is a medical device
manufacturer and worldwide distributor
specializing in protecting the heart during
cardiac surgery with the Quest MPS 2®
and Microplegia. Quest also offers a unique
variety of aortic punches, safety valves, vascular loops, and an anesthesia line designed
for optimum cardiovascular surgery.
Rose Micro Solutions
1306
4105 Seneca Street, West Seneca, NY 14224
www.rosemicrosolutions.com
Rose Micro Solutions sells High Quality
Optical Loupes & LED Lights for Less! Our
Loupes start @ $279.00. We are a “Family”
Business consisting of 4 Brothers. We named
the company after our mother “ROSE”. Stop
by Booth # 1307 to see for yourself!
RTI Surgical Inc.
805
11801 Research Circle, Alachua, FL 32615
www.rtisurgical.com
RTI Surgical™ is a leading global surgical
implant company providing surgeons with
safe biologic, metal and synthetic implants.
Committed to delivering a higher standard,
RTI’s implants are used in sports medicine,
general surgery, spine, orthopedic, trauma
and cardiothoracic procedures and are distributed in nearly 50 countries.
Rultract/Pemco Inc.
700
5663 Brecksville Road, Cleveland, OH 441311593
Péters Surgical develops, manufactures and
distributes high-end medical devices worldwide. Vitalitec, the US subsidiary, will be
highlighting the CYGNET® flexible clamp,
Enclose II™ anastomosis assist device and
our Péters Surgical® CVT sutures. We will
also proudly display the Geister® brand instrumentation that we distribute in the US.
PemcoMedical LLC is an international
distribution company located in Cleveland,
Ohio that focuses on the design and manufacturing of precision Cardiovascular surgical instruments. Currently we represent
Pemco Inc., the Rultract “Skyhook” and
Sontec Instrument Company.
Philips Healthcare
One Scanlan Plaza, St. Paul, MN 55107
www.scanlaninternational.com
1023
22100 Bothell-Everett Highway, Bothell, WA
98021
www.usa.philips.com/healthcare
Philips Healthcare – Image Guided
Scanlan International, Inc.
333
Highest quality surgical products designed and manufactured by the Scanlan
family since 1921. Over 3000 titanium
Siemens Healthcare
1117
Siemens Healthcare helps providers meet
clinical, operational and financial challenges. A global leader in medical imaging,
laboratory diagnostics and IT, we understand the entire care continuum—from
prevention and early detection to diagnosis
and treatment. For more: usa.siemens.
com/healthcare
Sontec Instruments Inc.
505
7248 South Tucson Way, Centennial, CO,
80112
www.sontecinstruments.com
Sontec offers a comprehensive selection of
exceptional hand held surgical instruments,
headlights and loupes 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.
Sorin Group
343
14401 W. 65th Way, Arvada, CO 80004
www.sorin.com
Solo Smart Aortic Pericardial Tissue
Valve
The Solo Smart aortic pericardial tissue
valve is 100% pure tissue – free of stents,
suture rings and obstructions to blood flow.
Solo Smart has no synthetic material and
provides native-like performance.
Memo 3D ReChord Annuloplasty
Ring
With dynamic cell structure allowing
true physiological 3D motion, Memo 3D
ReChord truly reflects the native mitral
annulus. The addition of our innovative
cordal guide system makes artificial chordae replacement a more standardized
procedure.
Spiration, Inc.
1005
6675 185th Ave NE, Redmond, WA 98052
www.olympusrespiratory.com
The Spiration® Valve System has a humanitarian device approval in the U.S. to
control specific post-operative air leaks of
the lung and has CE mark approval for
the treatment of diseased lung in emphysematous patients and for damaged lung
resulting in air leaks by limiting air flow to
selected areas.
St. Jude Medical, Inc.
931
6300 Bee Caves Rd., Austin, TX 78746
St. Jude Medical is dedicated to transforming the treatment of some of the world’s
most expensive epidemic diseases by creating cost-effective medical technologies that
save and improve lives of patients around
the world.
Continued on page 14
Stroke Prevention Systems
1200
27 Hoku Place, Paia, Maui, HI 96779
The Stroke Prevention System (SPS™) is
a patented technology based on external
carotid compression, creation of a pressure
gradient and deflection of cerebral emboli.
It is performed on demand when generation of cerebral emboli is anticipated. The
SPS™ device has been used successfully in
patients undergoing heart surgery.
