Sotirios N. Prapas, M.D., Ph.D, F.E.C.T.S.

Size: px
Start display at page:

Download "Sotirios N. Prapas, M.D., Ph.D, F.E.C.T.S."

Transcription

1 CORONARY ARTERY REVASCULARIZATION WITH MILD AORTIC STENOSIS: STRATEGIES OF TREATMENT 9 th ANNUAL MEETING OF THE EAB SOCIETY, Pravets, Bulgaria, 2012 Sotirios N. Prapas, M.D., Ph.D, F.E.C.T.S. Director of Cardiac Surgery Department Henry Dunant Hospital, Athens, Greece

2 ACC / AHA GUIDELINES CAD + SEVERE AS CABG +AVR (Mean > 50 mm Hg) CAD + MODERATE AS CABG +AVR (II a) (Mean > mm Hg) CAD + MILD AS CABG +AVR (II b) (Mean < 30 mm Hg)

3 ISSUES TO BE DISCUSSED 1 Incremental risk of concomitant AVR at the time of CABG 2 The likelihood that A.S. will progress requiring reoperative AVR

4 ISSUES TO BE DISCUSSED 3 The mortality of reoperations for AVR 4 The burden of prosthetic valve disease: Risk of endocarditis Early degeneration Anticoagulant related complications

5 RISK OF CONCOMITANT AVR STS Mortality CABG 2 3 % CABG + AVR 6 7 % # Calcified Ascending Aorta # Renal Dysfunction # COPD) # In dialysis patients, more than 30% # 1 year survival 59% # 5 years survival 21%

6 THE MORTALITY OF REOPERATION STS Mortality AVR after prior CABG 12-23,5%

7 FREEDOM FROM AV REOPERATION B. Sareyyupoglu et al, Ann Thorac Surg 2009;88:

8 REOPERATION RATE PER TIME B. Sareyyupoglu et al, Ann Thorac Surg 2009;88:

9 THE PROSTHETIC VALVE DISEASE Anticoagulant-related haemorrhages 2-4% per year Deterioration of bioprosthetic valve after years Possibility of endocarditis

10 THE PROSTHETIC VALVE DISEASE B. Sareyyupoglu et al, Ann Thorac Surg 2009;88:

11 RATE OF PROGRESSION Initial gradient in patients with isolated CABG J. Tam et al, Ann Thorac Surg 1998;65:

12 RATE OF PROGRESSION FINDINGS A) Calcified AV with initial gradient 0 mm Hg Progression gradient: 3,9 mm Hg per year B) Calcified AV with initial gradient 25 mm Hg Progression gradient: 7,1 mm Hg per year Initial gradient in patients with isolated CABG S.W. Davis et al, Eur Heart J, 1991;12:10 14

13 RATE OF PROGRESSION Severity of Valvular Calcification J. Tam et al, Ann Thorac Surg 1998;65:

14 RATE OF PROGRESSION A) Degenerative (more rapid progression) B) Rheumatic C) Related to Congenital Deformation Pathology of Valvular Stenosis J.J Collins et al, J Cardiac Surgery, 1994;9:145 7

15 RATE OF PROGRESSION A) LV Hypertrophy B) Systematic Atheromatosous Disease C) Elderly # Need for medical treatment Comorbidities which lead to more rapid progression W.T. Smith et al, J Am Coll Cardio, 2004;44:1241 7

16 RATE OF PROGRESSION D) Chronic Renal Failure - Haemodialysis HIGHLY PROGRESSION INCREASED MORTALITY (TOWARDS 39%) LOWER SURVIVAL RATE (1 year: 59% - 5 years: 21%) Comorbidities which lead to more rapid progression B. Sareyyupoglu et al, Ann Thorac Surg 2009;88:

17 OUTCOMES REOPERATION FREE SURVIVAL B. Sareyyupoglu et al, Ann Thorac Surg 2009;88:

18 OUTCOMES ALL CAUSE MORTALITY 107 CABG patients VS 209 CABG + AVR patients # 10 years survival, Mayo Clinic, 2009

19 If the decision favors combined surgery...

20 A) CABG + MILD AORTIC STENOSIS IMPACT OF MULTIPLE GRAFTS B) 86 CABG x 1 (CAD 1,76 ± 1,1) 81 CABG x 2 (CAD 2,90 ± 1,3) 66 CABG x3 (CAD 3,73 ± 1,2) C) Mean Age 75 ± 10,1, 73 ± 11, 72 ± 10 D) Lima to LAD: 94%, 92%, 94% Multiple VS Incomplete Revascularization E) Mortality: 9,3%, 11,1%, 7,6% F) Predictors: Age >65, E.F. <30, Urgency, COPD, NYHA III or IV K.J. Kobayashi et al, Ann Thorac Surg 2007;83:969 78

21 IMPACT OF MULTIPLE GRAFTS Multiple VS Incomplete Revascularization K.J. Kobayashi et al, Ann Thorac Surg 2007;83:969 78

22 IMPACT OF MULTIPLE GRAFTS Complete VS Incomplete Revascularization K.J. Kobayashi et al, Ann Thorac Surg 2007;83:969 78

23 If the decision favors combined surgery...

24 EFFICACY OF IMA IMA to LAD favors 5 YEARS SURVIVAL 63 ± 7 % (IMA group) 42 ± 5 % (SVG group) S.Gall et al, Ann Thorac Surg 2000;69:

25 EFFICACY OF IMA IMA to LAD favors 5 YEARS SURVIVAL S.Gall et al, Ann Thorac Surg 2000;69:

26 EFFICACY OF IMA Open LAD or LIMA to LAD have similar survival and proven superior than SVG to LAD S.Gall et al, Ann Thorac Surg 2000;69:

27 If the decision favors combined surgery...

28 CHOICE OF VALVE ACCORDING TO AGE

29 B-AVR versus M-AVR B-AVR versus predicted survival M-AVR versus predicted survival C. Akins et al, Ann Thorac Surg 2002;74:

30 If the decision favors combined surgery...

31 WHICH TECHNIQUE? 1 CLASSICAL CABG + AVR 2 OPCAB + AVR

32 WHICH TECHNIQUE? 3 OPCAB + TAVI (transapical) 4 PCI + TAVI (transcutaneous)

33 1 CLASSICAL CABG + AVR Classical method extends the CPB and aortic X-clamb time

