Monday - Thoracic Surgery News

MONDAY ISSUE
MONDAY
7:30 AM – 7:45 AM
AATS Business Session
(AATS Members Only)
9:00 AM – 4:30 PM
Exhibits Open
7:45 AM – 12:15 PM
Plenary Scientific Session
Award Presentations
10:00 AM – 10:40 AM
Basic Science Lecture: John E. Bares, PhD,
Carnegie Robotics, LLC: “Will a Robot Take
Your Job?”
11:25 AM – 12:15 PM
Presidential Address: Craig R. Smith, MD,
Columbia University: “To Model Excellence”
1:00 PM – 4:30 PM
Educational Program: Building the Hybrid OR
of the Future
2:00 PM – 5:00 PM
Simultaneous Scientific Sessions
Adult Cardiac Surgery
Congenital Heart Disease
General Thoracic Surgery
TUESDAY
7:00 AM – 9:00 AM
Cardiac Surgery Forum,
General Thoracic Surgery Forum
8:45 AM – 12:30 PM
Plenary Scientific Session
9:00 AM – 4:00 PM
Exhibits Open
11:40 AM – 12:30 PM
Honored Speaker Lecture:
Mehmet C. Oz, MD, Columbia University,
“Medicine in Media”
2:00 PM – 5:00 PM
Simultaneous Scientific Sessions:
Adult Cardiac Surgery
Basic Science Lecture Today
John Bares, PhD, president
and CEO of
Carnegie Robotics LLC, will
present this year’s Basic Science
Lecture, “Will a Robot
Take Your Job?” today at
10:00 a.m.
Cover photo courtesy: © Greg Pickens
Continued on page 3
JOHN BARES, PHD
Visit AATS Daily News and THORACIC SURGERY
NEWS online: www.thoracicsurgerynews.com
MOSCONE CONVENTION CENTER • SAN FRANCISCO, CA • APRIL 28-MAY 2, 2012
Matching the Treatment to the
Patient in Adult Cardiac Surgery
GT Skills Course: Safety and Speed
Saturday’s General Thoracic Skills
Course taught attendees who have
performed some of the newer technical
procedures how to do these operations
in a reliably safe and easy way. Course
participants shared their expertise in
how to improve procedures by finetuning
the operative steps and using
time-saving techniques.
Robert J. McKenna Jr. MD, head of
thoracic surgery at Cedars Sinai Medical
Center, discussed what he referred to as
“the easy way to do a VATS lobectomy.”
Teamwork and careful
consideration of the
patient’s anatomic disease
and comorbid conditions
are key to matching the
right treatment with the right
patient, Peter Smith, MD,
said in Sunday’s Adult Cardiac
Surgery Symposium.
The symposium, moderated
by Michael Argenziano, MD,
of Columbia University,
highlighted recent developments
in the treatment of
aortic and mitral valve disease,
thoracic aortic and
coronary artery disease, and
heart failure.
Allen S. Stewart, MD, of
Columbia University addressed
aortic valve repair in
the first session. The relative
merits of transcatheter aortic
valve implantation (TAVI) –
whether it is superior to aortic
valve repair or whether it
should play a limited role in
the treatment of aortic stenosis
– were debated by Paul
Teirstein, MD, of the Scripps
Clinic and D. Craig Miller,
MD, of Stanford University,
respectively.
Session II featured an update
on the clinical and regulatory
status of percutaneous
mitral repair devices and presentations
about mitral valve
repair by A. Marc Gillinov,
Continued on page 4
Robert J. McKenna, Jr., MD, said that VATS lobectomy
“is a reasonable treatment for lung cancer.”
The rate of VATS lobectomies performed
is 40% in the STS database, but
throughout the United States the rate is
only 15%, according to Dr. McKenna.
He warned that “if you want to lose
lung cancer surgery to RFA [radiofrequency
ablation] and SBRT [stereotactic
body radiation therapy], the best way is
for thoracic surgeons to continue not to
perform VATS lobectomy.”
Dr. McKenna detailed his own experience
with more than 2,800 VATS
lobectomies from 1992 to 2012. He performed
the procedure
in both women
(54.1%) and men
(45.9%). The patients
had a mean
age of 71.2 years.
Dr. McKenna explained
that VATS
Stewart Bloom/IMNG Medical Media
Peter K. Smith, MD, discussed appropriate use criteria
for PCI vs. CABG.
lobectomy should
be, in essence, the
same operation as an
open procedure, that
is, it should include
anatomic dissection
and node dissection
or sampling.
The operative approach
should begin
by switching from
postero-lateral thoracotomy
to a muscle-sparing approach.
The surgeon must get used to working
from the anterior.
It is important to set a time limit and
to become familiar with VATS incisions
and angles – making two, three, and four
incisions is fine, because enough incisions
must be made to get good exposure and
good angles for instruments, he said.
The patient should be in a lateral decubitus
position with the surgeon standing
anteriorly. Dissection starts in the
hilum of the lung and is performed anteriorly
to posteriorly, with care taken
not to move the lung back and forth.
Lymph nodes should be removed at the
start to define the anatomy, and dissections
should be on named structures.
Dr. McKenna reviewed the complexities
of stapling and compared the technical
aspects of performing a right upper
lobectomy and a left upper lobectomy.
“VATS lobectomy is a reasonable
treatment for lung cancer, and complete
nodal dissection is possible,” he said.
The procedure has low morbidity and
mortality, a low risk of major bleeding,
and a low risk of needing incisions, and
there is less acute pain than after thoracotomy,
he noted. There is some evidence
that the procedure may have less
of an impact on the immune system
Continued on page 17
Martin Allred/IMNG Medical Media

Committed to the
Cardiac Surgeon
VISIT US AT BOOTH 715
SJMprofessional.com
ST. JUDE MEDICAL, the nine-squares symbol and MORE CONTROL. LESS RISK. are registered and
unregistered trademarks and service marks of St. Jude Medical, Inc. and its related companies.
©2012 St. Jude Medical. All Rights Reserved.

MOSCONE CONVENTION CENTER • SAN FRANCISCO, CA • APRIL 28-MAY 2, 2012 3
Presidential
Address
Today
Visit the AATS
Welcome Center
Visit the AATS Welcome
Center, in the lobby area
next to registration for
information about the Annual
Meeting and San Francisco.
AATS staff are on hand to answer
your questions on AATS
initiatives, including AATS publications,
membership in AATS,
educational meetings, and
awards and scholarships.
In addition, San Francisco
hospitality staff are available to
answer questions about the local
area, make recommendations
and reservations for lunch
and dinner, suggest places to
visit, and help you make the
most of your visit to San Francisco.
■
At the Welcome Center you’ll get information on the AATS,
the meeting, and the City by the Bay.
Martin Allred/IMNG Medical Media
CRAIG R. SMITH, MD
AATS President Craig R. Smith
will present “To Model Excellence”
at 11:25 AM.
Dr. Smith is Chair of the Department
of Surgery at Columbia University.
Program Addition
AATS Lung Cancer
Screening Guidelines
General Thoracic
Simultaneous Session
Monday, 5:00 PM
Room: 2007, 2009, 2011
Michael T. Jaklitsch, MD
AATS Guidelines for Lung
Cancer Screening Using Low-
Dose Computed Tomography
Scans for Lung Cancer
Survivors and Other High-Risk
Groups: Report of the AATS
Lung Cancer Screening and
Surveillance Task Force
On-X ®
Prosthetic Heart Valves
PROACT * Clinical Trial Progress
Fall 2012: Submission of results to FDA to allow reduction
in anticoagulation recommendation for
On-X AVR patients to an INR of 1.5 - 2.0
Late 2012: Interim results available for the On-X low
risk AVR group (aspirin/clopidogrel therapy)
and low dose Coumadin in On-X MVR group
DAILY SCHEDULE
Continued from page 1
Congenital Heart Disease
General Thoracic Surgery
5:00 PM – 5:45 PM
AATS Executive Session
(AATS Members Only)
7:00 PM – 10:00 PM
AATS Special Reception
California Academy of Sciences
WEDNESDAY
7:00 AM – 9:00 AM
Emerging Technologies &
Techniques Forum
9:00 AM – 10:00 AM
Controversies in Cardiothoracic
Surgery
10:00 AM – 11:00 AM
Adult Cardiac Debate
Congenital Debate
General Thoracic Debate
11:00 AM – 2:30 PM
Transcatheter Therapy and Collaboration:
Defining Our Future
All of the meeting presentations
and events will take place at the
Moscone Convention Center unless
otherwise noted.
*The Prospective Randomized On-X Valve Anticoagulation Trial (PROACT)
was initiated in 2006 and is currently ongoing in 36 centers throughout the
United States and Canada. With over 1200 patients, PROACT is the only FDA
approved IDE trial for prosthetic heart valves with reduced anticoagulation
or antiplatelet therapy.
Moscone West Convention Center
Booth # 517
On-X aortic and mitral valves are FDA approved.
Until the completion and analysis of study data, On-X Life Technologies, Inc., continues to recommend standard
anticoagulation therapy as presently prescribed by various professional societies for the On-X heart valve.
CAUTION: Federal law restricts this device to sale by or on the order of a physician. Refer to the Instructions for Use
that accompany each valve for indications, contraindications, warnings, precautions and possible complications.
CAUTION: Investigational use of this device in the Prospective Randomized On-X Valve Anticoagulation Trial (PROACT)
is limited by federal law to investigational sites. For further information, visit www.onxlti.com.

4 AATS 92 ND ANNUAL MEETING
Continued from page 1
MD, of the Cleveland Clinic and Steven F.
Bolling, MD, of the Univeristy of Michigan.
Dr. Smith’s presentation
in Session III focused on
the criteria for appropriate
use of coronary artery bypass
grafting (CABG) and
percutaneous coronary intervention
(PCI). He discussed
the utility of the
most recent update of the
Appropriate Use Criteria
for Coronary Revascularization
in making this decision.
The document describes
the clinical
populations most likely to
benefit from one approach
or the other (J.
Am. Coll. Cardiol. 2011;
doi:10.1016/j/jacc.2011.12.001).
“The key change in the criteria is that,
while CABG is appropriate for all these
classes, PCI was not inappropriate for some
left-main disease,” said Dr. Smith, chief of
cardiovascular and thoracic surgery at the
Duke University Medical Center.
But while PCI had uncertain value or
was simply an inappropriate treatment for
many, it is a reasonable alternative for
some patient groups, he noted.
PCI is now considered appropriate for
those with two-vessel disease or three-vessel
disease with a low coronary disease
burden. It is contraindicated, however, in
patients with left-main stenosis and additional
vessel disease with an intermediate
to high disease burden.
The revised document relied heavily on
new data acquired from the Synergy between
PCI with TAXUS and Cardiac
Surgery trial (SYNTAX), which compared
CABG and PCI with drug-eluting stents in
patients who have de novo three-vessel disease
and/or left-main coronary disease.
According to the study, CABG should
be the standard of care for these patients,
since it was associated with significantly
fewer cardiac and cerebrovascular events
at 1 year after surgery (N. Engl. J. Med.
2009;260:961-71).
Allan S. Stewart, MD (left), Paul Teirstein, MD (center), and D. Craig
Miller, MD (right) had a panel discussion during the symposium.
However, Dr. Smith pointed out that
“There have been some other observational
trials suggesting that PCI might be
appropriate for some patients with leftmain
disease, particularly when isolated
and not associated with other coronary
disease, as in patients with a SYNTAX
score of 23 or lower.”
In fact, he said, new direct evidence
suggests that PCI appears to be as good
as surgery in these patients, who represent
up to 25% of all patients with leftmain
coronary disease.
“In this group, even though CABG is
still an excellent treatment, there is a role
for restraint in that choice – especially in
patients at higher than usual risk for
surgery,” he said.
But he emphasized that the updated
guidelines are merely guidelines. “They
are not so strict as to say that PCI should
never be done in a patient with an inappropriate
indication,” he said. “When the
indication is uncertain, there should also
be a level of explanation available as to
why you are choosing that, when there is
an appropriate alternative like CABG.”
Martin Allred/IMNG Medical Media
The guidelines stress the need for a fullteam
press in this decision-making
process. A heart team – consisting of cardiologists,
surgeons, and interventional
radiologists – helps
everyone see the overall
picture, rather than
the individual view.
“The team should
get together and decide
the appropriate
treatment to recommend
while separating
the processes of diagnosis
and treatment,”
according to Dr.
Smith.
Obviously, the patient’s
health is the ultimate
driving force in
this decision. But reimbursement
is also a
factor.
“These criteria are going to be used by
insurance companies. Some payers are already
beginning to ask for data showing
whether or not a procedure is appropriate,”
so documentation of the decisionmaking
process will play a crucial role,
Dr. Smith noted.
“Probably the lesson to be learned here
is that it’s not all black and white,” he said.
“CABG is not for everyone. Clearly there
will be some patients who could be treated
with PCI, and many who are treated
with PCI but who would be better served
by CABG.”
Other topics covered during the symposium
included recent clinical trial data
on percutaneous coronary interventions;
applying appropriateness criteria when
treating patients with coronary artery
disease; robotic and hybrid revascularization;
thoracic aortic disease treatment, including
aortic arch surgery and thoracic
endovascular aortic repair; and heart failure
treatments such as ventricular remodeling,
ventricular assist devices postcardiotomy
support, and stem cell
therapy.
■
Nap Your
Way to
Alertness
Strategic rest periods can help you
reach peak performance in the operating
room, and managing sleepiness is
something all surgeons need to know
how to do.
“In modern Western cultures we do not
value sleep, and choose instead to power
through fatigue. ‘After all, sleep is overrated.
All I need is 5 hours and I’m good.’
How many times have we heard that?” said
Scott Shappell, PhD, a senior professor at
Clemson University, during Sunday’s Luncheon
Surgery Symposium.
Surgeons tend to view themselves as almost
superhuman when it comes to stamina.
Yet fatigue contributes to serious,
sometimes fatal, accidents.
Strategic napping – a technique he introduced
during the session – is an excellent
way to minimize the risks of fatigueinduced
errors. Unlike a regular nap, these
mini-naps are really short periods of deep
Scott Shapell, PhD, told attendees how
to benefit from strategic napping.
Martin Allred/IMNG Medical Media
relaxation that exert very real physiologic
benefit, said Dr. Shappell, who has a PhD
in neuroscience and a professorship in industrial
engineering.
“Strategic napping is a short, 15-
20–minute ‘nap’ that you can easily do,
even standing up. You’re not asleep as
most of us define it; you’re not dreaming,
but in this state you do become very
relaxed. Brain activity starts to synchronize,
while respiration and heart rate begin
to slow down as the system recalibrates.”
Military studies, among others, have
shown that strategic napping improves
performance for the rest of the day.
“Imagine a cardiovascular surgeon taking
a 15-minute rest period before a 6-hour
surgery. If it’s good enough to improve the
performance of special ops soldiers and
fighter pilots, it’s going to be pretty good
for a surgeon.”
Dr. Shappell acknowledged that he has
a vested interest in taking care of AATS
members. “I’m 50 years old and I’m probably
going to end up on one of their tables
one day. And when I do, I want to make
sure my surgeon is playing at the top of the
game.”
■

