15^th World Cardiac Surgery & Angiology Conference December 08-09, 2016 Philadelphia, Pennsylvania, USA

Biography:

Dmitry Giller is currently the Director of the University Clinic of Phthisiopulmonology and also the Head of the Department of Phthisiopulmonology and Thoracic Surgery IM Sechenov First Moscow State Medical University. He has completed his PhD at the age of 33 years at the Central Research Institute of Tuberculosis RAMS. In 1997 he received the scientific title of Professor. In 2014 -2015 he was Chairman of the Society of Thoracic Surgeons of Moscow and Moscow region. Dmitry Giller is the author of more than 200 publications, including 35 patents, monographs, and manuals for doctors and students. 32 research works were done under his supervision and most his students are now PhD holders

Abstract:

189 patients (aged from 14 till 57) underwent surgery for bilateral drug-resistant destructive pulmonary tuberculosis with one totally destroyed lung from 1998 to 2015. All patients underwent pneumonectomies. In 54 cases – with contralateral lung resections, 30 preliminary transsternal occlusions of the main bronchus were performed on patients with low functional respiratory and cardiovascular reserve or with pleural empyema, including 6 cases of straightway one-stage contralateral lung resections. Lung collapse surgery on the pneumonectomy side or on the side of the only one lung was carried-out in 126 cases. All of them were performed with our original minimally invasive technique. We analyzed complications, the direct and remote results of the surgical treatment this group of patients. The 30-days mortality was in 3 cases: 1 after pneumonectomy, 1 after thoracomioplasty, 1 after transsternal occlusions of the main bronchus with straightway contralateral right lobectomy

Biography:

Dmitry Giller: Сurrently director of the University Clinic of Phthisiopulmonology. Head of the Department of Phthisiopulmonology and Thoracic Surgery IM Sechenov First Moscow State Medical University.

He has completed his PhD at the age of 33 years at the Central Research Institute of Tuberculosis RAMS. In 1997 he received the scientific title of Professor. 
In 2014 -2015 he was Chairman of the Society of Thoracic Surgeons of Moscow and Moscow region. 
Dmitry Giller is the author of more than 200 publications, including 35 patents, monographs, and manuals for doctors and students.
32 research works were done under his supervision and most his students are now PhD holders

Abstract:

We summarized the experience of performing repeated surgery for destructive drug-resistant pulmonary tuberculosis and other pathologies from 1984 to 2014. In total 276 (60,8%) pneumonectomies and pleuropneumonectomies and 178 (39,2%) lung re-resections were performed for recurrence of various diseases in the previously operated lung. 402 patients had a recurrence of pulmonary tuberculosis, 29 -  nonspecific pathology  and 25 – lung cancer. 454 patients underwent  765 operations including 44 preliminary transsternal occlusions of the main bronchus, 276 pneumonectomies and pleuropneumonectomies, 178 re-resections, 23 resections of the only one lung, 14 thoracoplasties  on the only one lung side, 32 operations for early postoperative complications.  Extrapleural VATS  thoracoplasty on the side of the first operation (by using our original method)  were carried-out on 75 patients with pneumonectomies and at 123 patients with re-resections for the purpose of the prevention of postoperative recurrence in the only one lung in the presence of considerable focal changes or cavities .

We explored frequency and character of the complications for re-operation and the risk factors of occurrence. Recommendations about the technique of performing of re-operations were developed that allowed to reduce the frequency of complications significantly. The postoperative mortality was 1% after pneumonectomies and pleuropneumonectomies. There was no mortality after re-resections. Full clinical effect reached in 94, 9% cases as a result of the carried-out surgical treatment. Long-term results and long-term survival after surgery were studied

Biography:

Enrico Ferrari, is a graduate of Turin Medical School (MD) in Italy and received Cardiovascular surgery training at University of Padova (Italy), Catharina Hospital of Eindhoven (The Nederland), and at University of Lausanne (Switzerland). He received special training in minimally invasive cardiac surgery and transcatheter heart valve procedures at University Hospital of Lausanne, Switzerland, where he became Associate Professor in 2010. Since 2015, he works as team leader at Cardiocentro Ticino Foundation in Lugano, Switzerland, and continues the academic career at Cardiovascular Research Unit of Lausanne. He is a member of the STS/AATS joint workforce on New Technology (2011-2018) and STS workforce on International Relationship 2011-2018. He is Associate Editor of the Interactive Cardiovascular and Thoracic Surgery Journal (ICVTS), member of the Editorial Board of the Archive of Sciences Journal, and member of the Editorial Board of the Multimedia manual of Cardio-Thoracic Surgery (MMCTS).

Abstract:

The aim of this brief report is to show technical details and feasibility of balloon-expandable stent-valve implantation in aortic position during conventional redo open-heart surgery in overweight patients with small-sized mechanical aortic prosthesis and patient-prosthesis mismatch.

Methods and results
Two consecutive symptomatic overweight patients (BMI of 31 and 38) with small mechanical aortic prosthesis (a 4 year-old 21mm Hancock II valve and a 29 year-old 23mm Duromedic valve), increased gradients (59/31mmHg and 74/44mmHg) and reduced indexed effective orifice area (0.50cm²/m² and 0.43cm²/m²) were treated successfully with surgical implantation of two 26mm balloon-expandable Sapien^TM 3 valves during redo procedures. Under full sternotomy, cardiopulmonary bypass and cardioplegic arrest the stent-valves were implanted under direct view through the aortotomy and after mechanical valves removal. In one patient, a concomitant regurgitant mitral valve was replaced with a standard bioprosthesis. Aortic cross clamp times were 162 and 126 minutes; cardiopulmonary bypass times were 178 and 180 minutes; total surgical times were 360 and 318 minutes. At discharge, the echocardiographic control showed transvalvular peak and mean gradients of 13/9mmHg and 23/13mmHg, and indexed effective orifice areas of 0.64cm²/m² and 1.08cm²/m². The 3-month echocardiographic control showed transvalvular peak and mean gradients of 18/9mmHg and 19/11mmHg, and indexed effective orifice areas of 0.78cm²/m² and 0.84cm²/m², with improved symptoms.

Conclusion
Balloon-expandable stent-valve implantation during redo open-heart surgery is feasible and safe and prevents patient-prosthesis mismatch in overweight and obese patients. Moreover, in case of stent-valve degeneration this approach allows for additional valve-in-valve procedures with big-size stent-valves and prevents high-risk re-redo surgery

Biography:

To be updated soon..

Abstract:

Over the past decade, there have been remarkable changes in our approach to Antithrombotic therapy.  Our therapeutic options have been enriched by the availability of new Antiplatelet agents--more potent P2Y12 inhibitors, protease-activated receptor inhibitors--and new anticoagulants--novel oral anticoagulants which inhibit factors IIa or Xa, low molecular weight heparins, and  intravenous direct thrombin inhibitors--which have dramatically changed the way we approach patients who require Antithrombotic therapy.  There are new inhibitors available which permit the safe and effective reversal of overdosage of some of these agents, or reduction of effect if emergency surgical interventions are necessary.  Past studies informing the use of anticoagulants such as heparin and warfarin and Antiplatelet agents such as aspirin were performed in patient cohorts of generally less than 1,000; modern trials leading to FDA approval generally randomize 10,000-25,000 patients.

There are now accepted protocols that guide the cardiac surgicalteam in the safe management of these agents during the peri operative period which will be discussed in this presentation.

Biography:

Dmitry Giller is currently the Director of the University Clinic of Phthisiopulmonology and also the Head of the Department of Phthisiopulmonology and Thoracic Surgery IM Sechenov First Moscow State Medical University. He has completed his PhD at the age of 33 years at the Central Research Institute of Tuberculosis RAMS. In 1997 he received the scientific title of Professor. In 2014 -2015 he was Chairman of the Society of Thoracic Surgeons of Moscow and Moscow region. Dmitry Giller is the author of more than 200 publications, including 35 patents, monographs, and manuals for doctors and students. 32 research works were done under his supervision and most his students are now PhD holders

Abstract:

189 patients (aged from 14 till 57) underwent surgery for bilateral drug-resistant destructive pulmonary tuberculosis with one totally destroyed lung from 1998 to 2015. All patients underwent pneumonectomies. In 54 cases – with contralateral lung resections, 30 preliminary transsternal occlusions of the main bronchus were performed on patients with low functional respiratory and cardiovascular reserve or with pleural empyema, including 6 cases of straightway one-stage contralateral lung resections. Lung collapse surgery on the pneumonectomy side or on the side of the only one lung was carried-out in 126 cases. All of them were performed with our original minimally invasive technique. We analyzed complications, the direct and remote results of the surgical treatment this group of patients. The 30-days mortality was in 3 cases: 1 after pneumonectomy, 1 after thoracomioplasty, 1 after transsternal occlusions of the main bronchus with straightway contralateral right lobectomy

Biography:

Dmitry Giller: Сurrently director of the University Clinic of Phthisiopulmonology. Head of the Department of Phthisiopulmonology and Thoracic Surgery IM Sechenov First Moscow State Medical University.

He has completed his PhD at the age of 33 years at the Central Research Institute of Tuberculosis RAMS. In 1997 he received the scientific title of Professor. 
In 2014 -2015 he was Chairman of the Society of Thoracic Surgeons of Moscow and Moscow region. 
Dmitry Giller is the author of more than 200 publications, including 35 patents, monographs, and manuals for doctors and students.
32 research works were done under his supervision and most his students are now PhD holders

Abstract:

We summarized the experience of performing repeated surgery for destructive drug-resistant pulmonary tuberculosis and other pathologies from 1984 to 2014. In total 276 (60,8%) pneumonectomies and pleuropneumonectomies and 178 (39,2%) lung re-resections were performed for recurrence of various diseases in the previously operated lung. 402 patients had a recurrence of pulmonary tuberculosis, 29 -  nonspecific pathology  and 25 – lung cancer. 454 patients underwent  765 operations including 44 preliminary transsternal occlusions of the main bronchus, 276 pneumonectomies and pleuropneumonectomies, 178 re-resections, 23 resections of the only one lung, 14 thoracoplasties  on the only one lung side, 32 operations for early postoperative complications.  Extrapleural VATS  thoracoplasty on the side of the first operation (by using our original method)  were carried-out on 75 patients with pneumonectomies and at 123 patients with re-resections for the purpose of the prevention of postoperative recurrence in the only one lung in the presence of considerable focal changes or cavities .