34 2 CABG + MILD AORTIC STENOSIS OPCAB + AVR Henry Dunant Hospital

35 OPCAB + AVR

36 OPCAB + AVR

37 OPCAB + AVR Henry Dunant Hospital

38 OPCAB + AVR Henry Dunant Hospital

39 OPCAB + AVR Henry Dunant Hospital

40 OPCAB + AVR Henry Dunant Hospital

41 Henry Dunant Hospital CABG + MILD AORTIC STENOSIS OPCAB + AVR PATIENTS (4 REDOS) Mean Age 72 Years Bioprosthetic: 97 Metalic:59

42 Henry Dunant Hospital CABG + MILD AORTIC STENOSIS OPCAB + AVR 30 days Mortality 3 / 156 (1,9%) 10 Years Survival 82 %

43 3 OPCAB + TAVI (transapical)

44 4 PCI + TAVI (transcutaneous)

45 CONCLUSIONS The decision of simultaneous treatment of mild aortic stenosis, in patients undergoing coronary revascularization, must be made, based on the evaluation of every case. Both groups of patients, the one of isolated CABG and the one of combined operation with AVR, as proven, have similar long term survival. But, a great percentage of patients from the first group, must undergo a redo operation, basically AVR one, because of progression of aortic stenosis.

46 CONCLUSIONS The decision of combined operation must be made based on the additional risk factors for every individual patient, as well as the estimated, for every case, progression of the aortic stenosis. Patients prone to faster progression of the stenosis, are those with an atheromatosous aortic stenosis, as well as those who are on chronic dialysis. Consequently, simultaneous AVR must be performed basically in patients with renal insufficiency -despite the high risk-, and in patients with degenerative calcified stenosis, who have a relevant higher gradient and higher calcification rate, especially if they are young.

47 CONCLUSIONS The use of IMA for LAD revascularization is beneficial for the long term cumulative survival. The use of bioprosthetic valves is related to better long term cumulative survival, compared with predective for age-and-gender-matched controls. Therefore, in combined operation of CABG + AVR, the use of bioprosthetic valve, should be considered even for younger patients.

48 CONCLUSIONS In combined surgery, the most important of all, in all groups of patients is the revascularization of the LAD using the LIMA. Even incomplete revascularization Is proven beneficial for older patients. OPCABG combined with AVR, as performed in our Department, in Henry Dunant Hospital, proves to be beneficial, while the perioperative mortality is lower that the STS mortality predicted.

49 CONCLUSIONS PCI + TAVI transcutaneous, applied in high risk patients has similar cumulative survival compared to the combined surgery and ranges around 12%. The use of Transapical TAVI in patients who previously underwent a ByPass operation has similar risk compared to the use of TAVI in patients with aortic stenosis, diagnosed for the first time.

50 CONCLUSIONS The final decision for a combined CABG + AVR operation must be taken according to the parameters related to each individual patient and to the Surgeon s experience. Ideally, this decision must be taken by a HEART TEAM.

51 Благодаря Thank you

Surgical AVR: Are there any contraindications? Pyowon Park Samsung Medical Center Seoul, Korea

Surgical AVR: Are there any contraindications? Pyowon Park Samsung Medical Center Seoul, Korea Surgical AVR: Are there any contraindications? Pyowon Park Samsung Medical Center Seoul, Korea Contents Decision making in surgical AVR in old age Clinical results of AVR with tissue valve Impact of 19mm

More information

Paris, August 28 th Gian Paolo Ussia on behalf of the CoreValve Italian Registry Investigators

Paris, August 28 th Gian Paolo Ussia on behalf of the CoreValve Italian Registry Investigators Paris, August 28 th 2011 Is TAVI the definitive treatment in high risk patients? Impact Of Coronary Artery Disease In Elderly Patients Undergoing TAVI: Insight The Italian CoreValve Registry Gian Paolo

More information

Potential conflicts of interest

Potential conflicts of interest Potential conflicts of interest Speaker's name: Petros Dardas MEDTRONIC proctor for TAVI Intermediate risk 83 FEMALE COAD SEVERE AS NYHA III Mean gradient 35 mmhg, AVA 0.45cm2, SVI 21ml/m2 Paradoxical

More information

Extension to medium and low risk patients? Friedrich Eckstein University Hospital Basel

Extension to medium and low risk patients? Friedrich Eckstein University Hospital Basel TAVI CON Extension to medium and low risk patients? Friedrich Eckstein University Hospital Basel Extension to medium and low risk patients? In octogenerians already reality in most of the swiss clinics!?

More information

42yr Old Male with Severe AR Mild LV dysfunction s/p TOF -AV Replacement(tissue valve) or AoV plasty- Kyung-Hwan Kim

42yr Old Male with Severe AR Mild LV dysfunction s/p TOF -AV Replacement(tissue valve) or AoV plasty- Kyung-Hwan Kim 42yr Old Male with Severe AR Mild LV dysfunction s/p TOF -AV Replacement(tissue valve) or AoV plasty- Kyung-Hwan Kim Current Guideline for AR s/p TOF Surgery is reasonable in adults with prior repair of

More information

TAVR y Enfermedad Coronaria. Mauricio G. Cohen, MD, FACC, FSCAI Director, Cardiac Catheterization Lab Associate Professor of Medicine

TAVR y Enfermedad Coronaria. Mauricio G. Cohen, MD, FACC, FSCAI Director, Cardiac Catheterization Lab Associate Professor of Medicine TAVR y Enfermedad Coronaria Mauricio G. Cohen, MD, FACC, FSCAI Director, Cardiac Catheterization Lab Associate Professor of Medicine CAD and AS Similar Pathological Processes CAD in TAVR Patients (n=390)

More information

Outcome of elderly patients with severe but asymptomatic aortic stenosis

Outcome of elderly patients with severe but asymptomatic aortic stenosis Outcome of elderly patients with severe but asymptomatic aortic stenosis Robert Zilberszac, Harald Gabriel, Gerald Maurer, Raphael Rosenhek Department of Cardiology Medical University of Vienna ESC Congress

More information

Bicuspid aortic root spared during ascending aorta surgery: an update of long-term results

Bicuspid aortic root spared during ascending aorta surgery: an update of long-term results Short Communication Bicuspid aortic root spared during ascending aorta surgery: an update of long-term results Marco Russo, Guglielmo Saitto, Paolo Nardi, Fabio Bertoldo, Carlo Bassano, Antonio Scafuri,

More information

Aortic Stenosis: Interventional Choice for a 70-year old- SAVR, TAVR or BAV? Interventional Choice for a 90-year old- SAVR, TAVR or BAV?

