International conference on Cardiovascular Medicine August 01-02, 2016 Manchester, UK

Biography:

Paulina Cisneros Clavijo completed her first speciality in Cardiology in Havana Uuniversity in 2007. After she completed a second speciality as Interventional Cardiology and Hemodynamics in Buenos Aires University. She did some courses in Yale Hospital and Italian Hospital from Buenos Aires. She presented and published some papers in reputed journals and in some congress like TCT, PCR, SOLACI among others.

Abstract:

Introduction: The early myocardial reperfusion obtained by primary angioplasty can reduce morbidity and mortality from acute myocardial infarction. The delay in the decision-making plays a fundamental role in the evolution of ischemia. Objective: Determine the differences of times of miocardial infarction resolute differences in technique and/or adjuvants as well as the evolution in women who suffered an acute myocardial infarction with ST segment elevation less than 24 hours of evolution. Material & Methods: 79 consecutive patients who suffered an acute myocardial infarction with ST segment elevation (STEMI) in <24 hrs admitted in our institution since April 2012 to June 2013 were selected and prospectively analyzed. All patients underwent coronary angioplasty with premedication: 300 mg aspirin, clopidogrel and heparin 70UI 600 mg/kg. It was the decision of the operator to use thrombus aspiration catheter and/or glycoprotein inhibitors IIbIIIa. The monitoring by medical history were embodied if the patients had reinfarction, major bleeding, minor bleeding, pain until arrival to hospital from time of onset, need for ventilatory assistance and use of balloon counterpulsation and hospital death. The above parameters were performed in the first 30 days. Results: 30 women from 79 infarctions were analyzed. The characteristics observed were gender (women vs. men) with age 66 +/- 15 vs. 66 +/- 25, No differences with previous revascularization: 3/30 vs. 3/49, peripheral vascular disease: 13/30 (43%) vs. 23/49 (46%). There was no significant difference in the presence of chronic renal failure. They were presented in between 8:00-18:00 (on-hours, women vs. men): 13 (43%) vs. 21 (42%)% and 18:00-08:00 (off-hours, women vs. men): 17 (56%) vs. 28 (57%). The delay in opening the artery (center-to-balloon time) was 62.3 ± 40 min with no significant differences between genders. CPK peak value of 2093 IU / L vs. 2032UI / L (women vs. men) was observed . Major bleeding: (0% vs. 0%) was observed; thrombosis: 0 vs. 0; need for mechanical ventilation: 2 vs. 5; use of aortic balloon counterpulsation pump 2 vs. 5; deaths in 3 patients before discharge. At the time of hospitalization despite no significant difference, there was a tendency of much time with women (8 vs. 7 days). Conclusions: The differences observed were mainly women were less smokers, they had less previous infarctions and less diabetes; but they had higher obesity rate that correlates with the frequency of dyslipidemia and had more hypertension. They had a higher percentage of infarctions corresponding with the territory of anterior descending artery and the presentation was at times off-hours. Women had more minor bleeding. It is mandatory to extend to large-scale studies to extrapolate the data in this small population analyzed. It is important to conclude that there is a significant delay in the onset of pain and arrival at the hospital that the KK producing them forward to a Class II or directly to a Class IV.

Biography:

Jean-Baptiste Fraison has completed his Doctoral thesis in Internal Medicine in the year 2013 from Montpellier University School of Medicine. He is currently an
Assistant Professor in Internal Medicine department of Dr. Alfred Mahr (Hôpital St Louis, Université Paris Diderot, France). His research interests include vasculitis especially Behcet disease and Kawasaki disease.

Abstract:

Kawasaki disease (KD) is a vasculitis that mostly occurs in young children and rarely in adults. We analyzed the characteristics of adult-onset KD (AKD) in France. We collected retrospective and prospective data for patients with a diagnosis of KD occurring after the age of 18 years. Cases were obtained via various French medical networks and identified from the international literature in 27 French centers. We included 44 cases of AKD, with mean (SD) age 31 (12) years (range 18–68) and sex ratio (M/F) 1:2; 33 cases met the American Heart Association criteria; 9 were incomplete and 2 were a typical AKD. The median time for diagnosis was 15 days (interquartile range 9–21). The main symptoms were fever (100%), exanthema (98%), changes in the extremities (91%), conjunctivitis (77%), oral cavity changes (89%), cervical adenitis (55%) and cardiac abnormalities (45%). Biological findings revealed the elevated levels of acute-phase reactants (100%), hepatic cytolysis (64%) and elevated bilirubin level (23%). Overall, 32% of cases showed large-vessel vasculitis: Coronary vasculitis (25%), coronary aneurysm (16%) and peripheral vasculitis (4.5%). Treatment was mostly intravenous immunoglobulins (73%) and aspirin (81%). Out of all the cases, four cases showed myocardial infarction due to coronary vasculitis, but none were treated with IVIg because of late diagnosis. After a median follow-up of 5 months (interquartile 2-17, range 1–117), persistent aneurysm was noted in 7% of cases. No deaths were reported hence, damage was significantly lower with early treatment than late or no treatment (p=0.02).

Biography:

John P Breinholt has completed his MD at the University of Utah School of Medicine. He completed his Pediatrics Residency, Pediatric Cardiology Fellowship and advanced training in Pediatric Interventional Cardiology at Baylor College of Medicine and Texas Children’s Hospital in Houston, Texas. He is the Division Director of Pediatric Cardiology at the University of Texas Health Science Center at Houston and the Chief of Pediatric Cardiology at Children’s Memorial Hermann Hospital. He is also the Pediatric Cardiology fellowship Director. He has published more than 25 papers in reputed journals and has been serving as an Editorial Board Member of repute.

Abstract:

The patent ductus arteriosus (PDA) of premature neonates continues to be a significant clinical problem contributing importantly to both morbidity and mortality. Surgical ligation and medical therapy both have their drawbacks. Medical therapy has a high failure rate and is associated with the renal dysfunction and gastrointestinal morbidities. Surgical ligation has a high success rate, but has been associated with pneumothorax, phrenic nerve palsy and vocal cord paralysis, and scoliosis. While transcatheter PDA closure has been performed for nearly 40 years, it has largely been reserved for children >5 kg. We have focused on the safety and efficacy of PDA device closure in premature neonates <3 kg. The hospital records and catheterization reports of premature neonates were reviewed with attention to procedural details, complications, and short term outcomes. We recorded the results of neonates
who received one of two commercially available devices for PDA closure, with a focus on a newly available microvascular plug that enables delivery via a microcatheter. The device is delivered with fluoroscopy and echocardiographic guidance. Complete closure was achieved in all patients. All patients survived the procedure and are currently living. There have been no instances left pulmonary artery obstruction or coarctation of the aorta. This preliminary study demonstrates that transcatheter PDA closure can be successfully performed in preterm neonates using currently available technology with a high success rate and a low incidence of complications. We also describe a novel transvenous approach using a combination of echocardiography and fluoroscopy to avoid arterial access in this fragile patient population.

Biography:

Ahmed Mostafa has completed his MD in Thoracic Surgery in the year 2009 from Faculty of Medicine, Ain Shams University, Egypt. He got his Pre-MD training in France and worked at reputed hospitals such as HEGP-Hôpital Européen Georges-Pompidou, and Tenon Hospital. He acquired the MRCS, and is GMC registered. He has special interest in Airway Surgery. The division of thoracic surgery at Ain Shams University hospitals has quadrupled its annual number of tracheal surgeries since 2009 due to the persistent adoption of the aforementioned management.

