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The EACTS Techno College Innovation Award

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The EACTS Techno College Innovation Award Daily News The official newspaper of the 30th EACTS Annual Meeting 2016 Issue 2 Sunday 2 October In this issue The EACTS Techno College Innovation Award Congratulations to this year’s 8 Cardiac arrest: recipients of the Techno College Update for emergency Innovation Award! The 2016 preservation & winner was Dr Maximilian resuscitation Kütting (pictured centre), for his work with a novel transcatheter prosthesis for the treatment of severe and massive tricuspid valve insufficiency. He was joined by runners-up Dr Johannes Holfeld (right) and Dr Itai Schalit (left). Read on to learn more about each recipient’s award-winning work. 9 ‘Flipping the classroom’: Innovations in Cardiac | Techno College | Aorta, Ablation, and Assist devices training 13 Aortic Type A A novel transcatheter prosthesis for the treatment of dissection during Glenn procedure severe and massive tricuspid valve insufficiency Maximilian Kütting NVT GmbH, Hechingen, Germany ricuspid valve regurgitation remains a disease with a poor prognosis for inoperable patients, but also for highly symptomatic patients 18 Novel bioabsorbable undergoing isolated repair or pulmonary valved replacement. Medical therapy conduit providesT short-term alleviation of symptoms in some cases, but the impact of the disease on quality of life 19 Platelet Rich Fibrin is substantial, leaving a pressing need for effective (PRF) therapy for minimally-invasive treatment options. Described by wound repair many as the “forgotten valve”, the tricuspid valve’s complexities, especially in patients with severe and 24 Single clip massive tricuspid regurgitation, arguably pose more implantation in edge- challenges to the development of treatment options advanced via the femoral vein to the right atrium. to-edge mitral repair than the other three valve positions. Radiopaque markers on the prosthesis help achieve NVT, a Swiss company with R&D and production precise orientation and positioning. Experience 33 Hybrid coronary facilities in Germany, is a specialist in developing gained during the development of the NVT Allegra revascularisation innovative catheter-based solutions for heart valve transcatheter aortic valve prosthesis, and also disease, and has conceived a prosthesis to address collaboration with JOTEC – experts in the field of improved along with the implantation technique. In tricuspid regurgitation. The concept involves stentgraft technology – helped ensure progress with an ovine model, massive tricuspid insufficiency was implanting a stentgraft-like device spanning from the device. first induced using a specially-built device, and then the inferior to the superior caval vein with a lateral The aim was to develop a technology which is treated via implantation of the prosthesis. Absence of bicuspid valve. The idea of placing a fifth heart valve effective in preventing backflow into the venous backflow into the venous system could be confirmed into the right atrium evolved after considering the system to alleviate symptoms, such as venous under echocardiography. The proof-of-concept was anatomy and flow pattern of the right atrium. The congestion and ascites. It had to be fast, simple and achieved so that the project has now moved into the decision to leave the tricuspid annulus untouched safe to implant, preferably by a single operator. stage of preparations for first-in-man implantation. 42 Apical closure device was also made considering previous unsuccessful The collaboration with Dr. Lausberg and Prof. The group of engineers and physicians from NVT for percutaneous attempts of other devices to anchor in this structure, Schlensak – two cardiothoracic surgeons from and the University Clinic in Tübingen are grateful and in order to avoid interference with the AV-node. the University Clinic in Tübingen – Germany, was for the recognition of their work, and are thrilled to transapical valve The prosthesis consists of nitinol stent springs and instrumental in refining the concept and developing accept the EACTS Techno College Innovation Award, procedures support structures covered by porcine pericardium. it to its current stage. In extensive in-vitro and in-vivo which is another reminder of the importance of taking It is delivered using a 22F catheter which is tests, both the prosthesis and delivery system were this concept to clinical reality. 