We explored frequency and character of the complications for re-operation and the risk factors of occurrence. Recommendations about the technique of performing of re-operations were developed that allowed to reduce the frequency of complications significantly. The postoperative mortality was 1% after pneumonectomies and pleuropneumonectomies. There was no mortality after re-resections. Full clinical effect reached in 94, 9% cases as a result of the carried-out surgical treatment. Long-term results and long-term survival after surgery were studied

Biography:

Branko Furst, is a graduate of the University at Ljubljana Medical School, Slovenia and completed post-graduate training in anesthesiology in London, UK, before embarking on an academic career at Texas Tech University Health Sciences Center in El Paso, Texas. Presently he holds the position of associate professor of anesthesiology at Albany Medical College in Albany, NY and divides his time between clinical work, resident education and research. His long-term research interest in circulation models has been summarized in a recently published book “The Heart and Circulation – An Integrative Model” (Springer, 2013). He has lectured on various aspects of circulation in the US and abroad

Abstract:

In spite of the general agreement that the pressure gradient provided by the heart is the source of blood propulsion, the issue about the control of cardiac output (CO) continues to be the subject of a vigorous debate. A systematic review of the circulation models shows that the classic pressure propulsion (PP) model falls short of explaining an increasing number of circulatory phenomena. For example: the debate over the source of blood propulsion in the valveless embryo heart remains unresolved; mechanical occlusion of the aorta results in a paradoxical increase in CO by 20-40% under controlled experimental conditions; a 4-5 fold increase in CO during aerobic exercise that exceeds the theoretical pumping capacity of the heart has long baffled exercise physiologists.

It is proposed that the long-standing impasse in the debate over the control of CO can be resolved by adopting the phenomenon-based, evolutionary model of circulation. Evidence shows that the movement of blood is the primary phenomenon generated at the levels of the capillaries. It exists before the functional maturity of the heart and is intricately linked with metabolic demands of the tissues. Accordingly, the pressure in the vessels is a derived phenomenon resulting from the rhythmic interruption of flow by the heart in combination with the dynamic response of the peripheral vasculature. The heart thus functions as an impedance-pump generating pressure, but not the flow of blood.

The importance of the proposed open-system, evolutionary circulation model for the understanding of basic physiology and clinical cardiology will be discussed and contrasted with the existing, closed-system PP models

Biography:

Dr. Eyal Porat is a Professor within the Department of Cardiothoracic and Vascular Surgery of the University of Texas Health Science Center at Houston. He serves as the department’s Division Director at St. Joseph Medical Center, Houston, Texas. Prior to his recent arrival to Houston, Porat served for 6 years as the Chairman of the Department of Cardiothoracic Surgery at Rabin Medical Center, Petah Tikva, Israel. He also headed the Division of Aortic Surgery within that Department. From 2000 until 2006 Dr. Porat served as Director of Minimally Invasive Surgery and Director of the Robotics Program, which he established at the Department of Cardiothoracic and Vascular Surgery of the University of Texas at Houston. He also founded “The Memorial Hermann Institute for Cardiovascular Research and Robotics Technology” where he served as Medical Director. Porat was born in Haifa, Israel. He attended medical school at Ben Gurion University in Be’er Sheva, Israel. He completed his residency in cardiothoracic surgery Suma Cum Laude at Carmel Medical Center, Haifa, Israel. During his residency, Dr. Porat was involved in clinical research at University Hospital “Vrije Universiteit” in Amsterdam, The Netherlands. Porat conducted academic teaching and research within the Tel Aviv University – Sackler School of Medicine and continues this activity at the University of Texas. His research and clinical interests include aortic surgery, robotic surgery as well as minimally invasive and beating heart coronary artery surgery. He is a member of many professional organizations and medical societies and serves on the editorial boards of prestigious professional journals. Porat is married and father of 3 children, the oldest serving as an air-force intelligence officer.

Abstract:

Background: The incidence of acute renal failure (ARF) after cardiac surgery and the risk of mortality associated with it continues to be high. The aim of this study was to evaluate if timing of cardiac catheterization influences the incidence of postoperative ARF.

Patients and methods: 408 patients undergoing cardiac surgery were prospectively evaluated. Mean age was 66+/-10 years, 22% were female, 38% diabetic, 69% had hypertension and 15% had peripheral vascular disease. Preoperative creatinine level and calculated creatinine clearance (CrCl) were 1.05+/-0.6 and 82+/- 27 respectively. Of the study population 39% underwent surgery within 24h of cardiac catheterization, 30% underwent surgery between the first and fifth day of catheterization, and 31% underwent surgery more than 5 days after cardiac catheterization. Endpoints were ARF, defined as a decrease in the calculated CrCl of 25% or more by the third postoperative day, and hospital mortality.

Results: 47% of patients who underwent surgery within 24h from cardiac catheterization have shown a decrease in calculated CrCl of 25% or more, as apposed to 29% in patients who underwent surgery between the 1^st and 5^th day after catheterization, and 23% in those who underwent surgery more than 5 days after catheterization (p=0.05). Mortality rate among patients who underwent surgery within 24h from catheterization was independently associated with acute renal failure ([OR]1.9, p=0.02). Preoperative calculated CrCl of less than 60ml/min and cardiac surgery within 24h from catheterization was independently related to hospital mortality ([OR]8, p=0.005).

Conclusion: Cardiac surgery performed within 24h from cardiac catheterization is a significant risk factor for acute renal failure, especially among patients with preoperative reduced renal function. Proper timing and patient selection is highly recommended.

Biography:

Sivaraj has completed his MBChB at the age of 26 years from  MBChB  at University of Glasgow, UK and MRCS  at Royal Colleage of Surgeons Edinburgh, UK. He works as senior resident at the Department of Cardiothoracic Surgery, National Heart Centre Singapore. Dedicated professional working in multi disciplinary team to manage patients. He is in year 4 of Cardiothoracic Surgery Residency Training program, National Heart Centre Singapore.

Abstract:

Heart disease incidence increases with advancing age. Patients with single vessel disease can undergo coronary bypass graft surgery (left internal mammary artery to left anterior descending coronary artery) with the approach of median sternotomy or left anterior thoracotomy. Left anterior Thoracotomy approach is used in the hope of achieving a less invasive operation. A total of 53 cases of single vessel coronary artery bypass graft (CABG) surgeries (left internal mammary artery to left anterior descending coronary artery) were performed at the National Heart Centre, Singapore between Oct 2009 and Nov 2011.  We performed a retrospective study on all 53 patients to compare surgical and post-surgical outcomes for single vessel CABG using two surgical approaches: median sternotomy (MS) and left anterior thoracotomy (LAT). 25 cases were performed using the left anterior thoracotomy approach and 28 cases were performed using the median sternotomy approach. 2 cases (8%) were converted from left anterior thoracotomy approach to median sternotomy. The average Euroscore-2 among all cases was 1.43; left anterior thoracotomy, 1.04; and median sternotomy, 1.72.  Extubation rates did not differ significantly between LAT and MS in the OT, or at 6 or 10 hours post surgery. The longest intubation was 22 hours among MS cases and 18 among LAT cases. One MS patient was re-intubated. Preoperative creatinine > 110 μmol/L occurred in 25.0% of MS cases compared to 20.0% for LAT (NS); 17.9% of MS cases had higher postoperative creatinine compared to 0.0% of LAT (p = 0.053). One of the MS case required Lasix infusion for acute renal failure and another required dopamine. No case in either group required dialysis. 1 LAT case experienced atrial fibrillation compared to 3 MS cases (NS). At 6 months post-surgery 12.0% of LAT and 21.4% of MS cases had not fully recovered (NS). 72% of LAT cases were not home by POD6 compared to 50% of MS cases (p = 0.013). Of 7 LAT cases, 4 were not discharged due to logistics or social reasons.  No significant differences were found between LAT and MS for ventilation duration, ICU stay, or hospital stay. However, after adjustment for confounders, a significant difference (p = 0.033) was exhibited between procedures for Blood loss (ml) (MS, 333; LAT, 230). The main finding of this report is that single coronary revascularization can be performed in a significant number of patients via the thoracotomy approach, giving similar results to that of the median sternotomy approach. In our single centre study, during a minimum period follow up of 1 year, morbidity and mortality were comparable.  In conclusion, left anterior thoracotomy approach for LIMA-LAD shortened both hospital and ICU stay. Benefits of less pain and earlier return to work cannot be understated from the left anterior thoracotomy approach

Biography:

Sibu P. Saha MD, MBA, Chief and Program Director of Residency and Fellowship Program in CT Surgery at UK. He is the Frank Spencer Endowed Chair of Surgery as well as Chairman of the Directors’ Council at the Gill Heart Institute.  He was the founding director of the Baptist Heart Institute in Lexington, KY. He is the benefactor of the Saha Cardiovascular Research Center.  He has received many awards including the Abraham Flexner Master Educator award. He is a past president of the International College of Surgeons, US Section and International College of Angiology. He is an Alley-Sheridan Fellow, Kennedy School of Government at Harvard

Abstract:

Purpose

This is a retrospective review of eleven cases of serious complications of pneumonectomy.

