DOCSLIB.ORG

Conference Program

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Conference Program Conference Program STS/EACTS Latin America Cardiovascular Surgery Conference September 21-22, 2017 | Cartagena, Colombia [email protected] www.CardiovascularSurgeryConference.org 2 STS/EACTS Latin America Cardiovascular Surgery Conference Table of Contents Course Description............................................................4 STS Education Disclosure Policy...............................................5 Program Director, Faculty, and Staff Disclosures..............................6 Sponsors.....................................................................8 Exhibitors.....................................................................9 Industry-Sponsored Satellite Activities........................................9 Educational Program Agenda................................................10 Scientific Abstracts..........................................................17 Adult Congenital Aorta and Aortic Arch Aortic Root Aortic Valve Atrial Fibrillation Coronary Heart Failure Mitral Valve Quality and Outcomes Tricuspid Valve Future STS Meetings......................................................103 3 STS/EACTS Latin America Cardiovascular Surgery Conference September 21-22, 2017 Hilton Cartagena | Cartagena, Colombia COURSE DESCRIPTION This new conference, led by Program Directors Juan P. Umana, MD (El Rosario University/Fundacion Cardioinfantil in Bogota, Colombia), Vinod H. Thourani, MD (MedStar Heart & Vascular Institute in Washington, DC, USA), Jose Luis Pomar, MD, PhD (University of Barcelona, Spain), and Joseph E. Bavaria, MD (University of Pennsylvania in Philadelphia, PA, USA), is a 2-day educational activity that will provide a unique and innovative format for the attendees, highlighting the management of cardiovascular surgical diseases. Sessions will incorporate not only invited lectures from a world-class international faculty on traditional and new technology procedures, but also original scientific abstracts presented in oral and poster sessions. They will concentrate on the multidisciplinary approach to coronary artery disease, valvular heart disease, thoracic aorta disease, atrial fibrillation, and the surgical management of heart failure.An integral component will be invited technical videos in regard to procedural expertise in these disease processes, followed by a robust panel discussion. This new and extremely innovative conference will provide attendees access to the highest level of education with the goal of improved patient management. TARGET AUDIENCE The conference is designed for all members of the cardiac surgical team, including cardiothoracic surgeons, cardiovascular surgeons, cardiologists, anesthesiologists, perfusionists, physician assistants, nurses, and other health care professionals interested in the topic. LEARNING OBJECTIVES Upon completion of this activity, participants should be able to: • Evaluate the impact of new knowledge and the application of new technology on the treatment of cardiovascular diseases • Discuss surgical techniques in order to improve the standard of care for cardiovascular patients • Review the results of clinical and laboratory investigations designed to reveal new knowledge of cardiovascular disease • Describe the multidisciplinary approach to coronary artery disease, valvular heart disease, atrial fibrillation, and the surgical management of heart failure. CERTIFICATES OF PARTICIPATION No continuing medical education credit is being offered for this meeting. To obtain a certificate of participation, you’ll need to complete an online evaluation. The link be available at the Registration Desk. You also may contact the STS Education and Member Services Department at (312) 202-5800 or [email protected] with any questions. 