Dr. Lantin giving a Top 10 review of #ACCACPC research in 2020, a truly crazy year! #ACC21
🔟 No mention of 2020 could possibly ignore the effects of the global pandemic on research, patient care, and the way we share knowledge. #COVID19#ACC21
9⃣ Imaging indices correlate with prognosis.
- Transplant/VAD-free survival correlates with MPI-DTI z-score
- Left atrial strain correlates with PCWP and helps identify graft rejection/failure #ACC21
8⃣New concepts in intervention
- Fetal cardiac interventions
- Encouraging results in the Ozaki repair for aortic valve disease
- Encouraging results in sirolimus for preventing restenosis in PVS #ACC21
7⃣EP Advancements
- CRT associated with improved transplant-free survival in pediatric and CHD patients #ACC21
6⃣Developement of a risk score for interstage death or transplant after stage 1 palliation of single ventricle patients #ACC21
5⃣Increasing focus on QOL, neurocognitive outcomes, palliative care, and social/racial disparities #ACC21
And finally, a moment to honor two giants in the field of #CHD care who we lost, Dr. Jacqueline Noonan and Dr. William Norwood #RIP #ACC21
I tweeted the same slide twice, so here are links to the #CHD documents to make it up to you: (1/2)
👉Sachdeva et al. Appropriate Use Criteria for #CHD imaging jacc.org/doi/full/10.10…
👉Rudd et al. Interstage Home Monitoring for Single Ventricle ahajournals.org/doi/10.1161/JA… #ACC21
👉Ahmed et al. Development of a validated risk score for interstage death or transplant after stage I palliation for single-ventricle heart disease jtcvs.org/article/S0022-… #ACC21
Of interest to the #CHD and #ACHD community, Matthew Gillespie of @HeartCare4Kids, a leader in transcatheter pulmonary valves, gave an update on the state of the art over in the Right Sided Valve Interventions session, and as he rightly points out, it all started with CHD! #ACC21
Who needs pulmonary valve replacement?
👉~40K babies born w/ #CHD each yr
👉~22% have RVOT abnormalities
👉For those w/ RV-PA conduits we've had Melody/Sapien valves
👉For the 85% of RVOT pts w/o conduits with PR, these usu won't work due to dilated/distorted/dynamic RVOTs #ACC21
Work that started ~2004 with Phil Bonhoeffer culminated in first-in-man implantation of a self-expanding RVOT valve reported in 2010 with several devices now available incl. the Medtronic Harmony devices and the Edwards Alterra combined with their Sapien valve in the US. #ACC21
In @abbykhanmd's talk Saturday, she highlighted three commonly used risk models for predicting adverse outcomes in pregnant women with heart disease: the modified WHO criteria, CARPREG II, and ZAHARA. #ACC21
Generally speaking, left-sided obstructive lesions (AS/MS) are known to impart the highest risk, while pulmonary valve disease and aortic regurgitation are regarded as relatively low risk and MR/TR fall somewhere in between. #ACC21
Keep this chart in mind. Pregnancy is a prolonged period of cardiovascular stress with increased cardiac output, plasma volume, and heart rate. Things get really interesting during labor/delivery with acute increases in BP and CO.
Various risk scores available: Modified WHO classification, CARPREG II, ZAHARA score. But clinical experience is extremely important since CHD patients are very heterogeneous and may not be well-represented in studies
Happy #VivienThomasDay! Today marks 110 years since the birth of Dr. Vivien Thomas. Although he never went to medical school, the surgical techniques he developed, such as the BTT shunt, are the foundation on which congenital heart surgery today was built. #CHD#ESCCongress2020
After graduating from high school, Thomas enrolled at Tennessee Agricultural & Industrial State College (now @TSUedu) as a pre-med. Unfortunately, the Great Depression depleted his savings, so he left college and found work as an assistant in Alfred Blalock's lab at @VUmedicine.
Blalock was doing research in traumatic shock and needed Thomas to help perform surgery on lab animals. Thomas learned quickly, and Blalock gave him more and more independence in the lab. Years later, surgical trainees who worked with Thomas would marvel at his surgical skill.
July 19, 1955, marked the last time that Dr. C. Walton Lillehei carried out a heart operation using the controlled cross-circulation technique. The patient was 5-year-old Paul Mathieu who was born with a ventricular septal defect. Here's a bedtime story for you history buffs...
In the early 1950s, few cardiac anomalies could be corrected or palliated. Valve stenosis had been treated with valvotomy. PDA and CoA had been repaired in 1938 and 1944. And kids with tetralogy of Fallot were being palliated with Blalock-Taussig shunts.
In 1951, the University of Minnesota’s Dr. Clarence Dennis made the first unsuccessful attempts to close atrial septal defects using a heart-lung bypass machine of his own design, but neither patient survived.
On the night of January 6, 1968, @StanfordMed surgeon Norman Shumway transplanted the heart of 43-year-old Virginia White into the chest of 54-year-old Mike Kasperak. It was the first adult heart transplant to be performed in the United States. #medhistory#DonateLife
By 1967, Shumway had already spent over a decade researching heart transplantation. In 1959, he and Richard Lower had performed the world's first successful heart transplant in a dog. Thus it was widely expected that he would be the first to perform a human heart transplant.
On Nov. 20, 1967, Shumway's team announced they were ready to attempt heart transplant in a human. However, just weeks later, on Dec. 3, Christiaan Barnard took the world, and Shumway, by surprise when he reported the world's first human heart transplant.