Abstract:

Aim & Introduction: Tracheal stenosis is one of the major complications following prolonged endotracheal intubation. Tracheal resection and anastomosis has proved to be the best solution for this serious problem. This study aims to review the experience of our institute in 7 years with patients presenting with post-intubation tracheal stenosis.
Methods: A retrospective study was performed in the period of January 2009 to January 2016. This study involved patients who were presented to the Ain Shams University Hospital with post-intubational tracheal stenosis, and who underwent tracheal resection and anastomosis as a primary treatment.
Results: We operated upon 60 patients, excluding glottic stenosis pathology, and patients with major co-morbidities with tracheostomies or stents as definitive treatment. Patients included 42 males (70%), 18 females (30%) and the mean age was 28.35 (ranging from 2 to 72 years). During the treatment, it was found that 45 patients (70%) had previous endoscopic dilataions, 38 patients (63.3%) had tracheostomies, 19 patients (31.6%) had a history of tracheal stenting whereas, 17 patients (28.3%) had cricotracheal resections (CTR) for subglottic stenosis. Cervicotomy was sufficient in 41 patients (68.3%), but additional manubriotomy was needed in 15 patients (25%), while full sternotomy was done in only 4 patients (6.6%). All patients were given a chance for immediate postoperative extubation and the anastomotic success rate was (96.6%) and hospital mortality was (1.6%).
Conclusion: Tracheal resection and anastomosis proves to be a safe and satisfactory option for post-intubational tracheal stenosis. This intervention must be applied widely in developmental countries where there is frequent rush for tracheostomies, and abuse of tracheal stenting and dilatation. Hence, quality of life improves dramatically following an effective surgery.

Biography:

Ana-Catarina Pinho-Gomes has completed her MSc in Medicine as well as in Cardiovascular Pathophysiology from the University of Porto, Portugal. She has been training in UK since then and is currently a Cardiothoracic Surgery trainee in Manchester. She has already won over 25 academic prizes and published 8 papers in reputed journals. She is member of the leading committees like Association of Surgeons in Training and the Cardiothoracic Trainees Research Collaborative. Besides translational and clinical research in Cardiovascular Medicine, she is keen on teaching and she is doing a MSc in Medical Education at the University of Liverpool.

Abstract:

Background: Above Knee Amputation (AKA) is a last-resort operation with high post-operative morbidity and mortality. The aim of this study was to identify preoperative risk factors for mortality in patients undergoing AKA for lower limb ischaemia.
Methods: Medical records of all the patients who underwent AKA for limb-threatening ischaemia between the 1st September 2014 and the 31st December 2015 were retrospectively reviewed. Patients were followed-up until 31st January 2016.
Results: A total of 65 patients (33 male; median age 75 [IQR 65-82] years) were included. 54 were treated for critical limb ischaemia, and the remainder for acute ischaemia. Hypertension, ischaemia heart disease, chronic obstructive pulmonary disease and type 2 diabetes mellitus were common (prevalence of 71%, 37%, 40% and 47%, respectively). Median length of stay was 27 [IQR 17-56] days and the proportion of patients requiring long-term residential care significantly increased from admission to discharge (p=0.005).
In-hospital mortality was 17% (11 patients), in all cases due to septic complications, most commonly from respiratory and wound sources. 90-day mortality was 30% (19 patients). Heart failure (OR8.9 95%CI 2.1-36.8; p=0.003) and eGFR<30 (OR11.9 95%CI 1.4-101.6; p=0.023) were independent predictors for 90-day mortality. At a median follow-up of 7.5 [IQR 2-16] months, all-cause mortality was 38% (25 patients) and median survival was 60 [IQR 29-102] days.
Conclusions: AKA performed for limb-threatening ischaemia is associated with high morbidity and mortality and hence, it imposes a major health-care burden. Patients with renal impairment and heart failure on admission have a significantly increased mortality risk.

Biography:

Abdul Aziz, MD MRCP associate specialist in preventive cardiology. He is working at nobles hospital. His special interest in preventing af related strokes. He is involved in making effective strategies to improve the detection and effective anticoagulation of af in the community and secondary care.

Abstract:

Atrial fibrilation is the most common sustained arrhythmia affectng apropximately 2 percent of population in devellopng countries. It is the most common preventable cause of strokes. Atrial fibrilation accounts directly for 15 percent of strokes and is contributary factor in 20 percent of strokes.
Strokes related to AF caries high mortality and morbidity, 1 in 4 patients will die in the first 30 days and 50 percent will die with in the first year. Stroke related to AF are more debiliating and has higher chance of recurence.
The estimated cost for a new stroke with AF is £14000/year comared to stroke with no AF at £9000. Aging population is on the rise so is AF and AF related strokes. Despite the availability of modern tooles approximatley half of patients are undetected, and only 50% of patient diagnosed with AF recieving optimal anticoagulation. Despite the availability of NOACs there seems to be no significant improvement in prevent devastating strokes in AF. Review of performance in the UK from SSNAP audit data and GARFIELD-AF inthe UK, use of NOACs
 

Biography:

Azar Hussain has completed his MBBS from Pakistan and completed his MRCS from Royal College of Surgeons of Edinburgh. He completed his MSc in Translational Research in cardiovascular medicine from university of Bristol. At present, he is pursuing his MD on ‘Effect of oxygen on small human pulmonary artery’ from Hull York Medical School. He is also pursuing a Diploma in Post-graduate research training and an MSc in healthcare improvement leadership. He published 5 papers in reputed journals and delivered talks on both national and international cardiothoracic forum.

Abstract:

Background: Different models are used to explore the underlying cellular and molecular mechanism of lung disease especially pulmonary vascular disease but most of the experiments were performed on animal models with little evidence available from humans.
Objective: The aim of this study is to provide a baseline optimal resting tension (ORT) value for performing experiments on human pulmonary artery rings and strips.
Methods: After REC approval, tissue samples were collected from lung surgery patients. Total 20 PA rings of internal diameter 2-4 mm and 2 mm long were prepared and mounted under physiological conditions in organ bath system and myograph. After equilibration at 1g basal tension, 40mM KCl induced active tension (AT) recorded. Samples washed for 30 minutes and repeated twice at 1g to confirm reproducibility. Further experiments performed at 1.2g, 1.4g, 1.6g, 1.8g and 2g basal tension and KCl induced AT recorded.
Results: In human pulmonary artery rings increasing the basal tension from 1.0 g to 1.6 g significantly augmented the 40mM KCl induced active tension. Increasing the active tension from 1.6 g to 2.0 g either decreased or plateaued the 40mM KCl induced response. Both organ bath and myograph shows similar result and confirmed that optimal RT for human pulmonary artery rings to be 1.61 g. The optimal resting tension in our experiment was 1.61 g for pulmonary artery ring.
Conclusion: More studies are needed to validate this data and also to identify if the optimal resting tension is different in different size pulmonary arteries.

Biography:

Mohamed Elsakka was awarded half a scholarship, free of charge grant, by Mansoura University due to his good performance in high school. He has gained his Bachelor of Medicine and Surgery (MBBCh Degree) from Mansoura-Manchester Programme for Medical Education, Mansoura University, Egypt, with excellent degree with honour, and he was one of the top five students of his class. Afterwards, he started working as a Cardiothoracic resident at Mansoura University Hospitals. He is fully registered with the GMC, and has applied for his Master’s Degree in Cardiovascular research at the University of Manchester under supervision of Dr. Elizabeth Cartwright.