Instruments
of change.
Want to simplify the task of delivering and seating
secure knots during MICS? Or address the difficulty
of inadequate exposure? These instruments are just
two examples of how in a time of change, Medtronic
is helping you seize simplicity by allowing you to
decide what’s best.
For more, visit us at booth #701.
The JOSEPH LAMELAS Knot Pusher is intended for use to advance throws of extracorporeal knots to
an intracorporeal surface or object within a small cavity during limited access cardiothoracic procedures.
The JOSEPH LAMELAS Atrial Lift System is intended for use to retract the atrial wall during limited
access cardiac surgical procedures.
©Medtronic, Inc. 2012 UC201204039aEN

6 AATS 92 ND ANNUAL MEETING
Experts Reviewed Minimally Invasive Surgery
The Adult Cardiac Skills Course on
Saturday highlighted indications and
techniques for advanced operations,
especially minimally invasive and robot-assisted
approaches to valve-sparing aortic
root replacement, aortic root enlargement,
septal myectomy, and complex mitral valve
repair.
Transcatheter-based approaches increasingly
are being used to treat patients with
aortic valve stenosis and should be adopted
by cardiac surgeons, according to Vinod
H. Thourani, MD, of Emory University.
“The treatment of severe aortic stenosis
has been radically transformed over
the past 3 to 4 years by the introduction
of technology that allows the transition
from open surgical therapies like medial
sternotomy or minimally invasive sternotomy
techniques to more transcatheter
technology–based treatment algorithms
in either inoperative or very-high-risk
surgical patients,” Dr. Thourani said.
As catheters continue to get smaller,
Vinod H. Thourani, MD, talked about
the latest developments in TAVR.
Martin Allred/IMNG Medical Media
Michael Argenziano, MD, discussed
new approaches to mitral valve repair.
surgeons need to gain and improve
catheter skills so that they can perform all
aspects of transcatheter treatments, including
transfemoral procedures, and avoid
focusing on a specific niche, he explained.
“It is critical for surgeons who historically
have been the main physicians treating
the surgical aspects of aortic valve
stenosis to be involved in the preoperative,
intraoperative, and postoperative management
in conjunction with the cardiologist.”
Dr. Thourani explained the different techniques
of transcatheter aortic valve replacement
(TAVR) using the transfemoral,
transapical, and transaortic routes. He also
discussed the most recent data from randomized
trials in the United States and
some non-U.S. trials, as well as the management
and avoidance of complications associated
with transcatheter valve therapies,
such as valve dislodgement, apical bleeding,
aortic dissection, or coronary occlusion.
“Other complications include strokes
Martin Allred/IMNG Medical Media
In Sunday’s Congenital Heart Disease Symposium, David
Barron, MD, of Birmingham Children’s Hospital, UK,
discussed the rationale of using the RV-PA conduit in the
Norwood procedure for managing hypoplastic left heart
syndrome (HLHS).
He pointed out that Dr. Norwood’s initial concept was
to use an RV-PA conduit to provide pulmonary blood flow,
but this was technically difficult, and the use of a BT shunt
became the standard in what is now referred to as the ‘classic’
Norwood procedure. “Nevertheless, despite remarkable
improvements in outcomes, the procedure still carries
a significant early mortality of 10%-20% in most
centers around the world, and the circulation can be notoriously
difficult to balance in the early postoperative period,”
Dr. Barron said.
There is good evidence that the RV-PA conduit results
in better maintenance of diastolic blood pressure, and this
may secure better coronary blood flow, he noted. Potential
advantages of the RV-PA conduit include maintenance
of higher diastolic blood pressure and better mean coronary
perfusion pressure, lower stroke work and higher
mechanical efficiency when compared with the BT shunt,
and better and more symmetrical development of the
branch pulmonary arteries.
However, these benefits must be balanced against the
need for a ventriculotomy and the potential short- and
long-term problems it can create, he said. The technique
is also technically more challenging.
“Current outcomes would suggest that there is a survival
benefit at 1 year, but we do not yet know whether
this benefit will be maintained in the medium to long
term,” Dr. Barron concluded.
Less than a decade ago, extracorporeal membrane oxygenation
(ECMO) was essentially the only form of support
for children with heart failure resistant to medical
therapy. “Today, we reserve our use of ECMO for patients
with cardiopulmonary failure or those who are arresting.
Even in these cohorts, if lung function improves, we will
often convert these patients to a VAD,” said David L.S.
Hartzell V. Schaff, MD, shared his
expertise on septal myectomy.
and perivalvular leaks, which have been the
Achilles’ heel for transcatheter valve therapies,”
he said.
He reviewed the PARTNER study, which
compared transfemoral transcatheterization
of a pericardial valve to standard therapy in
patients with severe aortic stenosis who
were not considered suitable surgical candidates
(N. Engl. J. Med. 2010;363:1597-607).
He also reviewed studies of transcatheter
aortic valve implantation with a
Medtronic device in patients with severe
aortic stenosis. Most transcatheter aortic
valve procedures have been performed
through the transfemoral or transapical
route, but very recently Dr. Thourani and
other surgeons have started to perform
transaortic cases by going directly through
the aorta, instead of the apex.
Dr. Thourani reviewed his experience
with transaortic valve replacement, which
he said shows promise as an important option
for some patients, such as an elderly patient
with a friable apex.
Michael Argenziano, MD, director of the
minimally invasive cardiac surgery and arrhythmia
surgery program and chief of the
adult cardiac surgery section at New
York–Presbyterian Hospital/Columbia University
Medical Center, examined the percutaneous
approach to mitral valve repair.
“The currently available percutaneous
technology for mitral valve repair and eventually
replacement is still in its relative infancy
– there’s a lot of exciting material out
there that’s being tested – but even with
what’s available today, we think we can have
an impact on the natural history of mitral
valve disease by offering something to patients
who previously had been considered
inoperable,” he said.
He reviewed the devices that are becoming
available to treat mitral valve disease
without surgery and related clinical
trial data.
A variety of techniques and devices are
being studied, but the most significant device
that is the farthest along in development
is Abbott Vascular’s MitraClip Mitral
Valve Repair System, which is a clip that is
used to grasp leaflets of the mitral valve
and hold them together to correct regurgitation.
The MitraClip has been studied in
clinical trials for about 7-8 years and has
been approved in Europe.
The device “is not a magic bullet … it’s
not the solution for every patient,” but for
many patients, it may make treatment possible
without the need to undergo open
heart surgery, he said.
Elderly, sick patients with mitral valve
prolapse who are inoperable or considered
high risk for surgery represent a large patient
population that historically has been
treated with medications that are not always
Continued on page 9
CHD Surgery: New Techniques, New Devices
David J. Barron, MD, elucidated the pros and cons of
using RV-PA conduits to manage HLHS.
Stewart Bloom/IMNG Medical Media
Morales, MD, of the Baylor College of Medicine.
When heart failure is presumed transient such as in the
case of myocarditis or acute graft rejection, an infant of
any size can be supported with a temporary device such
as the RotaFlow or PediMag. Dr. Morales and his colleagues
use these devices “when we feel that recovery will
occur within 2 weeks.” The Berlin Heart EXCOR, approved
by the FDA in 2011, is the only device available in
North America that can support small children and infants
over a prolonged period of time to cardiac transplantation.
“We have limited our use of the device to children with
chronic cardiomyopathy, congenital patients who have
slow progression to heart failure, and those patients who
have been bridged by a temporary device. We have been
fortunate to avoid using it in patients who undergo cardiac
surgery who develop heart failure post-cardiopulmonary
bypass or in the same hospitalization. The outcomes of using
the EXCOR in these patients or those that are transferred
from ECMO to the EXCOR are poor,” he said.
“Within the next 5 years, there is a good chance of being
able to use intracorporeal VADs in small children and
infants,” he said. “The PUMP for Kids Infants and
Neonates (PUMPKIN) program from the NHLBI is helping
to develop two intracorporeal VADs for small children.
They are the Jarvik Pediatric 2000 and PediaFlow. Industry
is also developing smaller devices.”
Dr. Morales also stressed the importance of the Pedi-
MACs database, which has the potential to house data for
all pediatric VADs, including temporary devices. ■
Martin Allred/IMNG Medical Media

MOSCONE CONVENTION CENTER • SAN FRANCISCO, CA • APRIL 28-MAY 2, 2012 7
Perioperative Considerations
Key in Allied Health Symposium
Saturday’s Allied Health Symposium,
now in its second year, covered
new developments and controversial
issues facing allied health
personnel, including nurses, nurse practitioners,
perfusionists, and physician assistants
caring for patients in the perioperative
setting.
Kevin Greason, MD, of the Mayo Clinic
discussed the management of postoperative
pleural and pericardial effusions.
He emphasized the importance of deciding
which type of imaging studies
should be obtained and how often,
whether every left pleural effusion should
be tapped, and whether it was possible to
predict when diuretics alone would lead
to resolution of pleural effusions.
Managing prophylaxis and treatment
of perioperative atrial fibrillation was
addressed by Ralph Damiano, MD, of
the Washington University School of
Medicine. He stated that there was a
higher incidence of postoperative atrial
fibrillation after valvular surgery and
combined valvular and coronary bypass
grafting, whereas the lowest figures are
seen after heart transplantation. Most
atrial fibrillation episodes occur within
the first 6 days following cardiac surgery,
with the highest incidence on the second
or third day.
“Patients with sustained atrial fibrillation
should be started on anticoagulation,
usually initiated with intravenous
heparin. Then patients can be converted
to oral warfarin therapy for the first 1-2
months. Anticoagulation is initiated to
prevent the most dreaded complication
of postoperative atrial fibrillation,
thromboembolic stroke,” he noted.
A series of pro and con “debates” addressed
whether off-pump coronary
artery bypass surgery is superior to
conventional CABG, whether minimitral
valve repair is better than conventional
repair, and whether there is
really a need for an artificial heart. ■
Kevin Greason, MD, explored problems
associated with pleural effusion.
Martin Allred/IMNG Medical Media
Ralph Damiano, MD, presented on
management of perioperative AF.
AATS Allied Symposia
Monday, April 30
12:15 PM – 2:00 PM
Moscone West Convention Center,
Room 2010
The Increasing Options
for Aortic Valve
Replacement: Competitive or
Complementary?
Cardiovascular Research Foundation
(CRF)
Supported by Edwards Lifesciences
5:00 PM – 7:00 PM
Moscone West Convention Center,
Exhibit Floor/OR of the Future
The Benefits of the Hybrid OR Suite
for the TAVR Procedure
Supported by Phillips/Maquet
Tuesday, April 30
12:30 PM – 2:00 PM
Moscone West Convention Center,
Room 2010
Strategies for the Mitral and
Tricuspid Valve
Supported by Medtronic
Martin Allred/IMNG Medical Media
Revealing success.
To see the complete patient picture, having accurate and timely oxygenation information is essential.
With a comprehensive portfolio of monitoring technologies, the Sensing Systems of Covidien allow
caregivers to detect subtle, yet critical variations in patient status for faster, more informed interventions.
As part of the Sensing Systems suite, INVOS Cerebral/Somatic Oximeter facilitates:
• Real-time regional oxygen saturation (rSO 2
) measurement
• Reduced cognitive decline and major organ morbidity/mortality 1,2
• Enhanced detection of oxygen threats associated with neurologic damage 3,4
• Decreased ICU and hospital length of stay 1,5
LEARN MORE ABOUT THE SENSING SYSTEMS OF COVIDIEN AT COVIDIEN.COM/RMS
VISIT US AT AATS BOOTH #511
THE SENSING SYSTEMS OF COVIDIEN
BIS Brain Monitoring | INVOS Cerebral/Somatic Oximetry
LiDCO Hemodynamic Monitoring | Nellcor Pulse Oximetry with OxiMax Technology
1. Murkin JM, Adams SJ, Novick RJ, et al. Monitoring brain oxygen saturation during coronary bypass surgery: a randomized, prospective study. Anesth Analg. 2007;104(1):51-58.
2. Slater JP, Guarino T, Stack J, et al. Cerebral oxygen desaturation predicts cognitive decline and longer hospital stay after cardiac surgery. Ann Thorac Surg. 2009;87(1):36-44.
3.Dent CL, Spaeth JP, Jones BV, et al. Brain magnetic resonance imaging abnormalities after the Norwood procedure using regional cerebral perfusion. J Thorac Cardiovasc Surg.
2006;131(1):190-197.
4.Kussman BD, Wypij D, Laussen PC, et al. Relationship of intraoperative cerebral oxygen saturation to neurodevelopmental outcome and brain magnetic resonance imaging at
1 year of age in infants undergoing biventricular repair. Circulation. 2010;122(3):245-254.
5.Casati A, Fanelli G, Pietropaoli P, et al. Continuous monitoring of cerebral oxygen saturation in elderly patients undergoing major abdominal surgery minimizes brain exposure
to potential hypoxia. Anesth Analg. 2005;101(3):740-747.
COVIDIEN, COVIDIEN with logo, Covidien logo and positive results for life are U.S. and internationally registered trademarks of Covidien AG. Other brands are trademarks
of a Covidien company. Covidien is the exclusive distributor of LiDCOrapid products in the United States. LiDCO is the manufacturer of record for the LiDCO product line
and is responsible for maintaining all governmental and regulatory authorizations for the LiDCOrapid product. LiDCO and LiDCOrapid are trademarks of LiDCO Ltd.
©2012 Covidien. All rights reserved. 11-PM-0337c

