Tag: 2012

Graft pharmacoprotection evidence

N Roberts (London, UK) reviews the evidence for aspirin, clopidogrel, statins and ACE-inhibitors in improving graft patency.

Posted in Coronary Tagged with: , , , , ,

TAVI anaesthetics

A Klein (Cambridge, UK) explains the role of an anaesthetist in the transcatheter aortic valve implantation team.

Posted in Aortic valve Tagged with: , , , , , ,

TAVI cost effectiveness

J Eaton (Oxford, UK) looks at models of cost-effectiveness to consider the benefits of transcatheter aortic valve implantation.

Posted in Aortic valve, Data & statistics Tagged with: , , , , , , ,

Manubrial AVR

E Akowuah (Middlesbrough, UK) describes his early experience with the technique of aortic valve replacement via a manubrial incision.

Posted in Aortic valve Tagged with: , , , , ,

Trans subclavian TAVI

M Bhabra (Wolverhampton, UK) describes the subclavian / axillary approach for transcatheter aortic valve implantation, with a video demonstration and case presentations.

Posted in Aortic valve Tagged with: , , , , ,

AVR ministernotomy trial

S Nair (Cambridge, UK) gives an overview of a single centre ongoing trial of mini- versus full sternotomy for aortic valve replacement.

Posted in Aortic valve Tagged with: , , , , ,

TAVI neurological injury

Aiman Alassar (London, UK) looks at the incidence of neurological injury with transcatheter aortic valve implantation, causative mechanisms and the use of protection devices.

Posted in Aortic valve Tagged with: , , , , ,

TAVI complication management

M Borger (Leipzig, Germany) talks about his unit’s experience in dealing with complications of transcatheter aortic valve implantation.

Posted in Aortic valve Tagged with: , , , ,

Non RBC components & bleeding

W Lester (Birmingham) considers the use of non-red blood cell components in major haemorrhage, with emphasis on the role of fibrinogen.

Posted in Blood Tagged with: , , , , ,

Mini-sternotomy AVR tips

C Young (London, UK) gives a detailed description of his techniques for minimal-access aortic valve replacement.

Posted in Aortic valve Tagged with: , , , , ,

Percutaneous tricuspid valve replacement

M Borger (Leipzig, Germany) reviews the current status of percutaneous tricuspid valve implantation.

Posted in Right heart Tagged with: , , , , ,

VATS AF ablation programme

N Davidson (Manchester, UK) covers minimally invasive procedures in the treatment of atrial arrhythmias, emphasising the benefits of an integrated approach.

Posted in Arrhythmias Tagged with: , , , , ,

Right anterior thoracotomy AVR

B Gersak (Ljubljana, Slovenia) describes his techniques for performing aortic valve replacement via a right anterior mini-thoracotomy.

Posted in Aortic valve Tagged with: , , , , ,

TAVI & mitraclip transoesophageal echocardiography

A McNab (Manchester, UK) describes the role of echocardiography in pre-procedural assessment, peri-procedural support and post-procedural follow-up of transcatheter aortic valve implantation cases. The mitraclip system is also considered.

Posted in Aortic valve, Imaging, Mitral valve Tagged with: , , , , , , ,

Endoscopic mitral valve surgery with endoclamp

B Gersak (Ljubljana, Slovenia) describes his techniques for minimally-invasive mitral valve surgery using an endoclamp.

Posted in Mitral valve Tagged with: , , , ,

Bleeding & Factor VII

R Gill (Southampton, UK) considers haemostatic mechanisms and the use of rFVIIa as a bail out adjunct.

Posted in Blood Tagged with: , , , , ,

Transcatheter valve training

C Young (London, UK) ponders the future of cardiac surgical training in the era of TAVI.

Posted in Aortic valve Tagged with: , , , , ,

Thoracoscopic IMA harvest

A de Souza (London, UK) describes his technique for endoscopic internal mammary artery harvest.

Posted in Coronary Tagged with: , , , , , , , ,

Diastolic dysfunction transoesophageal echocardiography

M Patrick (Manchester, UK) reviews the echocardiographic assessment of diastolic function.