Abstract:

Heart failure (HF) confers a poor prognosis with an annual 30-40% mortality rate for patients. 40% of HF-related mortality is linked to a sudden arrhythmic event. Increased intracellular calcium has been observed in failing cardiomyocytes, and attention has been drawn to calcium handling and cardiac electrical activity in these cells. Plasma membrane calcium ATPases (PMCA), a family of calcium-extrusion pumps, were found to contribute little to total calcium-extrusion processes in normal cardiomyocytes but can be activated by Ca2+-dependent processes. We have previously shown that PMCA4 is part of a protein complex which modulates localised Ca2+ levels in cardiomyocytes. We have found that genetic ablation of PMCA4 (PMCA4KO) protected against hypertrophy-induced HF in mice. However, little is known about how PMCA4 may influence arrhythmic events. Therefore, we sought to assess PMCA4s
role in cardiac electrical signalling. We report that no significant difference was found in any ECG parameters between PMCA4KO and PMCA4 wild-type mice in either conscious or unconscious ECG. No significant difference was found in gene expression of calcium handling proteins. However, in PMCA4KO mice, a trend was seen for reduced expression of potassium channels, including Kir2.1 (inward-rectifier channel encoded by KCNJ2), Kv1.4 and Kv4.2 (transient-outward channels encoded by KCNA4 and KCND2 respectively). Such channels have important roles in cardiac repolarisation, which governs the action potential duration. This study,
so far, has found no significant difference in cardiac electrical activity between PMCA4KO and PMCA4 wild-type mice under basal conditions. Further assessment under arrhythmic stress and hypertrophic conditions is required.

Biography:

Azar Hussain has completed his MBBS from Pakistan and completed his MRCS from Royal College of Surgeons of Edinburgh. He completed his MSc in Translational Research in cardiovascular medicine from University of Bristol. Currently, he is pursuing his MD on ‘Effect of oxygen on small human pulmonary artery’ from Hull York Medical School. He is also pursuing a diploma in Post-graduate research training and an MSc in Healthcare Improvement leadership. He published 5 papers in reputed journals and delivered talks on both national and international cardiothoracic forum.

Abstract:

Little data are available on the characterization of the basic physiological pulmonary vascular reactivity to vasoconstrictors. The aim of this study was to characterize pharmacological properties of human pulmonary artery (PA). Patients undergoing lung resection were consented for inclusion in this study. Research ethics committee approval was obtained and total 19 patients were enrolled for this study. Pulmonary arteries dissected from disease free areas of lung resection and 57 PA rings of internal diameter 2-4 mm and 2mm long were prepared. Integrity of endothelium was confirmed with 1uM acetylcholine and KCl was used to check the contractility of PA rings. Multi-wire myograph system was used to mount the PA rings under physiological conditions in modified Krebs solution. A basal tension of 1.61gm was applied and the rings were left to equilibrate for 60 min. After equilibration increasing concentration of potassium chloride, Nor-adrenaline, Adrenaline, Vasopressin, Endothelin-1 and Prostaglandin F2a were used. Endothelin 1 was the most potent vasoconstrictor and PGF2a and KCl are equally highly efficacious. Vasopressin had no effect on the pulmonary artery while adrenaline and noradrenalin resulted in significant increase in pulmonary contraction. This study demonstrated the differential effect of vasoconstrictors on pulmonary vessels. Vasopressin may be safe to use for systemic vasoconstriction in patients with pulmonary hypertension.

Biography:

Amin Al-awar is a PhD student at University of Szeged. He is currently conducting research at the Biology Doctoral School/ Faculty of Sciences and Informatics, specifically in the department of Physiology, Anatomy and Neurosciences at Csaba Varga’s Endocrinology Lab, as he is the head of the department too. His PhD studies and research is under the supervision of Dr. Krisztina Kupai, who holds a PharmD and PhD degree and in her account around 30 papers published in international and reputed journals in the field of Diabetes and Cardiovascular diseases. He is also a member in the European Cardiovascular Society.

Abstract:

It is well established that physical exercise continues to be one of the most valuable forms of non-pharmacological therapy against diabetes mellitus; however, the precise mechanism remains unknown. The aim of this study was to investigate the cardio-protective effect of voluntary exercise in the Goto-Kakizaki type 2 diabetic rat hearts against ischemia reperfusion injury and to clarify its biochemical background, focusing on the nitric oxide synthase/hemeoxygenase system.

Biography:

Markus Rottmann has completed his Master of Science degree from Karlsruhe Institute of Technology (KIT), Germany. Currently, he is pursuing PhD in Biomedical Engineering at the Institute of Biomedical Engineering, KIT. He is engaged in research on Computational Cardiology.

Abstract:

Introduction: Persistent atrial fibrillation (AF) is associated with increased prevalence of atrial fibrosis. However, the role of fibrosis in arrhythmogenesis for AF is not well understood.
Methods: Clinical data of 18 patients with persistent AF and AF termination by ablation were analysed with regard to spatial relationship of AF termination sites and low voltage areas (LVA<0.5mV). For the first time, numerical simulations in 3D human atrial models assessed the impact of variable size and degree of myocardial fibrosis (DoF) on development and stability of focal and re-entrant sources in AF. Conduction velocity (CV), fiberorientation, pacing frequency and repetition of sources were analyzed.
Results: 14/18 (78%) of AF termination sites located to low voltage areas (0.5mV) and 4/18 (22%) to borderzones (<1cm distance to LVA). Simulations of persistent AF in a 3D-atrial model with regional fibrosis revealed stable (>20 AF cycles) anchoring of meandering rotational and focal sources within fibrosis (<5mm of borders). Rotational excitation wavefronts spread out from fibrosis area to healthy tissue, resulting in focal-like excitation patterns. However, the focal sources originated from variable locations around the fibrosis borders, potentially leading to beat-to-beat variabilities in the electrogram morphology. CV was 1 m/s within healthy tissue, 0.2 m/s at fibrosis > 40% and 0.4 m/s at fibrosis 30-40%. With increasing degree of fibrosis, electrogram amplitudes decreased but the cycle lengths, stability and consistency of sources increased.
Conclusions: Region of increased atrial fibrosis display low voltage amplitudes and harbour rotational and focal sources responsible
for AF.

Biography:

Shehanah Fahad Al Omair is currently a final year medical student at King Saud University- College of medicine in Riyadh, Saudi Arabia. She is interested in
otolaryngology as a specialty but the field of research has always been intriguing to her. She has four researches; two of them are in the process of being published.

Abstract:

Background & Aim: Oral anticoagulant therapy (OAT) is one of the most widely used therapies. Being on oral anticoagulation regimens requires high degree of compliance and adequate knowledge to avoid serious complications. Our aim is to assess compliance with and awareness about OAT among Saudi patients and their willingness to use the point-of-care (POC) INR testing devices for self- monitoring.
Methods: A self-administered questionnaire was carried out for all patients and analyzed according to demographics, adherence; knowledge and INR control. A total of 162 patients were interviewed, females (69.1%) exceeded males (30.1%). The mean age was 52.09±15.34. Most of them were on warfarin, (80.2%) received education by their physicians. Generally, patients had poor knowledge and medium adherence (53.1%) (Scored<50%).
Results: (24%) of the Poor Knowledge Group (PKG) were highly adherent compared to (14.5%) of the Fine Knowledge Group (FKG). However, (53.2%) of FKG had a controlled INR where this percentage falls into (27%) in the PKG, with a significant difference between the two regarding their INR range (p=0.001). The most incorrect answered question in both groups was related to warfarindrug-interactions (75.3%). Majority (74.7%) was eager to make use of the POC-INR devices.
Conclusion: The participants knowledge was generally poor but level of knowledge didn’t play a role in INR control. Regardless, an education program should be accommodated to help patients in improving their medication control and reducing clinical visits. The majority was willing to adopt (POC) INR devices that will certainly help them in managing their treatment and potentially reducing adverse clinical outcomes.

Biography:

Sergio Mejía Viana has completed his Cardiology training and Doctorate at the University Clinic of Navarre. He was an interventional Cardiologist, Angiologist and Phlebologist for 20 years. He is a Fellow of the European Society of Cardiology, has written more than 100 scientific publications including abstracts, articles and book chapters. He returned to clinical practice with high interest in prevention. Currently, he is a Consultant at the Medical Investigation Unit in St. Bernard´s Hospital in Gibraltar.