Aortic Stenosis: Interventional Choice for a 70-year old- SAVR, TAVR or BAV? Interventional Choice for a 90-year old- SAVR, TAVR or BAV? Aortic Stenosis: Interventional Choice for a 70-year old- SAVR, TAVR or BAV? Interventional Choice for a 90-year old- SAVR, TAVR or BAV? Samin K Sharma, MD, FACC, FSCAI Director Clinical & Interventional

More information

Mechanical vs. Bioprosthetic Aortic Valve Replacement: Time to Reconsider? Christian Shults, MD Cardiac Surgeon, Medstar Heart and Vascular Institute

Mechanical vs. Bioprosthetic Aortic Valve Replacement: Time to Reconsider? Christian Shults, MD Cardiac Surgeon, Medstar Heart and Vascular Institute Mechanical vs. Bioprosthetic Aortic Valve Replacement: Time to Reconsider? Christian Shults, MD Cardiac Surgeon, Medstar Heart and Vascular Institute Assistant Professor, Georgetown School of Medicine

More information

Valve Disease. Valve Surgery. Total Volume. In 2016, Cleveland Clinic surgeons performed 3039 valve surgeries.

Valve Disease. Valve Surgery. Total Volume. In 2016, Cleveland Clinic surgeons performed 3039 valve surgeries. Valve Surgery Total Volume 1 1 Volume 35 3 5 15 1 5 1 13 1 N = 773 5 79 15 93 1 339 In 1, surgeons performed 339 valve surgeries. surgeons have implanted more than 1, bioprosthetic aortic valves since

More information

Valvular Intervention

Valvular Intervention Valvular Intervention Outline Introduction Aortic Stenosis Mitral Regurgitation Conclusion Calcific Aortic Stenosis Deformed Eccentric Calcified Nodular Rigid HOSTILE TARGET difficult to displace prone

More information

It is controversial whether to perform aortic valve replacement

It is controversial whether to perform aortic valve replacement Management of Patients With Mild Aortic Stenosis Undergoing Coronary Artery Bypass Grafting James W. Tam, MD, Roy G. Masters, MD, Ian G. Burwash, MD, Alain D. Mayhew, BS, and Kwan-Leung Chan, MD University

More information

When Should We Consider TAVI. (Surgeon s Viewpoint)? Pyowon Park Samsung Medical Center Seoul, Korea

When Should We Consider TAVI. (Surgeon s Viewpoint)? Pyowon Park Samsung Medical Center Seoul, Korea When Should We Consider TAVI Procedure in Korea (Surgeon s Viewpoint)? Pyowon Park Samsung Medical Center Seoul, Korea Aortic Stenosis in Korea Rapidly increasing valve disease in Korea Still low incidence

More information

Experience with 500 Stentless Aortic Valve Replacements

Experience with 500 Stentless Aortic Valve Replacements Experience with 500 Stentless Aortic Valve Replacements Dimitrios C. Iliopoulos, MD Cardiac Surgeon Ass. Professor of Surgery University of Athens, School of Medicine I declare no conflict of interest

More information

Expanding Relevance of Aortic Valve Repair Is Earlier Operation Indicated?

Expanding Relevance of Aortic Valve Repair Is Earlier Operation Indicated? Expanding Relevance of Aortic Valve Repair Is Earlier Operation Indicated? RM Suri, V Sharma, JA Dearani, HM Burkhart, RC Daly, LD Joyce, HV Schaff Division of Cardiovascular Surgery, Mayo Clinic, Rochester,

More information

TAVI- Is Stroke Risk the Achilles Heel of Percutaneous Aortic Valve Repair?

TAVI- Is Stroke Risk the Achilles Heel of Percutaneous Aortic Valve Repair? TAVI- Is Stroke Risk the Achilles Heel of Percutaneous Aortic Valve Repair? Elaine E. Tseng, MD and Marlene Grenon, MD Department of Surgery Divisions of Adult Cardiothoracic and Vascular and Endovascular

More information

AS with reduced LV ejection fraction: Contractile reserve should be systematically assessed: PRO

AS with reduced LV ejection fraction: Contractile reserve should be systematically assessed: PRO AS with reduced LV ejection fraction: Contractile reserve should be systematically assessed: PRO Jean-Luc MONIN, MD, PhD Henri Mondor University Hospital Créteil, FRANCE Potential conflicts of interest

More information

FFR and CABG Emanuele Barbato, MD, PhD, FESC Cardiovascular Center Aalst, Belgium

FFR and CABG Emanuele Barbato, MD, PhD, FESC Cardiovascular Center Aalst, Belgium FFR and CABG Emanuele Barbato, MD, PhD, FESC Cardiovascular Center Aalst, Belgium Conflict of Interest Institutional research grants and speaker s fee from St. Jude Medical and Boston Scientic to Cardiovascular

More information

Carpentier-Edwards Pericardial Valve in the Aortic Position: 25-Years Experience

Carpentier-Edwards Pericardial Valve in the Aortic Position: 25-Years Experience SURGERY: The Annals of Thoracic Surgery CME Program is located online at http://www.annalsthoracicsurgery.org/cme/ home. To take the CME activity related to this article, you must have either an STS member

More information

Moderate Aortic Stenosis in Coronary Artery Bypass Grafting Patients More Than 70 Years of Age: To Replace or Not to Replace?

Moderate Aortic Stenosis in Coronary Artery Bypass Grafting Patients More Than 70 Years of Age: To Replace or Not to Replace? Moderate Aortic Stenosis in Coronary Artery Bypass Grafting Patients More Than 70 Years of Age: To Replace or Not to Replace? François Dagenais, MD, Patrick Mathieu, MD, Daniel Doyle, MD, Éric Dumont,

More information

Management of Difficult Aortic Root, Old and New solutions

Management of Difficult Aortic Root, Old and New solutions Management of Difficult Aortic Root, Old and New solutions Hani K. Najm MD, Msc, FRCSC,, FACC, FESC Chairman, Pediatric and Congenital Heart Surgery Cleveland Clinic Conflict of Interest None Difficult

More information

Emergency Intraoperative Echocardiography

Emergency Intraoperative Echocardiography Emergency Intraoperative Echocardiography Justiaan Swanevelder Department of Anaesthesia, Glenfield Hospital University Hospitals of Leicester NHS Trust, UK Carl Gustav Jung (1875-1961) Your vision will

More information

TAVR for Valve-In-Valve. Brian O Neill Assistant Professor of Medicine Department of Medicine, Section of Cardiology

TAVR for Valve-In-Valve. Brian O Neill Assistant Professor of Medicine Department of Medicine, Section of Cardiology TAVR for Valve-In-Valve Brian O Neill Assistant Professor of Medicine Department of Medicine, Section of Cardiology Temple Hearth and Vascular Institute Disclosures: Consultant: Cardiac Assist TAVR for

More information

Valve Disease. Valve Surgery. In 2015, Cleveland Clinic surgeons performed 2943 valve surgeries.