Posted in Imaging Tagged with: , , , ,

Emerging blood products

N Currie (London, UK) discusses the emerging roles of fibrinogen concentrate and prothrombin complex concentrate (PCC).

Posted in Blood Tagged with: , , , , , , ,

Sutureless valves in high risk AVR

C Young (London, UK) and S Livesey (Southampton, UK) argue for the use of sutureless valves in high-risk aortic valve replacement.

Posted in Aortic valve Tagged with: , , , , , ,

Trans femoral TAVI

M Buch (Manchester, UK) looks at the trans-femoral approach to trans-catheter aortic valve implantation, with emphasis on assessment, access and possible complications.

Posted in Aortic valve Tagged with: , , , , ,

Intracardiac masses transoesophageal echocardiography

N Fletcher (London, UK) shows several examples of atrial myxoma and intra-cardiac thrombus.

Posted in Imaging Tagged with: , , , , ,

TAVI heart team

O Wendler (London, UK) explores the indications for transcatheter aortic valve implantation and the role of the heart team in decision-making.

Posted in Aortic valve Tagged with: , , , , ,

Paravalvular leak transoesophageal echocardiography

J Swanevelder (Leicester, UK) examines the assessment of intra-operative paravalvular leak.

Posted in Imaging Tagged with: , , ,

Preoperative anaemia and adverse outcomes

M Ranucci (Milan, Italy) explores the literature evidence for adverse outcomes associated with preoperative anaemia in cardiac surgery.

Posted in Blood Tagged with: , , , , ,

Bleeding & point of care testing

M Ranucci (Milan, Italy) discusses the bleeding patient and point of care testing, particularly with the use of TEG / ROTEM.

Posted in Blood Tagged with: , , , , ,

VATS AF ablation

M Castella (Barcelona, Spain) uses a number of video clips to help explain his approach to minimally invasive atrial fibrillation surgery.

Posted in Arrhythmias Tagged with: , , , , , ,

MIDCAB procedure evolution

R Stanbridge (London, UK) describes the evolution of minimally invasive coronary surgery from his initial experience in 1995, and considers the results of the procedure.

Posted in Coronary Tagged with: , , , , , ,

Trans apical TAVI

M Borger (Leipzig, Germany) shows the 5 year Leipzig data for trans-apical transcatheter aortic valve implantation.

Posted in Aortic valve Tagged with: , , , , ,

Aortic valve surgery risk stratification

N Howell (Birmingham, UK) discusses aspects of data analysis and the building of a new risk model for aortic valve replacement.

Posted in Aortic valve, Data & statistics Tagged with: , , , , , ,

Graft pharmacoprotection USA view

T Sundt (Boston, USA) gives a brief overview of the evidence for various drugs which could be used to improve vein graft patency.

Posted in Coronary Tagged with: , , , , , ,

Aortic dissection transoesophageal echocardiography

M Bewsher (Manchester, UK) describes the echocardiographic findings in acute aortic dissection.

Posted in Aorta, Imaging Tagged with: , , , , ,

ECMO review

R Firmin (Leicester, UK) presents an overview of paediatric extracorporeal membrane oxygenation. A Combes (Paris, France) gives a tutorial on VA and VV ECMO in adults.

Posted in Congenital, Mechanical support, Technology Tagged with: , , , , , , , ,

Tranexamic acid

A Kelleher (London, UK) considers the use of tranexamic acid to reduce bleeding in cardiac surgery.

Posted in Blood Tagged with: , , , ,

Acute severe RV dysfunction

D Jenkins (Cambridge, UK) discusses decision-making and management in acute severe right ventricular dysfunction after cardiopulmonary bypass.

Posted in Mechanical support, Right heart Tagged with: , , , ,

Endoscopic mitral valve surgery with portaclamp

I Birdi (Basildon, UK) discusses and shows a video demonstration of his techniques in minimally invasive mitral surgery.