Abstract:

There is increasing concern regarding the health effects of exposure to various heavy metals in the environment. This is particularly true for mercury, cadmium, lead, aluminum and arsenic. The cardiovascular consequences of metal toxicity have not been published widely enough because of some sort of misunderstanding of the cholesterol role and the atherosclerosis pathological findings. Lead exposure increased through the mid 1970´s, largely as a result of use of tetraethyl lead in gasoline. At the peak of lead production, the atmospheric release of lead reached 600.000 tons annually. The half-life of lead in the body is extremely long as it accumulates in the bone. The association between lead and cardiovascular disease has been recognized for years and there is consistent epidemiological evidence that lead is an established risk factor for hypertension, promotes oxidative stress and inflammation, the triggering event of atherosclerosis. Cadmium production increased during the 20^th century as a result of the production of nickel-cadmium batteries, metal coatings and plastic stabilizers. Food and smoking are the major sources of cadmium for the general population. Once ingested, cadmium is stored in the kidneys, liver, lungs, pancreas and central nervous system, with a half-life of over 15 to 45 years. A recent systematic review concluded that the evidence supports the role of cadmium as a cardiovascular disease risk factor, especially for coronary disease. Understanding that atherosclerosis is an inflammatory disease and not “fat deposits blocking arteries” will improve preventative strategies.

Biography:

Massimo Capoccia is a Cardiac Surgeon with particular interest in heart failure and mechanical circulatory support. In view of his additional interest in cardiovascular engineering, he is currently pursuing his research interest at the University of Strathclyde as a part-time PhD Student. He has published articles in peer reviewed journals and he enjoys the teaching aspect of his clinical activity aiming to be a role model for his junior colleagues. He strongly believes in close cooperation with engineers and scientists in order to achieve a patient-specific modelling approach in clinical practice.

Abstract:

The impact of Ventricular Assist Devices (VAD) for the treatment of advanced heart failure has played a significant role as a bridge for transplantation and more recently as a long-term solution for non eligible candidates. Continuous flow rotary blood pumps are currently the most popular devices because of their size and performance and the trend towards their use is increasing. Although, very successful and technologically advanced, but still thrombus formation remains a feared complication that can affect clinical outcome. VADs operate in a flow regime which is difficult to simulate as the transitional region is at the boundary of laminar and turbulent flow (low Reynolds number). Different methods have been used but the best approach remains debatable. Computational Fluid Dynamics (CFD) has been an attractive and invaluable tool for the study of the interactions between VADs and the cardiovascular system. The development of a pre-operative strategy aimed at the reduction of complications and patient-device suitability may be appropriate. Patient-specific modelling based on 3D reconstruction from CT-scan combined with computational fluid dynamic studies is an attractive solution in order to identify potential areas of stagnation or challenging anatomy that could be addressed to achieve the desired outcome. The HeartMate II (axial) and the HeartWare HVAD (centrifugal) rotary blood pumps have been now used worldwide with proven outcome. There are enough pumps on the market; it is now time to focus on the complications in order to achieve the full potential and selling-point of this type of technology for the treatment of the increasing heart failure patient population.

Biography:

Arun Beeman completed his cardiothoracic and vascular surgery training in The Jawaharlal Institute of Postgraduate Medical Education & Research in India in 2015. He has special interest in Pediatric cardiac surgery and heart lung transplants. He is a member of Royal College of Surgeons, Edinburgh from 2011 and also a life member of Tamil Nadu Medical Council, India. He has 2 international publications and also won the upcoming young surgeon award (SUNDARAM AWARD) in 2008, awarded by Tamil Nadu and Pondicherry Association of Surgeons, India. At present working as specialty registrar in pediatric cardiothoracic surgery in Great Ormond street, London.

Abstract:

Objective: A retrospective study was undertaken to find out the prevalence of aortic wall diseases among the South Indian population Methods: The databases of all patients admitted with aortic wall diseases from August 2008 to July 2012, in the department of cardiothoracic and vascular surgery at our center were analyzed. Results: Among the 49 patients diagnosed to have aortic wall disease, 20 patients (40%) had aortic aneurysm, 18 patients (37%) had aortic occlusive disease and 11 patients (22%) had aortic dissection. The mean age of presentation for males and females were 48 years and 35 years respectively. Majority (67%) of the patients with aortic wall disease were hypertensive. Coronary artery disease was associated only in 8 patients (16%). Average time taken to diagnose aortic vessel wall disease varied from few days to years. The diameter of ascending aorta was more than 5 cm in 85% of patients. More than 60% of the patients with aortic occlusion disease had to travel an average of 220 km from their place of residence for final diagnosis of the disease. Nearly 40% of the patients with aortic occlusion had critical limb ischemia at the time of definitive diagnosis. Conclusion: This study will help in deriving population based screening program to detect the aortic diseases at the earlier stage in all the high risk selective groups so that the expensive and hi-tech dependent investigations and the other resources can be appropriately utilized.

Biography:

Hatem Al-Masri is a cardiac critical care intensivist and consultant of cardiac surgery. Dr. Al-Masri completed his medical degree (M.D.-doctorate) at Charles University – Faculty of Medicine, holds a degree in biochemistry from the University of Waterloo - Canada, completed his residency training in Germany (Leading Facharzt) and holds training fellowships in Cardiac Surgery from IJN KL Malaysia, Switzerland, and Canada. Dr. Al-Masri is the author of an award-wining medical research paper titled “Hemodynamic Support Requires Integrated Approach Comparing pl.VAD vs. IABP in Patients Experiencing Left Venticular Failure” (Best Paper of Young Cardiac Surgeon) at the 8th International Congress of Update in Cardiology and Cardiovascular Surgery (UCCVS 2012) awarded by European Society for Cardiovascular Surgery, World Society of Arrhythmias (WSA ) and the Society of Cardiology and the International Academic of Vascular and Endovascular Surgery (ISCP). Dr. Al-Masri is a member of the Medical German Association, Malaysian Medical Association and the Saudi Medical Council.

Abstract:

Background: Surgical aortic valve replacement whether mechanical or biological valves is the treatment of choice in patients with severe symptomatic aortic valve stenosis (< or = 0.61 cm(2)/m(2)) or with left ventricular dysfunction, advanced age with severe comorbidities. As a matter of fact, bioprosthesis of both types, Sutured and Sutureless aortic valve, last is a new prosthesis and promising tool because it provides excellent early and long-term clinical outcomes in terms of potential hemodynamics, valve durability, and freedom from valve-related complications. Theses valves were designed to be less obstructive, and thus result in a lower transvalvular gradient. Technically the implantations of these valves are more demanding resulting in longer cross clamp and bypass times. Sutureless aortic bioprosthetic valves, introduced in clinical practice in 2009. Surure technique is of two types, contrary to the conventional surgical technique for implantation (conventional interrupted or continuous sutures, after thorough annular decalcification). Numerous advantages such as simple, quick, and effective with regard of continuous. However, important comorbid conditions in elderly patients referred for aortic valve replacement require alternative treatment options with possible reductions of the extracorporeal bypass time and reliable hemodynamic features. In order to comply with these requirements, percutaneous valves and sutureless surgical valves have been developed. The percutaneous technique has the advantage of being performed without circulatory bypass but leaving the aortic calcifications in place, thereby resulting in a high degree of paravalvular insufficiency, atrioventricular block and strokes. However, it requires cardiopulmonary bypass. In addition, it can be performed with a low mortality (<3% in isolated aortic replacement, even in older patients). This article reviews the various techniques, strength and limitations of these sutureless valves implanted in the aortic position. Methods: Comparing intraoperative data, postoperative clinical outcomes, and echocardiographic results from patients receiving 3f Enable, Perceval S and Intuity, randomized study trials showed a hemodynamic advantage for stentless valves, but several could not reach a significant level three devices are currently available. The 3f Enable (ATS, Minneapolis, USA) and the Perceval S (Sorin Group, Saluggia, Italy) have a CE mark, whereas the intuity (Edwards Lifesciences, Irvine, California) is still under investigation. We present the above valves, focusing on the Perceval S. The Sorin Perceval S is a biologic pericardial aortic valve assembled in a metal super elastic alloy stent and implanted in the aortic root without the need of suturing. The design of stentless valve prostheses is intended to achieve a more physiological flow pattern and superior hemodynamics in comparison to stented valves. Results: Between January 2010 to June 2010, 134 patients with aortic valve stenosis underwent aortic valve replacement alone or with other concomitant cardiac procedures including mitral valve surgery in our hospital. Baseline patient characteristics were similar in both groups. The patients were randomly divided into two groups: Ninty-Seven patients (67%) in the P group and 37 patients (59.5%) in the E group (P = 0.24) underwent minimally invasive AVR with either ministernotomy or right anterior minithoracotomy approach. There were no statistical differences between two groups in age, sex, body surface area, concomitant cardiac procedures, blood loss, and postoperative extubation time., aortic cross-clamp time was 31 ± 12 minutes in the P group and 53 ± 25 minutes in the E group (P < 0.0015) , survival was 97% (one death in the P group). In five patients (P group = 1, E group = 4), a moderate paravalvular leak was present. Conclusions: This new technology may offer improved results. Cost-effectiveness and fine-tuning of patient selection are two aspects that future investigation should address. The sutureless Perceval S aortic valve is hemodynamically excellent and a safe prosthesis in selected patients due to a simple and fast implantation technique. Aortic valve replacement with sutureless aortic bioprosthesis is feasible, also with a minimally invasive approach. The Perceval S showed lower operative times and moderate paravalvular leaks and lower mean transvalvular gradients than did the 3f Enable, related to the larger diameter of the Perceval S implanted. Both prostheses showed an excellent hemodynamic performance. This new technology needs long-term follow-up.