Materials and Methods

Eleven patients developed serious complication after pneumonectomy.(112 consecutive cases), which included Herniation of the Heart  (1), ARDS (4), Bronchopleural fistula (4), Tension hemothorax (1) and post pneumonectomy empyema (2). All patients had emergent or urgent surgical intervention except for patients with post pneumonectomy pulmonary edema (ARDS).

Results

3 patients died from respiratory failure and sepsis.

Conclusion

Current management has improved survival of this group of patients.

However, this requires vigilance and prompt intervention in the management of these serious complications.

Biography:

Giuseppe Petrone has completed his degree in medicina and surgery at the age of 24 years from
Second University of Naples (Italy) and he is specialist in Cardiovascular surgery since May 2015.
He worked as Registrar and Clinical Fellow in Hammersmith Hospital (Imperial College, London)
for a year (from May 2014 to April 2015). He is Resident in the Cardiovascular Department of
“Heart Centre – City of Alessandria”. He has been invited to discuss his research projects in
occasion of important meeting (59th annual conference of the Israel Heart society, Tel Aviv 2012;
61st annual conference of the Israel Heart society, Tel Aviv 2014, Heart Valve Society meeting,
New York 2014; Mitral Valve Conclave, New York 2015; EACTS,Amsterdam 2015; he has
published 4 papers in reputed journals

Abstract:

Background: Since 1996, we have developed an innovative technique of ventriculoplasty, the “Twist Technique”(TT). The procedure performed has the purpose of preserving not only the volume and the shape of the LV but, above all, to restore the physiologic counterclockwise (CCW) twist of the cardiac apex through a rearrangement of its fibers, rebuilding the natural apical vortex of the LV. We present our experience in LV remodeling.
Methods: From 1996 to 2015, 289 patients with post-infarction LV aneurysm underwent reconstructive procedures. Mean age was 56.4 ± 7.3 years. Average LV ejection fraction (EF) was 38.9% ± 11.6%. LV reconstruction was performed by using the TT in 265 patients (91.7%). Jatene technique is performed. Afterwards, the orifice closure is obtained performing the TT: a running 2-0 polypropylene suture orients cardiac fibers remodeling heart apex in a cone shape; stitches are outdistanced of 1 cm on the lateral side of the endocardial wall and of 1/2 cm on the endocardial septum. The distal and akinetic portion of the septum is folded and therefore excluded. In 257 patients (88.9%) concomitant myocardial revascularization was performed.
Results: Perioperative mortality was 2.4%. Mean follow-up was 8.45 ± 4.2 years. Actuarial survival rate at 13 years was 73 %. The physiological movement of the new apex, that unfolds in a natural CCW twist, considerably improved LV EF. Mean post-operatively EF was 46.1 ± 9.3 %.
Conclusion: LV remodeling using the TT reproduces physiological CCW torsion of the cardiac apex, it is a safe surgical procedure with low perioperative mortality and excellent long-term survival.

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:

Tajdit has completed his MBBS from Sir Salimullah Medical College, Dhaka and working as a resident student of thoracic surgery in National Institute of Chest Disease Hospital, Dhaka. He is a very enthusisatic student from his early days and attached with several research works. He has published several conference paper and working hard to start a new era of research in thoracic surgery in Bangladesh

Abstract:

Esophageal cancer is the eighth most common malignancy worldwide. It shows marked diversity in geographical distribution both internationally and nationally with exceptionally high rates in limited areas of Asia. However, the patterns are changing in several western countries. But there are very few studies in Bangladesh regarding the trend and epidemiology of esophageal cancer though many of the patients undergo surgical intervention. The aim of this study was to determine the epidemiology and pattern of esophageal carcinoma with respect to age and sex groups and to identify the trends of histology, site and specific risk factors of esophageal carcinoma of the patients who undergone surgical intervention. A prospective study was carried out in 210 patients with esophageal carcinoma to find out the trend and risk factors who admitted for surgical intervention. Maximum number of the patients of esophageal carcinoma was seen in male in 5^th and 6^th decades of life. Etiology of the cancer is multi-factorial. Tobacco & betel nut chewing were the most common risk factors for esophageal cancer. Squamous cell carcinoma was the most common malignancy seen in patients (93.81%) and mainly localised in lower oesphagus. Additional research on the etiology of this emerging carcinoma may provide more information which will add more aid in the development of readily implementable preventive strategies in Bangladesh

Biography:

To be updated soon

Abstract:

Background: Although the long-term benefits of angiotensin-converting enzyme inhibitors (ACEIs) in myocardial infarction and heart failure have been repeatedly proven, reports concerning their continuation in patients scheduled for heart surgery have produced conflicting results.  The purpose of this meta-analysis was to assess the impact of preoperative ACEIs on short term outcomes following cardiac surgery.

Methods: We performed a meta-analysis of articles comparing preoperative ACEIs with no ACEIs in patients undergoing cardiac surgery.  The EMBASE and MEDLINE databases were searched until the first week of October 2013 for English-language articles.  Two reviewers performed independent article review and study quality assessment.  Data on atrial fibrillation, vasopressor requirements, acute kidney injury and mortality all occurring in the first month following surgery were collected.  Since most included studies were retrospective, the generic inverse variance method was used to analyse adjusted odds ratios, calculating pooled odds ratios (ORs) and associated 95% confidence intervals (CIs) using a random effects model.

Results: We retrieved 21 studies (1 randomized trial, 18 cohort studies and 2 case-control studies) enrolling a total of 51 826 patients.  Preoperative administration of ACEIs significantly increased postoperative atrial fibrillation (OR: 1.16; 95% CI: 1.03 – 1.30) and vasopressor requirements (OR: 1.84; 95% CI: 1.32 – 2.56).  There was also a trend towards increased acute kidney injury (OR: 1.10; 95% CI: 0.91 – 1.33). However, no difference in mortality was observed (OR: 0.95; 95% CI: 0.79 – 1.15).

Conclusion: Preoperative use of ACEIs is potentially associated with an increased risk of adverse events following heart surgery, including atrial fibrillation and greater vasopressor requirements.  Large randomized trials are required to confirm these findings.

Biography:

Jing-song Ou has completed his M.D and Ph.D from Sun Yat-sen University of Medical Sciences and postdoctoral training from Medical College of Wisconsin at the age of 35 years. He is a Changjiang Scholar Professor and Pear River Scholar Professor as well as a Distinguished Young Scholars of National Science Fund. He is currently the Associate Chief of Division of Cardiac Surgery, and Vice Director of Guangdong Province Engineering Laboratory for Diagnosis and Treatment of Vascular Diseases in The First Affiliated Hospital of Sun Yat-sen University. He has published more than 70 papers in peer review journals and serving as an editorial board member in American Journal of Physiology- Endocrinology and Metabolism

Abstract:

Circulating microparticles are a group of membrane vesicles which are released by cell activation or apoptosis. Previous studies demonstrated that circulating microparticles or certain subgroups of circulating microparticles increased in a variety of cardiovascular diseases, such as hypertension, acute coronary syndromes and mitral valve disease. Vascular function is very important for maintaining circulation after cardiac surgery. However, the impact of microparticles generated from patients with valvular heart disease before and after cardiac surgery on vascular function remains unknown. Therefore, we investigated if circulating microparticles from valvular heart disease patients undergoing cardiac surgery would lead to vascular dysfunction. We found that circulating microparticles from valvular heart disease patients could impair endothelium-dependent vasodilation by decreasing nitric oxide production and increasing superoxide anion generation, which was caused by uncoupling endothelial nitric oxide synthase and inhibition of its activity. As this effect was more prominent during perioperative period after cardiac surgery, hemodynamic abnormality might be induced. Our findings suggested that circulating microparticles might be potential therapeutic targets for maintaining vascular function after cardiac surgery

Biography:

Sonjoy Biswas has completed his MS (Cardiothoracic Surgery) under University of Dhaka, Bangladesh in 2013 and FCPS (Cardiovascular Surgery) in 2015 under Bangladesh College of Physicians and Surgeons (BCPS). He has been exposed to almost every facets of  both adult and congenital heart surgeries in Bangladesh.  He worked as  a Registrar in Cardiac Surgery at National Heart Foundation Hospital & Research Institute, Dhaka, Bangladesh  while doing these case reports  till December, 2015. Now, he has been working in United Hospital Limited, Dhaka, Bangladesh as a Specialist in the Department of Cardiac Surgery

Abstract:

Management of adult coarctation of aorta surgically is difficult. Moreover, concomitant acquired disease with it becomes more challenging and complex. Staged surgical procedures exhibit more complexity. We have depicted our experiences of single-staged surgery for those cases. From June, 2013 till to date we have performed 4 single staged repair for coarctation of aorta with concomitant acquired cardiac diseases at our centre. In this series, age ranged from 20 to 49 years, all were male.
Out of four, one case of operated coarctation of aorta with severe MR died on the 11^th post-operative day due to ARDS. Single-staged surgery for intracardiac procedure along with co-arctation of aorta is safe, cost effective and reproducible.
Key wards: Coarctation of aorta, single-staged surgery, mitral regurgitation etc.

Biography:

To be updated  soon

Abstract:

Background: Mitral valve repair in patients with mitral valve regurgitation is associated with an improved quality of life with less morbidity as well as better long-term survival as opposed to replacement. We assessed  the characteristics and outcome of patients treated with conservative mitral surgery in our centers. 