STS
134
633 N. St Clair, Chicago, IL 60611
www.sts.org
The Society of Thoracic Surgeons represents
more than 6,900 cardiothoracic surgeons,
researchers, and allied health care professionals worldwide who are dedicated to
ensuring the best surgical care for patients
with diseases of the heart, lungs, and other
organs in the chest. The Society offers a
wide variety of member benefits, including
reduced participation fees in the renowned
STS National Database, a complimentary
subscription to The Annals of Thoracic
Surgery, clinical practice guidelines, dynamic educational offerings, online patient
information resources, and much more.
Stop by booth #134 or visit www.sts.org to
learn more.
STS Advocacy Center
136
20 F. St. NW, Washington, DC 20001
www.sts.org
Stop by STS Advocacy Center booth #136
where you can receive timely information
on federal legislative and regulatory initiatives impacting the specialty, obtain tools to
engage members of Congress, and become
a Key Contact for government affairs issues
in your district. STS members can also
contribute to STS-PAC and support champions of cardiothoracic surgery in Congress.
Surgitel/General Scientific Corp
907
77 Enterprise Drive, Ann Arbor, MI 48103
www.surgitel.com
A PRIL 25-29, 2015
loupes and headlights sold around the
world from their headquarters in Ann
Arbor, Michigan. Holding a variety of patents, SurgiTel is always on the forefront of
Vision and Ergonomics.
SynCardia Systems, Inc.
605
1992 E Silverlake Drive, Tucson, AZ 85713
www.syncardia.com
The SynCardia temporary Total Artificial Heart (TAH-t) is the world’s only
FDA, Health Canada and CE approved
Total Artificial Heart. It is approved as
a bridge to transplant for patients dying
from end-stage biventricular failure. Visit
our booth for updates on the Freedom®
portable driver, 50cc TAH-t, and destination therapy.
Terumo Cardiovascular Group
531
6200 Jackson Road, Ann Arbor, MI 48103
www.terumo-cvs.com
Vascutek, a Terumo company, will display Gelweave™ gelatin-sealed, woven and
branched vascular grafts. The Vascutek
CE-marked Thoraflex™ Hybrid device
will also be featured (Not cleared for
sale in the USA). Terumo will display
the VirtuoSaph® Plus Endoscoipc Vessel
Harvesting System, Beating Heart and
Surgical Stabilization products for cardiothoracic procedures, and Terumo®
Perfusion Products.
Thompson Surgical Instruments,
Inc.
600
10170 East Cherry Bend Road, Traverse City,
MI 49684
www.thompsonsurgical.com
Thompson Surgical is a leader in exposure and the original manufacturer of the
table-mounted Thompson Retractor. In
cardiovascular surgery, surgeons will benefit from the Thompson Surgical Bolling
Retractor. The Bolling Retractor provides
extremely low profile, stable, and Uncompromised Exposure of the heart structures
for valve procedures.
SurgiTel is the manufacturer of premium
•
Thoracic Surgery Foundation for
Research and Education
1309
633 N. St Clair, Chicago, IL 60611
www.tsfre.org
TSFRE was established in 1988 as a
501c(3) not-for-profit charitable organization by the four leading thoracic surgery
societies: AATS, STS, STSA, and WTSA.
TSFRE’s mission is to foster the development of surgeon scientists in cardiothoracic
surgery; increasing knowledge and innovation to benefit patient care.
Thoramet Surgical Products
Thoratec Corporation
520
6035 Stoneridge Drive, Pleasanton, CA 94588
www.thoratec.com
Thoratec is the world leader in mechanical circulatory support with the broadest
product portfolio to treat the full range of
clinical needs for patients suffering from
advanced heart failure. The company’s
products include the HeartMate LVAS and
Thoratec VAD, with more than 20,000
devices implanted in patients suffering from
heart failure.
Transonic Systems Inc.
706
34 Dutch Mill Rd., Ithaca, NY 14850
www.transonic.com
Transonic’s new ELSA® Extracorporeal
Life Assurance Monitor provides novel
quantification of recirculation in VV-ECMO, oxygenator blood volume for VA/VV
ECMO as well as Transonic’s gold standard flow measurement for CPB.
Vitalcor, Inc.