Valve Disease. Valve Surgery. In 2015, Cleveland Clinic surgeons performed 2943 valve surgeries. Valve Surgery 11 15 Volume 3 1 11 1 13 1 N = 1 773 5 79 15 93 In 15, surgeons performed 93 valve surgeries. surgeons have implanted more than 1,5 bioprosthetic aortic valves since the 199s, with excellent

More information

Transcatheter aortic valve implantation and pre-procedural risk assesment

Transcatheter aortic valve implantation and pre-procedural risk assesment Transcatheter aortic valve implantation and pre-procedural risk assesment Alec Vahanian,FESC, FRCP(Edin.) Bichat Hospital University Paris VII, Paris, France Disclosures Relationship with companies who

More information

TRANSCATHETER AORTIC VALVE IMPLANTATION: PSCC EXPERIENCE DR HUSSEIN ALAMRI PSCC RIYADH

TRANSCATHETER AORTIC VALVE IMPLANTATION: PSCC EXPERIENCE DR HUSSEIN ALAMRI PSCC RIYADH TRANSCATHETER AORTIC VALVE IMPLANTATION: PSCC EXPERIENCE DR HUSSEIN ALAMRI PSCC RIYADH Available systems: Edwards (TA and TF) and Core valve. INTRODUCTION 3 4% 0f > 65 y. 30 40% of elderly denied surgery,.

More information

Prof. Patrizio LANCELLOTTI, MD, PhD Heart Valve Clinic, University of Liège, CHU Sart Tilman, Liège, BELGIUM

Prof. Patrizio LANCELLOTTI, MD, PhD Heart Valve Clinic, University of Liège, CHU Sart Tilman, Liège, BELGIUM The Patient with Aortic Stenosis and Mitral Regurgitation Prof. Patrizio LANCELLOTTI, MD, PhD Heart Valve Clinic, University of Liège, CHU Sart Tilman, Liège, BELGIUM Aortic Stenosis + Mitral Regurgitation?

More information

OPCAB IS NOT BETTER THAN CONVENTIONAL CABG

OPCAB IS NOT BETTER THAN CONVENTIONAL CABG OPCAB IS NOT BETTER THAN CONVENTIONAL CABG Harold L. Lazar, M.D. Harold L. Lazar, M.D. Professor of Cardiothoracic Surgery Boston Medical Center and the Boston University School of Medicine Boston, MA

More information

Indication, Timing, Assessment and Update on TAVI

Indication, Timing, Assessment and Update on TAVI Indication, Timing, Assessment and Update on TAVI Swedish Heart and Vascular Institute Ming Zhang MD PhD Interventional Cardiology Structure Heart Disease Conflict of Interest None Starr- Edwards Mechanical

More information

Hani K. Najm MD, Msc, FRCSC FACC, FESC President Saudi Society for Cardiac Surgeons Associate Professor of Cardiothoracic Surgery King Abdulaziz

Hani K. Najm MD, Msc, FRCSC FACC, FESC President Saudi Society for Cardiac Surgeons Associate Professor of Cardiothoracic Surgery King Abdulaziz Hani K. Najm MD, Msc, FRCSC FACC, FESC President Saudi Society for Cardiac Surgeons Associate Professor of Cardiothoracic Surgery King Abdulaziz Cardiac Centre Riyadh, Saudi Arabia Decision process for

More information

Hani K. Najm MD, Msc, FRCSC, FRCS (Glasgow), FACC, FESC President of Saudi Heart Association King Abdulaziz Cardiac Centre Riyadh, Saudi Arabia.

Hani K. Najm MD, Msc, FRCSC, FRCS (Glasgow), FACC, FESC President of Saudi Heart Association King Abdulaziz Cardiac Centre Riyadh, Saudi Arabia. Hani K. Najm MD, Msc, FRCSC, FRCS (Glasgow), FACC, FESC President of Saudi Heart Association King Abdulaziz Cardiac Centre Riyadh, Saudi Arabia. Decision process for Management of any valve Timing Feasibility

More information

In , three studies described patients

In , three studies described patients Heart 2001;85:337 341 VALVE DISEASE Should patients with asymptomatic mild or moderate aortic stenosis undergoing coronary artery bypass surgery also have valve replacement for their aortic stenosis? Shahbudin

More information

Declaration of conflict of interest NONE

Declaration of conflict of interest NONE Declaration of conflict of interest NONE Claudio Muneretto MD, PhD Director of Division of Cardiac Surgery University of Brescia Medical School Italy Hybrid Chymera Different features and potential advantages

More information

Measuring the risk in valve patients Lessons learnt from the TAVI story? Bernard Iung Bichat Hospital, Paris, France

Measuring the risk in valve patients Lessons learnt from the TAVI story? Bernard Iung Bichat Hospital, Paris, France Measuring the risk in valve patients Lessons learnt from the TAVI story? Bernard Iung Bichat Hospital, Paris, France Faculty disclosure Bernard Iung I disclose the following financial relationships: Consultant

More information

Aortic Valve Practice Guidelines: What Has Changed and What You Need to Know

Aortic Valve Practice Guidelines: What Has Changed and What You Need to Know Aortic Valve Practice Guidelines: What Has Changed and What You Need to Know James F. Burke, MD Program Director Cardiovascular Disease Fellowship Lankenau Medical Center Disclosure Dr. Burke has no conflicts

More information

Reverse left atrium and left ventricle remodeling after aortic valve interventions

Reverse left atrium and left ventricle remodeling after aortic valve interventions Reverse left atrium and left ventricle remodeling after aortic valve interventions Alexandra Gonçalves, Cristina Gavina, Carlos Almeria, Pedro Marcos-Alberca, Gisela Feltes, Rosanna Hernández-Antolín,

More information

Decellularization of Aortic Homografts: South American and European Current Experience

Decellularization of Aortic Homografts: South American and European Current Experience Department of Cardiac Surgery Instituto de Neurologia e Cardiologia de Curitiba (INC-Cardio) Decellularization of Aortic Homografts: South American and European Current Experience Francisco Diniz Affonso

More information

Mitral Valve Surgery: Lessons from New York State

Mitral Valve Surgery: Lessons from New York State Mitral Valve Surgery: Lessons from New York State Joanna Chikwe, MD Professor of Cardiovascular Surgery Icahn School of Medicine at Mount Sinai Chairman & Program Director Department of Cardiovascular