8 AATS 92 ND ANNUAL MEETING
GT Surgery Forum: Research Highlights
Cardiac Surgery Forum
Comprised Cutting-
Edge Research
This year’s General Thoracic Surgery
Forum on Tuesday at 7:00 a.m. in
Room 2007 features new basic and
clinical research on important topics in
general thoracic surgery.
“This session highlights the cutting-edge
research within our specialty of cardiothoracic
surgery,” said session moderator,
Dao M. Nguyen, MD, of the University of
Miami.
“In my opinion, the session is one of the
highlights of the Annual Meeting,” he said.
Featured presentations include the following:
Development of a serum biomarker
panel predicting recurrence in node-negative
non–small cell lung cancer patients.
The in vitro and in vivo therapeutic efficacy
of the CXCR4 antagonist BKT140
against non–small cell lung cancer.
Lung cancer lymph node micrometastasis
detection using RT-PCR: Correlation
with vascular endothelial growth factor expression.
Paclitaxel cytotoxicity in non–small cell
lung cancer is significantly enhanced by a
novel small molecule by direct activation
of procaspase-3.
Altered protein homeostasis in lung
adenocarcinoma.
“High-quality research is being conducted
by cardiothoracic surgeons both in
The Cardiac Surgery Forum
on Tuesday at 7:00 a.m. in
Ballroom 3 will feature frontline
research validating surgical
procedures and exploring new
surgical directions. The forum
will be moderated by Mark D.
Rodefeld, MD, of Indiana University
and Todd K. Rosengart,
MD, of Stony Brook University.
A key presentation involves
the use of thymectomy to secure
the operative field during
surgery for congenital heart defects
in early infancy.
Hirotsugu Kurobe, MD,
PhD, of the University of
Tokushima and colleagues will
present data from infants
younger than 3 months who
underwent surgery for congenital
heart defects. They found
that total lymphocyte counts
were significantly reduced in
infants who underwent complete
thymectomies compared
with those who did not. However,
hospitalization rates for
infectious diseases, such as
measles, were higher among infants
with complete thymectomies.
Niv Ad, MD, of Inova Heart
and Vascular Institute and his
colleagues will present data on
a novel method of applying
protein-pathway–activation
mapping techniques in patients
with and without atrial
fibrillation. The techniques
identified signaling networks
in atrial fibrillation patients,
which could ultimately pave
the way for new atrial fibrillation
treatments.
Research on pulmonary
artery reconstruction, complete
thymectomy, the use of
resveratrol to preserve mycardial
function, and interventions
for atrial fibrillation will
also be presented, and David
G. Greenhouse, MD, and colleagues
at New York University
will share data on the
effectiveness (and cost-effectiveness)
of a simulator to help
surgical residents hone their
skills at mitral valve replacement.
■
Be Sure to Attend AATS
Reception Tuesday Evening
Featuring the ‘Battle of
the Valleys’
Wine Tasting Event
Tuesday, May 1
7:00 p.m. – 10:00 p.m.
Join us for the “Battle of
the Valleys” at the California
Academy of Sciences.
Enjoy passed hors d’oeuvres
and live music from a top
jazz band while you sample
the finest wines from both
Sonoma and Napa Valleys.
Participate in a wine tasting
competition and test your
palate. Tickets are available
for purchase at Registration
(Moscone West Convention
Center – Level 1). ■
© Kirby Hamilton
There is convincing evidence
through both observational
and randomized studies
that lung volume reduction
surgery (LVRS) for a subset of
emphysema patients improves
pulmonary function, exercise
capacity, quality of life, and – in
one subset – survival, said Malcolm
M. DeCamp, MD, of
Northwestern Memorial Hospital
during Sunday’s General
Thoracic Symposium.
However, the operation is
associated with a relatively
high mortality and morbidity.
On balance, LVRS offers clear
therapeutic benefits in an illness
that is highly debilitating.
For reasons that are unclear, however,
it is rarely performed and
thus is underutilized, according to
Dr. DeCamp.
A variety of bronchoscopic lung
volume reduction (BLVR) strategies
have been developed and tested.
When these procedures were
analyzed in phase II and/or III trials,
each showed that some clinical
indices improve in the short term
(3-12 months) but to a lesser magnitude
than the improvement seen
with LVRS.
At present it appears unlikely
that one specific approach to
BLVR will address each phenotype
of emphysema. Just as LVRS
has been demonstrated to be safe
and most beneficial in patients
with upper-lobe predominant disease,
discrete BLVR interventions
may prove best reserved for specific
morphologies and/or severities.
Furthermore, it seems that referral
for LVRS ought to be
expanded since this approach has
proven safe, effective, and durable
for a subset of emphysema patients.
Evolving BLVR strategies
may be suitable for non-LVRS candidates.
Jens C. Ruckert, MD, of the
Charite CCM in France, discussed
factors affecting the decision of
basic science and translational clinical research,
the results of which may be applicable
in the clinic to enhance the understanding
of the molecular biology of
disease or for therapeutic application,” Dr.
Nguyen noted.
“I have submitted many research abstracts
in the past two decades to the AATS
General Thoracic Surgery Forum, and I
can attest [to] the fact that every year, the
abstract review committee and the organizing
committees select the 10 best abstracts
out of hundreds of excellent and
competitive submissions to be featured.
Most of the works selected for presentation
are high-caliber basic science or clinical/translational
research conducted by
clinicians/scientists in our specialty in
North America as well as worldwide,” Dr.
Nguyen said.
He added that the research presented at
the forum is wide ranging, and covers thoracic
oncology, pulmonary hypertension,
and lung transplantation.
“The quality of the research to be presented
is exceptional. It is important to recognize
the fact that these research projects
are designed and conducted by clinician
and scientists whose ultimate goal is the
potential for translation to clinical application,
which adds to the excitement of the
session,” he concluded.
■
GT Symposium Featured
Decision-Making Criteria
Jens C. Ruckert, MD, offered insight
into how to decide what is the best
approach to thymic malignancies.
Mitchell J. Magee, MD, at left, and Joshua R. Sonett, MD,
moderated Sunday’s General Thoracic Symposium.
Stewart Bloom/IMNG Medical Media
Stewart Bloom/IMNG Medical Media
whether to use minimally or
maximally invasive surgery for
thymic malignancies. “In
many institutions, median sternotomy
is still the method of
choice for tumors of the anterior
mediastinum–especially
for thymoma,” Dr. Ruckert
stated. “However, there is an
increasing tendency toward
minimally invasive thoracoscopic
methods, even though
there is not enough data concerning
the most adequate surgical
procedure for thymoma.”
He pointed out that the
choice of surgical procedure
for thymoma was actually dependent
on factors including
symptoms, anatomical location,
size, comorbidity, and radiological
imaging. However, there are also
surgeon-dependent factors, such
as “surgical school,” surgeon experience,
and, not least, whether
the facility has access to a da Vinci
surgical system.
“Minimally invasive surgery for
thymoma is actually increasingly
performed in most centers worldwide,
and the refinement of robotic
assistance is promising,” he
said.
In pointing out the benefits of
various techniques and tips for
handling tracheal resection
surgery, Douglas J. Mathisen, MD,
of Massachusetts General Hospital
stressed that the margin between
success and failure in tracheal
surgery is thin.
“Optimizing the circumstances
is critical; the decison to
operate should not be based on
convenience, and shortcuts are
to be avoided,” he advised,
stressing the need for careful radiologic
and bronchoscopic assessment.
Securing a safe airway
is imperative. There is also a crucial
need for an experienced
anesthetist and a facility with
rigid bronchoscopes. ■

MOSCONE CONVENTION CENTER • SAN FRANCISCO, CA • APRIL 28-MAY 2, 2012 9
Continued from page 6
effective, and thus has had a reduced
quality and length of life,
he added.
Dr. Argenziano is one of the
investigators in the COAPT
(Clinical Outcomes Assessment
of the MitraClip Percutaneous
Therapy for High Surgical Risk
Patients) trial, which will soon
start to enroll patients.
“What we’re hoping to do
with this clip is begin to offer
some form of real valve repair”
for patients who were previously
not eligible for surgery, he said.
In his “How I Do It” presentation
on septal myectomy, incoming
AATS President Hartzell
V. Schaff, MD, of the Mayo Clinic,
gave a detailed run-through of
the techniques that he and his
colleagues have used in treating
more than 1,900 patients at the
clinic.
Routinely, they use intraoperative
transesophageal echocardiography
to identify residual
mitral regurgitation, systolic anterior
motion, and any septal
defects created by excision of
septal muscle. In their hands,
operative mortality for most patient
subgroups is less than 1%,
and more than 90% of patients
have relief of symptoms.
Because of this success rate
with myectomy and its patient
benefits, he and his colleagues
reserve mitral valve replacement
for those patients with intrinsic
leaflet abnormalities that cannot
be repaired, Dr. Schaff concluded.
■
Tuesday’s Honored
Guest Speaker Is
Mehmet C. Oz, MD
AATS is pleased to have
Mehmet C. Oz, MD, as the
Honored Guest Speaker at this
year’s Annual Meeting.
His presentation, “Medicine in
Media,” will be given at 11:40 a.m.
immediately after the Plenary Scientific
Session.
MEHMET C. OZ, MD
Terumo Cardiovascular Systems develops and markets a broad portfolio of innovative medical devices
and disposables that enable cardiac surgeons worldwide to perform a variety of surgical procedures.
Estech CABG On-Pump and
Off-Pump Products
Provides the most reliable, versatile and
stable solution for cardiac bypass surgery.
TigerPaw ® System II
A safe, simple and highly effective
compliant LAA occlusion fastener and
delivery tool designed with cardiac
surgeons' input.
VirtuoSaph ® Plus Endoscopic
Vessel Harvesting System
Harvesting a new standard of care.
Vascutek ® Vascular Grafts
Offering a comprehensive portfolio of
vascular grafts, including Gelweave
Valsalva − the world’s first anatomically
designed aortic root graft.
AATS 2012 Annual Meeting attendees – We invite you to come visit Terumo at booth #213 to see all our product lines.
Terumo Cardiovascular Systems Corporation Ann Arbor, Michigan, USA 734.663.4145 888.758.8000
©2012 Terumo Cardiovascular Systems Corporation. Terumo ® and VirtuoSaph ® are trademarks of Terumo Corporation. TigerPaw ® is a registered trademark of LAAx, Inc.
Vascutek ® is a registered trademark and Gelweave Valsalva is a trademark of Vascutek Ltd. 825837