516
100 E. Chestnut Avenue, Westmont, IL 60559
www.vitalcor.com
Latex Free Coronary Artery Balloon
Cannulae with self-inflating Balloon
(3-year shelf life). Reusable Dingo (Bulldog) Clamp. Titanium and stainless
steel specialty instruments and retractors.
Reusable stabilizer for Beating Heart
AATS Annual Meeting Welcome Reception
On Sunday evening, the AATS Welcome Reception
helped launch the 95th Annual Meeting and provided
meeting attendees with the opportunity to greet their
colleagues and visit with industry partners in
a convivial environment.
1006
301 Route 17 N, Suite 800, Rutherford, NJ
7070
www.thoramet.net
•
S EATTLE , WA
Surgery and Mitral Valve Retractor.
Wexler Surgical
919
11333 Chimney Rock Road Suite #110,
Houston, TX 77035
www.wexlersurgical.com
Wexler Surgical designs and manufactures
a variety of titanium and stainless steel
specialty surgical instruments and products
for Cardiac, Vascular, Thoracic, and Micro Surgery. Come see our VATS/MICS
instruments and ask about our Optimus
Series. Visit us online at www.wexlersurgical.com for more information about our
products and the services.
Wolters Kluwer Health
501
2001 Market Street, Philadelphia, PA 19103
www.wolterskluwer.com
Wolters Kluwer is a leading publisher of
medical, health and science publications.
We offer an extensive selection of medical
books, journals, and electronic media for
doctors, nurses, specialized clinicians and
students. Please visit booth 501 to browse
our comprehensive product line.
WSPCHS
908
2300 Tupper Street Room C8-29, Montreal,
QC, H3H 1P3, Canada
The mission of the World Society for Pediatric and Congenital Heart Surgery is to
promote the highest quality comprehensive
cardiac care to all patients with congenital
heart disease, from the fetus to the adult,
regardless of the patient’s economic means,
with an emphasis on excellence in teaching,
research and community service.
ZipperBelt.com
1305
3419 Westminster #276, Dallas, TX 75205
The zipper belt Brace was developed for
patients who are now zipper club members.
Transient events such as coughing or sneezing or even pushing up from a chair can be
very painful. The zipper belt is a brace that
the patient can wear and at a moments
notice can get relief from a violent sneeze or
cough instead of just squeezing a pillow.
Future AATS
Annual Meetings
AATS 96th Annual Meeting
May 14 - 18, 2016
Baltimore Convention Center
Baltimore
AATS Centennial
“Celebrating 100 Years of
Modelling Excellence”
April 29 – May 3, 2017
Boston Hynes Convention Center
Boston
AATS 98th Annual Meeting
April 28 – May 2, 2018
San Diego Convention Center
San Diego
A PRIL 25-29, 2015
•
Awards: Lifetime and Scientific
Timothy J. Gardner,
MD received the
2015 AATS Lifetime
Achievement
Award from G. Alec
Patterson, MD,
during Monday’s
plenary session.
Dr. Gardner was
honored for
his leadership,
commitment,
and lifelong
contributions to
the cardiothoracic
surgery specialty.
James L. Cox, MD received
the 2015 AATS Scientific
Achievement Award from G.
Alexander Patterson during
Monday’s plenary session.
Dr. Cox was recognized for
his scientific contributions
to the field of CT surgery,
including his pioneering
work in atrial fibrillation,
his leadership at the World
Heart Foundation, and
his mentorship in leading
numerous trainees to
scientific discoveries.
AATS
ANNUAL
MEETING
2016
•
S EATTLE , WA
“Every Heartbeat Matters”
David J. Sugarbaker,
MD, thanked Edwards
Lifesciences for their
continued partnership
with AATS in the Every
Heartbeat Matters
initiative. “With the
support provided by the
Edwards Lifesciences
Foundation we were
able to add two new
programs to the Graham
Foundation portfolio
as we strive to fulfill
our mission of Driving,
Leadership, Learning, and
Innovation in the pursuit
of excellence.” The
first new program is the
Every Heartbeat Matters
Valve Fellowship which aims to enhance the skills of cardiothoracic
surgeons so that they can better treat underserved populations at their
home institution. To do this, successful applicants will spend up to three
months visiting a host institution for advanced valvular heart disease
training to acquire skills that can be clinically implemented in their daily
practice. The second new program is the 2015 AATS Cardiovascular
Valve Symposium which will be taking place November 20-21 in Sao
Paulo, Brazil. This meeting was a perfect complement to the Fellowship
program as it allows the AATS to visit an area of need and provide
educational programming which will reach hundreds of practicing
surgeons and ultimately thousands of underserved patients.
