Cutting Edge Presentations During Masters Day 2013 ANNUAL MEETING 12-15 June HILTON PRAGUE, CZECH REPUBLIC INSIDE FRIDAY’S ISSUE Technical Challenges: Pitfalls and Disasters 2013 Consensus Conference: OPCAB/Off Pump Surgery 2013 Exhibitors & Product Descriptions 2013 Industry Sponsors Industry Sponsored Symposia Poster Competition FINALISTS ISMICS Masters Day Keynote Speaker: Joseph Bavaria, MD Kit V. Arom Lecture: William (Billy) Cohn, MD Thoracic Track Thoracic Movie Day Cardiac Track Perfusion Session Live On Tape Session Preview of ECHI /ISMICS Cardiac Surgery Summit INSIDE FRIDAY’S ISSUE (continued on page 3) (continued on page 7) Niv Ad, MD presented the State of the Art Lecture on “Surgical Ablation Atrial Fibrillation” during the Masters Day Program morning session on Wednesday. ISMICS President Focuses on Policy, Politics and Performance The ISMICS Annual Meeting kicked off with the traditional Masters Day program, but with a new twist this year. In addition to the focused scientific sessions on cutting-edge topics in minimally invasive surgery, a new interactive format was featured, including State-of-the-Art Lectures and “Great Debates.” Sessions were designed to allow maximum dialogue between the audience and presenters and questions were encouraged through the day-long program. Topics included Robotic Revascularization, Atrial Fibrillation, CABG, Mitral Valves, TAVI, and Coronary Surgeries. International leaders in the field debated such issues as Atrial Fibrillation Monitoring, OPCAB vs. ONCAB, Transcatheter Mitral Valve Repair, and Expanding TAVI Indications to Medium Risk Patients. On Thursday 13 June ISMICS President Alan Menkis, MD presented his thought-provoking Presidential Address which focused on three areas, “Policy, Politics and Performance.” Dr. Menkis’ talk was punctuated with multiple quotes from thought leaders, and included an unspoken challenge to the audience of cardiothoracic surgeons to converge, in the sense of working together to improve policy, performance, and most of all, patient care. Dr. Menkis used an example of how an analysis of post-operative patient care done by a Formula One pit crew helped put a new perspective on the activities of a hospital team. When concepts such as placement of personnel, specific duties, assigned tasks and single focus were International Society for Minimally Invasive Cardiothoracic Surgery 500 Cummings Center, Suite 4550 Beverly, Massachusetts USA www.ismics.org “Anyone who has never made a mistake has never tried anything new.” – Albert Einstein ISMICS President, Alan Menkis, presented his Presidential Address. Technical Challenges: Pitfalls & Disasters The Technical Challenges Session, chaired by Valavanur Subramanian, MD, continues to be one of the most popular sessions held during the ISMICS Annual Meeting. More than 100 participants attended this year’s session where eleven challenging and unusual cases were presented. Topics included such challenges as a successful rescue of hemodynamic collapse during TAVI and what to do after rupture of the right coronary artery following aortic root replacement.
Transcript
Cutting Edge Presentations During Masters Day
2013 ANNUAL MEETING 12-15 June HILTON PRAGUE, CZECH REPUBLIC
INSIDE FRIDAY’S ISSUE
Technical Challenges:Pitfalls and Disasters
2013 ConsensusConference:OPCAB/Off Pump Surgery
2013 Exhibitors & Product Descriptions
2013 Industry Sponsors
Industry Sponsored Symposia
Poster Competition FINALISTS
ISMICS Masters Day
Keynote Speaker:Joseph Bavaria, MD
Kit V. Arom Lecture:William (Billy) Cohn, MD
Thoracic Track
Thoracic Movie Day
Cardiac Track
Perfusion Session
Live On Tape Session
Preview of ECHI /ISMICS CardiacSurgery Summit
INSIDE FRIDAY’S ISSUE
(continued on page 3)
(continued on page 7)
Niv Ad, MD presented the State of the Art Lecture on “SurgicalAblation Atrial Fibrillation” during the Masters Day Program morningsession on Wednesday.
ISMICS President Focuses onPolicy, Politics and Performance
The ISMICS Annual Meeting kicked off with the traditionalMasters Day program, but with a new twist this year. In addition tothe focused scientific sessions on cutting-edge topics in minimallyinvasive surgery, a new interactive format was featured, includingState-of-the-Art Lectures and “Great Debates.” Sessions weredesigned to allow maximum dialogue between the audience andpresenters and questions were encouraged through the day-longprogram. Topics included Robotic Revascularization, AtrialFibrillation, CABG, Mitral Valves, TAVI, and Coronary Surgeries.International leaders in the field debated such issues as AtrialFibrillation Monitoring, OPCAB vs. ONCAB, Transcatheter MitralValve Repair, and Expanding TAVI Indications to Medium RiskPatients.
On Thursday 13 June ISMICSPresident Alan Menkis, MD presented histhought-provoking Presidential Addresswhich focused on three areas, “Policy,Politics and Performance.” Dr. Menkis’talk was punctuated with multiple quotesfrom thought leaders, and included anunspoken challenge to the audience ofcardiothoracic surgeons to converge, inthe sense of working together to improve
policy, performance, and most of all,patient care.
Dr. Menkis used an example of howan analysis of post-operative patient caredone by a Formula One pit crew helpedput a new perspective on the activities ofa hospital team. When concepts such asplacement of personnel, specific duties,assigned tasks and single focus were
International Society for MinimallyInvasive Cardiothoracic Surgery
500 Cummings Center, Suite 4550Beverly, Massachusetts USA
www.ismics.org
“Anyone who has never made a mistake hasnever tried anything new.”