4 STS/EACTS Latin America Cardiovascular Surgery Conference The Society of Thoracic Surgeons Education Disclosure Policy As a sponsor of continuing medical education accredited by the Accreditation Council for Continuing Medical Education (ACCME), The Society of Thoracic Surgeons requires that any individual who is in a position to control the content of an educational activity must disclose all relationships with commercial interests (including known relationships of his or her immediate family, department, and partners). The ACCME defines a commercial interest as “any entity producing, marketing, reselling, or distributing health care goods or services consumed by, or used on, patients. The ACCME does not consider providers of clinical service directly to patients to be commercial interests.” The question of whether a disclosed conflict situation could represent undue influence on the educational activity by a commercial interest or whether the disclosed information is sufficient to consider an abstract, presentation, or other educational enduring material to represent potentially biased information must be resolved prior to an individual’s involvement in STS educational programming. Required disclosures include (1) a financial interest of any amount (e.g., through ownership of stock, stock options, or bonds) (2) the receipt of any amount of cash, goods or services within the current 12-month period (e.g., through research grants, employment, consulting fees, royalties, travel, or gifts) or (3) a non-remunerative position of influence (e.g., as officer, director, trustee or public spokesperson). EXCLUDED from this disclosure requirement are blind trusts or other passive investments such as mutual funds. In the case of a financial or other relationship disclosure, the company, product/service, and specific nature of the relationship must be noted. Disclosure is mandatory for any person involved in the planning, management, presentation, and/or evaluation of STS educational activities. Failure to disclose all relationships with commercial interests disqualifies the individual from being a planning committee member, a teacher, or an author of educational materials, and this individual cannot have any responsibility for the development, management, presentation, or evaluation of STS educational activities. This requirement is intended neither to imply any impropriety of such relationships nor to prejudice any individual planner, presenter or author. It is merely to identify such relationships through full disclosure, and to allow STS to assess and resolve potential influences on the educational activity prior to the planning and implementation of an educational activity. If no relationships with commercial interests exist, the individual must indicate this on the disclosure form. Additionally, the fact that the presentation, paper, or other educational product describes (a) the use of a device, product, or drug that is not FDA approved or (b) an off-label use of an approved device, product, or drug must also be disclosed. This requirement has been adopted in response to FDA policy and case law involving medical societies, and is not intended to prohibit or inhibit independent presentation or discussion regarding the uses of devices, products, and drugs as described in (a) or (b) above. For live presentations, all disclosures must be stated orally and on a slide at the beginning of the presentation and will be noted in published material related to the activity. Slides, handouts, and other materials utilized as part of an educational activity cannot contain any advertising, trade names or a product group message. Speakers are required to disclose that they have nothing to disclose if this is the case. Amended by the STS Executive Committee: April 11, 2012 5 STS/EACTS Latin America Cardiovascular Surgery Conference Program Director, Faculty, and STS Staff Disclosure Information Unless otherwise noted the individuals listed below have nothing to disclose. Program Directors Joseph C. Cleveland Jr., MD COMMERCIAL RELATIONSHIPS Research Grant, Abbott Juan P. Umana, MD Francisco da Costa, MD Vinod H. Thourani, MD COMMERCIAL RELATIONSHIPS Ownership Interest, COMMERCIAL RELATIONSHIPS Research Grant, Abbott, Tissue Regenix (patent); Consultant/Advisory Board, Edwards Lifesciences, Medtronic Tissue Regenix Jose L. Pomar, MD, PhD Jacob DeLaRosa, MD COMMERCIAL RELATIONSHIPS Consultant/Advisory Board, LivaNova, Medtronic; Speaker’s Ricardo Ribeiro Dias, MD Bureau/Honoraria, Edwards Lifesciences Dario Echeverri, MD Joseph E. Bavaria, MD Gebrine El Khoury, MD Roberto R. Favaloro, MD Faculty COMMERCIAL RELATIONSHIPS Nonremunerative Position of Influence, Favaloro Foundation Homograph Ayyaz Ali, MD Tissue Bank (Technical Director) Manuel J. Antunes, MD Enrico R. Ferrari, MD David S. Bach, MD Sergio Franco, MD COMMERCIAL RELATIONSHIPS Consultant/Advisory Board, Abbott, Edwards Lifesciences, Medtronic Ovidio A. Garcia-Villarreal, MD Vinay Badhwar, MD Walter J. Gomes, MD Jorge M. Balaguer, MD Jeffrey P. Jacobs, MD COMMERCIAL