PRESIDENT & ANNUAL MEETING CHAIR
Joseph S. Coselli
ANNUAL MEETING CO-CHAIRS
Charles D. Fraser
David R. Jones
May 14 – 18, 2016
Baltimore Convention Center
Baltimore, MD, USA
www.aats.org
H
A PRIL 25-29, 2015
•
•
S EATTLE , WA
Exploring Improvements in Perioperative Care
emodialysis patients are at added
risk of complications and mortality from cardiac surgery, compared
with patients not on dialysis. A modified perioperative management plan
can improve early outcomes, compared
with standard methods in these patients, according to Hiroyuki Tsukui,
MD, and colleagues from the Tokyo
Women’s Medical University.
At Monday’s Perioperative Care
Symposium, Dr. Tsukui presented
a study that evaluated one such
Hiroyuki Tsukui, MD, reported on a
management system for HD patients.
modified perioperative management
system in hemodialysis (HD) patients undergoing cardiac surgery,
which was designed to improve early
outcomes, compared with the previous regimen. The researchers found
that their new management system
improved both early mortality and
morbidity, as well as several other
measured outcomes.
The new management system was as
follows: 1) one week before surgery,
they discontinued medications for hyperphosphatemia; 2) a low-fiber diet
and medications were introduced for
defecation; 3) after surgery, alprostadil
alfadex (120 mcg/day) was infused
continuously to maintain organ perfusion; 4) continuous HD was used
routinely for several days from postoperative day 1, and then at regular intermittent HD was introduced.
The researchers studied consecutive HD patients undergoing cardiac
surgery. They were divided into two
groups (Group M: modified management versus Group P: previous management). Most of the patients took
7 to 10 days to reach the target dry
weight after surgery, said Dr. Tsukui.
There were no significant differences
between the two groups in terms of
preoperative status or surgical procedures except for operation time.
In terms of mortality, there were no
hospital deaths in Group M, whereas
eight patients (12.3%) died in Group
P, which was a significant difference..
In addition, in terms of postoperative
complications, the rate of reexploration for bleeding was significantly
lower in Group M, compared with
Group P, and there was also a significant difference in favor of Group M in
the lengths of intubation period and
in-hospital stay
Although no statistically significant
differences were observed in the following other complications examined,
a lower rate was found in Group M of
superficial wound infection, mediastinitis, pneumonia, sepsis, ileus, pancreatitis, cholecystitis and respiratory
failure requiring tracheotomy.
“Modified perioperative management improved early mortality and
morbidity, and shortened the length of
intubation period and hospital stay in
HD patients undergoing cardiac surgery,” concluded Dr. Tsukui.
The relative impact of preoperative
anemia versus packed red blood cell
(PRBC) transfusion on outcomes remains poorly understood, according
to Damien J. LaPar, MD, University
of Virginia, and his colleagues. He reported on their study that investigated
the relative association between preoperative hematocrit (Hct) level versus
PRBC transfusion on postoperative
outcomes after coronary artery bypass
grafting (CABG).
They evaluated the records of
21,641 patients who had isolated
CABG operations from January 2007
Damien J. LaPar, MD, discussed the
role of PRBC transfusions in CABG.
to June 2014 at 17 cardiac surgery
centers. They used multivariate analysis to estimate the relationship between baseline preoperative Hct level
as well as PRBC transfusion and the
likelihood for postoperative mortality
and morbidity, adjusted for baseline
patient risk.
As expected, a strong association was
observed between preoperative Hct
and the likelihood for PRBC transfusion. After risk adjustment, PRBC
transfusion (not Hct level) demonstrated stronger associations with post-
Marc Ruel, MD, addressed the risk
factors for reopening for bleeding.
operative mortality, renal failure, and
stroke, said Dr. LaPar.
Decreasing preoperative Hct was significantly associated with an increased
probability of mortality and renal failure. Preoperative anemia (compared
with an Hct level of 40%) was associated with up to a 66% increase in the
probability of PRBC transfusion, 50%
increase in renal failure, and a 43% increase in mortality.