Methods and Materials: We considered for enrollment in this study 62  patients with mitral valve disease who underwent mitral valve repair for moderate to severe mitral regurgitation, in two hospitals between January 2009 and December 2012. Patients who underwent concomitant surgery for other conditions were also included. 34 patients (55%) were men. Mean age was 57.5+-12.5 years.  The primary outcome of interest was death, mitral residual regurgitation and need for reintervention. On admission, 79 % of the patients had heart failure NYHA III-IV. Severe mitral regurgitation was present in 40 (64.5%)patients. Median sternotomy was surgical aproach, using moderate hypotermia during bypass time. Surgical techniques used were implantation of a prosthetic ring in 95.2 %, quadrangular resection of posterior leaflet in 19.4%, cordal replacement in 6.5%, mitral commissurotomy in 14.5%, cordal transfer in 8%, Alfieri stich in 4.8% of patients. Patients were followed up for 1 and 6 months after the mitral surgical procedure. Evaluation of mitral valve repair is based in transthoracal and transesophageal echocardiographic examinations.

Results: No deaths in early postoperative period. Early after surgery, 58 % of patients had no mitral regurgitation, 34% had mild mitral regurgitation; only one patient had moderate mitral regurgitation. After one month, only 1 (1.8%) patient had more than  moderate mitral regurgitation.At six month follow-up only 2 (4%) patients had more than moderate mitral regurgitation. There were no deaths or reinterventions during 6-month follow up. 

Conclusion: Mitral valve repair for mitral regurgitation  has been associated with  good short to midterm results.

Biography:

He is Head of Pediatric Cardiac center in scientific Center of Surgery named after M.A. Topchubashov, Azerbaijan. He holds a Master Degree (PhD) from Novosibirsk Research Institute of Circulation Path, Russia in the 2008-2009, followed by a Post-Graduation from Novosibirsk Research Institute of Circulation Path, Russia in the 2006-2008. He is extending his valuable service as a cardiac surgeon in Federal State Institution Academician E.N.Meshalkin Novosibirsk State Research Institute of Circulation Pathology Rusmedtechnology, for 2009-2010 years and has been a recipient of many award and grants. His research experience includes various programs, contributions and participation in different countries for diverse fields of study. His research interests as a cardiac surgeon reflect in his wide range of publications in various international journals

Abstract:

Objective: to evaluate the function of baroreceptors in patients after different types of surgical correction of hypoplastic aortic arch.

Materials and methods: In this prospective cohort study evaluated the results of surgical treatment of 54 patients who underwent surgical treatment for aortic coarctation. The patients were divided into two groups according to the method of correction of the defect: reconstruction with the use of a modified reverse plasty of LPA (group I, n=27) and reconstruction using the "extended" anastomosis (group II, n=27 patients).

Results: the Postoperative period of observation was 25 (21-30) months. Spontaneous sensitivity of the baroreceptors differed between groups and was significantly higher in group II is 11.6 (10,5; 12,6) vs 9,1 (8,2;10,1) in group I, p -0,04. The velocity of pulse blood flow was also higher in group II 7,7 (5,8;9) (m/s) -1 compared to 6.5 (5,4;7,1) (m/s) -1 in group I and differed between groups P – 0,04.

Conclusions: Reduced sensitivity of baroreceptors in patients after a modified reverse plastic of the left subclavian artery may be regarded as the method of choice in patients with coarctation and hypoplasia of the arch as a method of reducing the frequency of arterial hypertension in the late postoperative period

Biography:

To be updated soon.

Abstract:

Objectives: The general purpose of the study was to examine the course of the early period after surgery, total cava-pulmonary anastomosis in children of different age groups with atresia of the tricuspid valve
Material and methods: In the period from 2011 until 2015, the centre for paediatric cardiac surgery at Scientific Center of Surgery named after academician M. A.Topchibashev, together with the Scientific and Practical Center of pediatric surgery of the Republic of Belarus was carried out scientific research work. We compared the results of operations of the extracardiac modification of total cava-pulmonary anastomosis in 59 children of different age groups. At the time of surgery,  patients average age was 49.4 ± 14.0 months. The average body weight was 15.4 ± 3.0 kg. The patients were divided according to age into two groups. The first group included patients younger than 4 years, and the second group of patients older than 4 years.There were   32 patients in the  first group. The average body weight of patients was 13.48 ± 2.29 kg. There were 27 patients in the second group. In this group the average body weight of the patients were 16.3 ± 3.0 kg. All patients were performed extracardiac modification of the operation of  total cavo-pulmonary  anastosis.

The results of the study: In the early postoperative period in the first group the mortality rate was of 6.25%. And mortality in the second group was 22.2%. In both groups the most frequent complications were heart failure and paresis of the dome of the diaphragm. Acute heart failure was found in 26% patients of the first group, and 47.6% of patients of the second group. Paresis of the dome of the diaphragm was noted in 30% of patients of the first group and 38.9% of patients of the second group. These two complications significantly influenced the course of the early postoperative period. In the same period between the two groups were compared, the performance factor of inotropic support, duration of  ventilation and duration of  leakage from the pleural cavity. In patients of the first group factor inotropic support was 8.7 (5,0-10,0), and the average length of transudation from pleural cavities was 6 (4-8,5) days.In the patients of the second group factor inotropic support was 12 (7,2-12,8), and the average length of transudation from pleural cavities was 9.0 (5.0 to 13.0) days.

Conclusion: Thus, it is possible to note that the early, postoperative results were satisfactory in children under 4 years old.

Biography:

Dmitry Giller: Сurrently director of the University Clinic of Phthisiopulmonology. Head of the Department of Phthisiopulmonology and Thoracic Surgery IM Sechenov First Moscow State Medical University.

He has completed his PhD at the age of 33 years at the Central Research Institute of Tuberculosis RAMS. In 1997 he received the scientific title of Professor. 
In 2014 -2015 he was Chairman of the Society of Thoracic Surgeons of Moscow and Moscow region. 
Dmitry Giller is the author of more than 200 publications, including 35 patents, monographs, and manuals for doctors and students.
32 research works were done under his supervision and most his students are now PhD holders

Abstract:

5721 thoracic operations at 5502 patients (aged from 3 till 89) were performed during the period from 1999 to 2015 by one surgeon.
73,5% of operations were for pulmonary tuberculosis, 15,8% - for oncopathology and 10,7% - for other diseases.
4011 (70,1%) operation were performed with miniaccesses and VATS.
VATS was used during 236 (31,8%) of 741 pneumonectomies and pleuropneumonectomies, 739 (72,8%) of 1015 lobectomies and bilobectomies, 695 (73,8%) of 942 anatomic polysegmentary resections, 768 (87,4%) of 879 not anatomic lung resections, 181 (84,2%)  of 215 pleuroectomies, 636 (70,9%) of 897 thoracoplasties and thoracomioplasties.
Most operated patients had expressed pleural adhesions, typically for pulmonary tuberculosis.
We studied frequency and character of complications, the direct and remote results of all operations for pulmonary tuberculosis with the minimally invasive and standard accesses.
The 30-days mortality was 0,02% in the VATS group and 1% in thoracotomy group.

Biography:

Antonio Romero Berrocal has completed his PhD at the age of 25 years from Alcalá University (Madrid) and postdoctoral studies from Alcalá University. Anesthesiologist at the Hospital Puerta de Hierro-Majadahonda. Team member postoperative critical care and lung transplantation.
He has published articles in scientific journals

Abstract:

Case Report
This is a patient who underwent left single lung transplantation for emphysema type COPD. During the immediate postoperative period came early graft dysfunction grade III, which necessitated the implantation of an ECMO (extracorporeal membrane oxygenator). Respirator ventilatory parameters were adjusted to avoid lung distension, low tidal volume (Vc) (280 ml), high respiratory rates (20 rpm) and a level of PEEP (positive pressure at end expiration) 8 cmH2O. By monitoring pulmonary tidal volume distribution Electrical Impedance Tomography (EIT), bedside, we note that most of the tidal volume was distributed in the native lung emphysema. Alveolar recruitment maneuver  under control of the EIT allowed to observe the volume and distribution of current which were necessary to ventilate the lung transplant was performed pressures.

Biography:

To be udated soon.

Abstract:

While some surgeons believe that one biopsy taken from the most suggestive part of the lung as shown by CT scan of the chest is enough to arrive at a histological diagnosis, others believe that multiple biopsies from different lobes (2 or 3) are less likely to result in a missed diagnosis due to inadequate or unrepresentative sample. We compared the results of the patients who had a single biopsy with those that had multiple biopsies in terms of positive yield of histological diagnosis, the length of in-hospital stay after the procedure, as well as the length of time the chest drain remained in the chest post-operatively before it was removed after cessation of post-operative air-leak.

Methods:

Data of all the patients referred by respiratory physicians and who underwent VATS lung biopsy for suspected ILD was collected retrospectively from our hospital data system and the patients were grouped into those that had a single lung biopsy (Group A) and those that had multiple lung biopsies (Group B). High resolution CT scan of the chest was reviewed for every patient prior to the procedure, and the part(s) of the lung that was most appropriate area(s) for sampling chosen, often buttressed by recommendation from the respiratory physicians. The lingula of the left upper lobe was avoided in all cases. All cases were performed through three-port VATS.

Results:

115 patients underwent VATS lung biopsy in our Department between 2009 and 2015. A single biopsy was taken from 67 patients, while 48 patients had more than one biopsy (36 patients had two biopsies while 11 had three biopsies from different lobes). Histological diagnosis was arrived at in all patients in both groups, with no incidence of inappropriate, insufficient, or normal lung tissue. There was no in-hospital or 30-day mortality reported in either group. The overall median length of post-operative hospital stay was 3 days, and the median duration of chest drainage was 1 day. There was no statistically significant difference between the two groups in terms of length of hospital stay post-operatively (p = 0.235), or in terms of the duration of chest drain post-operatively (p = 0.303).