RELATIONSHIPS Consultant/Advisory Fabio B. Jatene, MD, PhD Board, Johnson & Johnson Vadim Kotowicz, MD Pedro Becker, MD COMMERCIAL RELATIONSHIPS Consultant/Advisory Christian A. Bermudez, MD Board, Johnson & Johnson, Medtronic Alejandro M. Bertolotti, MD Christian Kreutzer, MD Steven F. Bolling, MD Javier D. Maldonado, MD COMMERCIAL RELATIONSHIPS Ownership Interest, COMMERCIAL RELATIONSHIPS Speakers Bureau/ Millipede; Consultant/Advisory Board, Abbott, Edwards Honoraria, AtriCure, Edwards Lifesciences Lifesciences Juan C. Mejia, MD Joao R. Breda, MD Fernando R. Moraes, MD Victor Caicedo, MD COMMERCIAL RELATIONSHIPS Other, LivaNova (proctor for Perceval valve) Jaime Camacho, MD Daniel O. Navia, MD 6 Francis
Load more

Recommended publications
  • Arterial Switch Operation Surgery Surgical Solutions to Complex Problems
    Pediatric Cardiovascular Arterial Switch Operation Surgery Surgical Solutions to Complex Problems Tom R. Karl, MS, MD The arterial switch operation is appropriate treatment for most forms of transposition of Andrew Cochrane, FRACS the great arteries. In this review we analyze indications, techniques, and outcome for Christian P.R. Brizard, MD various subsets of patients with transposition of the great arteries, including those with an intact septum beyond 21 days of age, intramural coronary arteries, aortic arch ob- struction, the Taussig-Bing anomaly, discordant (corrected) transposition, transposition of the great arteries with left ventricular outflow tract obstruction, and univentricular hearts with transposition of the great arteries and subaortic stenosis. (Tex Heart Inst J 1997;24:322-33) T ransposition of the great arteries (TGA) is a prototypical lesion for pediat- ric cardiac surgeons, a lethal malformation that can often be converted (with a single operation) to a nearly normal heart. The arterial switch operation (ASO) has evolved to become the treatment of choice for most forms of TGA, and success with this operation has become a standard by which pediatric cardiac surgical units are judged. This is appropriate, because without expertise in neonatal anesthetic management, perfusion, intensive care, cardiology, and surgery, consistently good results are impossible to achieve. Surgical Anatomy of TGA In the broad sense, the term "TGA" describes any heart with a discordant ven- triculoatrial (VA) connection (aorta from right ventricle, pulmonary artery from left ventricle). The anatomic diagnosis is further defined by the intracardiac fea- tures. Most frequently, TGA is used to describe the solitus/concordant/discordant heart.
    [Show full text]
  • TGA Surgical Techniques: Tips & Tricks
    TGA Surgical techniques: tips & tricks (Arterial switch operation) Seoul National University Children’s Hospital Woong-Han Kim Surgical History • 1951 Blalock and Hanlon, atrial septectomy • 1954 Mustard et al. arterial switch op • (monkey lung, 7 patients, 19 days old) • 1958 Senning, Atrial switch operation • 1963 Mustard, Mustard operation • 1966 Raskind and Miller, Balloon atrial septostomy • 1969 Rastelli, Rastelli operation • 1975 Jatene, first successulful ASO in patients with TGA and large VSD • 1977 Yacoub et al. two stage repair • 1983 Quaegebeur and Castaneda, primary repair in neonate • 1988 Boston group, rapid two-stage ASO The wide range of spatial relationships between the great arteries in TGA d-TGA Taussig-Bing (DORV) Posterior TGA Complete Transposition of the Great Arteries . Ventriculoarterial discordance . Also known as d-TGA (d = dextroposition of the bulboventricular loop) . Aorta on the right and anterior • Morphogenesis – Failure of the septum to spiral • Straight septum • Parallel arrangement of RVOT and LVOT – Abnormal growth and development of subaortic infundibulum – Absence of subpulmonic infundibulum growth Major coexisting anomalies * About 75% of neonates presenting TGA have no other cardiac anomalies, other than PFO or ASD and 20% have VSD and only 5% have LVOTO. 1 VSD Conoventricular(not necessarily juxtapulmonary) 55~60% Juxtaaortic 5% Juxtaarterial 5% Inlet septal 5% Juxtatricuspid Juxtacrucial : straddling muscular 25~30% 2 LVOTO It occurs 0.7% in TGA + IVS at birth and 20% in TGA+VSD, and may develop after birth in others and so reach an overall prevalence of 30%. Dynamic type - leftward bulging of septum Anatomic type - subvalvar fibrous ridge, fibrous tags, aneurysm, muscular (malalignment) or fibromuscular obstruction, valvar hypoplasia, combined.