10 AATS 92 ND ANNUAL MEETING
2012 AATS Annual Meeting Exhibitors
A
A & E Medical Corporation 545
2310 South Miami Blvd., Suite 240,
Durham, NC 27703
www.aemedical.com
A&E Medical is a global provider of MYO/Wire
temporary pacing wires, MYO/Wire II sternum wires,
DoubleWire high strength sternal closure system for
use in large (over 90 kg) and COPD patients, a redesigned
Direct View Retractor (DVR) to assist in
minimally invasive saphenous vein harvest, and a
rotating surgical punch.
ABIOMED, Inc. 137
22 Cherry Hill Drive, Danvers, MA 01923
www.abiomed.com
Abiomed, Inc. is a leading provider of breakthrough
heart support technologies enabling safer
revascularization, heart muscle recovery and costeffective
patient care. Abiomed is dedicated to
finding ways to treat heart failure so that patients
and physicians have the most advanced, successful,
and beneficial technology available to improve
quality of life.
Acute Innovations 133
21421 NW Jacobson Road, Suite 700,
Hillsboro, OR 97124
www.acuteinnovations.com
Furthering their reputation as a pioneer in their industry,
ACUTE Innovations continues to make advancements
in chestwall stabilization technology. Stop by
booth 133 to learn about ACUTE’s cutting-edge
products: the RibLoc® Rib Fracture Plating system,
Biobridge® Resorbable Chest Wall Stabilization Plate,
and the AcuTie® Sternal Closure System.
Air Force Reserve 549
180 Page Road, Bldg. 208, Robins ARB,
GA, 31098
www.airforce.com
The Air Force Reserve is a part-time commitment
with lifetime benefits. By joining the Air Force Reserve,
you can make a significant impact on the
world and your career. Opportunities exist for humanitarian
and peacetime missions around the
world. Some specialties may be eligible to receive
student loan repayment or special pay incentives.
American Association for
Thoracic Surgery
Lobby
500 Cummings Center, Suite 4550,
Beverly, MA 01915
www.aats.org
Founded in 1917, the American Association for Thoracic
Surgery is dedicated to excellence in research,
education, and innovation in cardiothoracic surgery
and has become an international professional organization
of more than 1250 of the world's foremost
cardiothoracic surgeons.
American Board of Thoracic
Surgery 136
633 North Street, Ste 2320, Chicago, IL 60611
www.abts.org
The American Board of Thoracic Surgery will
demonstrate its new interactive website
(www.abts.org). New online features include verification
of certification, electronic application for
Maintenance of Certification and secure individual
web pages for Diplomates. Board members and
staff will be on hand to answer questions about
Certification and Maintenance of Certification.
American Heart Association 629
7272 Greenville Ave., Dallas, TX 75231
www.heart.org
American Heart Association offers the latest information
on cardiovascular and stroke research.
Pick up free 2012 Core Collection CDs and Scientific
Sessions Abstracts. Receive information on Emergency
Cardiovascular Care, Professional Membership,
Scientific Publications, and more.
Antimicrobial Copper 449
260 Madison Ave., New York. NY 10016
www.antimicrobialcopper.com
Antimicrobial Copper is a new category of touch
surface materials that aid infection control practices.
No other material is proven to be more effective
in continuously killing bacteria that cause
infections. Please visit us to learn about these products
and see some examples in the ICU of the Future
display.
Applied Fiberoptics 544
100 E. Chestnut Avenue, Westmont, IL 60559
www.appliedmedical.com
Introducing the NEW improved/brighter Gemini Plus
headlight with a low profile design, which does not
interfere with loupes. Larger spot size and brighter
light output. Eliminates the ramming effect during
surgery. The 300-watt Sunbeam Light Source brings
the clarity of sunlight into the operating room.
ATMOS, Inc. 119
3717 Huckleberry Road, Allentown, PA 18104
www.atmosmed.us
ATMOS, a medical device manufacturer with over
100 years of expertise in medical suction technology,
introduces the ATMOS S201 Thorax. This advanced
digital thoracic drainage system, provides improved
patient safety, greater patient mobility and may reduce
patient hospital stays.
AtriCure, Inc. 348
6217 Central Park Drive,
West Chester, OH 45069
www.atricure.com
AtriCure, the leader in cardiac surgical ablation of
Afib featuring bipolar RF clamps, pens, and cryothermic
energy devices. Providing CV Surgeons with the
only FDA endorsed surgical Afib certification course.
AtriCure’s portfolio includes the AtriClip®, which is
the only atraumatic device FDA cleared specifically
designed for LAA exclusion.
Atrium Medical – a division of MAQUET
Getinge Group 529
5 Wentworth Drive, Hudson, NH 03051
www.atriummed.com
See Atrium’s complete line of Thoracic Drainage Devices,
including the Express Mini 500 TM and Pneumostat
TM Mobile Chest Drains, OceanTM Water Seal,
Oasis TM Dry Suction and Express TM Dry Seal Chest
Drains. Coated and uncoated PVC and Silicone
Thoracic Catheters, PleuraGuideTM Disposable
Chest Tube Kit, and complete line of vascular grafts.
B
Baxter Healthcare 101
One Baxter Parkway, DF323E,
Deerfield, IL 60015
www.baxter.com
Baxter is a global, diversified health care company
with expertise in medical devices, pharmaceuticals,
and biotechnology. The company continues its
quest for advancing BioSurgery by offering a comprehensive
line of products for hemostasis and sealing,
adhesion reduction solution, and
preparation/delivery devices based on the latest scientific
advances in the field.
BFW, Inc. 632
2307 River Road, #103, Louisville, KY 40206
www.bfwinc.com
Recognized worldwide for unmatched design and
engineering in surgical illumination, from its Thruthe-Lens
Headlight Video System to the groundbreaking
10,000-hour ChromaLUME Plasma
Headlight System, or the incredibly bright and
portable VistaView II LED, BFW is the technological
leader offering the most dependable headlight
illumination systems in the medical field today.
Biomet Microfixation 110
1520 Tradeport Drive, Jacksonville, FL 32218
www.biometmicrofixation.com
Biomet Microfixation is a leading global health
care provider of orthopedic products. Our thoracic
portfolio includes the Pectus Bar for repair
of Pectus Excavatum and the SternaLock Blu Primary
Closure System for sternal closure. The Blu
ORF
ICU
ORF
CAFE
CAFE
INTERNET CAFE
CAFE
3
6
7
Continued on following page
Moscone
Lead
Retrieval
Freeman
Service Desk
St. Jude
Medical, Inc.
Medtronic, Inc.
FOOD & BEVERAGE
251
450 451 550 551 650 651
249 348 349 448 449 548 549
649 748
347 446 447 546
646 647 746
644
545
344
REGISTRATION
1 2
C M E
C M E
145
142
140 141
138 139
136 137
132 133
128 129
122
123
118
119
116
114
110
108
111
100 101
245
742
643
542
442 443
343
242
638
Kapp Surgical
Instrument, Inc.
238
736
636 637
537
437
336 337
237
334
234 235
732
632 633
232
231
Surgitel/General
Scientific Group
728
628 629
529
328 329
228 229
425
622 623
On-X Life
Technologies, Inc.
523
423
322 323
222 223
218
617
517
417
317
715
Terumo
Covidien
213
511
207
Sorin
Group
Edwards
Lifesciences
701
501
300 301
201
1601
Edwards
Lifesciences
1301 1401 1501
ENTRANCE ENTRANCE ENTRANCE
L1 L2 L3 L6 L7 L8 L9
ENTRANCE
PODS
Sorin
Group
AATS
Welcome
Center
AATS Daily News Advertisers

MOSCONE CONVENTION CENTER • SAN FRANCISCO, CA • APRIL 28-MAY 2, 2012 11
Continued from previous page
System aligns and stabilizes the sternum after
sternotomy and enables easier closure after minimally
invasive access.
Blue Mountain Research 138
144 Rolling View Drive,
Schuylkill Haven, PA 17972
Blue Mountain Research provides market research
services with a niche in qualitative research for the
medical device industry. Hosting in-depth interviews
during industry conferences allows the opportunity
to gain insight from key opinion leaders and decision
makers. Visit our booth for an opportunity to voice
your opinion about surgical products.
C
Cadence Pharmaceuticals 638
12481 High Bluff Drive, San Diego, CA 92130
www.OFIRMEV.com
Cadence Pharmaceuticals is a biopharmaceutical
company focused on in-licensing, developing and
commercializing proprietary product candidates
principally for use in the hospital setting. The company
is currently marketing OFIRMEV® (intravenous
acetaminophen) for the treatment of acute pain
and fever. Please stop by and visit us at booth
#638.
California Medical Laboratories 242
1570 Sunland Lane, Costa Mesa, CA 92626
www.calmedlab.com
California Medical Laboratories designs and manufactures
high quality Cardiovascular Cannulation
Products. Our product line includes Cardiovascular
Cannulae, Catheters, an array of Cardioplegia
Delivery Products, Minimally Invasive Products, Suction
and Venting Devices. Known throughout the
world for excellent quality and innovation,
CalMed’s product line continues to expand each
year. We look forward to seeing you at Booth 0242
to discuss recent developments.
Cardiac Assist 334
240 Alpha Drive, Pittsburgh, PA 15238
www.cardiacassist.com
Cardiac Assist's TandemHeart system enables both
Surgeons and cardiologists to initiate high flow circulatory
support in minutes, with optimal unloading of
the left ventricle. As the most versatile extracorporeal
circulatory support system available, Tandem-
Heart offers multiple configurations to customize support
for each individual patient’s needs.
CardioNet 116
227 Washington St, 2nd Floor,
Conshohocken, PA 19428
www.cardionet.com
CardioNet is the leading provider of a comprehensive
suite of cardiac arrhythmia monitoring services
for diagnosing patients and monitoring treatment.
The CardioNet AF Management Program is the most
robust and comprehensive AF data available, providing
physicians with the information they need to
better diagnose, treat, and manage their patients.
CASMED 122
44 E. Industrial Road, Branford, CT 06405
www.CASMED.com/FORE-SIGHT
CASMED, a leader in vital signs monitoring systems,
presents the innovative FORE-SIGHT® Absolute Tissue
Oximeter for non-invasive, continuous monitoring of
absolute tissue oxygen saturation. This intelligent device
enables tailored patient management and a
reduction in catastrophic desaturation events.
Castlewood Surgical 251
91 Main Street, Suite 302, Concord, MA 01742
www.castlewoodsurgical.com
Castlewood Surgical markets the Cyclone System.
The Cyclone facilitates hand sewn clampless proximal
anastomoses during OPCAB procedures.
Chain of Hope 229
South Parade, London, SW36NP,
United Kingdom
www.chainofhope.org
Chain of Hope is an international medical charity
that aims to create sustainable cardiac services in
countries where such facilities are currently unavailable.
Established by Professor Sir Magdi Yacoub
in 1995, the charity is currently developing
services in Jamaica, Egypt, Mozambique, Ethiopia,
and Uganda.
Chase Medical Inc. 622
1876 Firman Drive, Richardson, TX 75081
www.chasemedical.com
Chase Medical is dedicated to providing cardiac
surgeons innovative device development.
The SVR System creates an elliptical ventricle
every time. The Triumph System is an innovative
aortic balloon occlusion cannula used for minimally
invasive valve procedures. Our beating
heart products include heart stabilizers, shunts,
blower misters, and apical lift devices.
Cook Medical 238
P. O. Box 489, Bloomington, IN 47402
www.cookmedical.com
Founded in 1963, Cook® Medical pioneered many
of the medical devices now commonly used to perform
minimally invasive medical procedures throughout
the body. Today, the company integrates medical
devices, drugs and biologic grafts to enhance
patient safety and improve clinical outcomes.
Cormatrix Cardiovascular, Inc. 323
286 South Main Street Suite, 200 Alpharetta,
GA 30009
www.cormatrix.com
CorMatrix® Cardiovascular markets its ECM® Technology
biomaterial devices for pericardial closure,
cardiac tissue repair, and carotid repair and is currently
conducting preclinical studies to evaluate future
applications in heart failure as well as other cardiovascular
applications.
CORONEO Inc. 123
9250 Park Avenue, #514,
Montreal, H2N 1Z2 Canada
www.coroneo.com
Unique devices for less-invasive cardiac procedures,
including: EXTRA-AORTIC RING to correct
aortic insufficiency in valve repair surgery; COR-
VALV System to enhance exposure during valve
surgery with fully adaptable tissue retractors for
both intercostal and sternotomy approaches;
COR-VASC stabilizers for cost-effective OPCAB;
SWIFT-LOOP with integral pledget for effective
control of coronary blood flow during robotic and
minimally invasive surgery; and PEDIATRIC TITANI-
UM retractors with custom swivel blades.
Covidien 511
555 Long Wharf Drive, New Haven, CT 06511
www.covidien.com
Covidien is a leading global health care products
company that creates innovative medical solutions
for better patient outcomes and delivers value
through clinical leadership and excellence.
CryoLife, Inc. 329
1655 Roberts Blvd. NW, Kennesaw, GA 30144
www.cryolife.com
CryoLife is a global provider of life restoring technologies
for complex cardiac and vascular reconstructive
surgery. With the acquisition of Cardiogenesis,
CryoLife now offers Cardiac Surgeons a
viable treatment for patients with Refractory Angina.
By continuing to develop and explore new
treatment options, CryoLife helps people with cardiac
and vascular issues throughout the world.
CTSNet
L8
633 N. St. Clair, Chicago, IL 60611
www.ctsnet.org
CTSNet (www.ctsnet.org) is the leading international
source of online resources related to cardiothoracic
surgery, as well as the major hub of the international
online community of cardiothoracic
surgeons and allied health care professionals.
D
Delacroix - Chevalier / MED Alliance Solutions,
LLC 423
3825 Commerce Dr., St. Charles, IL 60174
www.delacroix-chevalier.com
Delacroix-Chevalier manufactures cardiovascular
and thoracic instrumentation and retractors – best
known for their Carpentier MV Retractor, Resano
Forceps, and IMA Retractor. Dr. Gossot’s VATS and
major pulmonary procedure instrument kit is the
newest line available. Products distributed in the
U.S. by MED Alliance Solutions, an ISO 13485-certified
medical device company.
Designs For Vision, Inc. 223
760 Koehler Avenue, Ronkonkoma, NY 11779
www.designsforvision.com
Just See It with the finest Telescopes and brightest
L.E.D. Headlights exclusively from Designs for Vision,
Inc. Ask about our Nike® frames.
Dynasil Products 249
44 Hunt Street, Watertown, MA 02472
www.dynasilproducts.com
Dyansil Products, formally RMD Instruments, manufactures
the Navigator gamma positioning system
with Daniel Lung Probe. The Daniel Probe addresses
the challenges of localizing small indiscriminate
lesions in MIS pulmonary procedures. This VATS
technique uses radioisotope localization to facilitate
rapid, precise identification of targeted tissue,
while minimizing the resection of healthy tissue.
E
EACTS
L3
Maderia Walk, Windsor, SL4, 1LU,
United Kingdom
www.eacts.org
The EACTS is the largest European Association devoted
to the practice of Cardio-thoracic surgery.
The main objects of the Association are to advance
education in the field of cardio-thoracic
surgery and to promote, for the public benefit, research
into cardiovascular and thoracic physiology
and therapy and to correlate and disseminate
the useful results thereof. Visit the booth for information
on membership, future meetings, and all
activities of EACTS.
Edwards Lifesciences 301, 1401, 1501
One Edwards Way, Irvine, CA 92614
www.edwards.com
Edwards Lifesciences is the global leader in the science
of heart valves and hemodynamic monitoring,
with more than five decades of experience in
partnering with clinicians to develop life-saving innovations.
The company's global brands include
Cosgrove-Edwards, EDWARDS INTUITY, Edwards
SAPIEN, Carpentier-Edwards PERIMOUNT Magna
Ease, and Carpentier-Edwards Physio II.
Elsevier, Inc. 100
1600 JFK Blvd., Ste 1800,
Philadelphia, PA 19103
www.us.elsevierhealth.com
ELSEVIER is a leading publisher of health science
publications, advancing medicine by delivering
superior reference information and decision support
tools to doctors, nurses, health practitioners
and students. With an extensive media spectrum –
print, online, and handheld, we are able to supply
the information you need in the most convenient
format.
Essential Pharmaceuticals 446
770 Newtown Yardley Road, Suite 212,
Newtown, PA 18940
www.essentialpharma.com
Essential Pharmaceuticals is devoted to development
and sales of pharmaceutical products in
the transplant and cardiothoracic surgery fields
including Custodiol® HTK organ preservation solution.
Originally developed for cardiac surgery,
Custodiol® HTK offers superior convenience with
water like viscosity and no need for additives or
filters.
Estech 349
2603 Camino Ramon, Ste 100,
San Ramon, CA 94583
www.estech.com
Estech develops and markets a broad portfolio of
innovative medical devices and disposables that
enable cardiac surgeons worldwide to perform a
variety of traditional and minimally invasive surgical
procedures.
ESTS
L1
P.O. Box 159, Exeter, Devon,
EX2 5SH, United Kingdom
www.ests.org
ESTS has over 1200 members and welcomes thoracic
surgeons from all countries. Our mission is to
improve the care of thoracic surgical patients
through the education and support of thoracic
surgeons in Europe and worldwide. The 20th European
Conference on General Thoracic Surgery will
be held in Essen, Germany 10-13 June 2012.
Ethicon Endo-Surgery 128
4545 Creek Road, Cincinnati, OH 45242
www.ethiconendosurgery.com
Ethicon Endo-Surgery, a Johnson & Johnson company,
develops and markets advanced medical
devices for minimally invasive and open surgical
procedures, focusing on procedure-enabling devices
for the interventional diagnosis and treatment
of conditions in general and bariatric
surgery, as well as gastrointestinal health, gynecology
and surgical oncology.
F
Fehling Surgical Instruments, Inc. 742
509 Broadstone Lane, Acworth, GA 30101
www.fehlingsurgical.com
FEHLING SURGICAL features the “CERAMO® Instrument
Line”, “SUPERPLAST Probes,” and new innovative
Retractor Systems for Minimally Invasive Cardiac
Surgery. CERAMO® surface means high
efficiency through enhanced performance, increased
endurance and minimal maintenance.
First Choice 548
5731 Pray Street, Bonita, CA 91902
www.firstchoicedentalproducts.com
First Choice provides surgical loupes and LED
headlights.
G
Genesee BioMedical, Inc. 207
1308 South Jason Street, Denver, CO 80223
www.geneseebiomedical.com
Design Beyond Standard. Genesee BioMedical, Inc.
provides thoughtful tools and timely solutions for cardiothoracic
surgery including innovative sternal and
thoracic valve retractors for adult, pediatric, and
neonatal patients as well as coronary graft markers,
suture guards, and myocardial temperature probes.
All products are CE marked.
GerMedUSA 139
2417 Jericho Turnpike, #333,
Garden City Park, NY 11040
www.germedusa.com
GerMedUSA Inc., is the leading
manufacturer/supplier of Quality Operating
Room German Surgical Instruments serving the
health care dealer market today. GerMedUSA
offers the finest Quality Instruments at the most
affordable prices, available for immediate delivery
anywhere in the world. Our years of experience
and industry inside know how, is the key to
our quality and affordable instruments, which
speak for themselves. GerMedUSA understands
the importance of details when crafting Medical
Surgical Instruments and Equipment, therefore
GerMedUSA craftsmen continue to manufacture
the most superior German Medical Surgical Tools
and Hospital Equipment in the industry.
Gore & Associates, Inc. 447
PO Box 2400, Flagstaff, AZ 86009
www.goremedical.com
Gore Medical Products Division has provided creative
therapeutic solutions to complex medical
problems for three decades. The extensive Gore
Medical family of products includes vascular
grafts, endovascular and interventional devices,
surgical materials for hernia repair, soft tissue re
construction, staple line reinforcement, and sutures
for use in vascular, cardiac, and general surgery.
H
Haemonetics Corp. 231
400 Wood Road, Braintree, MA 02184
www.haemonetics.com
Haemonetics THE Blood Management Company
has been a global leader engaged in the design,
manufacture and worldwide sales and marketing
of blood management solutions. Recognized as
the innovator in blood technologies, our mission is
to create innovative products, design information
technology platforms and to provide consulting
services to advance the safety, quality and availability
of the world’s blood supply.
Heart Hugger/Gen'l Cardiac
Technology 145
15814 Winchester Blvd., #105,
Los Gatos, CA 95030
www.hearthugger.com
Heart Hugger-Sternum Support Harness is a patient
operated support harness applied post-op
to splint surgical wounds. Benefits include improved
patient compliance, faster return to premorbid
respiratory levels, fewer wound complications,
and better post-op mobility. It is useful for
post open-heart, thoracotomy, fractured rib, and
other chest trauma patients.
HeartWare, Inc 141
205 Newbury St., Framingham, MA 01701
www.heartware.com
HeartWare, Inc. is developing a family of implantable
mechanical circulatory support systems for the treatment
of advanced heart failure. HeartWare’s lead
device, the HeartWare® Ventricular Assist System, incorporates
state-of-the-art peripherals and features
the only full-output pump designed to be implanted
less invasively in the pericardial space. The Heart-
Ware® System is commercially available in Europe
and is the subject of a 150-patient US IDE trial.
HRA Hospital Research Associates 448
400 Lanidex Plaza, Parsippany, NJ 07054
www.hraresearch.com
Our team of experienced interviewers will be distributing
carefully developed questionnaires. We'll
be gathering the answers to vital marketing and
clinical questions-answers that can affect the introduction
of new products or the continuation of existing
heath care products and services.
I
Integra Lifesciences 643
311 Enterprise Drive, Plainsboro, NJ 08536
www.integralife.com
Integra is a leader in Acute Care Surgical Products.
The company’s portfolio includes quality instrumentation
solutions for your sterile processing
and OR needs in laparoscopic, general, cardiovascular,
neuro, plastic and reconstructive surgery.
Products include Luxtec® illumination systems and
cables, instruments from Jarit®, Redmond, Padgett
®, Omni-Tract® table-mounted retractors,
and CIMS® Consulting Services.
International Society for Minimally Invasive
Cardiothoracic Surgery
L9
500 Cummings Center, Suite 4550,
Beverly, MA 01915
www.ismics.org
ISMICS is the leader in innovative techniques, technologies,
and minimally invasive cardiac and thoracic
surgery. ISMICS 2012 Annual Scientific Meeting,
30 May - 2 June 2012, JW Marriott Los Angeles at LA
Live, Los Angeles, California.
Intuitive Surgical, Inc. 111
1266 Kifer Rd, Bldg 101, Sunnyvale, CA 94086
www.intuitivesurgical.com
Intuitive Surgical, Inc. is the global technology
leader in robotic-assisted, minimally invasive
surgery. The Company's da Vinci® Surgical System
offers breakthrough capabilities that enable cardiac
surgeons to use a minimally invasive approach
and avoid sternotomy. As a result, the da
Vinci Surgical System is changing the practice of
cardiac surgery as it's known today.
K
Kapp Surgical Instrument, Inc. 442
4919 Warrensville Center Rd.,
Cleveland, OH 44128
www.kappsurgical.com
Kapp Surgical is a custom design shop which designs
surgical instruments and implants, manufactures
them, and sells as well as distributes domestically
and internationally. Kapp’s exclusive products
are: The Cosgrove Heart Retractor, Bariatric Ring,
Strip T’s surgical organizer, and countless surgical devices
all FDA approved with several pending approvals.(Kapp
owns 39 patents.)
Kardium 732
100 - 12851 Rowan Pl., Richmond,
BC V6V2K5, Canada
www.kardium.com
Kardium introduces the TORQ, a new device for
sternal closure. The TORQ produces an increased
tension on the sternal wires, resulting in a tighter
and more repeatable closure.
Continued on following page