– Albert Einstein
ISMICS President, Alan Menkis, presented hisPresidential Address.
Technical Challenges:Pitfalls & Disasters
The Technical Challenges Session, chaired by Valavanur Subramanian, MD, continues to be one ofthe most popular sessions held during the ISMICS Annual Meeting. More than 100 participants attendedthis year’s session where eleven challenging and unusual cases were presented. Topics included suchchallenges as a successful rescue of hemodynamic collapse during TAVI and what to do after rupture ofthe right coronary artery following aortic root replacement.
Conform to the new standard for Left Atrial Appendage (LAA) Occlusion.
Angled jaw aligned with Fastener elbow aids in optimal placement
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® MAQUET is a registered trademark of MAQUET GmbH & Co. KG • Copyright MAQUET Cardiovascular LLC or its affiliates. All rights reserved.
CAUTION: Federal (U.S.A.) law restricts this device to sale, distribution and use by or on the order of a physician. 05/13
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1 Slater AD, Tatooles AJ, Coffey A, et al. Prospective clinical study of a novel left atrial appendage occlusion device. Ann Thorac Surg. 2012
Jun;93(6):2035-8; discussion 2038-40.
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The TIGERPAW® System II with its unique Fastener technology is designed with soft silicon housing
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ISMICS INSIDER12-15 JUNE
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Presidential Address (continued from page one)
MAQUET EDITORIAL: Can Routine Left Atrial Closure During Open Heart Surgery Reduce Peri-operative Stroke? Sacha P. Salzberg, MD, PD and Maximilian Y. Emmert, MD, PhD
Concern about peri-operative stroke limits the acceptance of coronary artery bypass grafting (CABG) despite its well documented long-term superiority. Technical advancesincluding avoidance of aortic manipulation are interesting adjunct therapies to reduce stroke; yet, approximately half of CABG related strokes occur in the post-operative periodfollowing surgery, and are most often related to new- onset atrial fibrillation (AF).1,2-4
New-onset AF is a common complication, occurring in close to 20% patients following CABG.2 Recent studies have documented increased incidence of stroke with new-onsetAF after CABG surgery. In a recent study of 16169 consecutive isolated CABG patients with no prior history of AF, postoperative stroke risk was significantly greater for patients whodeveloped new-onset AF vs. those who did not (3.2% vs. 1.3%, p<0.001). Further, new postoperative AF was associated with a 21% relative increase in mortality over a meanfollow up of 6 years, even after controlling for 32 covariates.
As with other forms of AF, the primary mechanism of stroke secondary to postoperative AF is believed to be cerebroembolism of thrombus from the left atrial appendage (LAA).In a recent report (2067 patients, 81% CABG), postoperative AF was associated with a nearly three-fold increase in stroke (OR=2.79). Among patients who developed postoperativeAF, those who had undergone concomitant LAA ligation had significantly lower risk of stroke than those who had not (0.0% vs. 6.1%, p=0.003).
Shortcomings of past surgical approaches to LAA exclusion using sutures or staples include risk of injury and incomplete closure. Recently a new epicardial clip was shown toprovide easy, reliable, safe and durable exclusion during cardiac surgery procedures, without leaks or significant residual LAA cavity. 5,6
Despite earlier conceptions as benign, postoperative AF carries significant risk for late cerebral injury following non-eventful cardiac surgery. LAA closure may be an importantadjunct to all cardiac procedures to reduce the risk of postoperative AF-related cerebrovascular accident. The current generation of epicardial clip-based LAA closure devices maymake routine concomitant management of LAA easier and safer than past approaches. The role of these new devices in attenuating risk of postoperative stroke resulting from new-onset AF merits further investigation.
References1. Tarakji KG et al. JAMA. 2011 Jan 26;305(4):381-90.2. Almassi GH et al. Ann Surg. 1997 Oct;226(4):501-113. El-Chami MF et al. J Am Coll Cardiol. 2010 Mar 30;55(13):1370-6.4. Kim R et al. J Thorac Cardiovasc Surg. 2013 Feb;145(2):582-9;5. Emmert MY et al. Eur J Cardiothorac Surg. 2013 May 8. [Epub ahead of print]6. Slater AD et al. Ann Thorac Surg. 2012 Jun;93(6):2035-8
implemented, post-op team performancewas significantly improved. Such laserfocus on communication and conver-gence was demonstrated in a video clipof a 2.3 second 4-tire change by aFormula One pit crew in France.
The Presidential Address also lookedat how ever increasing technology alsorequires greater cooperation and collabo-ration, particularly in the OR and ICUsettings. Dr. Menkis presented slidesshowing the development of the B17bomber in the 1930s, and how the newerplanes’ bells and whistles proved toomuch for a single pilot to handle, resultingin the development of aviation checklistsand crew collaboration. A question is
whether the same could be said for the modern day OR. Should the traditional hierar-chical setting be replaced by a more open and collaborative environment where allinvolved personnel have the right to point out concerns or potentially harmful ordangerous situations.
The discussion was an interesting one for the ISMICS audience, which is the largestembracer of new technology, and again, left open the question of whether ISMICSshould help lead the charge in terms of challenging the traditional systems in order toimprove performance.
The Presidential Address was introduced by Program Co-Chair Bob Kiaii, who gavea personal and warm presentation on Dr. Menkis and his path from Northern Territorydentist, to a pioneer in transplantation, to a world renowned heart surgeon. It alsomade clear Dr. Menkis dedication to not only his patients and practice, but his family.