Posted in Mitral valve Tagged with: , , , ,

Off-pump CABG anaesthetic viewpoint

C Palin (Oxford, UK), a cardiac anaesthetist, explains his view on how practice has become so polarised. This is followed by a panel and audience debate.

Posted in Coronary Tagged with: , , , , , ,

Hybrid coronary revascularisation

G Angelini (Bristol, UK) explains the evolution and current status of hybrid coronary revascularisation.

Posted in Coronary Tagged with: , , , , , ,

Coagulopathy pathogenesis

H New (London, UK) reviews coagulation, tests for coagulopathy, and changes in DIC and acute traumatic coagulopathy. Management strategies are discussed.

Posted in Blood Tagged with: , , , , ,

RV dysfunction management

A Combes (Paris, France) describes mechanisms of right ventricular dysfunction and risk scoring for prediction, particularly in the contact of transplantation an LVAD therapy. Treatment options, including ECMO and RVAD implantation, are discussed. J Pepke-Zaba (Cambridge, UK) then discusses the

Posted in Mechanical support, Right heart Tagged with: , , , , , ,

Endoscopic tricuspid valve surgery

J Zacharias (Blackpool, UK) describes some tips in performing endoscopic tricuspid valve surgery.

Posted in Right heart Tagged with: , , , ,

Mini mitral anaesthesia

D Cheng (London, Canada) gives an overview of the anaesthetic implications of minimally invasive mitral surgery.

Posted in Mitral valve Tagged with: , , , , , ,

Conduit alternatives

R Hasan (Manchester, UK) gives an overview of the alternative conduits for bypass grafting. A de Souza (London, UK) reviews to evidence for these conduits.

Posted in Coronary Tagged with: , , , , , , , , ,

Trans aortic TAVI

V Bapat (London, UK) introduces the trans-aortic approach to trans-catheter aortic valve implantation, including a video demonstration.

Posted in Aortic valve Tagged with: , , , , , ,

Blood conservation methods

A Klein (Cambridge, UK) looks at blood conservation measures in cardiac surgery.

Posted in Blood Tagged with: , , , ,

Surgery for late RV failure after mitral valve surgery

F Wells (Cambridge, UK) discusses the difficult area of tricuspid regurgitation and failing right ventricular function late after mitral valve surgery.

Posted in Right heart Tagged with: , , , ,

Mitraclip update

M Buch (Manchester, UK) reviews the status of and indications for transcatheter mitral valve therapies.

Posted in Mitral valve, Technology Tagged with: , , , , , ,

BIMA evidence

D Taggart (Oxford, UK) argues in favour of using bilateral internal mammary arteries for surgical revascularisation.

Posted in Coronary Tagged with: , , , , , , ,

TAVI surgeon’s role

A Borger (Leipzig, Germany) considers the role of a surgeon in transcatheter aortic valve implantation.

Posted in Aortic valve Tagged with: , , , ,

MIDCAB programme setup

E Akowuah (Middlesbrough, UK) shares his experience of setting up a minimally-invasive coronary surgery programme.

Posted in Coronary Tagged with: , , , , , ,

Transoesophageal echocardiography of aortic stenosis during CABG

H Skinner (Nottingham, UK) discusses aortic stenosis guidelines, estimation of severity, and patient-prosthesis mismatch.

Posted in Aortic valve, Imaging Tagged with: , , , , , ,

Blood transfusion and adverse outcomes

G Murphy (Leicester, UK) dissects the evidence for an association between blood transfusion and adverse outcome.

Posted in Blood Tagged with: , , , , ,

Right mini-thoracotomy sutureless AVR

M Solinas (Massa, Italy) presents his experience with the right anterior mini-thoracotomy approach for aortic valve replacement, including a video demonstration of the sutureless technique with the Perceval prosthesis.

Posted in Aortic valve Tagged with: , , , , , , ,

How to do it: (1) Mediastinal robotics (2) Airway obstruction management

P Van Schil (Antwerp, Belgium) presents videos with the use of robotics in the resection of mediastinal masses. D Breen (Galway, Ireland) shows some cases of airway obstruction management.