    [Show full text]
  • Appendix A: Surgical Procedure Terms and Definitions
    Appendix A: Surgical Procedure Terms and Definitions Anomalous Systemic Venous Connection Anomalous Systemic Venous Connection Repair Repair includes a range of surgical approaches, including, among others: ligation of anomalous vessels, reimplantation of anomalous vessels (with or without use of a conduit), or redirection of anomalous systemic venous flow through directly to the pulmonary circulation (bidirectional Glenn to redirect LSVC or RSVC to left or right pulmonary artery, respectively). Aortic Aneurysm Aortic aneurysm repair Aortic aneurysm repair by any technique. Aortic Dissection Aortic Dissection repair Aortic dissection repair by any technique. Aortic Root Replacement Aortic Root Replacement, Bioprosthetic Replacement of the aortic root (that portion of the aorta attached to the heart; it gives rise to the coronary arteries) with a bioprosthesis (e.g., porcine) in a conduit, often composite. Aortic Root Replacement, Mechanical Replacement of the aortic root (that portion of the aorta attached to the heart; it gives rise to the coronary arteries) with a mechanical prosthesis in a composite conduit. Aortic Root Replacement, Homograft Replacement of the aortic root (that portion of the aorta attached to the heart; it gives rise to the coronary arteries) with a homograft Aortic Root Replacement, Valve sparing Replacement of the aortic root (that portion of the aorta attached to the heart; it gives rise to the coronary arteries) without replacing the aortic valve (using a tube graft). Aortic Valve Disease Ross Procedure Replacement of the aortic valve with a pulmonary autograft and replacement of the pulmonary valve with a homograft conduit. Konno Procedure (with and without aortic valve replacement) Relief of left ventricular outflow tract obstruction associated with aortic annular hypoplasia, aortic valvar stenosis and/or aortic valvar insufficiency via Konno aortoventriculoplasty.
    [Show full text]
  • 101St Annual Meeting Share Your Annual Meeting Experience on Twitter: Featuring Aortic Symposium @AATSHQ and Mitral Conclave #AATS2021 a Virtual Learning Experience
    TABLE OF CONTENTS AATS Annual Meeting Committees ............................................................................. 2 Accreditation ......................................................................................................................... 5 Scientific Program ...............................................................................................................8 Abstracts ............................................................................................................................108 C. Walton Lillehei Abstracts ..................................................................................341 Case Video Abstracts ..............................................................................................350 PROGRAM BOOK 101st Annual Meeting Share your Annual Meeting experience on Twitter: Featuring Aortic Symposium @AATSHQ and Mitral Conclave #AATS2021 A Virtual Learning Experience April 30-May 2, 2021 This program book went to ePrint on April 29, 2021. Any program changes made after this date are available at aats.org/annualmeeting. President Marc R. Moon *AATS Member ◆AATS New Member 1 101st Annual Meeting AMERICAN ASSOCIATION April 30 – May 2, 2021 | A Virtual Learning Experience FOR THORACIC SURGERY AORTIC SYMPOSIUM AATS – PROMOTING SCHOLARSHIP IN Co-Chairs THORACIC AND CARDIOVASCULAR SURGERY *Joseph S. Coselli *Steven L. Lansman Since 1917, when it was founded as the first organization dedicated to thoracic surgery, the Committee Members American Association for Thoracic Surgery
    [Show full text]
  • NATIONAL QUALITY FORUM National Voluntary Consensus Standards for Pediatric Cardiac Surgery Measures
    NATIONAL QUALITY FORUM National Voluntary Consensus Standards for Pediatric Cardiac Surgery Measures Measure Number: PCS‐001‐09 Measure Title: Participation in a national database for pediatric and congenital heart surgery Description: Participation in at least one multi‐center, standardized data collection and feedback program that provides benchmarking of the physician’s data relative to national and regional programs and uses process and outcome measures. Participation is defined as submission of all congenital and pediatric operations performed to the database. Numerator Statement: Whether or not there is participation in at least one multi‐center data collection and feedback program. Denominator Statement: N/A Level of Analysis: Group of clinicians, Facility, Integrated delivery system, health plan, community/population Data Source: Electronic Health/Medical Record, Electronic Clinical Database (The Society of Thoracic Surgeons Congenital Heart Surgery Database), Electronic Clinical Registry (The Society of Thoracic Surgeons Congenital Heart Surgery Database), Electronic Claims, Paper Medical Record Measure Developer: Society of Thoracic Surgeons Type of Endorsement: Recommended for Time‐Limited Endorsement (Steering Committee Vote, Yes‐9, No‐0, Abstain‐0) Attachments: “STS Attachment: STS Procedure Code Definitions” Meas# / Title/ Steering Committee Evaluation and Recommendation (Owner) PCS-001-09 Recommendation: Time-Limited Endorsement Yes-9; No-0; Abstain-0 Participatio n in a Final Measure Evaluation Ratings: I: Y-9; N-0 S: H-4; M-4; L-1 U: H-9; M-0; L-0 national F: H-7; M-2; L-0 database for Discussion: pediatric I: The Steering Committee agreed that this measure is important to measure and report. and By reporting through a database, it is possible to identify potential quality issues and congenital provide benchmarks.