2 Issue 2 Sunday 2 October 2016 EACTS Daily News Cardiac | Techno College | Aorta, Ablation, and Assist devices First in-man shockwave application for spinal cord ischaemia after Type-A aortic dissection Johannes Holfeld University acute Type-A aortic dissection surgery. evoked potentials on both legs could Clinic of Cardiac Surgery, Innsbruck A 72-year old patient suffered from be observed at day 0. However, Medical University, Innsbruck, Austria acute Type A aortic dissection with an the patient started to feel his right early onset of lower limb malperfusion leg after three weeks. While he had [email protected] prior to hospital admission. been letting the nurse inject his daily o causal treatment option Uncomplicated acute aortic surgery heparin dose to the left leg, he then has thus far existed for including arch replacement was began to feel pain from the needle the devastating condition performed, however it resulted in at this leg as well. Results were of paraplegia due to paraplegia due to ischaemic spinal confirmed by neurological assessment Nspinal cord ischaemia following aortic cord injury. After obtaining permission by independent neurologists, and surgery or endovascular aortic repair. from the local ethics board, as well quality-of-life questionnaires showed a However, shockwave therapy has as written informed consent by the significantly-improved overall condition been shown to induce regeneration of patient, we performed the first in-man of the patient after six months. ischaemic myocardium.1 Therefore, in spinal shockwave treatment. previous work we evaluated whether Numerous neurologic assessments Conclusion shockwave treatment of ischaemic were then performed over a six- Shockwave treatment of the spinal spinal cord injury may be beneficial, month period, including motor- and cord is safe, feasible, and is capable with traumatic spinal injury. Six Please get in contact with us if you like and were able to prove that it does in sensory-evoked potentials, magnetic of improving symptoms of spinal weeks after complete paraplegia to participate in the trial. fact cause regeneration of the spinal resonance imaging of the spine, and cord ischaemia. In-vitro shockwaves due to an ischaemic injury to the cord in an animal model.2 Now, our additional experimental mechanistic even caused neuronal sprouting. myelon, no regenerative potential References current work shows deeper insights studies with spine slices from dead Shockwave treatment immediately was estimated for our patient 1. Holfeld J, et al. Epicardial shockwave therapy into the mechanism of spinal cord bodies. after spinal cord injury due to from an independent neurologist. improves ventricular function in a porcine model of ischaemic heart disease. J Tissue Eng Regen Med. shockwave treatment, and for the ischaemia from aortic dissection Nevertheless, the experience from 2014 May 19. doi:10.1002/term.1890. first time reports on results in human Results may therefore develop into the first this single case plus the encouraging 2. Lobenwein D and Tepeköylü C, et al. Shockwave treatment protects from neuronal degeneration tissue, specifically the first in-man The patient suffered from complete ever causal treatment option for this results from experimental studies via a Toll-like receptor 3 dependent mechanism: application for paraplegia following paraplegia at day 0 after surgery, after devastating condition. It is known need to be confirmed in a clinical Implications of a first-ever causal treatment for ischemic spinal cord injury. J Am Heart Assoc. which he received six shockwave that spontaneous improvement of trial. A randomised, controlled clinical 2015 Oct 27;4(10):e002440. doi:10.1161/ treatments starting six weeks after symptoms can occur. However, this multicentre trial therefore is on its way! JAHA.115.002440. EACTS Daily News the surgery. No somatosensory is more likely to happen in patients Publishing and Production MediFore Limited EACTS President Friedrich W. Mohr EACTS Secretary General A. Pieter Kappetein Editor-in-Chief Peter Stevenson Managing Editor Rysia Burmicz Editor Joanne Waters Design Peter Williams Industry Liaison Manager Amanda D’rojcas Head Office 51 Fox Hill London SE19 2XE United Kingdom Telephone: +44 (0) 7506 345 283 [email protected] Copyright © 2016: EACTS. All rights Figure 1 (above). Shockwave treatment was applied paravertebral at a reserved. No part of this publication may 45-degree angle to the spine on both sides. Six treatments over a period be reproduced, stored in a retrieval system, 2 transmitted in any form or by any other of six weeks were performed at an energy flux density of 0.1mJ/mm . means, electronic, mechanical, photocopying, Shockwave application was not painful to the patient. recording or otherwise without prior permission in writing from the EACTS or its Figure 2 (right): The patient developed a significant improvement of the associated parties. The content of EACTS Daily News does not necessarily reflect the ASIA (American Spinal Injury Association) score, indicating spinal cord opinion of the EACTS 2016 Annual Meeting, its regeneration. His sensibility on both legs recovered completely and the Chairs,
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