Biography:

Kunlun He has completed his Medical School degree from The Third Military Medical University, PhD from Chinese PLA Medical School, and Post-doctoral studies from College of Physicians and Surgeons of Columbia University. He is the Vice President of Chinese PLA General Hospital, and the Professor of Department of Cardiology. In recent years, he focuses on Translational Medicine of Cardiovascular disease. He has published more than 158 peer reviewed papers, achieved the first class awards of Beijing Science and Technology, and also has been serving as Editorial Board Members for three medical journals.

Abstract:

Objectives: Early prediction and identification of the onset of adverse cardiac events in high-risk patients are of great significance for preemptive treatment and a better prognosis. We sought to establish a risk evaluation model to predict the adverse cardiac events during hospitalization in patients with heart failure (HF). Methods: In-hospital, patients with HF was randomly selected from intensive care units of Chinese PLA General Hospital. Patients were then allocated into model derivation group and validation group, respectively. In the derivation group, independent risk factors for adverse cardiac events were evaluated by multivariate logistic regression. We established a prediction score system using the independent risk factors. In the validation group, receiver operator characteristic curve (ROC) and C-statistic testing were utilized to assess the performance of the constructed model in comparison with a previous published Modified Early Warning Score (MEWS) model. Results: The binary logistic regression analysis revealed that the level of heart rate, left ventricular ejection fraction, pH value, renal dysfunction and NT-pro BNP are independent risk factors of adverse cardiac events during hospitalization for HF patients. The effectiveness of our risk prediction score system (PSS) is better than modified early warning score (MEWS) system. Conclusions: Through data analysis of patients with heart failure, we found heart rate, left ventricular ejection fraction, pH value, renal dysfunction and NT-pro BNP were closely associated with adverse cardiac events during hospitalization. It has important significance for the precision risk stratification of in-hospital patients with heart failure.

Biography:

Sung Ho Shinn is an Associate Professor of Thoracic and Cardiovascular Surgery in Eulji Hospital, Eulji University, South Korea. He has completed his graduation and PhD from Hanyang University, South Korea. He was a Clinical Fellow of Cardiovascular Surgery in Mayo Clinic, Rochester USA between 2011 and 2013. He was also a Research Collaborator in Mayo Clinic, Rochester, USA in 2014. He is currently a Board Member of Korean society of Thoracic and Cardiovascular surgery. His research interests include tricuspid valve surgery for functional tricuspid regurgiatation, trans-catheter aortic valve replacement, and hybrid aortic surgery.

Abstract:

Functional tricuspid regurgitation is mainly caused by left heart disease, specifically mitral or aortic valve disease, but the etiology is multi-factorial. The functional tricuspid regurgitation had been ignored due to the previous recognition of “the disease of forgotten valve”. However, the correction of functional tricuspid regurgitation is recognized as the procedure influencing the prognosis of the function of right heart recently and the studies for this have been introduced. The author wants to explain the pathophysiology of the functional tricuspid regurgitation and when and how to fix the tricuspid valve for functional tricuspid regurgitation, especially which is better suture or ring annuloplasty, in the perspective of cardiac surgeon.

Biography:

Will be updated soon...

Abstract:

Background: Massive pulmonary embolism (PE) is life-threatening complication in hospitalized patients. Optimal management of massive PE remains controversial. Despite advances in thrombolytic therapy major bleeding was reported in many series. Urgent surgical embolectomy has been the treatment of choice in patients with hemodynamic instability. We believe that patients with more or less stable hemodynamic, aggressive surgical intervention have beneficial with good outcome and still superior to medical treatment. Patients: 19 hospitalized patients suffered massive PE. Diagnoses were as follow: Post partum (n: 6), post RTA (n: 5), acute abdomen (n: 2), diagnosed intra-op (n: 2), failure of thrombolytic therapy (n: 2), one pre-op and one transferred from another hospital as acute on top of chronic PE. TEE confirmed the presence of huge clots in the heart and intra-pericardial pulmonary arteries. All patients were underwent surgical removal of the clots. Mean bypass time was 123.83 min, clamp time 57.50 min. Five patients suffered of low cardiac output required vasopressor and dopamine early postoperative. The mortality was one patient transferred from another hospital with acute on top of chronic massive PE and one pre-op patient waiting open heart surgery. Conclusion: Early aggressive surgical intervention for even hemodynamically stable patients may constitute an important form for treatment of in hospital massive pulmonary embolism with good outcome. TEE is the best tool to confirm the presence of associated intra-cardiac and intra-pulmonary thrombi helping the surgeon to locate embolus site.

Biography:

Ayman Raweh is a Surgeon in Heart Center Dortmund in Germany and studied Medicine between 2000 and 2006 then continued to specialize in Cardiac Surgery. His research focus includes aortic diseases and aortic surgery since 2010 and currently minimal invasive mitral valve repair. He is a member of several national and international Cardiac Surgery Associations including the European Association for Cardio-Thoracic Surgery (EACTS) in Europe, the Society of Thoracic Surgeons (STS) in USA and the German Society of Cardiothoracic Surgery (DGTHG) in Germany.

Abstract:

The aortic valved prosthesis is a reliable solution to repair the aneurysm in aortic root and ascending aorta with involved aortic valve. The introduction of biological valved conduits brought important benefits to a large group of patients suffering from the anticoagulation therapy. Two of the most commonly used pre-sewn stentless biological conduits are BioValsalva™ and BioIntegral BioConduit™. As a result of the lack of comparative studies between the different biological valved conduits, there was a need to review the midterm haemodynamic performance of these two conduits. Between July 2008 and June 2014, a total of 55 patients underwent aortic root replacement using a Bio-Valsalva conduit (n=27) or a Bio-Integral conduit (n=28). The median echocardiographic followup for the Bio-Valsalva group was 44.0 months compared with 8.4 months for the Bio-Integral group. The echocardiographic followup for the Bio-Integral group was shorter because of the later introduction of Bio-Integral prosthesis to the market. It was hypothesized that, the Bio-Integral prosthesis with no sewing ring will provide benefits to the in valve haemodynamics; however, these potential benefits were not observed when compared with the Bio-Valsalva prosthesis in our echocardiographic follow-up. The effective orifice area in the Bio-Valsalva group was 1.85 cm² compared with 1.80 cm² in the Bio-Integral group (p=0.24). The mean pressure gradient in the Bio-Valsalva group was 11.0 mm Hg compared with 11.5 in the Bio-Integral group (p=0.82). In conclusion, we did not observe a significant difference in the outcome between the two biological valved conduits, and both of them had excellent outcomes.