They found, however, that packed
red blood cell transfusion appeared
to be more closely associated with
risk-adjusted morbidity and mortality
than was the preoperative hematocrit
level alone, supporting efforts to reduce unnecessary PRBC transfusions.
“However, because preoperative
anemia does independently increase
the risk of postoperative morbidity and
mortality, these data suggest that preoperative hematocrit levels should be
included in the STS risk calculators. In
addition, efforts to optimize preoperative hematocrit should be investigated
as a potentially modifiable risk factor,”
Dr. LaPar said.
“The results of our analyses have
significant clinical implications. Our
study’s demonstration that there exists
a highly significant and strong association between preoperative Hct and
the likelihood for PRBC transfusion
further emphasizes the critical role
of proper preoperative planning and
correction of preoperative anemia
when possible to avoid the untoward
effects of PRBC transfusion following
cardiac surgery. These results further
corroborate blood conservation efforts
and guidelines advanced by the Society
of Thoracic Surgeons and Society of
Cardiovascular Anesthesiologists,” Dr.
LaPar concluded.
Reopening for bleeding is known to
be a lethal, morbid and costly complication of cardiac surgery. Marc Ruel,
MD, reported in a study that he and his
colleagues at the University of Ottawa
performed to establish the risk factors
and impact of reopening for bleeding
(Rf B) in a large, modern cardiac surgical cohort.
The baseline, index procedural, reopening, outcome and readmission
characteristics of nearly 17,000 consecutive adult cardiac surgical patients
were prospectively entered into a
dedicated clinical database. Determinants of Rf B, as well as its independent
impact on outcomes and readmission,
were examined by using multivariable
regression models supplemented with
bootstrap simulations.
The mean age of the patients was
nearly 66 years, and 71.4% of the patients were men. Reopening after the
index operation occurred in 4.2% of
patients with over 90% of these being
Rf B. Perioperative mortality was 2.8%
in those who did not undergo Rf B and
12.0% in those who had Rf B, which
was a significant difference, independent of other mortality risk factors.
Hospital length of stay was greatly
increased by RfB (median 12 versus 7
days in patients who did not have RfB, a
signficant difference).
This increased length of stay was
greater than for any other predictor including postoperative atrial fibrillation
(median increase by 2 days). RfB also
was significantly and independently
associated with new-onset postoperative
atrial fibrillation (36.3% versus 26.0%)
in non-RfB patients.
Significant risk factors for Rf B were
tricuspid valve repair, on-pump versus
off-pump CABG, emergency status,
cardiopulmonary bypass (CPB) duration, low body surface area, and low
CPB hematocrit.
Rf B was not predicted by age, creatinine level, or preoperative hematocrit,
and Rf B did not increase the incidence
of hospital readmission.
“Because reopening for bleeding
after cardiac surgery is an independent
detrimental effect that surpasses any
other known potentially modifiable
risk factor, as shown in this large cohort, all efforts should be made to
minimize the incidence and burden
of Rf B, including further research on
transfusion management during CPB,”
Dr. Ruel concluded.
A PRIL 25-29, 2015
T
•
•
S EATTLE , WA
General Thoracic Surgery Adapts to Changing Therapeutics
he question of how to manage locally advanced thymomas (LATs)
is controversial and, so far, no specific oncological strategies have been
recommended, according to Giovanni
Leuzzi, MD.
In order to address this question, Dr.
Leuzzi of the Regina Elena National
Cancer Institute in Rome and his colleagues performed a retrospective analysis on the use of multimodal therapies
for LATs. In Monday’s General Thoracic Surgery Symposium, Dr. Leuzzi
presented their results, which were
obtained by assessing a database developed and maintained by the European
Society of Thoracic Surgeons (ESTS)
Thymic Working Group.
Clinico-pathological, surgical, and
oncological features were reviewed in
a cohort of 370 Masaoka-Koga stage
III thymoma patients (WHO Classification A to B3) who were treated at
38 institutions from January 1990 to
January 2010.
In order to identify independent predictors of outcomes, a multivariate Cox
proportional hazard model and a propensity score match were performed
to identify independent predictors of
Overall (OS), Cancer-specific (CSS)
and Relapse-free survival (RFS).
Induction and adjuvant therapy were
administered to 88 and 245 patients,
respectively. Overall, 5 and 10-year
Giovanni Leuzzi, MD, discussed the
management of LATS.