“We are what we repeatedly do; excellencethen, is not an act but a habit.”
– Aristotle 384-322 BC
Program Co-Chair Bob Kiaii introduced Dr.Menkis and traced his path to becoming aworld renowned heart surgeon.
TODAY’S SPEAKERHIGHLIGHTS
10.40 – 11.25Medical Device Innovation 101:
One Surgeon’s Perspective on
Developing Disruptive Technology
William (Billy) Cohn, MDTexas Heart Institute, Houston
KIT V. AROM LECTURESHIP
15.40 – 16.30Integrating Innovation by
Changing Culture
Joseph E. Bavaria, MDUniversity of Pennsylvania
Philadelphia
KEYNOTE SPEAKER
ISMICS INSIDER 2O13 ANNUAL MEETING
Hilton Prague, Czech Republic4
INDUSTRY SPONSORED SYMPOSIA
These topic-driven sessions provide attendees with current,detailed information on new techniques and technologies. Thefollowing companies are supporting industry symposia, whichare not part of the official ISMICS scientific program.
Friday, 14 June 2013
06.30 - 07.50 (6:30am - 7:50am) Palmovka & Rokoska & HerkovkaInitiating MICS Strategies in Your Daily Practice
Hosted by Medtronic
12.20 - 13.50 (12:20pm - 1:50pm) Roma & Vienna & MadridTreatment Of Aortic Stenosis: Tailoring The
Best Combination Of Options For Your PatientsHosted by Edwards Lifesciences
A Multi-Pronged Approach Is Required ToReduce CABG Stroke Rates
Hosted by MAQUET
12.20 - 13.50 (12:20pm - 1:50pm) Palmovka & Rokoska & HerkovkaLifetime Management of Valve Disease in the Era of TAVR
Hosted by Medtronic
Report from the 2013 Consensus Conference: OPCAB/Off Pump SurgeryThe 2013 Consensus Statement on
OPCAB/Off-Pump Surgery will bepresented today, Friday 14 June, from10.00 - 10.40 in Congress Hall 2-3. TheInternational Society for MinimallyInvasive Cardiothoracic Surgery(ISMICS) is proud to have its tenthExpert Panel Consensus Statementbeing delivered for 2013 here in Prague.
This year’s panel, chaired by Dr. JohnPuskas of Emory University, is focusingon “OPCAB/Off-Pump Surgery.” Dr. DavyCheng of London Health Sciences Centrein Ontario, Canada is serving as primaryresearcher and biostatician. The Consen-sus Conference was held last month atThe Shelbourne Dublin Hotel in Dublin,
Ireland on 25-27 May 2013. Other panelists were as follows:Stefano Benussi, MD Johannes Bonatti, MDAnno Diegeler, MD Francis Ferdinand, MDTeresa Kieser, MD Michael Mack, MDAlan Menkis, MD Nirav Patel, MDMark Ruel, MD Joseph Sabik, MDVipin Zamvar, MD Janet Martin, PhD (Principle Investigator)
On Wednesday evening 12 June, Dr. Cheng presented the results of the ConsensusConference to the ISMICS Board of Directors. There was extensive discussion aboutthe results that evening and Dr. Puskas, in tandem with Dr. Cheng, will be presentingthe statement details to the Annual Meeting attendees today. The statement will then be
published in Innovations, the official publication of ISMICS, following the 2013 meeting.ISMICS has assembled this international panel of experts to share their knowledge
and expertise and to review the current literature as related to Off Pump Coronary ArteryBypass Surgery. The main objective of the conference was to determine whether off-pump coronary artery bypass surgery (OPCAB) is superior to conventional on-pumpcoronary artery bypass surgery (CCAB) with respect to clinical outcomes and resource-related outcomes, and to determine whether effects differ across pre-specified riskgroups and settings. The primary outcomes of interest are death, stroke, AMI, RBC txand need for reintervention, both in the short term and long-term follow-up. Secondaryoutcomes involve all other clinically relevant outcomes listed above, and resource-related outcomes.Systematic review of randomized trials were conducted according torecent guidelines set out by Cochrane Collaboration, and will be reported according tothe PRISMA guidelines. Comprehensive searches of the literature were done inMedline, Embase, and Cochrane library.
As with previous Consensus Statement results delivered during the ISMICS AnnualMeeting, a question and answer period will follow Dr. Puskas’ presentation.
Dr. Davy Cheng presented the currentliterature to the Consensus Panel inDublin.
Consensus panel members reviewed the current literature to determine whetherOPCAB is superior to conventional on-pump coronary artery bypass surgery.
Attendees of the International Residents and Fellows Program test their skills inSIM City – supported by Medtronic.
ISMICS Attendees Visit SIM City
How To Claim CME Credits andLetter Of Attendance
CME certificates will be sent via the post meeting evaluation after the meeting.For attendees who require a letter of attendance or CME certificate, you will beable to make application electronically the week following the meeting. ISMICSrequires an email address to forward you the link to apply. If you registered via faxor post, and are not an ISMICS member, the Society may not have your emailaddress. Email update forms are available at the ISMICS Registration Desk.
When we set out to design the new COBRA Fusion, our goal was to create a new standard of
performance for the treatment of Atrial Fibrillation. The result is a uniquely adaptable and
effective platform that you have to experience to believe.
The first and only device with proprietary VersapolarTM technology, COBRA Fusion can deliver
both Bipolar and Monopolar energy. Powered by patented TCRF (Temperature Controlled
Radiofrequency), Fusion incorporates a unique suction design that eliminates the heat sink
effect, enabling surgeons to create reproducible transmural lesions and return patients to
normal sinus rhythm.