12 AATS 92 ND ANNUAL MEETING
Continued from previous page
Karl Storz Endoscopy-America, Inc. 637
2151 E. Grand Ave, El Segundo, CA 90245
www.karlstorz.com
KARL STORZ Endoscopy-America, Inc., a leader in
endoscopic equipment and instruments, offers
solutions for video-assisted thoracic surgery
(VATS). Our Video Mediastinoscopes with DCI-D1
Camera allow video recording while working under
direct vision. The KARL STORZ ENDO-
CAMELEON combines the comfort of conventional
0* laparoscopes with variable viewing,
adjustable between 0* and 120*.
Kimberly Clark 636
1400 Holcomb Bridge Road,
Roswell, GA 30076
www.kcc.com
KLS Martin, LP 343
PO Box 16369, Jacksonville, FL 32245
www.klsmartin.com
KLS Martin, a responsive company, is focused on
the development of innovative products for oral,
plastic, and craniomaxillofacial surgery. New
product developments in our titanium osteosynthesis
plating systems allow these products to be
used for rapid sternal fixation and reconstruction.
L
Lexion Medical 328
109 Preston Court, Macon, GA 31210
www.lexionmedical.com
Traditional EVH CO2 causes conduit desiccation,
shrinkage, and damage. VesselGuardian® maintains
normal tissue moisture and temperature
preventing damage and vasospasm. Vessel-
Guardian® maintains vascular morphology and
compliance, elasticity, and bioelectric impedance.
For the highest quality conduit for CABG
VesselGuardian® preserves the in situ homeostatic
environment. DewHeart® provides controlled
molecular water vapor for vascular site clearing
creating an unimpeded view, reducing vasospasm,
and preventing desiccation damage.
LifeNet 728
1864 Concert Dr., Virginia Beach, VA 23453
www.lifenethealth.org
LifeNet Health helps save lives and restore health
for thousands of patients each year. We are the
world's most trusted provider of transplant solutions,
from organ procurement to new innovations
in bio-implant technologies and cellular
therapies – a leader in the field of regenerative
medicine, while always honoring the donors and
health care professionals that allow the healing
process.
Lippincott Williams & Wilkins 108
PO Box 5053, Walnut Creek, CA 94596
www.lww.com
Lippincott Williams and Wilkins/WK Health is a global
publisher and provider of information for health
care professionals.
LSI Solutions 129
7796 Victor-Mendon Road, Victor, NY 14564
www.lsisolutions.com
Cor-Knot® delivers instant security with automated
knotting and integrated suture trimming in one
easy step. Cor-Knot® may reduce CPB and crossclamp
time. Internationally recognized innovation
for advanced CT surgeons.
M
Masimo Corporation 647
40 Parker, Irvine, CA 92618
www.masimo.com
Masimo is a global medical technology company
responsible for the invention of award-winning
noninvasive technologies, medical devices, and
sensors that are revolutionizing patient monitoring,
including Masimo SET®, Masimo rainbow SET®
Pulse CO-Oximetry, noninvasive and continuous
hemoglobin (SpHb®), acoustic respiration rate
(RRa), Masimo Patient SafetyNet, and SED-
Line® (EEG-based) Brain Function Monitors.
McGraw-Hill Medical 235
1221 Ave. of the Americas,
45th Floor, New York, NY 10020
www.mcgraw-hill.com
McGraw-Hill Medical is the publisher of the new
edition of Cardiac Surgery in the Adult, edited by
Lawrence Cohn, MD, and Adult Chest Surgery,
edited by David Sugarbaker, MD. Visit our Booth
#235 to view these great titles and more.
Medela, Inc. 118
1101 Corporate Drive, McHenry, IL 60050
www.medela.com
Medela has manufactured innovative medical
suction pumps and systems for use in the hospital,
home, and LTC facilities for over 25 years, in addition
to being the market leader in breast pumps.
Medela’s vacuum technology knowledge and experience
has resulted in the first digital cardiothoracic
drainage system.
Medical Concepts Europe 550
1083 Delaware Ave, Buffalo, NY 14209
www.medicalconcepts.eu
MCE provides complete solutions for temporary
pacing. Advanced design of temporary pacing
leads and FastLockSingle Use Interconnect Cables
increase reliability and efficacy of pacing while reducing
potential bleeding. Bipolar and Pediatric
leads are available.
Medistim 317
73rd Avenue North, #12,
Maple Grove, MN 55369
www.medistim.com
Medistim provides the most comprehensive quality
control technology designed to reduce post-
CABG MACCE. The new VeriQC provides a novel
combination of our proven transit time flow assessment
along with a 15-MHz imaging probe, specifically
designed for epiaortic and epicardial scanning.
"C" what you've been missing!
Medtronic, Inc. 701
710 Medtronic Parkway, Minneapolis, MN 55432
www.medtronic.com
Find Opportunity in Change and consider Medtronic’s
intuitive solutions in Structural Heart and Aortic
Diseases including: tissue, mechanical and transcatheter
valves; irrigated RF and cryosurgical ablation
devices; aortic stent graft systems; and OPCAB,
MICS CABG, cannulae and perfusion products.
N
Neomend, Inc. 417
60 Technology Drive, Irvine, CA 92618
www.neomend.com
Progel® Pleural Air Leak Sealant is a resorbable hydrogel
designed to seal air leaks incurred during
pulmonary surgery. Progel is the only commercially
available, FDA approved product with compelling
clinical results that show a significant reduction in
post operative air leaks and a reduction in inpatient
length of stay.
Northwest Tissue Services 140
509 SW 39th Street, Renton, WA 98057
www.nwts.org
Northwest Tissue Services is one of the Nation's
leading providers of allograft implants for cardiovascular
and vascular repair.Northwest Tissue Services
is a fully AATB-accredited, non-profit organization
dedicated to providing high quality
allograft heart valves, conduits, and patches as
well as saphenous and femoral veins.
O
Olympus Medical Systems Group 646
3500 Corporate Parkway,
POB 610, Center Valley, PA 18034
www.olympusamerica.com
Olympus develops solutions for health care professionals
that help improve outcomes and enhance
quality of life for patients. By enabling less
invasive procedures, innovative diagnostic and
therapeutic endoscopy and early stage lung
cancer evaluation, Olympus is transforming the
future of health care.
On-X Life Technologies, Inc. 517
1300 E. Anderson Lane, Building B,
Austin, TX 78752
www.onxlti.com
On-X® Heart Valves: Patented natural design and
On-X® Carbon offer reduced turbulence in a mechanical
valve to rival the clinical and hemodynamic
performance of bioprostheses. FDA IDE approved
PROACT (Prospective Randomized On-X®
Anticoagulation Clinical Trial) is in process.
Oxford University Press 651
198 Madison Avenue, New York, NY 10016
www.oup.com
OUP publishes some of the most respected medical
books and journals in the world. From 2012, this includes
the three journals of the European Association
for Cardio-Thoracic Surgery. Visit our stand to
browse books and pick up journal sample copies.
P
Pemco, Inc. 228
5663 Brecksville Road, Cleveland, OH 44131
www.pemcomed.com
Rultract/Pemco designs and manufactures cost saving
reusable instruments for the cardiovascular field.
Products include Perfusion Cannula, Coronary Ostial
Cannula, Cardiac Suckers, Anesthesia Screens,
Pemco retractors, and the Rultract Retractor.
PeriOptix, Inc. 347
1001 Ave. Pico C620, San Clemente, CA 92673
www.perioptix.com
PeriOptix offers innovative, comfortable styling in
high performance loupes featuring Adidas frames.
An experienced leader in portable LED technology,
its Solaris TM has the highest intensity rating of
any portable headlight. Contact us: 1-888-360-
0033; e-mail at customerservice@perioptix.com.
Peters Surgical 425
42, Rue Benoit Frachon,
Bobigny cedex, 93000 France
www.peters-surgical.com
Expert in cardiovascular surgery Péters Surgical
offers a wide range of sutures including: Corolene®
polypropylene monofilament with a minimal
memory, Premio® PVDF monofilament designed
for cardiopediatric surgery, Cardionyl®
unique monofilament suture for MV repair, Cardioxyl®
and Cardioflon®, respectively, siliconized
and teflonized polyester braids for valve and ring
fixation, and also Uniring® Universal Annuloplasty
System.
Philips Medical Systems 748
22100 Bothell-Everett Highway,
Bothell, WA 98021
www.healthcare.philips.com
More room to work in your hybrid OR suite with the
new Philips FlexMove! A high quality X-ray imaging
system provides critical support during hybrid
surgery. But these systems can also get in the way of
staff and other equipment in a crowded room. Flex-
Move is the new solution that solves that problem!
Pioneer Surgical Technology 114
375 River Park Circle, Marquette, MI 49855
www.pioneersurgical.com
The Pioneer Sternal Cable System® consists of multi-strand
cable which is tensioned and crimped in
place for a secure closure. With significantly more
static and fatigue strength than traditional monofilament
wire, its flexibility and ease of use make it a
better choice, while its price tag offers an economic
alternative.
Pluromed 132
175 F New Boston St., Woburn, MA 01801
www.pluromed.com
Pluromed’s LeGoo® is revolutionizing how surgeons
control bleeding during anastomoses in
cardiac surgery (OPCAB/MIDCAB/TECAB/CABG
), vascular surgery and other specialties. FDA approved
and CE-Marked, LeGoo provides a
blood-free field without conventional techniques
that damage vessels. LeGoo can allow a faster
anastomosis and shorter dissection, and is effective
on calcified arteries.
Q
Qualiteam S.R.L. 450
Casale Nassio Sopra, 15A Chiaverano TO
10010, Italy
www.qualiteam.com
Qualiteam develops, manufactures, and distributes
unique products gentle to the human body
with a focus on patient comfort and functional
convenience for staff. Come visit our booth for an
in-depth look at how our products could help your
patients recover sooner and ultimately decrease
the costs of cure.
Quest Medical Inc. 628
One Allentown Parkway, Allen, TX 75002
www.questmedical.com
Quest Medical, Inc. is a medical device manufacturer
and worldwide distributor specializing in protecting
the heart during cardiac surgery with the
Quest MPS 2® and Microplegia. Quest also offers a
unique variety of aortic punches, safety valves, vascular
loops, and an anesthesia line designed for optimum
cardiovascular surgery.
R
Rose Micro Solutions 336
4105 Seneca Street, West Seneca, NY 14224
www.rosemicrosolutions.com
Rose Micro Solutions sells high quality optical loupes
and LED lights for less! Loupes starting @ $279.00.We
are a “family” business consisting of 4 brothers.We
named the company after our mother “Rose.”
Rultract Inc. 230
5663 Brecksville Road, Cleveland, OH 44131
www.rultract.net
Rultract’s surgical retractor systems provide gentle
and uniform lift allowing maximum exposure
for IMA dissection, re-do hearts, xiphoid entry,
subxiphoid pericardial procedures, minimally invasive
procedures (capable for use with Thoratrak),
parasternal procedures, pediatric/ASD, t-incisions,
trans-abdominal GEA midcab, Pectus,
and TEMLA procedures.
Rumex International 451
8601 4th Street North, Suite 201,
St. Petersburgh, FL 33702
www.rumex.net
Rumex International is a US company specialized
in the field of microsurgical instruments. We bring
cutting edge technology to the hands of surgeons
at affordable prices. Stop by and learn
about our innovative cardiovascular line including
German Super Cut Scissors and Titanium needle
holders with TC inserts.
S
Scanlan International, Inc. 300
One Scanlan Plaza, St. Paul, MN 55107
www.scanlaninternational.com
Highest quality surgical products designed and
manufactured by the Scanlan family since 1921.
Over 3000 titanium and stainless steel precision
instruments including: VATS/MICS thoracoscopic
instruments, Scanlan® SUPER CUT Scissors, and
Scanlan® LEGACY titanium needle holders and
forceps. Single-use products include Aorta/Vein
Punches, VASCU-STATT® bulldog clamps and
graft markers.
SIC Brevetti SRL 142
206 Country Club Way, Ipswich, MA 01938
www.d-s-s.it/
The DSS (Device for Sternal Synthesis) is a new,
simple, and inexpensive approach to stabilize
the sternum and promote fusion. The DSS protects
the bone from the wire, it’s quick and easy
to implant, and the surgeon closes in the usual
method with wires or cables. No special tools are
required.
Siemens Healthcare 736
51 Valley Stream Parkway, Malvern, PA 19355
www.usa.siemens.com/surgery
The Siemens Healthcare Sector is one of the
world's largest suppliers to the health care industry
and a trendsetter in medical imaging, laboratory
diagnostics, medical information technology, and
hearing aids. With over 150 installations in the US
(over 300 worldwide), Siemens is a leading
provider of imaging systems for the Hybrid OR.
Society for Heart Valve Disease L2
500 Cummings Center, Suite 4550,
Beverly, MA 01915
www.shvd.org
The Society for Heart Valve Disease is an organization
formed to undertake, promote, support, and
encourage research and the education of the
public in the causes of heart valve disease, the
prevention of, and the treatment of heart valve
disease, or any related cardiac disease, illness, or
condition. The Society is comprised of individuals
interested in and dedicated to improving heart
valve disease in the global population, including
cardiologists, cardiothoracic surgeons, researchers,
allied health professionals, students, and
institutional representatives. Members of the Society
span the globe and encompass nearly 50
countries and counting.
Society of Thoracic Surgeons L7
633 N. St. Clair, Chicago, IL 60611
www.sts.org
The Society of Thoracic Surgeons represents more
than 6,400 surgeons, researchers, and allied health
care professionals worldwide who are dedicated to
ensuring the best possible outcomes for surgeries of
the heart, lung, and esophagus, as well as other surgical
procedures within the chest. The STS 49th Annual
Meeting, the Society’s pre-eminent educational
event, will be held January 26 – January 30, 2013,
in Los Angeles, California. STS/AATS Tech-Con 2012
will be held January 26-27. The Society offers a wide
variety of member benefits, including reduced participation
fees in the renowned STS National Database,
a complimentary subscription to the prestigious
Annals of Thoracic Surgery, dynamic
educational offerings, online patient information resources,
and much more. Stop by Booth #L4 or visit
the STS website, www.sts.org, to learn more about
The Society of Thoracic Surgeons.
Sontec Instruments Inc. 443
7248 South Tucson Way, Englewood, CO 80112
www.sontectinstruments.com
Sontec offers headlights and loupes and the most
comprehensive selection of exceptional hand
held surgical instruments available to the discriminating
surgeon. There is no substitute for the quality,
expertise and individualized service. Sontec's
vast array awaits your consideration at our booth.
Sorin Group 501, 1301
14401 W. 65th Way, Arvada, CO 80004
www.sorin.com
Sorin Group has developed some the of the industry’s
most innovative designs for tissue and mechanical
heart valves as well as annuloplasty repair devices.
Sorin Heart Valve’s comprehensive portfolio
combines superior performance with proven longterm
clinical outcomes to become the choice of
cardiac surgeons worldwide.
Spiration 222
6675 185th Ave, NE, Redmond, WA 98052
www.spiration.com
The IBV® Valve System has a humanitarian device
approval in the U.S. to control specific post-operative
air leaks of the lung and has CE mark approval
for the treatment of diseased lung in emphysematous
patients and for damaged lung resulting in air
leaks by limiting air flow to selected areas.
St. Jude Medical, Inc. 715
One St. Jude Medical Drive, St. Paul, MN 55117
www.sjmprofessional.com
St. Jude Medical’s commitment to cardiac surgery
continues with our legacy of market-leading heart
valves including the Trifecta valve, which continues
our passion of putting more control into the
hands of physicians to offer patients an improved
quality of life.
STS - PAC
L6
633 N. St. Clair, Chicago, IL 60611
www.sts.org
The STS/AATS Advocacy Center Booth #L6 is the
best place to learn about STS/AATS government
relations activities and to find out how you can
help your practice and the future of the specialty.
Stop by Booth L6 where you can e-mail your Congressional
representatives, receive timely information
on federal legislation and regulations impacting
your practice, and learn about new ways to
advocate for cardiothoracic surgery in your state
and congressional district.
Surge Cardiovascular / MED Alliance Solutions,
LLC 322
3825 Commerce Dr., St. Charles, IL 60174
www.surgecardiovascular.com
Surge Cardiovascular designs, develops, manufactures,
and markets a wide range of open heart surgical
products for cardiothoracic procedures. The
company serves commercial acute care hospitals,
federal government facilities, and provides OEM operations.
The Surge Cardiovascular portfolio is CE
Continued on following page