Conclusion:

VATS lung biopsy for the diagnosis of ILD is a safe procedure and is an essential diagnostic tool in distinguishing the various types of ILD whose diagnosis cannot be reached with certainty on the basis of clinical presentation and HRCT alone. When the sampling site is guided by HRCT and multidisciplinary approach, a single biopsy is enough to arrive at a histological diagnosis. Our experience has shown no added advantage in taking more than a single biopsy in this regard. Even though in our experience there was no statistical difference in terms of length of post-operative hospital stay or chest drainage, multiple lung biopsies, however, result in more operative time and attendant increase in cost by the use of more lung stapler re-loads.

Biography:

Aleksei Elkin has completed his MD in 1984 at the age of 23 from 1^st Leningrad Medical University. After graduating, he worked in lung surgery department of Leningrad state institute of phthisiopulmonology. In 1993 he has completed his PhD and in 2000 he received his DSc degree. Aleksei Elkin is being the professor of surgery since 2006.

Since 2011 to the present days, Aleksei Elkin is the chairholder in the department of phthisiopulmonology and thoracic surgery in the North-West Medical University named after the I.I. Mechnikov (Russia, Saint-Petersburg), being an author of more than 100 scientific works regarding the surgical treatment of pulmonary tuberculosis

Abstract:

 The results of 38 operations, performed upon the subject of pulmonary tuberculosis complicated with tuberculous pleural empyema and drug-resistance of mycobacteria, were studied. In 11 cases disease manifested itself in pneumothorax with subsequent detection of destructive pulmonary tuberculosis. 27 patients previously received prolonged and ineffective therapy for drug-resistant pulmonary tuberculosis. In all 27 cases, pulmonary tuberculosis progressed at the background of ineffective chemotherapy and was complicated with pleural empyema and broncho-pleural fistula in 19 cases, and in 8 cases - with loculated pleural empyema without bronchial fistula. More than a half of the patients (21) were hospitalized into the surgical department after prolonged and ineffective treatment of pleural empyema, using pleurocentesis and pleural drainage. Mycobacteria of tuberculosis were detected at the sputum and in cavities of pleural empyema of all patients during examination at the hospital. Active tuberculosis of the bronchus was diagnosed during bronchoscopy in 11 cases, in 4 cases tuberculosis of soft tissues at the place of pleural drainage insertion was diagnosed. Choose of pre-operative treatment was determined by data on drug resistance of mycobacteria tuberculosis – pre-operative treatment included maximally intense polychemotherapy combined with sanitation of cavity of pleural empyema using one or two drainages. Endobronchial valves were inserted into bronchi of 16 patients in order to block air leak through drainages, which allowed to irrigate pleural cavity actively without risk of aspiration. In total 38 patients underwent 56 surgical operations – 17 patients received two-stage treatment: VATS sanitation of cavity of pleural empyema and thoracostomy after the main surgery stage. Surgeries structure included: isolated pleurectomy – 9 cases, including 4 cases of VATS pleurectomy; lung resection in combination with pleurectomy and decortication – 11 cases; pleuropneumonectomy – 18 cases. Complicated postoperative course was registered in 10 cases, including the development of bronchial fistula after pneumonectomy on the background of pleural empyema in 2 cases, which required reoperation. One patient died due to total drug resistant tuberculosis progression, development of thoracic wall tuberculosis and tuberculous pericarditis

Biography:

To be updated soon

Abstract:

Objective: The aim was to estimate the effectiveness of thoracoscopic debridement in the advanced stages of pleural empyema.

Methods: All patients with pyogenic empyema (stage II & Stage III) in our Hospital, (admitted from January 2009 to December 2013) who did not respond to chest tube/pigtail drainage and/or antibiotic therapy were treated with VATSD and/or open thoracotomy. Prospective evaluation was carried out and the effect of this technique on perioperative outcomes was appraised to evaluate our technical learning with the passage of time and experience with VATS for late stage empyema management.

Results: Out of total 63 patients, 26 had stage II empyema and 37 had stage III empyema. VATSD was employed on all empyema patients admitted in our Hospital. VATSD was successful in all patients with stage II empyema. Twenty-five patients (67.6%) with stage III empyema completed VATSD successfully. However, only 12 cases (32.4%) required conversions to open (Thoracotomy) drainage (OD). The median hospital stay for stage III VATSD required 9.65±4.1 days. Whereas, patients who underwent open thoracotomy took longer time (21.82±16.35 days). Similarly, stage III VATSD and stage III open surgery cases showed significance difference among chest tube duration (7.84±3.33 days for VATS and 15.92±8.2 days for open thoracotomy).

Conclusions: VATSD facilitates the management of fibrinopurulent, organized pyogenic pleural empyema with less postoperative discomfort, reduced hospitalization, and have fewer postoperative complications. VATSD can be an effective, safe as first option for patients with stage II pleural empyema, and feasible in most patients with stage III pleural empyema.

Biography:

Rahul K. Bhardwaj has completed his medical education from Government Medical College, Amritsar (India). Currently he is second year Internal Medicine Resident at Mt. Sinai Hospital, Chicago

Abstract:

Thymic cancer is among one of the rarest malignancy found in humans and accounts for less than 1% of all neoplasms.  A rare variant is the basaloid subtype which has approximately 12 reported cases in literature. Treatment of such a malignancy is aimed at complete resection, incomplete resection, or a combination of chemotherapy, radiotherapy and resection.

A 65 year old woman presented with shortness of breath. Initial chest x-ray revealed a marked elevation of the right hemidiaphragm vs subpulmonic effusion. Patient was started on antibiotics and placed on continuous BiPAP.  A CT chest without contrast revealed an anterior mediastinal mass measuring approximately 3.6 x 4.5 x 5.8 cm. The patient underwent biopsy, which provided an inconclusive differential of: thymoma (type B), thymic carcinoma and lung squamous cell carcinoma. A repeat CT scan with contrast showed the anterior mediastinal mass measuring 4.2 x 4.9 x 5.2 cm. CT surgery performed a median sternotomy and was able to incompletely (85%) remove the mediastinal mass. The resection was limited due to the mass encasing right phrenic nerve and the pulmonary vein. Biopsy results of the mass showed: Thymic carcinoma-basaloid carcinoma subtype staging T4NxMx. Post-operatively patient had numerous complications requiring vasopressor support, going into A.fib with RVR, and having a cardiac arrest.  Considering the patient’s poor prognosis, her family decided for full withdrawal of support after which patient passed away.

This case illustrates the poor prognosis observed in patients with incomplete resection of basaloid subtype of thymic cancer when other structures are involved

Biography:

Blaz Mrevlje completed his primary qualification in general medicine in 2004 and received his license as a consultant of internal medicine in 2011. He has been working in the field of cardiology since 2006 and has been focusing on interventional cardiology since 2008. In the field of research he is interested in the coronary artery disease and intravascular imaging, namely the optical coherence tomography in elective and acute coronary syndrome patients

Abstract:

Introduction: Aortic stenosis is the most frequent and mitral stenosis is the least frequent native single-sided valve disease in Europe. Patients with the combination of severe symptomatic degenerative aortic and mitral stenosis are very rare. Guidelines for the treatment of heart valve diseases are clear for single-valve situations. However, there is no common agreement or recommendation for the best treatment strategy in patients with multiple-valve disease and severe concomitant comorbidities.

Case presentation: 76-yr old female patient with the combination of severe degenerative symptomatic aortic and mitral stenosis and several comorbidities including severe obesity, who was found unsuitable surgical candidate by the Heart Team and unsuitable for two-time general anesthesia in the case of two-step single-valve percutaneous approach by anesthesiologists, underwent successful percutaneous dual-valve single-intervention (transcatheter aortic valve implantation and percutaneous mitral balloon commissurotomy).

Conclusion: Percutaneous dual-valve single-intervention is feasible in selected symptomatic high-risk patients.

Biography:

Blaz Mrevlje completed his primary qualification in general medicine in 2004 and received his license as a consultant of internal medicine in 2011. He has been working in the field of cardiology since 2006 and has been focusing on interventional cardiology since 2008. In the field of research he is interested in the coronary artery disease and intravascular imaging, namely the optical coherence tomography in elective and acute coronary syndrome patients

Abstract:

Introduction: Stent implantation in a coronary artery results in mechanical injury of the vessel wall and involves de-endothelisation, stretching and tearing of media and in the case of an atherosclerotic plaque also plaque rupture. These processes are followed by the activation of platelets, thrombus formation and inflammation in the vessel wall. Activated chemokines and cytokines activate the proliferation and migration of smooth muscle cells within the media and from media into intima resulting in hypertrophy of the intima and restenosis of the stented segment of the coronary artery.

Methods: Three groups of young pigs were included in the study and followed-up with optical coherence tomography 14 days, 1 month and 2 months after angiographically-guided stent implantation. Three types of stents (bare-metal - BMS, drug-eluting - DES and multimode - MMS) were implanted in each individual pig in a randomized fashion. All stents were of 3.0 x 15 mm in size.

Results: After 14 days the neointima thickness was 118,77±54,27µm in BMS, 57,15±12,01µm in MMS and 53,04±9,50µm in DES. After 1 month the neointima thickness was 323,02±174,07µm in BMS, 173,46±60,11µm in MMS and 112,08±26,00µm in DES. After 2 months the neointima thickness was 250,25±213,66µm in BMS, 138,86±110,42µm in MMS and 159,55±53,95µm in DES.

Conclusion: Biologic response of a porcine coronary artery in terms of neoitnima thickness to stent implantation is as expected according to stent type and the time of follow-up

Biography:

Sonia Shahid is a final year M.B.B.S student of Karachi Medical and Dental College, Karachi Pakistan. She has been a part of several national and international researches and many are ongoing. She has attended several national and international seminars and conferences. She has good knowledge of clinical practices and protocols in variety of settings.
Sonia is an inquisitive student with a passion for education as a power for change and improvement in the healthcare field of her country and is very ambitious in pursuing her career

Abstract:

Objective: To determine the effect of congenital heart diseases on other systems of body in pediatric population.