Designed to deliver better outcomes – that’s the power of Fusion.
Visit us at Booth #7
Estech COBRA Fusion® Ablation System
DESIGNED TO
PERFORMBUILT TO
AMAZE
The Estech COBRA Fusion is intended to ablate cardiac tissue during cardiac surgery using radiofrequency (RF) energy when connected directly to the Estech Electrosurgical Unit (ESU). The Estech COBRA Fusion may be used for temporary cardiac pacing, sensing, recording, and stimulation during the evaluation of cardiac arrhythmias during surgery when connected to a temporary external cardiac pacemaker or recording device. Estech does not promote off-label use of its products and their use is at the discretion of the cardiac surgeon. Estech is undertaking an IDE clinical trial and subsequent PMA submission to obtain a specific atrial fibrillation indication. In Europe, the Estech COBRA RF ablation products are CE marked with an indication for the treatment of atrial fibrillation by ablating cardiac tissue during surgery. Refer to the Instructions for Use (IFU) for detailed information on device description, instructions, contraindications, warnings and precautions.
Visit us at Booth 21, and at Sim City where you can test your skills through hands-on simulation.
Cardiopulmonary Bypass Simulation: Perform hands-on aortic cannulation with the � rst fully-interactive cardiac perfusion simulator.
Beating Heart, Minimally Invasive Simulator: See the access you can achieve through a small thoracotomy, and test your MICS CABG sewing skills on a beating heart.
Change is nothing new to cardiac surgery.
And with change comes opportunity.
As the global leader in medical technology
for over 60 years, Medtronic o� ers solutions
that create a world of possibility…simple,
clear options that help you decide what’s best.
Visit us at Booth 21, and at Sim City where you
As the global leader in medical technology
for over 60 years, Medtronic o� ers solutions
that create a world of possibility…simple,
clear options that help you decide what’s best.
Visit us at Booth 21, and at Sim City where you can test your skills through hands-on simulation.
Cardiopulmonary Bypass Simulation:with the � rst fully-interactive cardiac perfusion simulator.
Beating Heart, Minimally Invasive Simulator:achieve through a small thoracotomy, and test your MICS CABG sewing skills on a beating heart.
Visit us at Booth 21, and at Sim City where you Visit us at Booth 21, and at Sim City where you
As the global leader in medical technology
for over 60 years, Medtronic o� ers solutions
that create a world of possibility…simple,
clear options that help you decide what’s best.
Visit us at Booth 21, and at Sim City where you Visit us at Booth 21, and at Sim City where you can test your skills through hands-on simulation.
Cardiopulmonary Bypass Simulation:with the � rst fully-interactive cardiac perfusion simulator.
Beating Heart, Minimally Invasive Simulator:achieve through a small thoracotomy, and test your MICS CABG sewing skills on a beating heart.
Visit us at Booth 21, and at Sim City where you can test your skills through hands-on simulation.
Cardiopulmonary Bypass Simulation:with the � rst fully-interactive cardiac perfusion simulator.
Beating Heart, Minimally Invasive Simulator:achieve through a small thoracotomy, and test your MICS CABG sewing skills on a beating heart.
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201400493_EE.indd 1 5/22/13 1:26 PM
ISMICS INSIDER12-15 JUNE
7www.ismics.org
Master’s Day Classes (continued from page one)
PHOTO OF MASTER CLASSThe faculty from the Robotic Revascularization session, moderatored by Husam Balkhy, MD
The session on Off Pump Surgery, moderated by JohnPuskas, MD, covered CABG, OPCAB techniques, eMesh,and Anastomic Connectors.
The Rountable Discussion during the Atrial Fibrillation session (l. to r.) Ralph Damiano, MD,Evelio Rodriguez, MD, Piotr Suwalski, MD, Niko Doll, MD and Laurent Pison, MD
Giulia Veronesi, MD presented“Robotic versus Open ThoracicSurgery - Feasibility Versus Validity.”
L. Wiley Nifong, MD gave a brief presentationon Cor-Knot during the Minimally InvasiveValve Surgery Masters Course, chaired by W.Randolph Chitwood, MD
Gino Gerosa, MD, moderated the MastersCourse on Transcatheter Valves which focusedon devices, alternatives, quality of life andcost-effectiveness.
West Chester, Ohio 45069 USAAtriCure, the leader in cardiac surgical ablationof Afib featuring bipolar RF clamps, pens andcryothermic energy devices. Providing CV Sur-geons with the only FDA endorsed surgical Afibcertification course. AtriCure’s portfolio includesthe AtriClip®, which is the only atraumatic de-vice FDA cleared specifically designed for LAAexclusion.
www.atricure.com
B. BRAUN AESCULAP 32Am Aesculap-Platz,
78532 Tüttlingen, GermanySurgery and Aesculap - a close relationship forover 140 years. With useful products and pro-cess-oriented advice we are pursuing a goal: toimprove therapies and make processes moreefficient. Whether with surgical instruments, su-ture materials, implants, or sterile containers, westrive for innovations which result in medicaladvances. Aesculap – a B. Braun company.
www.bbraun.com,www.aesculap.de
BARD DAVOL 15Forest House, Tailgate Forest, Business Park,
Brighton Rd., Crawley, West Sussex,RH119BP, UK
ProGel®PLATINUM: pleural air leak sealant is anew recombinant hydrogel specifically designedfor cardio-thoracic surgeons. ProGel, the onlyFDA approved product for pleural air leaks is asingle use device for application on the visceralpleura following standard visceral pleural closuretechniques. Formed as a result of mixing 2 com-ponents: Upon mixing, a clear flexible hydrogelis formed, and can be sprayed on the lungparenchym.
