2021/22 AAC Ancona Advanced Course spring

Minimally Invasive and Trans-catheter Aortic Valve Interventions for Cardiac Surgeons

Course Director: Prof. Marco Di Eusanio

Course objectives:

The treatment of patients with aortic valve stenosis has undergone a revolutionary evolution over the last decade with Trans-catheter Aortic Valve Implantation (TAVI) representing > 50% of all aortic valve implants. Given such scenario, in order to remain a key player in the treatment of valvopathies, it is crucial the cardiac surgeon rapidly evolves by increasingly offering minimally invasive surgical interventions and embracing catheter-based techniques and technologies. By doing so, the surgeon will have the possibility of being able to offer the best therapeutic option to all patients without conflicts of interest and unparalleled competence.

The course, through frontal teaching and observation of interventions performed in the operating and hybrid room, is ideated to be highly interactive and aimed at expanding the knowledge miniAVR and TAVI.

With regard to MiniAVR, approaches such as ministernotomy, anterolateral and transaxillary minithoracotomy for the exposure of the aortic valve will be taught in a thorough way so that these can then be applied by the learners independently. Additionally, a 360° multidisciplinary approach for miniAVR will be demonstrated by adding to reduced incisions the use of Minimally Invasive Extracorporeal Circulation (MiECC), ultrafast track anesthesia protocols and early ICU rehabilitation.

With regard to TAVI, after providing CT-based preoperative planning and catheters principles, transfemoral TAVI will be demonstrated in step-by-step fashion with the aids of videos and, on day 3 , directly in the hybrid room. The learning surgeon should return home well convinced TAVI is an intervention that can be learned and that should become part of his/her armamentarium.

The theoretical-practical course will be held by Prof. Marco Di Eusanio (Chief of Cardiac Surgery Dept.), Dr. Christopher Munch (Chief of Anesthesia and Cardiac Surgery ICU) and Cardiac Surgeons and anesthetists from the Ancona Team.

The course has a limited number of places available ((n=4). To participate in the allocation of seats, learners will need to make a reservation starting June 7, 2021.

Position in the ranking will be determined by the chronological order of registration.

Dates and registration fee will be shortly provided

A certificate of attendance will be provided at the end of the course

For further info and support: minicardiacsurgery-research@univpm.it

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DAY 1

Intro:

  • 14.45 Welcome

MINI AVR

  • 15.00 Minimally Invasive Aortic Valve Replacement (Mini AVR).
    • Why and how
    • Minimally Invasive Extracorporeal Circulation (MiECC)
    • Sutureless and Rapid Deplyment Aortic Valve Prosteses (SURD)
    • Ultra-fast track anesthesia (UFTA)
  • 15.30 MiniAVR approaches:
    • Ministernotomy (videos)
    • Minithoracotomy (videos)
    • Transaxillary (videos)
  • 16.15 Discussion.

TAVI

  • 16.45 a TAVI program in Cardiac Surgery
  • 17.00 Pre-operative CT Planning
  • 17.15 Getting familiar with wires and catheters
  • 17.30 Step by step Transapical TAVR (videos)
  • 17.45 Step by Step Transfemoral TAVR (videos)
  • 18.00 discussion
  • 18.30 end of day1

DAY 2

Into the operative theatre: MiniAVR (2 cases)

  • 7.45 Coffee & Case presentation
  • 9.00  Case 1
    • 360° mini AVR (Minist. + Miecc + SURD + UFTA)
  • 12:00 Discussion
  • 12:30 Lunch
  • 13:30 Case 2
    • Right Minithoracotomy or transaxilllary  AVR  + UFTA
  • 18.00 Discussion
  • 18.30 end of day 2

DAY 3

Into the operative theatre: TAVR (3 cases)

  • 7.45 Coffee & Case presentation
  • 09.00 Case 1: Transfemorlal TAVR
  • 11.30 Case 2: Transfemoral TAVR
  • 14:30 Case 3: Transfemoral TAVR
  • 16.30 Discussion
  • 17.00 end of ACC
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