Introduction: Congenital heart disease is defined as the structural, functional or positional defect of the heart in isolation or in combination, present from birth, but may manifest at any time after birth or may not manifest at all. There are many different types of congenital heart defects, they can be divided into three main categories; heart valve defects, heart wall defects and blood vessel defects. A normal heart has valves, arteries and chambers that carry the blood in a circulatory pattern: body--heart--lungs- -heart--body. When all chambers and valves work correctly, the blood is pumped through the heart, to the lungs for oxygen, back the heart and out to the body for delivery of oxygen. When valves, chambers, arteries and veins are malformed, this circulation pattern can be impaired. Common congenital heart diseases are tetralogy of Fallot, truncus arteriosus, transposition complexes, endocardial cushion defects, and univentricular heart. Conditions occurs are pulmonary hypertension, arrhythmias, infective endocarditis, anticoagulation and congestive heart failure. Causes of CHD are genetic defects, viral infection during 1st trimester, diabetic mellitus/gestational diabetes mellitus, drugs and alcohol intake. Affecting systems are respiratory system causing breathing problems and pulmonary hypertension, clotting disorders causing anticoagulation and skeletal malformations.

Methodology: This cross-sectional study was conducted from January 2015- September 2016. Sample size is 397. Pediatric patients under 7 years of age were recruited in this study. A history and examination form designed from an application "Forms" particularly for the study which was filled by concerned doctor. Diagnostic tests carried out to collect the data were fetal echocardiogram/echocardiogram (to record the electrical activity of patient's heart and can help diagnose heart defects or rhythm problems), CT scan (to take an X-ray movie of the heart and lungs), angiogram, chest X-ray (to see if the heart is enlarged, or if the lungs have extra blood or other fluid in them) and pulse oximetry (to check oxygen concentration in patient’s blood) . For data analysis SPSS 16.0 software was used.

Results: The median age of all patients with severe CHD was 3 years (interquartile range, 1.5 to 6 years). Distribution of CHD are 32.8% tetralogy of Fallot, 25.2% truncus arteriosus, 23.1% transposition complexes, 10.4% endocardial cushion defects and 8.5% univentricular heart.

Causes are genetic defects 47.2%, viral infection 29.8%, alcohol 17% and drugs 6%. Percentages of affecting systems are 47.2% respiratory system causing breathing problems and pulmonary hypertension, 24.8% clotting disorders causing anticoagulation and 24% skeletal malformations.

Conclusion: The best prognosis was found in pulmonary stenosis (survival rate 95.55%). The first week was survived by 91.46%, the first month by 87.14%, 6 months by 82.42%, and the first year of life by 80.02%, and 77.11% (95% CI 75.91–78.31%) survived to age 7 years.

Patients with severe primary pulmonary hypertension have a poor prognosis, but those with a patent foramen ovale may survive longer.

Biography:

To be updated soon.

Abstract:

“Torsades de Pointes” (TdP) ventricular tachycardia carry a high risk of sudden death even when it occurs in patients with structurally normal heart. Ultra short-coupled ventricular extrasystole (<300ms) has shown to be a trigger for TdP. This was first described in 1994 by Leenhardt et al and is known as Coumel sign.

Case
We present a 65-year-old man with medical history of cocaine abuse and coronary artery disease (CAD); who had just received 4 vessels coronary artery bypass grafts a week prior to his presentation. He presented to an outside hospital with palpitations and dizziness after using cocaine. His symptoms were due to fast polymorphic ventricular tachycardia (VT) with a rate of 230 beats per minute. He received eleven direct current cardioversion treatments. He was initially started on Amiodarone, which was changed to Lidocaine later as he continued to experience VT while on Amiodarone. His cardiac catheterization showed occlusion of one his bypass grafts for which medical management was recommended.
Lidocaine was stopped upon arrival to our facility as patient’s mental status was declining and Lidocaine toxicity was suspected. The following day, patient started experiencing episodes of TdP and required intubation due to hemodynamic instability. Careful telemetry review of his TdP events showed that short-coupled monomorphic ventricular extrasystole triggered each TdP episode. Patient was immediately started on Verapamil with resolution of his events. Meanwhile, patient was evaluated for implantable cardiovertor defibrillator, but he expired during his hospitalization due to sepsis.

Decision-making
Recognizing short-coupled ventricular extrasystole or Coumel sign as a trigger to TdP is crucial as it affects the patient’s management. Verapamil has been reported to be effective in managing patients with TdP with Coumel findings.

Conclusion
Short-couple variant of TdP has a high incidence of sudden death. It is very important to identify it and treat it promptly. Long term Verapamil treatment is effective but still insufficient and patients should be considered for implantable cardiovertor defibrillator therapy

Biography:

Daniel G Cacione is post graduate student at the Federal University of São Paulo and assistant medical doctor at São Paulo Hospital in Vascular & Endovascular Surgery. A Cochrane Collaboration  member since 2013, working with the Cochrane Vascular Group.
 

Abstract:

Objective: To assess the effectiveness of any pharmacological agent (intravenous or oral) compared with placebo or any other pharmacological agent in patients with Buerger's disease

Methods: The Cochrane Vascular Trials Search Co-ordinator searched their Specialised Register (last searched in April 2015) and the Cochrane Register of Studies (Issue 3, 2015). The review authors searched trial registers and the European grey literature; screened reference lists of relevant studies, and contacted study authors and major pharmaceutical companies. Selection criteria was randomised controlled trials (RCTs) involving pharmacological agents used in the treatment of Buerger's disease.

Results: Five randomised controlled trials (total 602 participants) compared prostacyclin analogue with placebo, aspirin, or a prostaglandin analogue, and folic acid with placebo.

Conclusions Moderate quality evidence suggests that intravenous iloprost (prostacyclin analogue) is more effective than aspirin for eradicating rest pain and healing ischaemic ulcers in Buerger's disease, but oral iloprost is not more effective than placebo. Very low and low quality evidence suggests there is no difference between prostacyclin (iloprost and clinprost) and the prostaglandin analogue alprostadil for healing ulcers and relieving pain respectively in severe Buerger's disease. Very-low quality evidence suggests there is no difference in pain scores and amputation rates between folic acid and placebo, in people with Buerger's disease and hyperhomocysteinaemia. High quality trials assessing the effectiveness of pharmacological agents (intravenous or oral) in people with Buerger's disease are needed

Biography:

To be updated soon.

Abstract:

Objective Evaluate the efficacy of biventricular lead location match on cardiac resynchrinization.
Methods Consecutive patients with dilated cardiomyopathy who candidate to CRTD were enrolled into the study. After posterior-lateral lead was implanted, patients were randomized into right ventricular apex match pacing group (RVA) and right ventricular output tract match pacing group (RVT). Active screw-in leads were anchored on the endocardial wall of RVA and RVOT respectively. Physiocurve CRTD generaters (Medtronic Co.) were connected and optimal working parameters were adjusted by ECG and echocardiography. Regular follow up was conducted in clinic for more than 6 months. NYHA class decrease, 6MWD increase, EF increase, BNP level decrease and QRS width decrease were compared between RVA and RVT groups.

Results  Fifty patients were enrolled into the study. Four patients were excluded for LV lead location. Forty-six patients (92%, 56.3+-5.7 yrs, male 27) were randomized into RVA group (22, 56.1+-5.3 yrs, male13) and RVT group (24, 56.5+-5.9 yrs, male 14). All procedures were successful wihout conplications. At the follow up of 11.3+-4.7 months, the resynchronization efficacy in RVT group was significantly superior to that in RVA groyp (NYHA class decrease 1.2+-0.5 vs 0.7+-0.3, P<0.05; 6MWD increase 236.75+-39.6m vs 129.3+-53.8m, P<0.01; EF increase 12.6+-5.1% vs 7.3+-6.5%, P<0.01; BNP decrease 3756.3+-379.2u vs 2027.5+-493.2u, P<0.01; QRS width decrease 19.6+-6.1ms vs 13.5+-7.2ms, P<0.05).

Conclusions RVOT lead location is superior to RV apex in the improvement of cardiac resynchronizayion efficacy by matching posterio-lateral LV pacng

Biography:

To be updated soon.

Abstract:

Objective  Evaluate the relationship between ablation dot number at pulmonary vein antrum (PVA)  and longterm efficacy of paroxysmal atrial fibrillation (PAF).

Methods  Parients with PAF history more than 6 minths were selected to isolate pulmonary veins (PV) at PVA. 3D mapping system (Carto-C3) and coolflow catheter (SmarTouch) were used to make the shell of atrium-PVA and ablation cicle around PVA. Superior and inferior PVAs were ablated by single ablation circle. Maxmal pependicular diameters of the circle were measured. The ablation dot on the circle was counted and divided by the sum of two maximal cicle diameters. Ablation dot number was defined as addition of left and right PVA ablation dot number. PVA isolation was defined as complete disappear of PV potential. PAF longterm efficacy was evaluated by regular clinical check and Hoter monitering at 6 and 12 months after procedure.

Results  160 patients with PAF (65.7+-8.6 yrs, male 110) and with PAF history of 15.7+-9.3 months were enrolled into the study. All PVs in each patient were isolated successfully by single procedure. Ablation dot number per circle and per patient was 32.6+-7.3 and 61.7+-9.1 respectively. During the follow up of 16.5+-3.3 months, 131 patients (81.9ï¼…) were free of PAF. PAF was recurrence in 29 patients (18.1ï¼…) in 4.2+-2.7 months after procedure. Ablation dot number was singnificantly different between patients with and without PAF recurrence (56.3+-5.7 vs 63.8+-7.1, P<0.01).