www.davol.com
BIOVENTRIX 4812647 Alocosta Boulevard
San Ramon, CA 94583, USABioVentrix is a privately held medical device com-pany that is based in San Ramon, USA. Wedesign and manufacture minimally-invasive de-vices for the treatment of congestive heart fail-ure. The Revivent™ Myocardial Anchoring Sys-tem, our first generation device, helps restorethe shape and size of the left ventricle in post-MIpatients with LV antero-septal scar. The LeftVentricular Restoration (LVR) is achieved througha novel procedure known as Less Invasive Ven-tricular Enhancement (LIVE™).
CORMATRIXCARDIOVASCULAR, INC. 5
286 South Main Street, Suite 200,Alpharetta, GA, 30009, USA
CorMatrix® Cardiovascular markets its ECM®Technology biomaterial devices for pericardialclosure, cardiac tissue repair, and carotid repairand is currently conducting preclinical studies toevaluate future applications in heart failure aswell as other cardiovascular applications.
www.cormatrix.com
ISMICS INSIDER12-15 JUNE
9www.ismics.org
ISMICS is pleased to be able to
provide an opportunity for
surgeons to view and test drive
the newest products, devices,
and technologies available.
DENDRITE CLINICALSYSTEMS, LTD. 46
The Hub, Station Road, Henley-on-Thames,Oxfordshire RG9 1AY UK
Dendrite is a specialist supplier of cardiac sur-gery database software, with installations in spe-cialist cardiac centres in over 40 countries andfor 10 national and international cardiac surgeryregistries including Euromacs and for the Ac-quired Cardiac Surgery Registry for EACTS.Visit our exhibition booth for a demonstration ofour software, now available for the iPad and inmulti-lingual formats.
www.e-dendrite.com
EACTS 47Eacts House, Madeiza Walk,8LU 1EU Windsor, Berks, UK
The EACTS is the largest European Associationdevoted to the practice of Cardio-thoracic sur-gery. The main objects of the Association are toadvance education in the field of cardio-thoracicsurgery and to promote, for the public benefit,research into cardiovascular and thoracic physi-ology and therapy and to correlate and dissemi-nate the useful results thereof. Visit the boothfor information on membership, future meetings,EACTS Academy and all other activities ofEACTS. www.eacts.org
EDWARDS LIFESCIENCES 23Rue de l’Etraz 70, 1260 Nyon, Switzerland
Edwards Lifesciences is the global leader in thescience of heart valves and hemodynamic moni-toring. Driven by a passion to help patients, thecompany partners with clinicians to develop in-novative technologies in the areas of structuralheart disease and critical care monitoring thatenable them to save and enhance lives.
www.edwards.com/eu
ESTECH 72603 Camino Ramon, Suite 100
San Ramon, CA 94503, USAEstech develops and markets a broad portfolioof innovative medical devices and disposablesthat enable cardiac surgeons worldwide to per-form a variety of traditional and minimally inva-sive surgical procedures.
www.estech.com
FEHLING INSTRUMENTS GMBH& CO. KG 4
Hanauer Landstr. 7A,63791 Karlstein, Germany
FEHLING INSTRUMENTS is a traditional familyowned and family run company with more thanthirty years of experience in the medical busi-ness. FEHLING INSTRUMENTS develops,manufactures, and distributes surgical instru-ments, implants and single use products for usemainly in the OR and provides all correspondingrepair service. FEHLING INSTRUMENTS is con-stantly striving for excellence in function andeconomy of products. This objective is achievedby continuous innovation in materials, mechan-ics and design.
www.fehling-instruments.de
GEISTER MEDIZINTECHNIK 40Fohrenstrasse 2, D-78532
Tüttlingen, GermanyIn close collaboration with partners from clinicalresearch and the medical industry, our aim is tomake a contribution with technical innovationsfor minimally invasive surgical procedures incardiovascular surgery. Our experienced instru-ment masters in Tuttlingen are dedicated tomanufacturing one of the best and highest qual-ity surgical instruments available worldwide.For more information: www.geister.com Thebetter way to operate™
www.geister.com
GENESEE BIOMEDICAL, INC. 31308 S. Jason Street
Denver, CO 80223, USADesign Beyond Standard. Genesee BioMedical,Inc. provides unique devices for cardiothoracicsurgery including sternal/thoracic valve retrac-tors, instruments for MICS, coronary graft mark-ers, suture guards, retraction clips and myocar-dial needles. All products are CE [email protected].
www.geneseebiomedical.com
INTUITIVE SURGICAL, INC. 11266 Kifer Rd, Bldg 101,
Sunnyvale, CA 94086, USAIntuitive Surgical is the global leader in minimallyinvasive, robotic-assisted surgery. Its da Vinci®System – with a 3D-HD vision system andEndoWrist® instrumentation – enables surgeonsto offer a minimally invasive approach to manypatients. With da Vinci, cardiothoracic surgerypatients avoid the large incision and rib-spread-ing associated with open surgery.