Pier Luigi Filosso, MD, spoke on the
most effective treatment for LCNEC.
OS, CSS and RFS rates were 82.8%,
88.4% and 80.0%, and, 68.9%, 83.3%
and 71.5%, respectively. Induction
therapy was associated to similar 5-year
CSS and RFS compared to primary
surgery. At propensity score analysis,
adjuvant therapy was confirmed as
the strongest predictive factor for OS
and CSS. Pathologic T classification
(according to IASLC/ITMIG TNM
staging proposal) was an independent
factor for relapse. When CSS was
adjusted for T classification, adjuvant
therapy confirmed a significant survival
advantage. On the other hand, for thy-
momas larger than 5 cm, stratifying for
tumor size and adjuvant therapy did
not affect 5-year CSS.
“The results of our study indicate that
induction therapy does not affect survival in LATs. Our results indicate that
adjuvant therapy should be administered
whenever possible, mainly in those tumors with specific pathological features
(pT2/3 or tumor size < 5 cm). These
data may be considered for development
of future clinical trials on adjuvant therapy,” Dr. Leuzzi concluded.
Large cell neuroendocrine carcinomas (LCNEC) of the lung are neo-
Graham Awards
Thoralf M. Sundt, III,
MD, Vice President
AATS Graham
Foundation; 2015
– 2016 Graham
Memorial Traveling
Fellow, Yaxing Shen,
MD, Fudan University
of Shanghi, China;
David J. Sugarbaker,
MD, President AATS
Graham Foundation
Thoralf M. Sundt, III,
MD, Vice President AATS
Graham Foundation; Pablo
Sanchez, MD, University of
Maryland, 2015 F. Griffith
Pearson Fellowship; David J.
Sugarbaker, MD, President
AATS Graham Foundation.
Not pictured: James Lubawski,
MD, Central DuPage Hospital,
2015 F. Griffith Pearson
Fellowship.
Cardiothoracic Surgical Investigators
David J. Sugarbaker, MD, President AATS
Graham Foundation; Felix Fernandez, MD,
Emory University School of Medicine;
Danielle Gottlieb, MD, Columbia
Presbyterian Hospital; Mark Onaitis, MD,
Duke University; Bo Tang, MD University of
Michigan; Thoralf M. Sundt, III, MD, Vice
President AATS Graham Foundation.
Not shown: Brendon Stiles, MD,
Weill Cornell Medical College.
plasms with very aggressive biological
behavior. In part because of their rarity,
there has been a lack of controlled
clinical trials concerning their most
effective treatment. Currently, the usefulness of adjuvant chemotherapy is
still debated, since these tumors do not
seem completely responsive to chemo/
radiotherapy and tumor recurrences
or metastases are very frequent. This
is true even in cases of early-stage neoplasms in which postoperative treatment has been administered, according
to Pier Luigi Filosso, MD, of the University of Torino.
Dr. Filosso reported on a study he and
his colleagues undertook to to evaluate
the impact of adjuvant chemotherapy in
resected LCNECs. They found that there
was no significant impact of adjuvant
chemotherapy on survival. Their retrospective study examined a cohort of
LCNEC patients operated on between
1992 and 2012 at 17 institutions.
Overall survival from date of resection was estimated by the Kaplan-Meier method. Patients receiving adjuvant
treatment showed slightly worse
three-year survival than the rest of the
patients, with no evidence of a protective effect. Sensitive analysis performed
using multivariable Cox model showed
similar results. Age and advanced
TNM stages were significant negative
predictors.
A PRIL 25-29, 2015
Thank you, JTCVS Team
Editorial Board Awards
The Journal of Thoracic and Cardiovascular Surgery would like to congratulate the following members of
the Editorial Board. They are the best
performers out of a group of very
high achievers and we
recognize them for their
dedication and accomplishment.
Education and Training
James I. Fann
Thoracic
Chadrick E. Denlinger
Victor A. Ferraris
Raja M. Flores
Katie S. Nason
Thomas Ng
•
S EATTLE , WA
Ethicon and AATS Graham Foundation Partnership
Reviewer Awards
The Journal of Thoracic and Cardiovascular Surgery would like to congratulate the following reviewers for their
performance in 2014. They are the
best performers out of the over 560
non-board reviewers!
Acquired
Grayson H. Wheatley III
Tirone E. David
Davis C. Drinkwater, Jr.