MOSCONE CONVENTION CENTER • SAN FRANCISCO, CA • APRIL 28-MAY 2, 2012 13
Continued from previous page
marked and distributed across North America, South
America, Europe, and Asia.
Surgical Acuity, Inc. 746
3225 Deming Way, Middleton, WI 53562
www.surgicalacuity.com
Surgical Acuity designs and manufactures highperformance
magnification loupes for surgeons
and other medical professionals. Renowned for
quality craftsmanship, Surgical Acuity loupes deliver
remarkable resolution over a deep and wide
viewing field. Superior visualization is achieved
through innovative, lightweight optics made from
only the finest grade of glass.
Surgitel/General Scientific Corp 234
77 Enterprise Drive, Ann Arbor, MI 48103
www.surgitel.com
Ultra lightweight surgical loupes, portable LED
lights, and the first loupe-mounted Lightweight digital
video camera are designed to improve the
user's working posture and the quality of patient
care. The use of SurgiTel® systems will take the
chronic neck and back fatigue/pain out of performing
long surgical procedures.
SynCardia Systems, Inc. 344
1992 E Silverlake Drive, Tucson, AZ 85713
www.syncardia.com
The SynCardia temporary Total Artificial Heart
(TAH-t) is the world’s only FDA, Health Canada,
and CE approved Total Artificial Heart. It is approved
as a bridge to transplant for patients dying
from end-stage biventricular failure. Visit our booth
for updates on the Freedom and Companion 2
Driver Systems and more.
Synthes CMF 245
1301 Goshen Parkway, West Chester, PA 19380
www.synthes.com
Synthes CMF develops, produces, and markets instruments
and implants for the surgical reconstruction
of the human skeleton and soft tissues. Our
product offering includes systems for internal fixation
of the sternum following a sternotomy / osteotomy
or fracture of the sternum and rib, with
options to stabilize and promote fusion.
T
Teleflex Medical 232
2400 Bernville Road, Reading, PA 19605
www.teleflex.com
The Teleflex portfolio offers today’s cardiothoracic
surgeon comprehensive resources including: Horizon,
Hemo-clip® ligation, Hem-o-lok®, Tevdek®,
Deklene® Maxx suture, Pleur-evac® chest
drainage. Weck, Deknatel, and Pilling are recognized
pioneer companies providing cardiovascular
products enhancing patient outcomes.
Terumo 213
6200 Jackson Road, Ann Arbor, MI 48103
www.terumo-cvs.com
Terumo will display Vascutek® Gelweave
gelatin-sealed, woven, branched vascular grafts
for debranching and associated hybrid procedures;
Estech’s OPCAB platform of stabilization
and positioning tools; the VirtuoSaph® Endoscopic
Vein Harvesting System; TigerPaw® System II for the
occlusion of the left atrial appendage; perfusion
products and cannulae.
Thompson Surgical
Instruments, Inc 649
10170 East Cherry Bend Road,
Traverse City, MI 49684
www.thompsonsurgical.com
Thompson Surgical Instruments is dedicated to providing
Uncompromised Exposure through Thompson
Retractor and other innovative access systems. Visit
our booth to see the low profile, Bolling Mitral Valve
Retractor system which provides uncompromised
mitral valve exposure and offers the versatility to be
used for multiple surgical approaches.
Thoracic Surgery Foundation for Research
and Education 1601
633 N. St. Clair, Chicago, IL 60611
www.tsfre.org
The Thoracic Surgery Foundation for Research and
Education (TSFRE) was established in 1992 to increase
knowledge and enhance treatment of patients
with cardiothoracic disease, to develop skills
of cardiothoracic surgeons as surgeon-scientists
and health policy leaders, and to strengthen society’s
understanding of the specialty. Physicians,
corporate partners and patients are urged to contribute
to TSFRE.
Thoramet Surgical Products 644
301 Route 17 N, Suite 800,
Rutherford, NJ 07070
www.thoramet.net
The Surgeon's choice for VATS instrumentation! We
offer the most comprehensive catalog of pure thorascopic
patterns available. The feel you want, the
actuation you need, the patterns you demand!
Come visit us in AATS Booth # 0644 to see and feel
our unique versatility!
Thoratec Corporation 523
6035 Stoneridge Drive, Pleasanton, CA 94588
www.thoratec.com
Thoratec is a world leader in therapies to address
advanced-stage heart failure. The company's products
include the HeartMate® LVAS (Left Ventricular
Assist System) and Thoratec® VAD (Ventricular Assist
Device) with more than 18,000 devices implanted in
patients suffering from heart failure. Thoratec also
manufactures and distributes the CentriMag® and
PediMag®/PediVAS® product lines.
Transonic Systems 650
34 Dutch Mill Road, Ithaca, NY 14850
www.transonic.com
You’re finishing another CABG, the patient
weaned smoothly, no ECG changes, the grafts are
fine…or are they? Know for sure before giving the
Protamine – get precise blood flow measurements
in each graft with Transonic’s ultrasound flow measurement
technology.
U
USB Medical, Ltd. 218
2000 Pioneer Road,
Huntingdon Valley, PA 19006
www.usb-medical.com
Medical Solutions! Innovations include the HV
Heart Retractor, co-invented with Dr. Hugo Vanermen
and used by renowned cardiac surgeons
throughout the world. Provides the largest and
clearest views during minimally invasive valve
procedures. PulseOne, the world's first and only
one-handed defibrillation delivery system for the
safest, easiest and most relaiable alternative to
spoons!
V
ValveXchange, Inc. 546
12635 East Montview Blvd., Aurora, CO 80045
www.valvexchange.com
ValveXchange® has developed the world’s first
lifetime tissue heart valve. The Vitality 2-part
pericardial bioprosthesis is designed to bring full,
active lifestyles to patients of all ages. The basering
is implanted without the leaflet-set attached,
allowing full visibility below the valve.
The leaflet-set is replaceable minimally invasively
for as-new performance.
Veran 237
1908 Innerbelt Business Center Drive,
St. Louis, MO 63110
www.veranmedical.com
Veran is focused on the next standard of care
for minimally invasive delivery of interventional
oncology therapies. Veran provides a suite of
clinical products using proprietary 4D registration
capabilities for targeting lesions within the human
body. By enabling minimally invasive early
stage diagnosis, patient survival and lower health
care costs may occur.
Vitalcor, Inc. 542
100 E. Chestnut Avenue, Westmont, IL 60559
www.vitalcor.com
Latex Free Coronary Artery Balloon Cannulae with
self-inflating Balloon (3-year shelf life). Reusable Dingo
(Bulldog) Clamp. Titanium and stainless steel specialty
instruments and retractors. Reusable stabilizer
for Beating Heart Surgery and Mitral Valve Retractor.
Vitalitec Geister 617
10 Cordage Park Circle, Suite 100,
Plymouth, MA 02360
www.vitalitec.com, www.geister.com
Vitalitec Geister will be displaying all our products,
highlighting our Enclose® II Anastomosis Assist Device,
Cygent® Flexible Clamps, Intrack® Atraumatic
Temporary Clamps and Inserts and Geister®
ValveGate® and ValveGate® PROTM line of MIS
CV instrumentation.
W
Wexler Surgical Supplies 201
11333 Chimney Rock Road,
#110-120, Houston, TX 77035
www.wexlersurgical.com
Wexler Surgical designs and manufactures a variety
of titanium and stainless steel specialty surgical
instruments and products for Cardiac, Vascular,
Thoracic, and Micro Surgery. Come see our
new VATS/MICS and Optimus instrument lines.
World Society for Pediatric and Congenital
Heart 551
2300 Tupper Street, Room C8-29,
Montreal, h3h1p3 Canada
www.wspchs.org
The mission of the World Society for Pediatric and
Congenital Heart Surgery is to promote the highest
quality comprehensive cardiac care to all
patients with congenital heart disease, from the
fetus to the adult, regardless of the patient’s
economic means, with an emphasis on excellence
in teaching, research, and community service.
Y
Yuma Regional Medical Center 633
2400 South Avenue, Yuma, AZ 85364
www.yumaregional.org
Yuma Regional Medical Center, located in sunny
southwestern Arizona, is a 369-bed acute care
hospital and the sole provider serving the city of
Yuma and the surrounding region. YRMC offers
high quality care and advanced technology
within a compassionate and caring environment.
How to Launch a Hybrid OR During
Today’s Special Course
In recent years, the AATS Annual
Meeting has included a display of the
latest hybrid operating room technology
in the Exhibit Hall along with a
course designed to familiarize attendees
with how to implement hybrid ORs at
their institutions. Together, the
display and the course provide
a unique opportunity to see
how the equipment works and
to hear from those who have experience
with hybrid ORs.
Hybrid operating rooms provide
an environment in which
open, minimally invasive, imageguided
and/or catheter-based
procedures can be performed in
the same operative setting. And,
they foster the ability to think of
new and different ways to care
for patients who require complex
procedures.
The project directors and opening
speakers for this year’s Building the Hybrid
Operating Room of the Future©
Course are Raphael Bueno, MD, associate
chief, division of thoracic surgery,
Brigham and Women’s Hospital, and John
Byrne, MD, chairman, department of cardiac
surgery, Vanderbilt Heart and Vascular
Institute. Dr. Bueno and Dr. Byrne,
along with other speakers, will share their
experience about the steps that need to be
taken to ensure successful implementation
and functionality of a hybrid OR.
Joseph E. Bavaria, MD, vice chief of the
division of cardiovascular surgery and director
of the thoracic aortic surgery program
at the Hospital of the University of
Be sure to see the state-of-the-art equipment and chat
with expert hybrid surgeons in the Exhibit Hall.
Pennsylvania, will offer suggestions on
how to convince hospital administrators
to fund a hybrid operating room. Gina
Cronin, administrator of the Cleveland
Clinic, will discuss how to identify and analyze
needs. Stephen Ball, MD, assistant
professor of cardiac surgery, Vanderbilt
Heart and Vascular Institute, will share
tips on how to build consensus within the
team. Ed Bernard, of Edwards, will take
a business school approach in a presentation
on the negotiations that are necessary
to get a hybrid OR off the ground.
Joseph L. Fredi, MD, director, Acute MI
Network, Vanderbilt Heart and Vascular Institute,
will discuss ways to identify industry
partners. David L. Brown, MD, president
and chairman of medical
staff, The Heart Hospital, will
share insights about how to implement
and avoid pitfalls of the
hybrid OR.
The “Operating Rooms of
the Future: Hybrid Technologies©”
display in the Exhibit
Hall gives attendees an opportunity
to examine a state-of-theart
operating room. This year’s
Martin Allred/IMNG Medical Media
display will feature both a cardiac
and general thoracic hybrid
OR, and each of these will
be staffed by an expert hybrid
surgeon during peak traffic
times in the Exhibit Hall to talk and
walk attendees through step-by-step procedures
that will provide a realistic view
of the hybrid approach.
Philips Healthcare and Siemens Medical
Solutions USA are the lead companies
for the displays. Also participating
are Maquet, Medtronic, Inc., Olympus,
Scanlan International, Simbionix USA
Corporation, Sorin Group, and Steris
Corporation.
■
Additional
Product Launch
CryoLife, Booth 329
BioGlue Delivery Tip Extension
Increase your reach with the new BioGlue
Delivery Tip Extension! The Delivery Tip
Extension (DTE) provides easier delivery of
BioGlue to those hard-to-reach friable tissues
or anastomoses.The DTEs easily attach
to the standard applicator tip and make
BioGlue even more versatile. Stop by the
CryoLife booth to see how the Delivery Tip
Extensions can make your case easier.
In-Booth
Presentations
Monday, 9:30 AM AND 3:10 PM
Why TMR? (Keith Allen, MD)
Tuesday, 10:10 AM
Valve Xchange Technology, Animal
Data, and an Update on Their In-man
Implants (Lars Svensson, MD)
New Exhibitor
Market Access Partners Booth 539
3236 Meadow View Drive
Evergreen, CO 80439
Market Access Partners provides market
research consulting to the medical device and
pharmaceutical industries. We use innovative
qualitative and quantitative methodologies to
research opinions of physicians, nurses, and
patients. We offer a management oriented
approach to product development and
marketing.