JenaValveTM Technology is an innovativ medicaldevice company focused on developingtranscatheter valve implantation systems to treatpatients suffering from aortic valve disease. Thecompany develops both transapical andtransfemoral TAVI systems to address the needsof the cardiac surgeon and cardiologist, respec-tively. The company’s products are currently tar-geted at high-risk patients unsuitable for openheart surgery. JenaValve Technology’s head-quarters are in Munich, Germany. Additional com-pany information is available atwww.jenavalve.com
www.jenavalve.de
KARL STORZ GMBH & Co. KG 6
Mittelstr. 8, 78532 Tüttlingen, GermanyKARL STORZ is a renowned manufacturer thatis well established in all fields of endoscopy. Thestill family held company has grown to one witha worldwide presence and 5800 employees.KARL STORZ offers a range of both rigid andflexible endoscopes for a broad variety of appli-cations.
www.karlstorz.com
KLS MARTIN GROUP 26Ludwigstaler Straße 132 ,
78532 Tuttlingen, GermanySurgical innovation is the KLS Martin Groupsdriving force since 90 years. Our innovations inall kind of surgical fields simplify the daily rou-tine of surgeons all over the world. The latestinstrument series marCore® is a prime examplemelting the surgeons hand with his tools for mini-mal invasive surgery.
www.klsmartin.com
LSI SOLUTIONS 117796 Victor-Mendon Road,
Victor, NY, 14564, USACOR-KNOT® delivers instant security with au-tomated knotting and integrated suture trimmingin one easy step. COR-KNOT® may reducecardiopulmonary bypass and cross-clamp timein your OR. Visit LSI SOLUTIONS® at booth11 and see the newest edition to the COR-KNOT® family, the CK® Standard.
www.lsisolutions.com
MAQUET MEDICAL SYSTEMS,USA 17
45 Barbour Pond Road Wayne, NJ 07470, USA
MIRA-i CS Retractor - A modular system fea-turing a unique, Pivoting Mechanism to maxi-mize access and visibility through the smallestof incisions.HEARTSTRING III PROXIMAL SEAL SYSTEMAllows you to achieve clampless hemostasisduring CABG proximal anastomoses while su-turing with your own hand.ACROBAT-i - Is an innovative mechanical tis-sue stabilization device.VASOVIEW HEMOPRO 2 - This EVH devicevirtually eliminates thermal spread and helpsharvesters safely acquire high-quality conduitsfor coronary artery bypass graft surgery.TIGERPAW® SYSTEM II - Achieve 100% leftatrial appendage occlusion. This device featuresan exceptionally soft silicone Fastener that con-forms to the patient’s appendage anatomy andtissue thickness.
www.maquet.com
MEDISTIM 27PB 6471 Etterstad NO-0605 Oslo, Norway
Medistim is the innovator and market leaderwithin intra-operative transit time flow measure-ment (TTFM) and ultrasound imaging. We de-velop, manufacture and bring to market the qual-ity assessment systems VeriQ and VeriQ C forcardiac, vascular and transplant surgery. OurTTFM technology became part of the ESC/EACTS guidelines on myocardialrevascularization in 2010, and in 2011 our VeriQTTFM system was recommended by the Na-tional Institute for Health and Clinical Excellence(NICE) for routine use within the UK nationalhealth system (NHS) based on clinical as wellas economic benefits.
www.medistim.com
MEDTRONIC, INC. 21710 Medtronic Parkway NE,
Minneapolis, Minnesota 55432 USAFind opportunity in change and considerMedtronic’s intuitive solutions in structural heartdisease, including tissue, mechanical andtranscatheter valves; irrigated RF and cryo sur-gical ablation devices; OPCAB, MICS CABG,cannulae, and perfusion products.
www.medtronic.com
SCANLAN INTERNATIONAL, INC. 29
One Scanlan Plaza,St. Paul, MN 55107, USAHighest quality surgical products designed andmanufactured by the Scanlan family since 1921.Over 3,000 titanium and stainless steel precisioninstruments including: VATS / MIS thoracoscopicinstruments, SCANLAN® Caliper and MEMORYinstruments, SCANLAN® LEGACY titaniumneedle holders and forceps. Single-use productsinclude SCANLAN® Aorta/Vein Punch, VASCU-STATT® bulldog clamps and graft markers.
www.scanlaninternational.com
SMARTCANULA LLC 4921 Ave. Du Tribunal Federal, CH-1105
Lausanne, SwitzerlandSmartcanula LLC is the leading manufacturer foradvanced interfaces between the circulatory sys-tem and cardio-pulmonary bypass, the key tech-nology for cardiac surgery. The innovative smartcannulation principle, which is based on collapsedcannula insertion and expansion within the tar-get vessels, allows for un-matched venous drain-age. A new special MICS smartcanula(R) will bepresented. www.smartcanula.com
SORIN GROUP 914401 W. 65th Way,Arvada, CO 80004, USA
SORIN Group (www.sorin.com ) is a global, medi-cal device company and a leader in the treatmentof cardiovascular diseases. The Company devel-ops, manufactures, and markets medical tech-nologies for cardiac surgery and for the treat-ment of cardiac rhythm disorders. Sorin Groupoffers a complete range of products and acces-sories for minimally invasive incisions cardiacsurgery: visit us at booth # 9 to see and touch thelatest product portfolio for cannulae, surgical in-struments, Perceval S suturless heart valve andMemo 3D annuloplasty ring.Contacts: [email protected]
www.sorin.com
ST. JUDE MEDICAL 45SJM Coordination Center BVBA, Da Vinci laan
11 - Box F1,B-1935 Zaventem, BelgiumSt. Jude Medical develops medical technologydesigned to put more control into the hands ofthose who treat cardiac, neurological and chronicpain patients worldwide. The company is dedi-cated to advancing the practice of medicine byreducing risk wherever possible and contribut-ing to successful patient outcomes. Learn moreat www.sjmprofessional.com
WEXLER SURGICAL 3411333 Chimney Rock Road, Suite #110,
Houston, Texas 77035, USAWexler Surgical designs and manufactures tita-nium and stainless steel specialty surgical instru-ments and products for Cardiovascular, Thoracic,and Micro Surgery. Visit us at
www.wexlersurgical.com
ISMICS INSIDER 2O13 ANNUAL MEETING
Hilton Prague, Czech Republic10
PRELIMINARY TOPICS
Robotic Mitral Valve RepairValvular Imaging in 2013
CT vs. TEE for Annular Sizing in TAVR3D TEE; Preoperative Planning
Current Status of TAVRDebate: Trans Apical or Trans Femoral
Robotic CryoMazePlanning the Perfect Mitral Repair
Simplifying Mitral RepairCurrent Status of CoreValve Use
Mitral Repair TechniquesManagement of Endovascular Complications
Fenestrated Grafts: Are We ReadyImplantation of Intuity Valve
When and How to Repair the TVSurgical Bailout of TAVR Gone Wrong
Understanding Atrial FibrillationThe Best MAZE Lesion Set
Minimally Invasive Techniques for AV DiseaseA Paradigm Shift in Training
Emerging Percutaneous Mitral TherapyHybrid Revascularization: Are we there yet?