Conclusions  Ablation dot number around PVA is positively related to the longterm efficacy of PAF. Dot creation per patient more than 63 singnificantly decreases PAF recurrence.

Biography:

Manuela Stoicescu is Consultant Internal Medicine Physician (PhD in Internal Medicine), Assistant Professor of University of Oradea, Faculty of Medicine and Pharmacy, Romania. She was invited as speaker at more than 30 International Conferences is USA, China, Japan, Canada, Thailand, Dubai, Spain, Germany, she is Committing Organizing Member at  many  International Conferences, is editorial board member in two ISSN prestigious Journal in U.S.A, published  more than 30 articles in prestigious ISSN Journals in U.S.A., published five books (two on Amazon– one is :“Sudden cardiac death in the young”), one monograph and two chapter books – Cardiovascular disease: Causes, Risks, Management CVD1- Causes of Cardiovascular Disease 1.5,1.6, U.S.A on Amazon

Abstract:

OBJECTIVE: The main objective of this presentation is to put in discussion the surgical treatment of atrial fibrillation between benefit and risk. Atrial fibrillation is one of the most common arrhythmia in the clinical practice, with a well-established protocol management. However a patient's response to treatment is very unpredictable.

Why some patients after a simple administration of an ampoule of digoxin i.v , or after a perfusion with an ampoule of 150mg  Cordarone i.v. come in sinus rhythm and they maintained in sinus rhythm after long-term treatment with the drugs scheme with Digoxin one drug/day five days/week  or with Cordarone 200mg/day and other patients after multiple repeated surgeries outbreaks ectopic ablation, atrial fibrillation relapse in repeated remaining after all the medication in order to maintain sinus rhythm, and this we fully secure.
What unpredictable factors can lead to these paradoxes therapeutic responses?
What could be the best decision of a person in this situation?                   
The conservative therapy with drugs or to follows surgical therapy?

MATHERIAL AND METHODS: Present the situation  of a patient 52 years old, with good life style non-smoker, no coffee drink,  non alcohol consumption, with normal weight of the body mass, who had an episode of paroxysmal atrial fibrillation, who didn’t came in sinus rhythm after therapy with Cordarone i.v. The heart ultrasound was normal without clots in the left atrium. Thyroidal hormones levels were normal and thyroid ultrasound was normal as well. Electric shock was performed but without any result. The patient follows therapy with beta-blocker but remain in atrial fibrillation. For this reason decided to perform ablation surgical procedure to revue in sinus rhythm. After the surgical procedure remained also with beta-blockers drugs 2X50mg/day but for a short period of time was in sinus rhythm and again revue in atrial fibrillation under therapy. For this reason performed again ablation surgical procedure follows also therapy with beta-blocker after that and the sinus rhythm was present for a short period of time. In this time appear two episodes of paroxysmal atrial fibrilation under medications and decided a third surgical procedures of ablation but during surgery procedure was induced atrial fibrillation and needs anti-arrhythmic therapy i.v. to become in sinus rhythm and after that remain on beta-blocker drugs in sinus rhythm during therapy. After two months the patient develops again atrial fibrillation under antiarrhythmic therapy.

Of course, this surgical procedure appears with all the good intentions for the patients to try solving the real cause of the problem – ectopic foci – but these must to can be localized first and we must to take into account also the risk of myocardial fibrosis induced. One thing is certain repeated surgeries through ablation process are themselves risky and can become a risk factor for subsequent episodes of atrial fibrillation. Sometimes the surgical procedure itself can induce this rhythm disorder. Moreover mechanical process of the atrium, with intent to destroy ectopic foci can affect healthy myocardial tissue, which can then generate new ectopic foci, plus they can induce atrial myocardial fibrosis.

CONCLUSION: Repeated surgeries ablation procedures to treat atrial fibrillation are not beneficial and even can become risky in itself a risk factor for new episodes of atrial fibrillation and myocardial fibrosis. If one procedure is with therapeutic success is good, but repeated procedures become risky.

Biography:

Manuela Stoicescu is Consultant Internal Medicine Physician (PhD in Internal Medicine), Assistant Professor of University of Oradea, Faculty of Medicine and Pharmacy, Romania. She was invited as speaker at more than 30 International Conferences is USA, China, Japan, Canada, Thailand, Dubai, Spain, Germany, she is Committing Organizing Member at  many  International Conferences, is editorial board member in two ISSN prestigious Journal in U.S.A, published  more than 30 articles in prestigious ISSN Journals in U.S.A., published five books (two on Amazon– one is :“Sudden cardiac death in the young”), one monograph and two chapter books – Cardiovascular disease: Causes, Risks, Management CVD1- Causes of Cardiovascular Disease 1.5,1.6, U.S.A on Amazon

Abstract:

OBJECTIVE: The main objective of this presentation is to put in discussion the surgical treatment of atrial fibrillation between benefit and risk. Atrial fibrillation is one of the most common arrhythmia in the clinical practice, with a well-established protocol management. However a patient's response to treatment is very unpredictable.

Why some patients after a simple administration of an ampoule of digoxin i.v , or after a perfusion with an ampoule of 150mg  Cordarone i.v. come in sinus rhythm and they maintained in sinus rhythm after long-term treatment with the drugs scheme with Digoxin one drug/day five days/week  or with Cordarone 200mg/day and other patients after multiple repeated surgeries outbreaks ectopic ablation, atrial fibrillation relapse in repeated remaining after all the medication in order to maintain sinus rhythm, and this we fully secure.
What unpredictable factors can lead to these paradoxes therapeutic responses?
What could be the best decision of a person in this situation?                   
The conservative therapy with drugs or to follows surgical therapy?

MATHERIAL AND METHODS: Present the situation  of a patient 52 years old, with good life style non-smoker, no coffee drink,  non alcohol consumption, with normal weight of the body mass, who had an episode of paroxysmal atrial fibrillation, who didn’t came in sinus rhythm after therapy with Cordarone i.v. The heart ultrasound was normal without clots in the left atrium. Thyroidal hormones levels were normal and thyroid ultrasound was normal as well. Electric shock was performed but without any result. The patient follows therapy with beta-blocker but remain in atrial fibrillation. For this reason decided to perform ablation surgical procedure to revue in sinus rhythm. After the surgical procedure remained also with beta-blockers drugs 2X50mg/day but for a short period of time was in sinus rhythm and again revue in atrial fibrillation under therapy. For this reason performed again ablation surgical procedure follows also therapy with beta-blocker after that and the sinus rhythm was present for a short period of time. In this time appear two episodes of paroxysmal atrial fibrilation under medications and decided a third surgical procedures of ablation but during surgery procedure was induced atrial fibrillation and needs anti-arrhythmic therapy i.v. to become in sinus rhythm and after that remain on beta-blocker drugs in sinus rhythm during therapy. After two months the patient develops again atrial fibrillation under antiarrhythmic therapy.

Of course, this surgical procedure appears with all the good intentions for the patients to try solving the real cause of the problem – ectopic foci – but these must to can be localized first and we must to take into account also the risk of myocardial fibrosis induced. One thing is certain repeated surgeries through ablation process are themselves risky and can become a risk factor for subsequent episodes of atrial fibrillation. Sometimes the surgical procedure itself can induce this rhythm disorder. Moreover mechanical process of the atrium, with intent to destroy ectopic foci can affect healthy myocardial tissue, which can then generate new ectopic foci, plus they can induce atrial myocardial fibrosis.

CONCLUSION: Repeated surgeries ablation procedures to treat atrial fibrillation are not beneficial and even can become risky in itself a risk factor for new episodes of atrial fibrillation and myocardial fibrosis. If one procedure is with therapeutic success is good, but repeated procedures become risky.

Biography:

Rohan Ravindranath completed his BSc. (Hons.) from the University of Toronto in chemistry and biotechnology. He is currently pursuing his MSc. in chemistry under the joint guidance of Professor Michael Thompson and Professor Alexander Romaschin at the University of Toronto and at St. Michael’s hospital. He has presented his past research at various local conferences and was recently awarded a best poster prize at the 2013 Astra Zeneca summer poster competition

Abstract:

Stenosis is a symptom of coronary artery disease (CAD), and is caused by narrowing of arteries in the heart. Over the past several decades, medical implants such as cardiac stents have been deployed in patients to counter stenosis. In patients with stent implants, narrowing of the artery can reoccur (restenosis) due to an immune response towards the implanted ‘foreign’ device. Restenosis is a major health concern for patients who have undergone heart surgery for CAD. Recently, there have been promising new approaches to combat restenosis. One such approach is to promote re-endothelialization of the implanted stent surface by capturing circulating endothelial cells in blood. This is hypothesized to help reduce the stent-induced immune response launched by the body. Our investigation involved developing a novel proof-of-concept cardiac stent, with the ability to bind endothelial cells. Steel coupons were coated with a self-assembled monolayer (SAM) made of benzothiosulfonate (BTS). Whole anti-human CD144 (VE-cadherin) antibodies were immobilized on the steel surface, which was then incubated in a cell culture of human umbilical vein endothelial cells (HUVECs) for several days, in vitro. The cells that bound to the steel were fixed and stained with fluorescently labeled anti-CD34. Using fluorescence microscopy it was evident that the cells were able to adhere and proliferate on the coated steel. These results demonstrate that re-endothelialization of the stent surface was induced

Biography:

Enrico Ferrari, is a graduate of Turin Medical School (MD) in Italy and received Cardiovascular surgery training at University of Padova (Italy), Catharina Hospital of Eindhoven (The Nederland), and at University of Lausanne (Switzerland). He received special training in minimally invasive cardiac surgery and transcatheter heart valve procedures at University Hospital of Lausanne, Switzerland, where he became Associate Professor in 2010. Since 2015, he works as team leader at Cardiocentro Ticino Foundation in Lugano, Switzerland, and continues the academic career at Cardiovascular Research Unit of Lausanne. He is a member of the STS/AATS joint workforce on New Technology (2011-2018) and STS workforce on International Relationship 2011-2018. He is Associate Editor of the Interactive Cardiovascular and Thoracic Surgery Journal (ICVTS), member of the Editorial Board of the Archive of Sciences Journal, and member of the Editorial Board of the Multimedia manual of Cardio-Thoracic Surgery (MMCTS).