More information

Valve Disease in Patients With Heart Failure TAVI or Surgery? Miguel Sousa Uva Hospital Cruz Vermelha Lisbon, Portugal

Valve Disease in Patients With Heart Failure TAVI or Surgery? Miguel Sousa Uva Hospital Cruz Vermelha Lisbon, Portugal Valve Disease in Patients With Heart Failure TAVI or Surgery? Miguel Sousa Uva Hospital Cruz Vermelha Lisbon, Portugal I have nothing to disclose. Wide Spectrum Stable vs Decompensated NYHA II IV? Ejection

More information

Options for my no option Patients Treating Heart Conditions Via a Tiny Catheter

Options for my no option Patients Treating Heart Conditions Via a Tiny Catheter Options for my no option Patients Treating Heart Conditions Via a Tiny Catheter Nirat Beohar, MD Associate Professor of Medicine Director Cardiac Catheterization Laboratory, Medical Director Structural

More information

Reoperation for Bioprosthetic Mitral Structural Failure: Risk Assessment

Reoperation for Bioprosthetic Mitral Structural Failure: Risk Assessment Reoperation for Bioprosthetic Mitral Structural Failure: Risk Assessment W.R.E. Jamieson, MD; L.H. Burr, MD; R.T. Miyagishima, MD; M.T. Janusz, MD; G.J. Fradet, MD; S.V. Lichtenstein, MD; H. Ling, MD Background

More information

Coronary Artery Bypass Grafting in Diabetics: All Arterial or Hybrid?

Coronary Artery Bypass Grafting in Diabetics: All Arterial or Hybrid? Coronary Artery Bypass Grafting in Diabetics: All Arterial or Hybrid? Dr. Daniel Navia M.D. Chief Cardiac Surgery Department ICBA, Buenos Aires Argentina, 2018 No disclosures 2 Current evidence The FREEDOM

More information

Role of Sutureless Valves in the Surgeon s Armamentarium Prof. Dr Malakh Shrestha Vice Chair, Director of Aortic Surgery Cardiothoracic,

Role of Sutureless Valves in the Surgeon s Armamentarium Prof. Dr Malakh Shrestha Vice Chair, Director of Aortic Surgery Cardiothoracic, Role of Sutureless Valves in the Surgeon s Armamentarium Prof. Dr Malakh Shrestha Vice Chair, Director of Aortic Surgery Cardiothoracic, transplantation and Vascular Surgery Hannover Medical School, Germany

More information

DESCRIPTION: Percentage of patients aged 18 years and older undergoing isolated CABG surgery who received an IMA graft

DESCRIPTION: Percentage of patients aged 18 years and older undergoing isolated CABG surgery who received an IMA graft Measure #43 (NQF 0134): Coronary Artery Bypass Graft (CABG): Use of Internal Mammary Artery (IMA) in Patients with Isolated CABG Surgery National Quality Strategy Domain: Effective Clinical Care 2017 OPTIONS

More information

The Ross Procedure: Outcomes at 20 Years

The Ross Procedure: Outcomes at 20 Years The Ross Procedure: Outcomes at 20 Years Tirone David Carolyn David Anna Woo Cedric Manlhiot University of Toronto Conflict of Interest None The Ross Procedure 1990 to 2004 212 patients: 66% 34% Mean age:

More information

Off Pump CABG is Dead. Hopeman Lecture Debate T. Brett Reece, MD September 10, 2007

Off Pump CABG is Dead. Hopeman Lecture Debate T. Brett Reece, MD September 10, 2007 Off Pump CABG is Dead Hopeman Lecture Debate T. Brett Reece, MD September 10, 2007 OPCAB Potential Pitfalls Technically Demanding Steep learning curve Incomplete revascularization Intraoperative ischemia

More information

Does Patient-Prosthesis Mismatch Affect Long-term Results after Mitral Valve Replacement?

Does Patient-Prosthesis Mismatch Affect Long-term Results after Mitral Valve Replacement? Original Article Does Patient-Prosthesis Mismatch Affect Long-term Results after Mitral Valve Replacement? Hiroaki Sakamoto, MD, PhD, and Yasunori Watanabe, MD, PhD Background: Recently, some articles

More information

Aortic Stenosis: Background

Aortic Stenosis: Background Transcatheter Aortic Valve Replacement in Low Surgical Risk Patients Barry George, MD The Ohio State University Structural Heart Disease Course May 19 th, 2017 Aortic Stenosis: Background Severe Symptomatic

More information

Prince Sultan Cardiac Center Experience Riyadh, Saudi Arabia

Prince Sultan Cardiac Center Experience Riyadh, Saudi Arabia Transcatheter Transapical Aortic Valve Implantation Prince Sultan Cardiac Center Experience Riyadh, Saudi Arabia Ahmed Elwatidy, MD,PhD, FRCS S Kassab, MD,S Ahmari, MD, H Amri, MD, H Ismail, MD, A Calafiori,

More information

Policy Specific Section: March 30, 2012 March 7, 2013

Policy Specific Section: March 30, 2012 March 7, 2013 Medical Policy Transcatheter Aortic Valve Replacement for Aortic Stenosis Type: Medical Necessity and Investigational / Experimental Policy Specific Section: Surgery Original Policy Date: Effective Date:

More information

Mixed aortic valve disease

Mixed aortic valve disease Mixed aortic valve disease IOANNIS NTALAS MD, PhD Cardiologist, Clinical Fellow in Cardiovascular Imaging & Non-Invasive Cardiology, St Thomas Hospital School of Biomedical Engineering & Imaging Sciences

More information

Australia and New Zealand Source Registry Edwards Sapien Aortic Valve 30 day Outcomes

Australia and New Zealand Source Registry Edwards Sapien Aortic Valve 30 day Outcomes Australia and New Zealand Source Registry Edwards Sapien Aortic Valve 30 day Outcomes A/ Professor Darren Walters On behalf of the ANZ Source Investigators Director of Cardiology Brisbane, Australia ANZ

More information

Gender Differences in Valvular Heart Disease. Linda D. Gillam, MD FESC Disclosure: Core Lab services Edwards Lifesciences

Gender Differences in Valvular Heart Disease. Linda D. Gillam, MD FESC Disclosure: Core Lab services Edwards Lifesciences Gender Differences in Valvular Heart Disease Linda D. Gillam, MD FESC Disclosure: Core Lab services Edwards Lifesciences Obstacles Interest in gender differences is a relatively new phenomenon Registries/RCT

More information

The increase in the lifespan of the western population

The increase in the lifespan of the western population Outcome After Aortic Valve Replacement in Octogenarians Bruno Chiappini, MD, Nicola Camurri, MD, Antonio Loforte, MD, Luca Di Marco, MD, Roberto Di Bartolomeo, MD, and Giuseppe Marinelli, MD Department

More information

Severe left ventricular dysfunction and valvular heart disease: should we operate?