Review of Robotic Assisted MIDCAB and TECAB
NEW THIS YEAR!NEW THIS YEAR!NEW THIS YEAR!NEW THIS YEAR!NEW THIS YEAR!
Live On TapeFriday, 08.00-09.30
Moderators:Bob Kiaii, MD and Niv Ad, MD
Transapical - DiscussionEhud Raanani, MD
”Valve-in-Valvein the Mitral Position”
Mini Mitral - DiscussionHugo Vanermun, MD
Ablation - DiscussionNiv Ad, MD
”Minimally InvasiveCryomaze Procedure”
ISMICS INSIDER12-15 JUNE
11www.ismics.org
POSTER COMPETITION FINALISTS
Thoracic and CardiacTracks
Friday’s Thoracic Track Programming will include Lung from 8.00 - 9.20;Miscellaneous from 11.25-12.20; Esophageal from 13.50 to 15.05. Saturday’sThoracic Track will be Thoracic Movie Day (see below for topics) from 9.30 -10.30 and 10.45 - 11.45. Thoracic Track is in the Grand Ballroom.
Friday’s Cardiac Track Programming will include Revascularization from11.25-12.20; Pediatric Imaging from 13.50 to 14.50. Saturday’s Cardiac Trackwill cover Minimallly Invasive Valve I from 9.30 - 10.45 and Minimally Inva-sive Valve II from 11.15 - 12.15. Cardiac Track is in Congress Hall 2-3.
Congratulations to all of the participants in the first round of the ISMICS Poster Competition held on Thursday evening. The following papers were the highest scorers and will move on to the Final Roundtoday at 16.30 during the main scientific session.
Topic 1: Revascularization RoboticClinical Outcomes of Total Endoscopic Coronary ArteryBypass (TECAB), A Single Center ExperienceFrancis P. Sutter1, MaryAnn A. Wertan1, Khawar Maqsood1, Wajeeha Saeed2,Trisha Senss1, Janet L. Reynolds1, Anny Luong1, Rizwan Sardar1.1Lankenau Medical Center, Wynnewood, PA, USA, 2Montefiore Medical Cen-ter, New York, NY, USA.
Topic 2: Revascularization ConduitsPerioperative Outcomes of Minimally Invasive CoronaryArtery Bypass Compared to Sternotomy Coronary ArteryBypass GraftingLimael E. Rodriguez, Dewei Ren, Basel Ramlawi, Mahesh Ramchandani.Methodist DeBakey Heart and Vascular Center, Houston, TX, USA.
Topic 3: Heart FailureRobotically-Assisted,CompletelyEndoscopicTransmyocardial Revascularization using an Optical Fiber-Based Laser Delivery System is Safe and EfficaciousLouis A. Brunsting, III1, Averel B. Snyder2, Eric A. Espinal5, Sudhir P. Srivastava4
/ 1University of Alabama at Birmingham, Birmingham, AL, USA, 2St. Joseph’sHospital, Atlanta, GA, USA, 3Akron City Hospital, Akron, OH, USA, 4The Inter-national Centre for Robotic Surgery, New Delhi, India, 5Summa Health Sys-tem, Akron, Ohio, USA.
Topic 4: Imaging and Facilitating Technology for Cardiac SurgeryMitral Valve Overlay Facilitates Beating Heart TransatrialAnnuloplasty in an Acute Animal TrialPhilipp Kiefer, Thilo Noack, Marcel Vollroth, Joerg Ender, Friedrich W. Mohr,Joerg Seeburger. Heart Center Leipzig, Leipzig, Germany
Topic 5: Valve AorticMinimally Invasive Aortic Valve Replacement withSutureless Calves by J-Sternotomy or Right ThoracotomyApproachGiuseppe Santarpino, Steffen Pfeiffer, Giovanni Concistré, Ferdinand Vogt,Martin Hinzmann, Theodor Fischlein. Klinikum Nürnberg, Nuremberg, Ger-many
Topic 6: Valve New DesignsComplete Tricuspid Valve Regeneration: A Novel MinimallyInvasive Surgical Technique and New Surgical Paradigm
Walter D. Boyd, MD1, James L. Cox, MD2, Anna M. Fallon, PHd3, J N. Young,MD1, Robert G. Matheny, MD3. / 1University of California Davis, Sacramento,CA, USA, 2Washington University, Saint Louis, MO, USA, 3Cormatrix Cardio-vascular, Alpharetta, GA, USA
Topic 7: Valve Mitral MiniFirst Experiences with Adjustable Annuloplasty inDegenerative MR patientsMarkus Czesla. Sana Herzchirurgie Stuttgart, Stuttgart, Germany.