14 AATS 92 ND ANNUAL MEETING
Career Tips From Academic Surgeon Session
In Saturday’s Developing the Academic
Surgeon symposium, W. Randolph Chitwood
Jr., MD, of East Carolina University,
spoke about how young faculty members
need to define and develop their own
academic niche.
Dr. Chitwood, an expert in mitral valve
surgery, said that early in his career, he
asked his chairman of surgery how he
could become a successful academic cardiothoracic
surgeon. The response was
that he needed to become a good teacher,
have respect for and ideally do both basic
science and clinical research, understand
operational issues and finances, and become
a hospital, university, and community
leader.
“Although we were all trained to be a
‘general’ CT surgeon, no training program
can teach all of the elements necessary to
develop focused expertise in one area. One
has to learn the techniques and the organization
needed to develop a successful
niche,” he said.
Your choice should be supported by
your division chief and it should fill a clinical
gap in the program. If another faculty
member has become the local expert in
that particular area, however, you must not
compete.
Dr. Chitwood advised doing a preliminary
literature research, followed by “sitting
at the feet of a master surgeon” in
your chosen area of subspecialization. In
addition, you should go to centers that
have a proven track record of success and
meet with surgeons who have achieved
great outcomes. When you are ready, you
should perform the simplest operative cases
in your chosen area, asking your senior
colleagues for assistance, he said.
In addition, he said, you must market
yourself to the local and regional cardiologists
and let them know what you are establishing
at your center.
“Remember that young cardiologists
like to refer to young surgeons,” Dr. Chitwood
said. “I cannot overemphasize the
OAKLEY ®
MicroLine Loupes and LED Headlights
All you need to see and feel your best
(magnification power available = 2.5x - 8.0x)
Dr. Chitwood advised finding a focus
niche and subspecialty mentors.
Martin Allred/IMNG Medical Media
Traditional loupes are 70% - 200%
heavier than SurgiTel ® micro loupes
Other Telescopes
process of referrals. You have to know and
call your referring doctors. They want to
know the immediate outcomes of your
operations. ... This keeps the human relationship
in the equation. This process has
kept my practice in good stead for over 25
years and can be the ‘touchstone’ to your
academic success,” added Dr. Chitwood.
Edward Verrier, MD, of the University of
Washington Seattle, disccussed how the
use of simulators in training is vital in today’s
academic world where work hour restrictions
have changed the nature of resident
education.
The use of simulators allow trainees to
practice under controlled mentor-monitored
conditions not only for standard operative
steps, but also for crisis situations
that may never come up in their normal period
of training but may likely appear when
they do many cases in the real world. He
also reported on some preliminary observations
from an AHRQ grant for implementing
simulation program training. ■
Drop-in X-ray Protection Filter
Built-in X-ray Protection Lenses
Digital Video Camera
Visit us at AATS
Booth #234
www.surgitel.com 800.959.0153
Dr. Verrier said that simulators may be
the answer to training restrictions.
Martin Allred/IMNG Medical Media

When Challenging
Anatomy Throws
You A Curve,
Respond With One
Of Your Own.
Endo GIA Curved Tip Reload
with Tri-Staple Technology
The first and only endoscopic stapler with a
curved tip feature
Enhanced direct visualization facilitates access
to the surgical site and the ability to dissect and
manipulate tissue and vessels 1
The Gray Curved Tip reload offers optimal
solution for vascular applications where
maneuverability is limited
Dedicated solutions for thoracic surgery. Visit Covidien at booth 511.
www.tristaple.com
The Endo GIA Gray Reload does not include Tri-Staple Technology
1 per clinical evaluations (data on file)
COVIDIEN, COVIDIEN with logo, and positive results for life are U.S. and/or internationally registered trademarks of Covidien AG.
All other brands are trademarks of a Covidien company. © 2012 Covidien. M120327

16 AATS 92 ND ANNUAL MEETING
Keeping Up With Congenital Skills
The Konno operation was developed
in order to significantly enlarge a
small aortic annulus by incising the
interventricular septum, resulting in an
aortoseptoplasty with prosthetic valve
placement. However, subsequent problems
such as arrhythmias and a daunting
reoperation for valve re-replacement, led
to development of the Ross-Konno operation.
This procedure resulted in improved
hemodynamics, limited interventricular
septal incision, and freedom from anticoagulation.
Some surgeons experienced a
higher incidence of complete heart block
with both the Konno and the standard
Ross-Konno operations, so the modified
Ross-Konno procedure was introduced.
During Saturday’s Congenital Skills
Course, Constantine Mavroudis, MD, of
Florida Hospital for Children, Orlando
compared these three procedures.
“The standard Konno-Rastan operation
has a high incidence of heart block and left
ventricular dysfunction at long-term follow-up.
The standard Ross-Konno operation
has improved hemodynamics and can
be used effectively in small children. The
modified Ross-Konno operation has the
potential for elimination of heart block and
preservation of left ventricular function,”
Dr. Mavroudis said.
An aortic valve-sparing septoplasty for
diffuse left ventricular outflow tract obstruction
first described in 1986 is a standard
surgical approach yet relatively uncommon,
according to Glen Van Arsdell,
MD, of the Hospital for Sick Children. He
pointed out some of the technical considerations
involved.
The aortic annulus must be of sufficient
size so that one is not simply shifting
the gradient to the annular level. There
have been reports that the anatomy of the
first septal artery is at risk for transaction
with the valve-sparing Konno, which may
create injury to the artery and lead to
complete heart block.
“Mortality for the procedure is low. The
primary morbidity is a 9% incidence of
THE OFFICIAL NEWSPAPER OF THE AMERICAN ASSOCIATION FOR THORACIC SURGERY
Visit our web site designed for cardio-thoracic surgeons.
·Specialty news and events in real time
·Galleries of clinical images, videos, and podcasts
·Commentaries and residents’ news
·Topic-specific newsletters
·And much more
Joseph A. Dearani, MD, chaired the
Congenital Skills Course.
heart block, which may be related to direct
conduction tissue injury or a secondary injury
caused by transaction of a septal perforator,”
Dr. Van Arsdell concluded.
Francois Lacour-Gayet MD, of Montefiore
Children’s Hospital, New York, discussed
his experience with the arterial
switch operation (ASO). Although this operation
is safely performed in many centers,
the complexity of the coronary artery
anatomy remains challenging, Dr. Lacour-
Stewart Bloom/IMNG Medical Media
Constantine Mavroudis, MD, discussed
the modified Ross-Konno procedure.
Stewart Bloom/IMNG Medical Media
www.thoracicsurgerynews.com
Gayet explained. “Even so, coronary transfer
in complex coronary arteries can be
achieved with minimal risk, and showed a
0% perioperative mortality in our series of
patients,” he stated.
There is nevertheless a small late risk of
around 2% of coronary failure following
arterial switch with complex coronaries.
“Coronary artery stenosis or occlusion
could be silent. It is our practice to check
the patency of the complex coronary arteries
using CT scan or MRI, completed by
coronarography when needed,” Dr. Lacour-Gayet
added.
■