Severe left ventricular dysfunction and valvular heart disease: should we operate? Severe left ventricular dysfunction and valvular heart disease: should we operate? Laurie SOULAT DUFOUR Hôpital Saint Antoine Service de cardiologie Pr A. COHEN JESFC 16 janvier 2016 Disclosure : No conflict

More information

TAVI Versus Suturless Valve In Intermediate Risk Patients

TAVI Versus Suturless Valve In Intermediate Risk Patients TAVI Versus Suturless Valve In Intermediate Risk Patients Walid Abukhudair FRCSc President of Saudi Society for Cardiac Surgeons Head of Cardiac Surgery in KFAFH Background AS is the most frequent cardiac

More information

Incremental Value of Multiple Arterial conduits in CABG

Incremental Value of Multiple Arterial conduits in CABG Incremental Value of Multiple Arterial conduits in CABG Nirav C Patel MD FRCS CTh Professor Zucker School of Medicine at Hofstra Northwell Director of Robotic Cardiac Surgery Northwell Health Vice Chairman

More information

Welcome 17 Michigan TAVR Participating Hospitals!

Welcome 17 Michigan TAVR Participating Hospitals! Welcome 17 Michigan TAVR Participating Hospitals! 1 MICHIGAN TAVR BRIEF OVERVIEW HOW AND WHY PRE-TAVR IMAGING EVALUATION AND THE TVT Michael Grossman, MD Co-Director, BMC2 Coordinating Center Why Michigan

More information

The Role Of Decellularized Valve Prostheses In The Young Patient

The Role Of Decellularized Valve Prostheses In The Young Patient The Role Of Decellularized Valve Prostheses In The Young Patient Francisco Diniz Affonso da Costa Human Tissue Bank PUCPR - Brazil Disclosures Ownership and patent license of the SDS decellularization

More information

Robotic & Hybrid Coronary Revascularization

Robotic & Hybrid Coronary Revascularization Robotic & Hybrid Coronary Revascularization Michael Chu, MD, FRCSC Associate Professor of Surgery Western University, London Health Sciences Centre, London, ON, Canada Saudi Heart Association 2017 Riyadh,

More information

Although mitral valve replacement (MVR) is no longer the surgical

Although mitral valve replacement (MVR) is no longer the surgical Surgery for Acquired Cardiovascular Disease Ruel et al Late incidence and predictors of persistent or recurrent heart failure in patients with mitral prosthetic valves Marc Ruel, MD, MPH a,b Fraser D.

More information

Ischemic Mitral Valve Disease: Repair, Replace or Ignore?

Ischemic Mitral Valve Disease: Repair, Replace or Ignore? Ischemic Mitral Valve Disease: Repair, Replace or Ignore? Fabio B. Jatene Full Professor of Cardiovascular Surgery, Medical School, University of São Paulo, Brazil DISCLOSURE I have no financial relationship

More information

Prospective Evaluation of the Eyeball Test for Assessing Frailty in Elderly Patients with Valvular Heart Disease

Prospective Evaluation of the Eyeball Test for Assessing Frailty in Elderly Patients with Valvular Heart Disease Prospective Evaluation of the Eyeball Test for Assessing Frailty in Elderly Patients with Valvular Heart Disease Background Frailty is a common occurrence in elderly patients Approximately half of the

More information

Aortic valve implantation using the femoral and apical access: a single center experience.

Aortic valve implantation using the femoral and apical access: a single center experience. Aortic valve implantation using the femoral and apical access: a single center experience. R. Hoffmann, K. Brehmer, R. Koos, R. Autschbach, N. Marx, G. Dohmen Rainer Hoffmann, University Aachen, Germany

More information

A 20-year experience of 1712 patients with the Biocor porcine bioprosthesis

A 20-year experience of 1712 patients with the Biocor porcine bioprosthesis Acquired Cardiovascular Disease Mykén and Bech-Hansen A 2-year experience of 1712 patients with the Biocor porcine bioprosthesis Pia S. U. Mykén, MD, PhD, a and Odd Bech-Hansen, MD, PhD b Objective: The

More information

CIPG Transcatheter Aortic Valve Replacement- When Is Less, More?

CIPG Transcatheter Aortic Valve Replacement- When Is Less, More? CIPG 2013 Transcatheter Aortic Valve Replacement- When Is Less, More? James D. Rossen, M.D. Professor of Medicine and Neurosurgery Director, Cardiac Catheterization Laboratory and Interventional Cardiology

More information

TAVR 2018: Cost-effective according to baseline patient risk. A real-world case example

TAVR 2018: Cost-effective according to baseline patient risk. A real-world case example TAVR 2018: Cost-effective according to baseline patient risk A real-world case example Male, 74 years old HTN, dyslipidaemia, CAD, PAD Past Hx 1991: CABG (LIMA LAD, SVG RCA) 2014: carotid endarterectomy

More information

Aortic Stenosis: UPDATE Anjan Sinha, MD Krannert Institute of Cardiology

Aortic Stenosis: UPDATE Anjan Sinha, MD Krannert Institute of Cardiology Aortic Stenosis: UPDATE 2010 Anjan Sinha, MD Krannert Institute of Cardiology None Disclosures 67-Year-Old Male Dyspnea and angina Class III heart failure No PND or orthopnea 3/6 late peak SEM Diminished

More information

Outcomes of Mitral Valve Repair for Mitral Regurgitation Due to Degenerative Disease

Outcomes of Mitral Valve Repair for Mitral Regurgitation Due to Degenerative Disease Outcomes of Mitral Valve Repair for Mitral Regurgitation Due to Degenerative Disease TIRONE E. DAVID, MD ; SEMIN THORAC CARDIOVASC SURG 19:116-120c 2007 ELSEVIER INC. PRESENTED BY INTERN 許士盟 Mitral valve

More information

EuroSCORE Predicts Short- and Mid-Term Mortality in Combined Aortic Valve Replacement and Coronary Artery Bypass Patients