Topic 8: ThoracicFeasibility of Video-assisted Thoracoscopic AnatomicPulmonary Resection in Patients with Central Lung CancerHyeong Ryul Kim1, Yong Jik Lee2, Geun Dong Lee1, Yong-Hee Kim1, DongKwan Kim1, Seung-il Park1. 1Seoul Asan Medical Center, University of UlsanMedical College, Seoul, Korea, Republic of,2University of Ulsan Medical col-lege, Ulsan, Korea, Republic of.
Topic 9: Aortic and Endovascular TherapiesEmployment of Extracellular Matrix Scaffold as a TubularGraft for Ascending Aorta Aneurysm Repair
Mahesh Ramchandani, Tadashi Motomura, Dewei Ren, Limael E. Rodriguez,Luis J. Garcia-Morales, Bagrat Grigoryan, Brandi Scully, Jane Grande-Allen.Methodist DeBakey Heart and Vascular Center, Houston, TX, USA
Topic 10: ArrythmiaFirst Report of Minimally Invasive Total EndoscopicRobotic Surgery for the Treatment of Inappropriate SinusTachycardiaEric M. Hoenicke, MD1, Jeff Nitzsche, MD2, Kevin Daly, BS3, Andrea Natale,MD4, John David Burkhardt, MD4. 1Cardiothoracic and Vascular Surgeons; St.David’s South Austin Medical Center, Austin, TX, USA, 2Austin Anesthesiol-ogy Group, Austin, TX, USA, 3Atricure, Westchester, OH, USA, 4Texas Car-diac Arrhythmia Institute, Austin, TX, USA
Topic 11: PerfusionImplementing Benchmarking in Perfusion Practice:Results of a Multicentre Quality Improvement InitiativeRobert A Baker, PhD, CCP (Aust), Richard F Newland, BSc, CCP (Aust),Carmel Fenton, Dip Perf,CCP (Aust) Timothy W Wilcox, Dip Perf, CCP (Aust)and Alan F Merry, FANZCA.For the Perfusion Downunder Collaboration
ISMICS INSIDER 2O13 ANNUAL MEETING
Hilton Prague, Czech Republic14
2012-2013 Board of Directors
PresidentAlan H. Menkis, MD
Past PresidentJohn L. Knight, MD, FRACS
President-ElectFrancis D. Ferdinand, MD
Vice PresidentVolkmar Falk, MD
SecretaryPaul F. Grundeman, MD, PhD
TreasurerGregory P. Fontana, MD
DirectorsNiv Ad, MDKeith B. Allen, MDTohru Asai, MD, PhDJohannes Bonatti, MDAnson Cheung, MDBob B. Kiaii, MDYoung Tae Kim, MD, PhDFrancesco Maisano, MDDaniel L. Miller, MDSimon C. Moten, MDFranca M.A. Melfi, MDPia S.U. Myken, MD, PhDPiotr Suwalski, MD, PhD
Editor, INNOVATIONSRalph J. Damiano, Jr., MD
Managing Editor, INNOVATIONSCarol Blasberg
ISMICS InsiderThe official newspaper of the ISMICS
2013 Annual MeetingExecutive Director
Aurelie J. Alger, JDAdministrative Director
Elizabeth ChouinardIndustry Relations
Stan AlgerYvonne Grunebaum
Meeting ManagerE.J. Weldon
Associate Meeting ManagerJillian West
Meeting CoordinatorAmanda Carignan
Managing Editor, ISMICS InsiderLorraine M. O’Grady
Produced and distributed by ISMICS. All rightsreserved. No part of this publication may bereproduced or transmitted in any form, by anymeans, without written permission from ISMICS.The opinions expressed in this publication arethose of the presenters and authors and do notnecessarily reflect the views of the Society.
Not an ISMICS Member?Join TODAYJoin TODAYJoin TODAYJoin TODAYJoin TODAY
ISMICS is helping shape the future of less invasive cardiac,vascular and thoracic surgery on a global basis. The mission of theSociety is to lead and promote innovation and technological ad-vancement in cardiothoracic and cardiovascular surgery throughscientific analysis and education. If you are here in Prague, youKNOW the value of ISMICS’ educational programs.
The Society has over 800 international members. Stop by theRegistration Area and complete an application onsite. CurrentMembers are available to serve as your sponsor.
ISMICS Members’Business Meeting
All ISMICSmembers arerequested toattend theMembers’Business Meeting, scheduled forSaturday morning, 09.00-09.30 andheld in the Scientific Session Hall inCongress Hall 2-3.
Saturday Morning10:45 - 11:15
DEBATE:SUTURELESS AORTIC
VALVES - HAS THE TRAINLEFT THE STATION?
It Hasn’t Left the StationHarold C. Eichstaedt
Klinik fur Herzchirurgie,Oldenburg, Germany
The Train is GoneVolkmar Falk
University of ZurichZurich, Switzerland
Francis Ferdinand, MD (left) and Rex Stanbridge, MD, demonstrate the new electronic posterformat. For the the first time, all ISMICS competition and display posters are being displayed in anall-electronic format, on large screen monitors.
Electronic Posters Unveiled DON’T MISS....
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