Abstract:

The aim of this brief report is to show technical details and feasibility of balloon-expandable stent-valve implantation in aortic position during conventional redo open-heart surgery in overweight patients with small-sized mechanical aortic prosthesis and patient-prosthesis mismatch.

Methods and results
Two consecutive symptomatic overweight patients (BMI of 31 and 38) with small mechanical aortic prosthesis (a 4 year-old 21mm Hancock II valve and a 29 year-old 23mm Duromedic valve), increased gradients (59/31mmHg and 74/44mmHg) and reduced indexed effective orifice area (0.50cm²/m² and 0.43cm²/m²) were treated successfully with surgical implantation of two 26mm balloon-expandable Sapien^TM 3 valves during redo procedures. Under full sternotomy, cardiopulmonary bypass and cardioplegic arrest the stent-valves were implanted under direct view through the aortotomy and after mechanical valves removal. In one patient, a concomitant regurgitant mitral valve was replaced with a standard bioprosthesis. Aortic cross clamp times were 162 and 126 minutes; cardiopulmonary bypass times were 178 and 180 minutes; total surgical times were 360 and 318 minutes. At discharge, the echocardiographic control showed transvalvular peak and mean gradients of 13/9mmHg and 23/13mmHg, and indexed effective orifice areas of 0.64cm²/m² and 1.08cm²/m². The 3-month echocardiographic control showed transvalvular peak and mean gradients of 18/9mmHg and 19/11mmHg, and indexed effective orifice areas of 0.78cm²/m² and 0.84cm²/m², with improved symptoms.

Conclusion
Balloon-expandable stent-valve implantation during redo open-heart surgery is feasible and safe and prevents patient-prosthesis mismatch in overweight and obese patients. Moreover, in case of stent-valve degeneration this approach allows for additional valve-in-valve procedures with big-size stent-valves and prevents high-risk re-redo surgery

Biography:

Jaideep Kumar Trivedi after completing his MBBS and MS did MCh in cardiothoracic surgery in 2007 from Grant Medical College,Mumbai. He was awarded 1^st rank by the Mumbai university in MCh examination. He has published papers in national and international journals.Presently he is working as consultant cardiothoracic surgeon at Apollo hospital Vishakhapatnam, India. Till date he has performed more than 1000 cardiothoracic surgeries independently

Abstract:

Dermoid cysts usually arise in the ovary.They can occur at other sites including the mediastinum.However,their intrapericardial location has been reported very occasionally .This case is being presented because of its rarity and unusual presentation as acute coronary syndrome and its successful removal on beating heart along with CABG. 44yrs male presented with severe chest pain and breathlessness in our emergency department.His ECG was done which showed T wave inversion in inferior and lateral leads,Xray showed calcified rim in middle mediastinum. Echocardiogramand ct scan thorax revealed large mass pressing over RA and RV.  Coronary angiogram was done which revealed severe tripple vessel disease and large calcified cystic mass pressing RA & RV and compressing right coronary artery.We did CABG on beating heart, 3grafts were given LIMA to LAD and SVG to OM and PDA.Intraop TEE was done and dermoid cyst was also removed on beating heart under TEE guidance carefully. It contained creamy sebaceous material H.P. report confirmed dermoid cyst.Pt. was discharged on 7^th day ,asymptomatic and following up with us since last 2 years.

Conclusion                                                                                             
Dermoid cyst rarely occur intrapericardially and presentation as acute coronary syndrome is very unusual.Successful removal along with coronary artery bypass grafting on beating heart has not been reported in the literature till date.

Biography:

Naseer Ahmed has completed his MBBS (Basic Medical Degree) from Pakistan at the age of 23 years from Riphah International University Islamabad, Pakistan. After that I completed my 1 year Internship. In January 2014, I started my PhD program at University of Verona, Verona Italy in program of Cardiovascular Sciences. Here I am working with collaboration of other European centers

Abstract:

Background:

Aortic Valve Replacement (AVR) is first line therapy of aortic stenosis (AoS). As the aortic valve is in close proximity to the atrioventricular node and His bundle manipulation during AVR may cause atrioventricular conduction abnormalities. The objective of this study was to examine the time course of alterations in the surface electrocardiogram after surgical aortic valve replacement.

Methods:

The study population consisted of 127 consecutive patients (mean age 66±12 years, 84 male), with AoS underwent AVR. Standard 12-lead ECGs were obtained at baseline (within 6 months prior to procedure) named as Group I, early (within 3 days) considered as Group II and late (4th post-operative day until 6 months) named Group III after valvular heart surgery.

Results

In 127 pre-operative ECGs, SR, Atrial Fibrillation (AF) and Atrial Flutter (AFL) was present in respectively 108(79%), 18(20%) and 1(1%) patients. Atrio-Ventricular (AV) block (first degree) (N=15, 13%), Left Bundle Branch Block (LBBB) (N=11, 9%) Right Bundle Branch Block (RBBB) (N=10, 8%) and Left Anterior Fascicular Block (LAFB) (N=8, 6%) were present in Group I. In Group III, AVB (N=13, 24%) (P=0.034), LBBB (N=10, 13%) (P=0.705), RBBB (N=12, 17%) (P=0.025), and LAFB (N=8, 12%) (P=0.414) were detected. Frequency of AF/AFL increased in Group III (N=23, 30%) (P=0.012) versus Group I (N=18, 14%). (p= 0.012).

Conclusion:

The electrocardiographic changes during aortic valve replacement surgery increases significantly incidence of conduction abnormalities including AV block (grade 1) and RBBB. Incidence of late post-operative AF is also significant as compared to pre-procedural AF

Biography:

Jaideep Kumar Trivedi after completing his MBBS and MS did MCh in cardiothoracic surgery in 2007 from Grant Medical College,Mumbai. He was awarded 1^st rank by the Mumbai university in MCh examination. He has published papers in national and international journals.Presently he is working as consultant cardiothoracic surgeon at Apollo hospital Vishakhapatnam, India. Till date he has performed more than 1000 cardiothoracic surgeries independently

Abstract:

Dermoid cysts usually arise in the ovary.They can occur at other sites including the mediastinum.However,their intrapericardial location has been reported very occasionally .This case is being presented because of its rarity and unusual presentation as acute coronary syndrome and its successful removal on beating heart along with CABG. 44yrs male presented with severe chest pain and breathlessness in our emergency department.His ECG was done which showed T wave inversion in inferior and lateral leads,Xray showed calcified rim in middle mediastinum. Echocardiogramand ct scan thorax revealed large mass pressing over RA and RV.  Coronary angiogram was done which revealed severe tripple vessel disease and large calcified cystic mass pressing RA & RV and compressing right coronary artery.We did CABG on beating heart, 3grafts were given LIMA to LAD and SVG to OM and PDA.Intraop TEE was done and dermoid cyst was also removed on beating heart under TEE guidance carefully. It contained creamy sebaceous material H.P. report confirmed dermoid cyst.Pt. was discharged on 7^th day ,asymptomatic and following up with us since last 2 years.

Conclusion                                                                                             
Dermoid cyst rarely occur intrapericardially and presentation as acute coronary syndrome is very unusual.Successful removal along with coronary artery bypass grafting on beating heart has not been reported in the literature till date.

Biography:

Kalpnath, pursuing PhD at the age of 33 years from All India Institute of Medical Sciences, New Delhi , INDIA. I have published 2 papers. I have involved in the  project entitled “Induction of therapeutic Angiogenesis in Limb Ischemia by Intra-arterial delivery of Autologous Bone-Marrow derived Stem cells” and Transplantation of Mesenchymal Stem Cells in animal models of Myocardial Infarction and Parkinson’s Disease” funded by Department of Biotechnology (DBT), Govt. of India.

Abstract:

Objective: Genetic susceptibility is an important risk factor for aortic wall degeneration and its leads to thoracic aortic aneurysm and dissection (TAAD). In many patients with TAD, the aorta progressively dilates and ultimately ruptures. The purpose of this study was to determine the single nucleotide polymorphism in 6 genes associated with thoracic aortic aneurysm and dissection patients in Indian population-A case-control study.

Methods: Genomic DNA was isolated from blood and aortic wall tissue of 66 patients with degenerative TAAD, and 67 control individuals. Six SNPs– rs819146, rs8003379, rs2853523, rs326118, rs3788205, and rs10757278 – were genotyped using TaqMan SNP Genotyping Assays (Applied Biosystems, Foster City, Calif). The data was analysed using STATA11.0 Statistical software. Associations between polymorphisms and disease in tissue, blood and within gender were estimated with odds ratios and their 95% confidence intervals.

Results: The T allele frequency for the SNP on 21q22.3, 5’ near gene as rs3788205 (- 2174 C/T) was higher in male patients than in male controls (P-.049). Moreover, with adjustment for traditional cardiovascular risk factors (sex, age, hypertension dyslipidemia diabetes and smoking), the rs3788205 {odd ratio (OD) 0.41, 95% confidence interval (CL) 0.14 to 1.09} polymorphism was found to be an independent susceptibility factor for TAAD in males.

CONCLUSION: Our results suggest that a sequence variant on 21q22.3 is an important susceptibility locus that confers high cross-race risk for development of TAAD in Indian population.

Key words: Single Nucleotide Polymorphism, Thoracic Aortic Aneurysm and Dissection