    [Show full text]
  • Mechanisms of Coronary Complications After the Arterial Switch for Transposition of the Great Arteries
    Ou et al Congenital Heart Disease Mechanisms of coronary complications after the arterial switch for transposition of the great arteries Phalla Ou, MD, PhD,a,b Diala Khraiche, MD,c David S. Celermajer, PhD, FRACP, DSc, FAA,d Gabriella Agnoletti, MD, PhD,c Kim-Hanh Le Quan Sang, MD,e Jean Christophe Thalabard, MD, PhD,b Mathieu Quintin, MS,f Olivier Raisky, MD, PhD,c Pascal Vouhe, MD, PhD,c Daniel Sidi, MD, PhD,c and Damien Bonnet, MD, PhDc Background: The arterial switch operation (ASO) for transposition of the great arteries requires transfer of the cor- onary arteries from the aorta to the proximal pulmonary artery (neoaorta). This is complicated by variable coronary anatomy before transfer. In 8% to 10% of cases, there is evidence of late coronary stenosis and/or occlusion, often with catastrophic clinical consequences. The mechanism of such complications has not been well studied. Methods and Results: We analyzed 190 consecutive high-resolution computed tomographic scans from the ASO procedure (patients aged 5-16 years) and found 17 patients with significant (>30% up to occlusion) cor- onary lesions (8.9%); all were later confirmed by conventional angiography. The left main coronary artery was abnormal in 9 patients (ostium in all), the left anterior descending artery in 3, the circumflex in 2, and the right coronary artery in 3 patients. Using multiplanar and 3-dimensional reconstructions of the coronary arteries, aorta, and pulmonary artery, we identified the commonest mechanisms of coronary abnormalities. For the left main and left anterior descending artery, anterior positioning of the transferred left coronary artery (between 12 and 1 o’clock on the neoaorta) appeared to predispose to a tangential course of the proximal left coronary CHD artery promoting stenosis.
    [Show full text]
  • CT Imaging in Congenital Heart Disease
    Journal of Cardiovascular Computed Tomography 7 (2013) 338e353 Available online at www.sciencedirect.com ScienceDirect journal homepage: www.JournalofCardiovascularCT.com Review Article CT imaging in congenital heart disease: An approach to imaging and interpreting complex lesions after surgical intervention for tetralogy of Fallot, transposition of the great arteries, and single ventricle heart disease B. Kelly Han MDa,b,*, John R. Lesser MDb a The Children’s Heart Clinic at The Children’s Hospitals and Clinics of Minnesota, 2530 Chicago Ave South, Suite 500, Minneapolis, MN 55404, USA b The Minneapolis Heart Institute and Foundation, Minneapolis, MN, USA article info abstract Article history: Echocardiography and cardiac magnetic resonance imaging are the most commonly per- Received 16 August 2013 formed diagnostic studies in patients with congenital heart disease. A small percentage of Received in revised form patients with congenital heart disease will be referred to cardiac CT subsequent to echo- 16 October 2013 cardiography when magnetic resonance imaging is insufficient, contraindicated, or Accepted 30 October 2013 considered high risk. The most common complex lesions referred for CT at our institution are tetralogy of Fallot, transposition complexes, and single ventricle heart disease. This Keywords: review discusses the most common surgical procedures performed in these patients and Cardiac CT the technical considerations for optimal image acquisition on the basis of the prior pro- Congenital heart disease cedure and the individual patient history. Cardiac CT can provide the functional and anatomic information required for decision making in complex congenital heart disease. Image interpretation is aided by knowledge of the common approaches to operative repair and the residual hemodynamic abnormalities.