MOSCONE CONVENTION CENTER • SAN FRANCISCO, CA • APRIL 28-MAY 2, 2012 17
Continued from page 1
Matthew Bacchetta, MD, discussed how to manage
injuries sustained in combat situations.
compared with other procedures, though
this is still open to debate.
However, it is a procedure that is definitely
not for all lung cancers, and also not
for all thoracic surgeons, Dr. McKenna
concluded.
Laparoscopic fundoplication represents
an effective therapeutic modality in patients
with refractory gastroesophageal reflux
disease (GERD) and/or hiatal hernia,
according to Rodney J. Landreneau, MD,
of the University of Pittsburgh.
Laparoscopic Nissen fundoplication,
however, can be associated with significant
postoperative sequelae, including recurrent
reflux, dysphagia, and gas bloat in up
to 20% of patients.
Dr. Landreneau his colleagues evaluated
the outcomes of a modified Toupet
fundoplication with associated fundic
(Dor) onlay flap that creates a dynamic
(near 360º) high-pressure zone upon the
intra-abdominal lower esophageal segment.
They performed a retrospective review
of patients undergoing a laparoscopic
modified Toupet/Dor fundoplication for
refractory GERD from 2002 to 2011.
Paraesophageal hernias were present in
22% of cases. The surgical technique involved
modification of the Toupet fundoplication
by transposing the lateral fundus
over the distal esophagus, with fixation to
the anterior crural arch just
to the right of the midline.
This method resulted in
an anterior fundic flap similar
to that of the Dor fundoplication.
The researchers
applied preoperative esophagogastric
motor function,
barium esophagram, and
endoscopy to all patients
and followed them postoperatively
at 6 months. They
then followed them at yearly
intervals with subjective
dysphagia, reflux, and gas
bloat scoring as well as routine
barium swallow and radionuclide
studies.
Primary outcome variables
included perioperative
outcomes (length of
stay, mortality), symptom
control, and freedom from reoperation.
At a mean follow-up of 34 months,
92% of patients had achieved overall control
of reflux symptoms. Postoperative
gas bloating and significant dysphagia occurred
in only 10% and 4% of patients, respectively.
Postoperative studies demonstrated
reflux in around 6% of patients
and the presence of small hiatal hernias
in 7%. Around 22% of patients underwent
postoperative esophageal dilation (median
dilations, and 8% underwent
repeat operation.
The procedure “achieves
durable reflux control while
minimizing postoperative
dysphagia and gas bloat
symptoms. This technique
provides an effective means
Stewart Bloom/IMNG Medical Media
of restoring a dynamic
near-circumferential antireflux
barrier receptive to a
food bolus without obstruction,”
he said.
Vertebral invasion by lung
cancer most commonly involves
the upper thoracic
spine in the setting of a patient
with a superior sulcus
(Pancoast) tumor. Because
superior sulcus tumors account
for only 3%-5% of all
lung cancers, operations for
vertebral invasion are not
commonly seen in most practices. Furthermore,
a surgical approach involves
careful preoperative evaluation and patient
selection, often induction chemoradiation,
and a multispecialty surgical team,
said Walter J. Scott, MD, of Fox Chase Cancer
Center.
Patient selection is based on preoperative
CT, PET/CT, and brain as well as thoracic
inlet MRI scans. Predicted postoperative
pulmonary function must be
adequate and take into account the effect
of resecting both chest wall and lung
parenchyma. Careful neurologic exam is
important, as is avoidance of resection of C-
8 or higher nerve roots.
The presence of N2-N3 lymph node
metastases has been associated with a poor
prognosis in most series, and bronchoscopy
with cervical mediastinoscopy should be
performed.
Induction therapy has not consistently
been shown to be of benefit in patients undergoing
vertebrectomy, said Dr. Scott. The
A modified Toupet/Dor fundoplication worked well
for refractory GERD, Rodney Landreneau, MD, said.
Stewart Bloom/IMNG Medical Media
authors of the largest series generally describe
at least three categories of involvement:
tumor invasion of the transverse
processes only, tumor invasion of the intervertebral
foramen requiring hemivertebrectomy
and spinal fixation, and more
extensive invasion requiring total vertebrectomy
and spinal fixation. A fourth category
could be added that includes excision
of multiple vertebral bodies.
A multidisciplinary team is important because
spine surgeons must reconstruct and
stabilize the spine after the thoracic surgeons
have performed the resection. The choice of
approach is based on the location of the tumor,
the extent of the resection, and the experience
of the surgical team.
Additionally, both simultaneous procedures
(spinal fixation and en bloc resection
of the lung and involved portion of the
spine) and sequential operative procedures
(spinal surgery followed by lung resection)
have been described. Sequential procedures,
spaced days or up to 2 weeks apart,
are often performed when resection of
multiple vertebral bodies and
complex spinal fixation (posterior
and anterior instrumentation,
bone grafts, or expanding
cages) are required, Dr. Scott
added.
Operative mortality rates are
variable, ranging in reports
from 0 to 8.5%, and postoperative
morbidity is significant
with these procedures. In addition
to respiratory failure, pneumonia,
empyema and/or or
pulmonary emboli, complications
include cerebral spinal fluid
leak, necrosis of posterior
skin flaps, and reoperation for
hardware or spinal stabilization
hardware that has become detached
resulting in spinal instability.
Something that cardiothoracic
surgeons typically don’t
encounter is the need to treat
patients after a natural disaster, but
Michael Phillips, MD, did just that when an
EF5 tornado touched down in Joplin, Mo.,
in May 2011.
St. John’s Regional Medical Center was
destroyed, and patients were transferred to
his hospital – which lacked water pressure,
The AATS Daily News
The Official Newspaper of
the AATS 92nd Annual Meeting
AATS Staff
Executive Director:
Cindy L. VerColen
Managing Editor:
Lorraine M. O’Grady
Publication Staff
Director, IMNG Society
Partners
Mark Branca
Advertising Sales:
Betty Ann Gilchrist, 203-938-3156
Manager, Onsite News Products:
Elizabeth Wood
Publication Editor:
Mark S. Lesney
Michael Phillips, MD, described some of the
horrific situations he encountered during the
2011 natural disaster in Joplin, Mo.
clean water, and x-rays. While the first
surge of patients was treatable, he said, patients
who arrived later had been extricated
from debris and were more difficult to
treat.
With a generator the only source of
power, the surgeons relied on Facebook,
Twitter, and texts to communicate while
treating injuries sustained from foreign
materials. Dr. Phillips said he worked nonstop
for almost 30 hours. He credited thoracic
surgeons, by virtue of their training,
as being able to act as leaders during critical
times such as these. “We as thoracic
surgeons are well trained to perform as
long as we keep our heads on straight,” he
said. “I strongly urge you to be prepared.”
Physicians practicing in tornado-prone
areas should take weather watch warnings
seriously, take shelter when sirens sound,
and review their plans for the worst-case
scenarios, he advised.
Other sessions in this course offered
practical information on new surgical procedures,
including artificial rib replacements,
diaphragm pacing, laparoscopic diaphragmatic
plication, and innovative uses
of wound vacuum-assisted closure systems.
Michael T. Jaklitsch, MD, of Brigham
and Women’s Hospital was the chair of the
course.
■
Designer:
Lisa Marfori
Photographers:
Martin Allred, Stewart Bloom
Production Specialist:
Maria Aquino
©Copyright 2012, American
Association for Thoracic Surgery, 500
Cummings Center, Suite 4550, Beverly,
MA 01915
Produced and distributed for AATS by
IMNG Society Partners, an Elsevier
company. All rights reserved. No part of
this publication may be reproduced or
transmitted in any form, by any means,
without prior written permission of the
AATS. The opinions expressed in this
publication are those of the presenters
and authors, and do not necessarily reflect
the views of the Association.
Stewart Bloom/IMNG Medical Media

18 AATS 92 ND ANNUAL MEETING
CT Critical Care Continues to Evolve
Patient safety is of paramount importance
in CT critical care. The
surgical space, by its nature, is a
high-risk environment where hazards lurk
around every corner and for every patient,
according to Juan A. Sanchez, MD, MPA,
of the University of Connecticut Health
Center.
During Sunday’s Cardiothoracic Critical
Care Symposium, Dr. Sanchez discussed
the benefits of treating a high-performing
ICU as a clinical microsystem. The very nature
of surgical treatment leads to a level
of complexity, both in task-oriented and
A clinical microsystem helps to mitigate
errors, said Juan A. Sanchez, MD, MPA.
Martin Allred/IMNG Medical Media
cognitive demands, that creates a dynamic,
unforgiving environment that can magnify
the consequences of even small lapses
and errors.
Other complex sociotechnical systems,
which operate in similar environments,
have been able to redesign their operations
such that they consistently perform at high
levels of safety with reliable outcomes.
Such high-reliability organizations (HROs)
include aircraft carriers and nuclear power
plants. These industries share an extraordinary
capacity to discover and manage
unexpected events.
“Using a clinical microsystems approach,
adapted from such HROs, can facilitate the
design of systems to identify, prevent, absorb,
and mitigate errors and can provide
remarkable opportunities for improving
safety,” Dr. Sanchez said.
Intensive Care Unit (ICU) care inevitably
involves the difficult decisions that must be
made about the continued usefulness of
extreme technologies, and eventually the
issue of end of life care, according to J.
Randall Curtis, MD, MPH, of the Harborview
Medical Center, who discussed
palliative care in the CT ICU.
“Since many deaths in the ICU are preceded
by a decision to withhold or withdraw
life support, high-quality decision
making and end-of-life care are essential,
and it can be an especially complex issue
Nevin M. Katz, MD, discussed how to
manage patients on VADs.
when advanced technologies are involved,”
said Dr. Curtis.
“Making such decisions requires adequate
training, good communication between the
clinician and family, and the collaboration of
a well-functioning interdisciplinary team,”
according to Dr. Curtis.
Nevin M. Katz, MD, of Johns Hopkins
University addressed the critical issue of
VAD support and how to deal with patients
on these devices who wind up in the ICU.
This is largely uncharted territory, according
to Dr. Katz, with situations where
the patient is hemodynamically unstable
Martin Allred/IMNG Medical Media
but conventional protocols are either ineffective
or counterproductive. In addition,
there are no animal models that can
be recruited to study these situations.
“As technology has advanced in the area
of simulation, we are finding that this is
perhaps the best teaching tool we have to
mimic the clinical dilemmas in which we
find ourselves from time to time,” said Dr.
Katz, who showed case examples to the audience.
“Since even an average sized mechanical
support program will not see each of these
problems on a regular basis, it would be
helpful to be able to study them and learn
how to handle them through simulation,”
according to Dr. Katz.
■
AATS Annual
Business Meeting
AATS Members Only
Business Session
Monday, April 30
7:30 a.m. – 7:45 a.m.
Executive Session
Tuesday, May 1
5:00 p.m. – 5:45 p.m.
American Association
for Thoracic Surgery
2012
Heart Valve
Summit
Medical, Surgical and
Interventional Decision Making
October 11 – 13, 2012
JW Marriott Chicago
Course Directors
David H. Adams, MD, FACC
Steven F. Bolling, MD, FACC
Robert O. Bonow, MD, MACC
Howard C. Herrmann, MD, FACC
Space is limited. Pre-register at
www.CardioSource.org/heartvalveP2
©2012 American College of Cardiology H193

I SEE LESS
TRAUMATIC AORTIC
OCCLUSION * THRU
the only intra-aortic occlusion device.
THRUPORT
IntraClude
INTRA-AORTIC OCCLUSION DEVICE
ThruPort IntraClude intra-aortic occlusion device
Visit us at Booth #301.
Progress Confidently
For professional use. CAUTION: Federal (United States) law restricts this device to sale by or on the order of a physician. Seeinstructions
for use for full prescribing information, including indications, contraindications, warnings, precautions and adverse events.
Edwards Lifesciences
Irvine, USA I Nyon, Switzerland I Tokyo, Japan I Singapore, Singapore I São Paulo, Brazil
edwards.com

Where can I find
unsurpassed performance
in aortic tissue valves?
Mitroflow
Stented
Freedom Solo*
Stentless
Whether you need a stented, stentless or
sutureless option for tissue aortic valves, you can
be confident in our exceptional track record for
performance and durability. Sorin Group’s portfolio
also includes solutions for supra-annular position
achieving a true 1:1 orifice to annulus match.
Perceval S*
Sutureless
Solutions that Fit
Your Practice and Your Patients
* Investigational device not available in the U.S.
Visit booth 501 to learn more.
HEART VALVES
Sorin Group USA, Inc.
14401 W. 65th Way, Arvada, CO 80004
United States of America
Tel. 800.289.5759 Fax 877.657.3605
© 2012 Sorin Group
ETHICAL
COLLABORATION
IN HEALTHCARE
CERTIFIED
Licensed by Eucomed
WWW.SORIN.COM
Caution: Federal law (USA) restricts this device
to sale by or on the order of a physician.
SADI IM-00019 2012