EuroSCORE Predicts Short- and Mid-Term Mortality in Combined Aortic Valve Replacement and Coronary Artery Bypass Patients c 2009 Wiley Periodicals, Inc. 637 EuroSCORE Predicts Short- and Mid-Term Mortality in Combined Aortic Valve Replacement and Coronary Artery Bypass Patients Kimiyoshi J. Kobayashi, B.S., Jason A. Williams,

More information

On-Pump vs. Off-Pump CABG: The Controversy Continues. Miguel Sousa Uva Immediate Past President European Association for Cardiothoracic Surgery

On-Pump vs. Off-Pump CABG: The Controversy Continues. Miguel Sousa Uva Immediate Past President European Association for Cardiothoracic Surgery On-Pump vs. Off-Pump CABG: The Controversy Continues Miguel Sousa Uva Immediate Past President European Association for Cardiothoracic Surgery On-pump vs. Off-Pump CABG: The Controversy Continues Conflict

More information

TAVR in patients with. End-Stage CKD or in Renal Replacement Therapy:

TAVR in patients with. End-Stage CKD or in Renal Replacement Therapy: TAVR in patients with End-Stage CKD or in Renal Replacement Therapy: Special Considerations and Prevention of early Valve Failure Antonios Chalapas, MD, PhD, FESC THV & Hygeia Hospital Heart Team Athens,

More information

Presenter Disclosure. Patrick O. Myers, M.D. No Relationships to Disclose

Presenter Disclosure. Patrick O. Myers, M.D. No Relationships to Disclose Presenter Disclosure Patrick O. Myers, M.D. No Relationships to Disclose Aortic Valve Repair by Cusp Extension for Rheumatic Aortic Insufficiency in Children Long term Results and Impact of Extension Material

More information

Kinsing Ko, Thom de Kroon, Najim Kaoui, Bart van Putte, Nabil Saouti. St. Antonius Hospital, Nieuwegein, The Netherlands

Kinsing Ko, Thom de Kroon, Najim Kaoui, Bart van Putte, Nabil Saouti. St. Antonius Hospital, Nieuwegein, The Netherlands Minimal Invasive Mitral Valve Surgery After Previous Sternotomy Without Aortic Clamping: Short- and Long Term Results of a Single Surgeon Single Institution Kinsing Ko, Thom de Kroon, Najim Kaoui, Bart

More information

Five-Year Outcomes of Transcatheter Aortic Valve Replacement (TAVR) in Inoperable Patients With Severe Aortic Stenosis: The PARTNER Trial

Five-Year Outcomes of Transcatheter Aortic Valve Replacement (TAVR) in Inoperable Patients With Severe Aortic Stenosis: The PARTNER Trial Five-Year Outcomes of Transcatheter Aortic Valve Replacement (TAVR) in Inoperable Patients With Severe Aortic Stenosis: The PARTNER Trial Samir R. Kapadia, MD On behalf of The PARTNER Trial Investigators

More information

Revascularization after Drug-Eluting Stent Implantation or Coronary Artery Bypass Surgery for Multivessel Coronary Disease

Revascularization after Drug-Eluting Stent Implantation or Coronary Artery Bypass Surgery for Multivessel Coronary Disease Impact of Angiographic Complete Revascularization after Drug-Eluting Stent Implantation or Coronary Artery Bypass Surgery for Multivessel Coronary Disease Young-Hak Kim, Duk-Woo Park, Jong-Young Lee, Won-Jang

More information

The operative mortality rate after redo valvular operations

The operative mortality rate after redo valvular operations Clinical Outcomes of Redo Valvular Operations: A 20-Year Experience Naoto Fukunaga, MD, Yukikatsu Okada, MD, Yasunobu Konishi, MD, Takashi Murashita, MD, Mitsuru Yuzaki, MD, Yu Shomura, MD, Hiroshi Fujiwara,

More information

Essential Support for a Structural Heart Program: The Valve and Structural Heart Clinic

Essential Support for a Structural Heart Program: The Valve and Structural Heart Clinic Essential Support for a Structural Heart Program: The Valve and Structural Heart Clinic Vincent Varghese, DO, FACC, FSCAI Director, Interventional Cardiology Fellowship Program Deborah Heart and Lung Center

More information

A Surgeon s Perspective Guidelines for the Management of Patients with Valvular Heart Disease Adapted from the 2006 ACC/AHA Guideline Revision

A Surgeon s Perspective Guidelines for the Management of Patients with Valvular Heart Disease Adapted from the 2006 ACC/AHA Guideline Revision A Surgeon s Perspective Guidelines for the Management of Patients with Valvular Heart Disease Adapted from the 2006 ACC/AHA Guideline Revision Prof. Pino Fundarò, MD Niguarda Hospital Milan, Italy Introduction

More information

Worldwide rheumatic fever is the most common cause of valve disease. In industrialized areas, valvular disease of old age predominates

Worldwide rheumatic fever is the most common cause of valve disease. In industrialized areas, valvular disease of old age predominates Michael Sumners DO Epidemiology Worldwide rheumatic fever is the most common cause of valve disease In industrialized areas, valvular disease of old age predominates Calcific aortic stenosis Functional

More information

OPCAB: A second or a conventional approach The aorta non-touch technique using the π-graft. Sotirios N. Prapas, MD FECTS

OPCAB: A second or a conventional approach The aorta non-touch technique using the π-graft. Sotirios N. Prapas, MD FECTS OPCAB: A second or a conventional approach The aorta non-touch technique using the π-graft Sotirios N. Prapas, MD FECTS Director, A Cardiac Surgery Department Henry Dunant LOGO Hospital Center Historical

More information

The Ins and Outs of Cardiac Surgery. Stephanie Wold RN MN NP

The Ins and Outs of Cardiac Surgery. Stephanie Wold RN MN NP The Ins and Outs of Cardiac Surgery Stephanie Wold RN MN NP 1 The Ins and Outs of Cardiac Surgery Cardiac Surgery in a Nutshell 2 Outline Wait Times and Referral Process for Cardiac Surgery Getting Ready

More information

Long-term results (22 years) of the Ross Operation a single institutional experience

Long-term results (22 years) of the Ross Operation a single institutional experience Long-term results (22 years) of the Ross Operation a single institutional experience Authors: Costa FDA, Schnorr GM, Veloso M,Calixto A, Colatusso D, Balbi EM, Torres R, Ferreira ADA, Colatusso C Department

More information

Neal Kleiman, MD Houston Methodist DeBakey Heart and Vascular Institute

Neal Kleiman, MD Houston Methodist DeBakey Heart and Vascular Institute Neal Kleiman, MD Houston Methodist DeBakey Heart and Vascular Institute Despite a 33 fold growth in the first five years, there is still tremendous variability among penetration in different countries