    [Show full text]
  • Cardiac Cardiac
    National Education Curriculum Specialty Curricula Cardiac Cardiac Table of Contents Section I: Anatomy and Physiology of the Heart ................................................................................. 3 Section II: Basic Embryology ................................................................................................................ 8 Section III: The Echocardiographic Examination ............................................................................ 10 Section IV: Principles of Cardiac Hemodynamics and Cardiac Cycle ........................................... 20 Section V: Ventricular Function ......................................................................................................... 24 Section VI: Coronary Artery Disease (CAD) ..................................................................................... 32 Section VII: Valvular Heart Disease ................................................................................................... 35 Section VIII: Cardiomyopathies ......................................................................................................... 65 Section IX: Systemic and Pulmonary Hypertensive Heart Disease ................................................ 71 Section X: Pericardial Diseases ........................................................................................................... 73 Section XI: Cardiac Tumors/Masses .................................................................................................. 78 Section XII: Diseases
    [Show full text]
  • The Arterial Switch Procedure: Closed Coronary Artery Transfer Edward L
    The Arterial Switch Procedure: Closed Coronary Artery Transfer Edward L. Bove, MD he arterial switch operation has been the accepted pro- coronary artery arises from the right coronary and passes Tcedure for the repair of transposition of the great arteries posterior to the pulmonary artery root, is seen in approxi- (TGA) with or without associated defects for over 2 decades. mately two-thirds of all patients with d-TGA. With increasing Many of the technical intricacies have been developed and operative experience, a variety of coronary artery patterns modified over these years such that this procedure is now were encountered by the surgeon, some rarely, and the tech- associated with very low risk even in the neonate with com- niques were altered to deal with these anomalies. Both early plex forms of TGA.1,2 From the earliest experience, the sur- and late follow-up reports emphasized the importance of gical techniques involved for the transfer of the coronary proper coronary artery alignment, the avoidance of tension arteries have received the most scrutiny. In the most common on the anastomoses, and the need to develop a reliable, re- coronary artery pattern, the right coronary artery arises from producible technique to deal with even subtle coronary ar- the right aortic sinus of Valsalva and the left main coronary tery anatomic variations. At the University of Michigan CS artery from the left aortic sinus (Fig 1). This pattern, in addi- Mott Children’s Hospital, the technique of transferring the tion to the most common variant in which the circumflex coronary artery buttons after reconstruction of the neo-aorta has been utilized since the beginning of our experience in the mid 1980s.3 This approach was used in an effort to minimize Section of Cardiac Surgery, Division of Pediatric Cardiac Surgery, The Uni- any “guesswork” in the transfer of the coronary artery buttons versity of Michigan Medical School, Ann Arbor, Michigan.