Biography:

Magdy Abdel Hamid is a Professor of Cardiology at the Faculty of Medicine, Cairo University, Egypt. He is a Secretary of the scientific committee upgrade for Cardiology, Egyptian Universities Promotion Committees. In addition, he has been nominated as the secretary of the Egyptian Society of Cardiology on March, 2016. He had a certificate from Harvard medical school for excellent performance and successful contribution to the program of heart failure at Brigham and Women’s hospital, 1999. He has received several awards including the Certificate of Appreciation and Medal of excellence from Egyptian Medical Syndicate in Cairo 2003 for excellence in service to the medical community. He is a member of numerous international societies such as the American College of Cardiology, the Society for Cardiovascular Angiography and Interventions (SCAI), European Society of Cardiology and European Association of Cardiovascular Intervention (EPACI). Prof Abdel Hamid has presented at several international conferences and published many original manuscripts in several peer review journals. The last two papers were recently published in the International Journal of Cardiology (January2016) and the Journal of Interventional Cardiology (February 2016). Prof Abdel Hamid has participated in many research projects and international registries and is the present principal investigator at Cairo university site for a multicenter international study (ISCHEMIA trial), the study which might change the practice of medicine in management of stable coronary artery disease. Prof Abdel Hamid has contributed to cardiology books including the Heart Failure Manual and Guidelines of Hypertension for Egyptian Hypertension Society (2002 and 2015). Prof Abdel Hamid is a clinical reviewer for many local and international Journals.

Abstract:

Biography:

To be updated soon...

Abstract:

Functional tricuspid regurgitation is mainly caused by left heart disease, specifically mitral or aortic valve disease, but the etiology is multi-factorial. The functional tricuspid regurgitation had been ignored due to the previous recognition of “the disease of forgotten valve”. However, the correction of functional tricuspid regurgitation is recognized as the procedure influencing the prognosis of the function of right heart recently, and the studies for this have been introduced. The author wants to explain the pathophysiology of the functional tricuspid regurgitation and when and how to fix the tricuspid valve for functional tricuspid regurgitation, specially which is better suture or ring annuloplasty, in the perspective of cardiac surgeon.

Biography:

Ayman Raweh, Medicine Doctor, is a surgeon in Heart Center Dortmund in Germany. He was born in 1982 and studied medicine between 2000 and 2006 then continued to specialize in cardiac surgery. His research focus includes aortic diseases and aortic surgery since 2010 and currently minimal invasive mitral valve repair. He is a member of several national and international cardiac surgery associations including the European Association for Cardio-Thoracic Surgery (EACTS) in Europe, the Society of Thoracic Surgeons (STS) in USA and the German Society of Cardiothoracic Surgery (DGTHG) in Germany.

Abstract:

The aortic valved prosthesis is a reliable solution to repair the aneurysm in aortic root and ascending aorta with involved aortic valve. The introduction of biological valved conduits brought important benefits to a large group of patients suffering from the anticoagulation therapy. Two of the most commonly used pre-sewn stentless biological conduits are BioValsalva™ and BioIntegral BioConduit™. As a result of the lack of comparative studies between the different biological valved conduits, there was a need to review the midterm haemodynamic performance of these two conduits. Between July 2008 and June 2014, a total of 55 patients underwent aortic root replacement using a BioValsalva conduit (n=27) or a BioIntegral conduit (n=28). The median echocardiographic follow-up for the BioValsalva group was 44.0 months compared with 8.4 months for the BioIntegral group. The echocardiographic followup for the BioIntegral group was shorter because of the later introduction of BioIntegral prosthesis to the market. It was hypothesised that the BioIntegral prosthesis with no sewing ring will provide benefits in valve haemodynamics; however, these potential benefits were not observed when compared with the BioValsalva prosthesis in our echocardiographic follow-up. The effective orifice area in the BioValsalva group was 1.85 cm² compared with 1.80 cm² in the BioIntegral group (p=0.24). The mean pressure gradient in the BioValsalva group was 11.0 mm Hg compared with 11.5 in the BioIntegral group (p=0.82). In conclusion, we did not observe a significant difference in the outcome between the two biological valved conduits, and both of them had excellent outcomes.

Biography:

Hatem Al-Masri is a cardiac critical care intensivist and consultant of cardiac surgery. Dr. Al-Masri completed his medical degree (M.D.-Doktorate) at Charles University – Faculty of Medicine, holds a degree in biochemistry from the University of Waterloo - Canada, completed his residency training in Germany (Leading Facharzt) and holds training fellowships in Cardiac Surgery from IJN KL Malaysia, Switzerland, and Canada. Dr. Al-Masri is the author of an award-wining medical research paper titled “Hemodynamic Support Requires Integrated Approach Comparing pl.VAD vs. IABP in Patients Experiencing Left Venticular Failure” (Best Paper of Young Cardiac Surgeon) at the 8th International Congress of Update in Cardiology and Cardiovascular Surgery (UCCVS 2012) awarded by European Society for Cardiovascular Surgery, World Society of Arrhythmias (WSA ) and the Society of Cardiology and the International Academic of Vascular and Endovascular Surgery (ISCP). Dr. Al-Masri is a member of the Medical German Association, Malaysian Medical Association and the Saudi Medical Council.

Abstract:

Surgical aortic valve replacement wether mechanical or biological valves is the treatment of choice in patients with severe symptomatic aortic valve stenosis (< or = 0.61 cm(2)/m(2)) or with left ventricular dysfunction , advanced age with severe comorbidities . As a matter of fact , bioprosthesis of both types ,Sutured and Sutureless aortic valve,last is a new prosthesis and promising tool because it provides excellent early and long-term clinical outcomes in terms of potential hemodynamics, valve durability, and freedom from valve-related complications . Theses valves were designed to be less obstructive, and thus result in a lower transvalvular gradient. Technically the implantations of these valves are more demanding resulting in longer cross clamp and bypass times .Sutureless aortic bioprosthetic valves, introduced in clinical practice in 2009. Surure technique of two types , , contrary to the conventional surgical technique for implantation (conventional interrupted or continuous sutures, after thorough annular decalcification). Numerous advantages such as simple, quick, and effective with regard of continuous .However, important comorbid conditions in elderly patients referred for aortic valve replacement require alternative treatment options with possible reductions of the extracorporeal bypass time and reliable hemodynamic features. In order to comply with these requirements, percutaneous valves and sutureless surgical valves have been developed. The percutaneous technique has the advantage of being performed without circulatory bypass but leaving the aortic calcifications in place, thereby resulting in a high degree of paravalvular insufficiency, atrioventricular block and strokes. however, it requires cardiopulmonary bypass. In addition, it can be performed with a low mortality (<3% in isolated aortic replacement, even in older patients). This article reviews the various techniques, strength and limitations of these sutureless valves implanted in the aortic position. Methods : Comparing intraoperative data, postoperative clinical outcomes, and echocardiographic results from patients receiving 3f Enable , Perceval S and Intuity , randomized study trials showed a hemodynamic advantage for stentless valves, but several could not reach a significant level Three devices are currently available. The 3f Enable (ATS, Minneapolis, USA) and the Perceval S (Sorin Group, Saluggia, Italy) have a CE mark, whereas the Intuity (Edwards Lifesciences, Irvine, California) is still under investigation. We present the above valves, focusing on the Perceval S .The Sorin Perceval S is a biologic pericardial aortic valve assembled in a metal super elastic alloy stent and implanted in the aortic root without the need of suturing. The design of stentless valve prostheses is intended to achieve a more physiological flow pattern and superior hemodynamics in comparison to stented valves. RESULTS : Between January 2010 and June 2010, 134 patients with aortic valve stenosis underwent aortic valve replacement alone or with other concomitant cardiac procedures including mitral valve surgery in our hospital. Baseline patient characteristics were similar in both groups .The patients were randomly divided into two groups: Ninty-Seven patients (67%) in the P group and 37 patients (59.5%) in the E group (P = 0.24) underwent minimally invasive AVR with either ministernotomy or right anterior minithoracotomy approach. There were no statistical differences between two groups in age, sex, body surface area, concomitant cardiac procedures, blood loss, and postoperative extubation time., aortic cross-clamp time was 31 ± 12 minutes in the P group and 53 ± 25 minutes in the E group (P < 0.0015) , survival was 97% (one death in the P group). In five patients (P group = 1, E group = 4), a moderate paravalvular leak was present . CONCLUSIONS: This new technology may offer improved results. Cost-effectiveness and fine-tuning of patient selection are two aspects that future investigation should address. The sutureless Perceval S aortic valve is hemodynamically excellent and a safe prosthesis in selected patients. Due to a simple and fast implantation technique . Aortic valve replacement with sutureless aortic bioprosthesis is feasible, also with a minimally invasive approach. The Perceval S showed lower operative times and moderate paravalvular leaks and lower mean transvalvular gradients than did the 3f Enable, related to the larger diameter of the Perceval S implanted. Both prostheses showed an excellent hemodynamic performance. This new technology needs long-term follow-up.