More information

Indications of Coronary Angiography Dr. Shaheer K. George, M.D Faculty of Medicine, Mansoura University 2014

Indications of Coronary Angiography Dr. Shaheer K. George, M.D Faculty of Medicine, Mansoura University 2014 Indications of Coronary Angiography Dr. Shaheer K. George, M.D Faculty of Medicine, Mansoura University 2014 Indications for cardiac catheterization Before a decision to perform an invasive procedure such

More information

Assessment and Preparation of Patients with TAVI. Rob Tanzola Associate Professor, Queen s University

Assessment and Preparation of Patients with TAVI. Rob Tanzola Associate Professor, Queen s University Assessment and Preparation of Patients with TAVI Rob Tanzola Associate Professor, Queen s University My patient has aortic stenosis and needs non-cardiac surgery Should (s)he get a TAVI? Rob Tanzola Associate

More information

Peri-operative results and complications in 15,964 transcatheter aortic valve implantations from the German Aortic valve RegistrY (GARY)

Peri-operative results and complications in 15,964 transcatheter aortic valve implantations from the German Aortic valve RegistrY (GARY) Peri-operative results and complications in 15,964 transcatheter aortic valve implantations from the German Aortic valve RegistrY (GARY) Thomas Walther, Christian W. Hamm, Gerhard Schuler, Alexander Berkowitsch,

More information

Appropriate Use of TAVR - now and in the future. A Surgeon s Perspective. Neil Moat Royal Brompton Hospital, London, UK

Appropriate Use of TAVR - now and in the future. A Surgeon s Perspective. Neil Moat Royal Brompton Hospital, London, UK Appropriate Use of TAVR - now and in the future A Surgeon s Perspective Neil Moat Royal Brompton Hospital, London, UK Disclosure Statement of Financial Interest Within the past 12 months, I or my spouse/partner

More information

Quality Outcomes Mitral Valve Repair

Quality Outcomes Mitral Valve Repair Quality Outcomes Mitral Valve Repair Moving Beyond Reoperation Rakesh M. Suri, D.Phil. Professor of Surgery 2015 MFMER 3431548-1 Disclosure Mayo Clinic Division of Cardiovascular Surgery Research funding

More information

Emergency surgery in acute coronary syndrome

Emergency surgery in acute coronary syndrome Emergency surgery in acute coronary syndrome Teerawoot Jantarawan Division of Cardiothoracic Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand

More information

Aortic Insufficiency: How Often Does It Occur and When To Treat

Aortic Insufficiency: How Often Does It Occur and When To Treat Aortic Insufficiency: How Often Does It Occur and When To Treat Simon Maltais, MD PhD Vice-Chair of Clinical Practice Director of MCS Program Department of Cardiovascular Surgery Mayo Clinic, Rochester,

More information

A patient with aortic stenosis and LV dysfunction EuroECHO & Other Imaging Modalities 2012 Athens, Greece

A patient with aortic stenosis and LV dysfunction EuroECHO & Other Imaging Modalities 2012 Athens, Greece A patient with aortic stenosis and LV dysfunction EuroECHO & Other Imaging Modalities 2012 Athens, Greece Jean-Luc MONIN, MD, PhD. University Hospital, Créteil, FRANCE My disclosures: Lecture and/ or consulting

More information

TAVI complication. Possible aetiology and how to manage

TAVI complication. Possible aetiology and how to manage TAVI complication. Possible aetiology and how to manage Dr Sanjeevan Pasupati Waikato Hospital, Hamilton, New Zealand Operators: Dr Sanjeevan Pasupati, Mr Nand Kejriwal, Mr Adam Elgamel Valve Positioning

More information

Results of Transapical Valves. A.P. Kappetein Dept Cardio-thoracic surgery

Results of Transapical Valves. A.P. Kappetein Dept Cardio-thoracic surgery Results of Transapical Valves A.P. Kappetein Dept Cardio-thoracic surgery Rotterda am, The Netherlands 2002 FIM 2003 2005 2006 2010 THV THV Cribier-Edwards Edwards Edwards Sapien Sapien XT Bovine pericardium

More information

Re-do aortic valve replacement after previous homograft aortic root replacement

Re-do aortic valve replacement after previous homograft aortic root replacement Re-do aortic valve replacement after previous homograft aortic root replacement Jullien Gaer, Toufan Bahrami, Fabio de Robertis, Ahmed Abdulsalam, John Pepper, NHS Foundation Trust, UK Professor Sir Magdi

More information

Less Invasive Reoperations for Aortic and Mitral Valve Disease. Peter Bent Brigham Hospital 1913

Less Invasive Reoperations for Aortic and Mitral Valve Disease. Peter Bent Brigham Hospital 1913 Shapiro CV Center 2008 Peter Bent Brigham Hospital 1913 Lawrence H. Cohn, MD, Professor of Cardiac Surgery, HMS Division of Cardiac Surgery, BWH, Boston, MA 70% of US valve patients select bioprosthetic

More information

Patient with low-flow low-gradient aortic stenosis and ischemic cardiomyopathy TAVR and possibly percutaneous revascularization

Patient with low-flow low-gradient aortic stenosis and ischemic cardiomyopathy TAVR and possibly percutaneous revascularization Patient with low-flow low-gradient aortic stenosis and ischemic cardiomyopathy TAVR and possibly percutaneous revascularization + K Spargias, MD, PhD THV Director Hygeia Hospital Disclosures - Proctor

More information

Rapid deployment aortic valve replacement for the treatment of severe aortic stenosis in high risk patients. Β. Κόλλιας, Σ. Ματιάτου, Δ. Αγγουράς.

Rapid deployment aortic valve replacement for the treatment of severe aortic stenosis in high risk patients. Β. Κόλλιας, Σ. Ματιάτου, Δ. Αγγουράς. Rapid deployment aortic valve replacement for the treatment of severe aortic stenosis in high risk patients. Οι βιοπροσθετικές αορτικές βαλβίδες ταχείας έκπτυξης στην αντιµετώπιση της σοβαρής αορτικής

More information

Implications of the New ESC/EACTS Guidelines for Myocardial Revascularization in 2011

Implications of the New ESC/EACTS Guidelines for Myocardial Revascularization in 2011 Implications of the New ESC/EACTS Guidelines for Myocardial Revascularization in 2011 Prof. Dr. Volkmar Falk Klinik für Herz- und Gefäßchirurgie, Universitätsspital Zürich, Schweiz In 2004 headlines were

More information