Thread by @EulertJ

Learned a lot at the Redo Cardiac Surgery Session with @RuelMarc1 at #sts2020 Especially Redo Sternotomy AVR After CABG is a hot topic in 2020 #Partner2a #cardiotwitter #tavr

https://twitter.com/VictorDayan1/status/1223465290828263424

Prof Naka exemplifiying #SAVR & SAVR post CABG: STS 1.06 vs 1.87 or Euroscore II 0.71 vs 2.13 " Re-operative cardiac surgery tends to be Associated with higher Rates of early mortality and morbidity than primary chest surgery" #tavr

2) As M.Pasic states in the OR his First rule in surgery " Vorbereitung ist alles' Preparing is Key. Second Slide by Prof.Naka on preparing for re-entry: - avoid unnecessarily exposing the innominate vein and opening the AP Window #lessismore

Beyond Risk scores: Imaging informs your risk tolerance -> From Low Risk (Perfusionist in room) -> femoral vessel exposure -> hypothermia and CPB in very high risk

4) From J.Chikwe's book CT surgery -> "Very high risk: e.g. aneurysmal Aorta, Patent LIMA or SVG adherent to midline of sternum"

5) LIMA crossing midline #sts2020 @RuelMarc1
JC "Patent LIMA to LAD anastomsis prior SAVR makes resternotomy potentially hazardous"

6) Goal directed therapy #sts2020

7)Dealing with patent LIMA in Redo
Different standpoints regarding myocardial protection.
To clamp or not to clamp IMA? @pomyers @rafasadaba @dompagano @tamaranihici @tomcnguyen @DrMoritzWvB @JessicaLuc1 @FaisalBakaeen @manuel_carnero @VictorDayan1 @drSujayShad @FernandoBiguria

@maraantonoff @CMichaelGibson @Argenscore @RuelMarc1 @rjcerq @Rodrigo79786035 @drkirmani @EduQuintanaCVS @ebender001 @drnikkistamp @GilbertTangMD @galdamiz65 @igeorge1975 @RayburnTom @sloaneguy @jisaezdeibarra @OPreventzaMD @erodcauCCV @RichardWhitloc2 @LuisDVelazcoDa1