Posted in Airways, Mediastinum, Technology Tagged with: , , , , , , ,

Circumflex artery injury during mitral valve repair

J Ender (Leipzig, Germany) shows cases of circumflex artery injury during mitral valve repair and explains the anatomy to demonstrate how easily this can happen.

Posted in Mitral valve Tagged with: , , , , , ,

Off-pump CABG data to inform practicing surgeons

D Taggart (Oxford, UK) undertakes a detailed exploration of the evidence for and against off-pump CABG.

Posted in Coronary Tagged with: , , , , , , , ,

Right ventricular assessment – congenital lessons

S Thorne (Birmingham, UK) reviews the preoperative assessment of the right ventricle and the tricuspid valve, stressing the importance of protection of RV function in the long-term.

Posted in Right heart Tagged with: , , , ,

Carcinoid heart disease

N Howell (Birmingham, UK) presents his unit’s experience with carcinoid heart disease. T Oelofse (Birmingham, UK) discusses the anaesthetic principles of managing these patients.

Posted in Right heart Tagged with: , , , , , , ,

Right ventricular preoperative assessment

M Seeberger (Basel, Switzerland) gives a detailed description of right ventricular preoperative imaging, with emphasis on extra TOE views to improve assessment.

Posted in Right heart Tagged with: , , , ,

Radial artery conduit – USA viewpoint

T Sundt (Boston, USA) gives a North American view of radial artery use as a bypass conduit.

Posted in Coronary Tagged with: , , , , , ,

Mesothelioma surgery

D Sugarbaker (Boston, USA) illustrates in detail his techniques for extrapleural pneumonectomy and pleurectomy/decortication.

Posted in Pleura Tagged with: , , , , , ,

Bicuspid aortic valve review

T Sundt (Boston, USA) discusses the timing of aortic intervention. G El Khoury (Brussels, Belgium) describes repair of a bicuspid regurgitant aortic valve, talking through a video of the David V technique. C Liopsis (London, UK) gives an update on

Posted in Aorta, Aortic valve Tagged with: , , , , , , , , , , , , ,

Blood management

G Murphy (Leicester UK) introduces blood management and how it affects outcomes in cardiac surgery.

Posted in Blood Tagged with: , , , ,

Off-pump CABG database evidence

B Bridgewater (Manchester, UK) presents provisional analysis of off-pump vs on-pump CABG from the SCTS database.

Posted in Coronary, Data & statistics Tagged with: , , , , , ,

Radial artery conduit

B Fabri (Liverpool, UK) explores the role of the radial artery as a conduit for bypass grafting.

Posted in Coronary Tagged with: , , , , , ,

Surgical practice polarisation

A Wechsler (Philadelphia, USA) explores some of the reasons for polarisation of surgical opinion, including intuition and the retention of biases.

Posted in Coronary Tagged with: , , , ,

Tricuspid valve echocardiography

A Roscoe (Toronto, Canada) describes echocardiography techniques for viewing the tricuspid valve and predictors of repair failure.

Posted in Right heart Tagged with: , , , , ,

Novel mitral valve technologies

M Dalrymple-Hay (Plymouth, UK) gives an update on the rapidly evolving field of new mitral valve technologies.

Posted in Mitral valve, Technology Tagged with: , , , , ,

Robotics in urology

V Ramani (Manchester, UK) lectures on how the use of robotics in urology has improved outcomes.

Posted in Technology Tagged with: , , , ,

Off-pump CABG future

D Glineur (Brussels, Belgium) discusses the off-pump CABG trials and argues for the use of bilateral internal mammary arteries as a composite Y-graft.

Posted in Coronary Tagged with: , , , , , , , ,

SYNTAX 4 year results

D Taggart (Oxford, UK) presents pre-syntax evidence for CABG vs PCI, before analyzing the results of the SYNTAX trial at four years.