Stephen E. Fremes
Craig R. Smith
Acquired
Paul Kurlansky
Vinay Badhwar
Richard Lee
Leonard N. Girardi
Congenital
Scott M. Bradley
William M. DeCampli
Joseph A. Dearani
•
Congenital
Tara Karamlou
Paul Chai
Osman O Al-Radi
Thoracic
Wael C. Hanna
David R. Jones
Betty Caroline Tong
Perioperative Management
Nicholas D Andersen
David J. Sugarbaker, MD, AATS Graham Foundation President, meet with representatives from Ethicon China and the Chinese International Medical Foundation who have partnered with the Graham Foundation to establish the Thoracic
Surgery Training Fellowship, which will provide an international training and educational experience for young thoracic surgeons from mainland China to spend
between one month and one year studying clinical techniques at North American
institutions.
Thomas A. D’Amico, MD, Duke University Medical Center is the lead surgeon
facilitating both the Ethicon China Fellowship and the Ethicon Fellowship for
Advanced Thoracic MIS. Dr. D’Amico provided an update on the unique educational experience that the awardees will be offered including operating room access to observe cases in minimally invasive thoracic surgery, conferences focused
on a better understanding of the science and practice of minimally invasive thoracic surgery, and access to the faculty to develop lasting working relationships.
Edward Zhou, VP of Ethicon Surgical Care was also part of the presentation.
AATS
AORTIC
SYMPOSIUM
2016
COURSE DIRECTORS
Joseph S. Coselli
Steven L. Lansman
May 12 – 13, 2016
Sheraton New York Times Square Hotel
New York, NY, USA
www.aats.org/aortic
A PRIL 25-29, 2015
•
•
S EATTLE , WA
The AATs was pleased to welcome the following new members to AATS
during the New Members Induction on Monday
Prasad S. Adusumilli
New York, NY
Shanda H. Blackmon
Rochester, MN
Cem H. Alhan
Istanbul, Turkey
Joanna Chikwe
New York, NY
Matthew Bacchetta
New York, NY
Ufuk Demirkilic
Ankara, Turkey
Clifford W. Barlow
Southampton, UK
Jessica S. Donington
New York, NY
Emre Belli
Le Plessis-Robinson, France
Alessandro Giamberti
San Donato Milanese, Italy
Mark F. Berry
Durham, NC
Peter J. Gruber
Salt Lake City, UT
Jay K. Bhama
Pittsburgh, PA
T. Sloane Guy
Philadelphia, PA
AATS DAILY NEWS
The Official Newspaper of the AATS 95th Annual Meeting
AATS Staff
Executive Director
Managing Editor
Cindy VerColen
Lorraine M. O’Grady
Michael E. Halkos
Atlanta, GA
Andrew J. Lodge
Durham, NC
Jianxing He
Guangzhou, China
S. Chris Malaisrie
Chicago, IL
David P. Jenkins
Cambridge, UK
Joseph T. McGinn
Staten Island, NY
Sunjay Kaushal
Baltimore, MD
Michael E. Mitchell
Milwaukee, WI
Minoo N. Kavarana
Charleston, SC
T. Brett Reece
Aurora, CO
Bob Kiaii
Arva, ON, Canada
Nabil Rizk
New York, NY
Anthony W. Kim
New Haven, CT
Gu Tianxiang
Shenyang, China
Young T. Kim
Seoul, Republic of Korea
Alper Toker
Istanbul, Turkey
Charles T. Klodell
Gainesville, FL
Ching Tzao
Taipei, Taiwan
Christoph Knosalla
Berlin, Germany
Thomas J. Watson
Rochester, NY
Christopher J. Knott-Craig
Memphis, TN
Dennis A. Wigle,
Rochester, MN
John R. Liddicoat
Mounds View, MN
THE OFFICIAL
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OF THE
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Therese Borden, Mark Lesney
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Copyright 2015, American Association for Thoracic Surgery, 500 Cummings
Center, Suite 4550, Beverly, MA 01915. Produced and distributed for AATS by
Frontline Medical Communications. All rights reserved. No part of this publication
may be reproduced or transmitted in any form, by any means, without prior written
permission of the AATS. The opinions expressed in this publication are those of the
presenters and authors, and do not necessarily reflect the views of the Association.
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Tuesday - American Association for Thoracic Surgery

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