    [Show full text]
  • Pediatric Acute Care Cardiology Handbook
    Pediatric Cardiac Acute Care Handbook Edition 2 (2018-2019) Compiled by: Alaina K. Kipps, MD, MS; Inger Olson, MD; Neha Purkey, MD; Charitha Reddy, MD I. General Principles of Cardiology a. Cardiac Anatomy…………………………………………………………………….1 b. History and Physical………………………………………………………………..6 c. Cardiac Catheterization………………………………..………………………..10 d. Echocardiography…………………………………………………………………..14 II. Common Complaints in Cardiology a. Murmurs………………………………………………………………………………..25 b. Chest Pain……………………………………………………………………………...28 c. Syncope………………………………………………………………………………….30 d. Preventative Cardiology………………………………………………………….32 III. EKG Interpretation and Common Arrhythmias a. EKG Reading……………………………………………………………………….….34 b. Arrhythmia Algorithm…………………………………………………………….42 c. Common Arrhythmias…………………………………………………………....45 IV. Congenital Heart Disease a. Neonatal Presentation of CHD………………………………………………..64 V. Acyanotic Lesions a. ASD…………………………………………………………………………………..……..68 b. VSD………………………………………………………………………………..……...71 c. AVSD………………………………………………………………………………..……..74 d. PDA………………………………………………………………………………..……….77 e. Ebstein Anomaly……………………………………………………………..……..81 f. Bicuspid Aortic Valve…….………………………………………………….……..84 g. Aortic Stenosis…………………………………………………………..…….…...86 h. Pulmonary Stenosis……………………………………..............……………..89 i. Coarctation…………….………………………………..............…………...…….92 j. Interrupted Aortic Arch……………………………..............……………….95 VI. Cyanotic Lesions a. DTGA……………………………………………………………………….………...97 b. TOF……………………………………….………………………………..………...100 c. TOF/PA/MAPCAs…………………………………………..…………………….103
    [Show full text]
  • Valve Sparing Root Replacement in Congenital Heart Disease
    Aortic program Surgery for Aortic Root Dilatation Following Repair of Congenital Heart Disease Christian Pizarro, MD Alfred I. Dupont Hospital for Children Wilmington, DE . USA Aortic program No disclosures Aortic program Root aneurysm / CHD • Increasing recognition during follow up of patients undergoing interventions for conotruncal anomalies • Surgical indication not well defined due to unknown natural history • risk of rupture or dissection • Multiple challenges – Technically complex – Exposure – Multiple operations – Challenging physiology – Surgical risk? Aortic program JACC 2003;42:533-40 Schwartz, M. L. Circulation 2004;110:II-128-II-132 sdfgh • Aortic root dilatation prevalence • Mod-severe AI in 3.5% cases (30% > 4 cm; O/E >1.5 is 6.6%). • Histology strikingly similar to Asc aorta >4 cm 19% Marfan syndrome. • Associated with older age at • Several case reports of dissection surgery, pulmonary atresia and mod- severe AI Mongeon. Circulation. 2013;127:172-179 Luciani Circ 2003;108[suppl II]:II-61-II-67 Aortic program Sections of aorta show accumulation of myxoid material (extracellular ground substance) within the media. [H&E, original magnification 40X (left) and 100X (right)] Elastin stain of aorta shows disruption and Aorta stained with trichrome stain (left) and smooth muscle actin immunohistochemistry loss of elastic fibers within the media. (right) shows expanded zones of extracellular ground substance and disruption and loss of [Elastin stain, original magnification 100X] smooth muscle cells within the media. [Trichrome
    [Show full text]
  • World Database for Pediatric and Congenital Heart Surgery Appendix A: Surgical Procedure Terms and Definitions
    World Database for Pediatric and Congenital Heart Surgery Appendix A: Surgical Procedure Terms and Definitions All surgeries are Tier 2 surgeries unless otherwise noted. Anomalous Systemic Venous Connection Anomalous Systemic Venous Connection Repair Repair includes a range of surgical approaches, including, among others: ligation of anomalous vessels, reimplantation of anomalous vessels (with or without use of a conduit), or redirection of anomalous systemic venous flow through directly to the pulmonary circulation (bidirectional Glenn to redirect LSVC or RSVC to left or right pulmonary artery, respectively). Aortic Aneurysm Aortic aneurysm repair Aortic aneurysm repair by any technique. Aortic Dissection Aortic Dissection repair Aortic dissection repair by any technique. Aortic Root Replacement Aortic Root Replacement, Bioprosthetic Replacement of the aortic root (that portion of the aorta attached to the heart; it gives rise to the coronary arteries) with a bioprosthesis (e.g., porcine) in a conduit, often composite. Aortic Root Replacement, Mechanical Replacement of the aortic root (that portion of the aorta attached to the heart; it gives rise to the coronary arteries) with a mechanical prosthesis in a composite conduit. Aortic Root Replacement, Homograft Replacement of the aortic root (that portion of the aorta attached to the heart; it gives rise to the coronary arteries) with a homograft Aortic Root Replacement, Valve sparing Replacement of the aortic root (that portion of the aorta attached to the heart; it gives rise to the coronary arteries) without replacing the aortic valve (using a tube graft). Aortic Valve Disease Ross Procedure Replacement of the aortic valve with a pulmonary autograft and replacement of the pulmonary valve with a homograft conduit.
    [Show full text]