Biography:

Alfredo Sanchez Gamboa has completed his studies in Cardiovascular Surgery in Zulia University (Venezuela), graduated as congenital cardiac surgeon at Universite Catholique de Louvaine (Belgium), graduated as pediatric cardiac surgeon at Universite Rene Descartes du Paris(France), he has complete several fellowship trainees in pediatric cardiac surgeon with Prof. Jean Rubay, Prof. Pascal Vouhe et Prof. Yves Lecompte. He has worked as a Chief of Pediatric Cardiac Surgery in Venezuela and currently works as a Consultant pediatric Cardiac Surgeon at King Faisal Cardiac Center in Jeddah, Saudi Arabia.

Abstract:

Establish a congenital pediatric cardiac surgery program represents a big challenge for an institution, however guarantee safety and sustainable pediatric cardiac surgery program requires not only high levels of administrative, institutional support and investment but also and most important: multidisciplinary heart team work, with clear short term, mid term and long term vision which is a key to succeed in the establishment of the program. Conscience on the heart team evolution and gradually growth is even more important than the personal talents and skills, a multidisciplinary approach taking special care into the details is mandatory to guarantee these gradual and sustainable advances according to the established plan. Define a complexity scale taking on count not only pathologies but also others factors is very important to win experience for the team in a planned and protected way that allows to built the heart team confidence and advance in complexity. We will present the strategy used to establish and evaluate the pediatric cardiac surgery program at the King Faisal Cardiac Center in Jeddah, Saudi Arabia.

Biography:

To be updated soon...

Abstract:

Massive pulmonary embolism (PE) is life-threatening complication in hospitalized patients. Optimal management of massive PE remains controversial. Despite advances in thermbolytic therapy major bleeding was reported in many series. Urgent surgical embolectomy has been the treatment of choice in patients with hemodynamic instability. We believe that patients with more or less stable hemodynamic, aggressive surgical intervention have beneficial with good outcome and still superior to medical treatment. Patients: 19 hospitalized patients suffered massive PE. Diagnoses were as follow: Post partum (n: 6), post RTA (n: 5), acute abdomen (n: 2), diagnosed intra-op (n: 2), failure of thrombolytic therapy (n: 2), one preop and one transferred from another hospital as acute on top of chronic PE. TEE confirmed the presence of huge clots in the heart and intra-pericardial pulmonary arteries. All patients were underwent surgical removal of the clots. Mean bypass time was 123.83 min, clamp time 57.50 min. five patients suffered of low cardiac output required vasopressor and dopamine early postoperative. The mortality was one patient transferred from another hospital with acute on top of chronic massive PE and one preop patient waiting open heart surgery. Conclusion: Early aggressive surgical intervention for even hemodynamically stable patients may constitute an important form for treatment of in hospital massive pulmonary embolism with good outcome. - TEE is the best tool to confirm the presence of associated intra-cardiac and intra-pulmonary thrombi helping the surgeon to locate embolus site.

Biography:

Arun Beeman completed his cardiothoracic and vascular surgery training in The Jawaharlal Institute of Postgraduate Medical Education & Research in India in 2015. Has special interest in Pediatric cardiac surgery and heart lung transplants. He is a member of Royal College of Surgeons, Edinburgh from 2011 and also a life member of Tamilnadu Medical Council, India. He has 2 international publications and has won the upcoming young surgeon award (SUNDARAM AWARD) in 2008, awarded by Tamilnadu and Pondicherry Association of Surgeons, India. At present working as specialty registrar in pediatric cardiothoracic surgery in Great Ormond street, London

Abstract:

OBJECTIVE : A retrospective study was undertaken to find out the prevalence of aortic wall diseases among the South Indian population METHODS: The databases of all patients admitted with aortic wall diseases from August 2008 to July 2012, in the department of cardiothoracic and vascular surgery at our center were analyzed.. RESULTS : Among the 49 patients diagnosed to have aortic wall disease, 20 patients (40%) had aortic aneurysm, 18 patients (37%) had aortic occlusive disease and 11 patients (22%) had aortic dissection. The mean age of presentation for males and females were 48 years and 35 years respectively. Majority (67 %) of the patients with aortic wall disease were hypertensive. Coronary artery disease was associated only in 8 patients (16%).Average time taken to diagnose aortic vessel wall disease varied from few days to years. The diameter of ascending aorta was more than 5 cm in 85 % of patients. More than 60% of the patients with aortic occlusion disease had to travel an average of 220 km from their place of residence for final diagnosis of the disease. Nearly 40% of the patients with aortic occlusion had critical limb ischemia at the time of definitive diagnosis CONCLUSION: This study will help in deriving population based screening program to detect the aortic diseases at the earlier stage in all the high risk selective groups so that the expensive and hi-tech dependent investigations and the other resources can be appropriately utilized

Biography:

To be updated soon...

Abstract:

Objective: This study was done to evaluate the effect of residual gradient on early mortality and follow up the fate of this gradient. Methods: Between December 2011 and 2013, 43 patients with Fallot tetralogy operated upon in Cardiothoracic Surgery Department, Alexandria University were reviewed, direct intraoperative measured gradient and the echo-gradient were recorded and pressure ratio between right and left ventricle. The residual gradient was considered significant if it exceeds 40 mmHg or pressure ratio exceeds 0.85, transannular patch was used in 17 patients. Clinical and echo data were assessed over the study and time and every 3 months after discharge. Results: Median age was 4.2 years (8 months – 37 years), there was 6 early deaths (13.95%) all of them not related to high outflow gradient 23 patients (53.48%) had gradient higher than 40 mmHg, one of them with fixed obstruction and gradient of 60 mmHg and is scheduled for revision. On follow-up echo. There was a significant fall in right ventricular outflow gradient on predischarge echocardiograms (47 + 16.8 to 31.5 + 14.7 mmHg p < 0.005). A further significant fall in gradients was noticed at a mean follow-up of 5 + 3 months (20 + 9 mmHg, p < 0.05). Conclusions: This study showed that in patients with dynamic obstruction, there was a significant reduction in residual outflow gradient, and immediate revision was not needed. Echo is essential in identifying dynamic from fixed obstruction in addition to the surgeon belief of the adequacy of the outflow

Biography:

Cathy M Holt was awarded her PhD at the University of Sheffield where she was subsequently appointed as Lecturer. She then moved to University of Manchester where she leads a research team investigating the causes and prevention of vascular occlusion and stem cell approaches for the treatment of myocardial infarction. She currently serves on the British Atherosclerosis Society committee. She is on the Editorial Board of the journal "Clinical Science" and is Section Head for the Cardiovascular Physiology/Circulation Section in Faculty of 1000. In addition she has a teaching role and was recently awarded Senior Fellowship from the Higher Education Academy.