Posted in Coronary Tagged with: , , , , , , ,

Tricuspid valve replacement indications

P Perier (Bad Neustadt, Germany) discusses the mechanisms of functional tricuspid regurgitation. The importance of the right ventricle is stressed. Mechanisms of repair failure are described and indications for valve replacement given.

Posted in Right heart Tagged with: , , , ,

Cardiac surgery datasets

B Bridgewater (Manchester, UK) describes some of the statistical processes behind the SCTS database. A Wechsler (Philadelphia, USA) discusses different types of high level clinical trials and interpreting significance.

Posted in Data & statistics Tagged with: , , , , ,

Off-pump CABG surgical viewpoint

G Angelini (Bristol, UK) talks about surgical attitudes to evidence-based medicine, professional competition and lack of innovation.

Posted in Coronary Tagged with: , , , , ,

RIMA to LAD revascularisation

N Howell (Birmingham, UK) explores whether RIMA-LAD revascularisation is equivalent to LIMA-LAD.

Posted in Coronary Tagged with: , , , , , ,

Tricuspid valve regurgitation surgical options

P Perier (Bad Neustadt, Germany) discusses the clinical significance of tricuspid valve regurgitation and options for surgical management.

Posted in Right heart Tagged with: , , , , ,

Aprotinin

D Cheng (London, Canada) reviews the rise and fall of aprotinin as an anti-fibrinolytic agent in cardiac surgery.

Posted in Blood Tagged with: , , , , ,

STITCH trial review

A Wechsler (Philadelphia, USA) reviews the surgical treatment for ischaemic heart failure (STITCH) trial. Problems with trial design, recruitment and results interpretation are highlighted.

Posted in Coronary, Heart failure Tagged with: , , , , , , ,

Tricuspid valve pathophysiology

P Punjabi (London, UK) describes the mechanisms involved in the development of tricuspid valve disease, imaging techniques for assessment and indications for intervention. Some operative videos of complex repairs are shown.

Posted in Right heart Tagged with: , , , ,

AV valves and ventricles comparison

F Wells (Cambridge, UK) describes the similarities and fundamental differences between both the A-V valves and the ventricles. Important aspects of embryology, morphology and physiology are highlighted.

Posted in Right heart Tagged with: , , , , ,

SCTS database evidence for BIMA

B Bridgewater (Manchester, UK) presents figures from the SCTS database comparing single versus bilateral mammary artery use in CABG.

Posted in Coronary Tagged with: , , , , , ,

Preoperative anaemia & poor outcomes

A Carey (Plymouth, UK) looks at the impact of low preoperative haemoglobin on outcomes in patients undergoing urgent coronary bypass surgery.

Posted in Blood Tagged with: , , , , , ,

Managing multimodality anti-platelet therapy

W Lester (Birmingham, UK) explains how anti-platelet agents work and gives evidence-based advice on peri-operative management.

Posted in Blood Tagged with: , , , ,

Sorin corporate news

The history of the Sorin company and its current innovative products are briefly described.

Posted in Technology Tagged with: , , ,

Medtronic corporate news

Product choice in valve replacement and a new ipad app are mentioned.

Posted in Technology Tagged with: , , ,

TAVI industry update

JP Herzog (Edwards), X Bertrand (Medtronic), U Lonn (St Jude) and K Leadley (JenaValve) give an overview of developments in the design of TAVI valves and delivery systems.

Posted in Aortic valve Tagged with: , , , , , , , ,

Blood economics

A Hofmann (Perth, Australia) discusses the economics of blood transfusion.

Posted in Blood Tagged with: , , , ,

Haemovigilance

P Bolton – Maggs (Manchester, UK), its Medical Director, reviews the history and role of Serious Hazards of Transfusion (SHOT).

Posted in Blood Tagged with: , , , , ,

Adopting new technology

S Chisholm (Manchester, UK) describes the work of the NHS Technology Adoption Centre.

Posted in Technology Tagged with: , , ,

Paediatric surgery bleeding

H New (London, UK) presents highlights from a multicentre survey of blood component use in paediatric cardiac surgery.

Posted in Blood, Congenital Tagged with: , , , ,