Abstract:

Human mesenchymal stem cells (MSCs) engineered to secrete a Glucagon-like peptide-1 (GLP-1) fusion protein and encapsulated in alginate (GLP-1 Cell-Beads) were developed as a novel therapy for myocardial regeneration post infarction. The effect of this therapy was assessed in an in vivo pig model of myocardial infarction and an in vitro human model of cardiomyocyte ischemia. GLP-1 Cell-Beads were delivered to the left anterior descending coronary artery branches in pigs, creating micro-infarcts. Cell-free beads (empty) and Cell-Beads containing MSCs without GLP-1 (Beads-MSC) were delivered as controls. Echocardiography was used to measure left ventricular function and infarct size was measured macroscopically. Tissue was analyzed for: Inflammation, apoptosis, collagen content and myofibroblast number. Atomic force microscopy (AFM) was used to examine the ultra-structure of the collagen scar. To examine direct effects on apoptosis, human adult cardiomyocytes underwent ischemia followed by incubation with MSC conditioned media echocardiography confirmed MI in all experimental groups of pigs. Four weeks post-MI, treatment with GLP-1 Cell-Beads significantly improved LVEF and limited infarct expansion. Beads-MSCs increased inflammation, which was reduced by GLP-1. Collagen content was increased in the infarct of Bead-MSC and Beads GLP-1 MSC groups compared to the empty bead group, which was associated with a decreased number of myofibroblasts and alterations in the collagen fiber structure. No differences in apoptosis were observed between groups in the in vivo model, however, significantly fewer TUNEL+ cells were observed in human cardiomyocytes in vitro. In conclusion, GLP-1 Cell-Beads have a beneficial effect on healing following MI. The effects are due to a combination of both the GLP-1 and paracrine factors released from the MSCs. These findings require further validation prior to clinical translation.

Biography:

Yaping Tian is the Professor of Department of Clinical Biochemistry, Chinese PLA General Hospital and Military Medical School. He is also a Professor at Nankai University, and at the Tsinghua University. He has received his Master’s Degree in Medicine from Chinese PLA Postgraduate Medical School in the year 1989 and PhD from Academy of Military Medical Sciences in 1993. He had been trained as Postdoctoral Fellow for 2 years (1995-1997) in The Queen Elizabeth Hospital, Australia. He has been focusing on the study of the specific serum proteomic profiles and genetic signatures in different diseases, especially on cancer and cardiovascular diseases. He also focused on the studies of antioxidants in herbal medicine and free radical biology and has received more than 20 grants and published more than 300 scientific papers in peer-reviewed journals. He is on the Editorial Boards of several journals and the Honor Chairman of Clinical Biochemistry and Applied Molecular Biology Association, CSBMB.

Abstract:

Atherosclerosis is a chronic, progressive, inflammatory disease with a long asymptomatic phase. Therefore, early finding of the risks of atherosclerosis, and then changing one’s lifestyle, preventing and treating the disease at an early stage are very important. Finding sensitive and no invasive biomarkers of atherosclerosis in blood is necessary. MicroRNAs (miRNAs) are a group of small, noncoding regulatory RNAs. They could inversely regulate the expression of their target genes at the post-transcriptional level by inhibiting translation or causing the degradation of the target messenger RNA (mRNA). miRNAs play a crucial role in the development of animals, by regulating the formation of tissues and organs. Previous studies have demonstrated that miRNAs are present in clinical samples of plasma and serum in a remarkably stable form, and they are often regulated in a tissue- and pathology specific manner. The use of circulating miRNAs as clinical biomarkers has generated great interest. Solexa sequencing followed by bioinformatics analysis have been used to predict the novel miRNAs in control individuals (n=15), coronary disease (AS) patients (n=15) and unstable angina pectoris (UAP) patients (n=15). Four miRNAs were discovered and validated in large scale number of clinical blood sample. All of them have been registered in microRNA database (http://mirbase.org). The bioinformatics analysis suggested that most of them might be involved in the disease process, including the regulation of Rho protein signal transduction, cell migration, and the induction of apoptosis.

Biography:

Sang Joon Lee received his PhD from KAIST in 1986. Ever since, he has been a Professor of Department of Mechanical Engineering at the Pohang University of Science and Technology (POSTECH). He is the Director of BBRC (Center for Biofluid Flow and Biomimic Research) sponsored by Korean Government. He was selected as a POSTECH fellow in 2010 and APS fellow in 2014. He has published more than 320 papers in reputed international journals and has been serving as Editorial Board Member of several journals.

Abstract:

In vivo measurement of hemodynamic information from real blood flows in arteries is very important for investigating the pathologies of circulatory vascular diseases. Especially in vivo experiments using animal disease models are essential for investigating the effects of various clinical treatments on hemodynamic parameters in the animal models. To get hemodynamic information of various cardiovascular diseases (CVDs), X-ray PIV (particle image velocimetry) technique in which X-ray beam is used as a transmissiontype light source was developed. At first, the feasibility of the X-ray PIV technique for measuring blood flows was confirmed through in vitro tests. Then surface-modified gold nanoparticles and biocompatible CO2 microbubbles were developed as tracer particles of blood flows. The X-ray PIV was found to have high temporal and spatial resolution to measure real pulsatile blood flows in a nondestructive manner with micrometer resolution. For in vivo X-ray PIV measurements, tracer particles were injected into rat models directly or to the extracorporeal loop connecting a microtube between the jugular vein and abdominal artery of a rat model. The velocity field information of real pulsatile blood flows was obtained with varying flow rate and pulsatility. This new advanced flow visualization technique could be effectively used to investigate hemodynamic and hemorheological features of blood flows related with CVDs.

Biography:

Jeffrey R Bender graduated from the University of California, San Francisco School of Medicine in 1979. He works in New Haven, CT and specializes in Cardiovascular Disease. Jeffrey R Bender is affiliated with Yale New Haven Hospital.

Abstract:

There is a longstanding debate about whether hormone replacement therapy (HRT) is protective against heart disease in postmenopausal women. This is in light of non-randomized epidemiological data demonstrating an increased incidence of coronary heart disease in premenopausal women, compared to age-matched males, and protection of ovariectomized women by estrogen use. Secondary and primary prevention trials of HRT have been conflicting and controversial. Most recent data have been supportive of estrogen preventing or delaying CV pathology, when therapy is started early, i.e., in the perimenopausal period. It is imperative to understand the mechanisms by which estrogen can be protective. Indeed, estrogen has potent effects on the vascular endothelium. Normal homeostasis of a healthy endothelium is critical to maintain an anti-atherosclerotic state. The key, athero-protective molecule of this homeostatic endothelium is nitric oxide (NO). Estrogen is a potent activator of the endothelial enzyme that generates NO, eNOS, through activation of plasma membrane estrogen receptors and a sequential signaling cascade involving the kinases c-Src, PI-3 kinase and Akt. This is therefore mediated through the "nongenomic" pathway of steroid hormone activation, mediated most notably by a splice inform of the estrogen receptor, ER46, in human endothelial cells (ECs). In fact, there is a transmembrane version of endothelial ER46, demonstrated by elegant plasma membrane imaging studies. It is this transmembrane version that creates a huge selective therapeutic targeting opportunity. The molecular features of this receptor will be discussed, as will the controversy of HRT use in postmenopausal women, for cardiovascular protection.