#EACTS2021
The C TAH is probably the world's most advanced total artificial heart & is designed for patients with severe biventricular failure (i.e. for whom an LVAD would be insufficient).
It gained a CE mark last year and has an FDA approval for early feasibility studies
C TAH has 2 chambers, separated by a membrane into blood & fluid compartments. Electro-hydraulic pumps help produce pulsatile flow. Pressure sensors & electronics are embedded in the prosthesis. Biological valves are placed at the inlets and outlets of the ventricles
Prof Netuka shared an example of a 61yr old patient with severe BiV failure and fixed pulm HTN that could not be weaned from IABP and inotropic support
A Cardiomems device is placed as well to assist monitoring of pulmonary pressures
Well deserved round of applause at the end!
Eager to see where this technology goes. It's not new. I think Carmat started work on this in the early 1990s, initially a collaboration between Alain Carpentier & engineers from a subsidiary of Airbus. More tomorrow!
If someone has already lived far past the average life expectancy in their country and is now into their 90s, can we *promise* the patient that TAVI will make them live longer?
In our centre, we feel that patients >90 need to be very motivated to have a procedure
This is a 🧵all about Transcatheter Mitral Valve Implantation (TMVI). If you don't know a lot about this and want to learn more - read on! This is a summary of a great expert focus session
First talk from Dr Gry Dahle (Oslo), on why TMVI is not the same as TAVI
TAVI has revolutionised treatment of aortic stenosis; TMVI is further behind largely due to anaromical complexity of treating the MV compared to the AV - the AV valves are much more complex than the semilunar valves!
Abstract session on Hot Topics in Transcatheter Therapies
Presentation from Dr Justin Robinson on use of TAVI in patients with very large aortic annuli - Results from the Michigan TAVI Quality Collaborative
#EACTS2021
Methods here: just over 200 patients with aortic annuli in excess of the normal ranges for both the Edwards Sapien and Medtronic Corevalve systems
This is a 🧵 about physical examination, and what role it (still) plays in modern clinical practice. Decided to write this after seeing a post earlier this yr by @RichardLehman1 on this issue and some people replying that examination was much less relevant in the modern era
I'd like to share 3 case examples of why I don't believe that is true. POCUS is a valuable *adjunct* to the initial clinical assessment, which includes both history & exam (H&E). The H&E should direct which tests you want & what Q you're asking
1. MR case 2. AS case 3. HF case
Case 1
Pt referred to @UHS_valveclinic with new murmur. Completely asymptomatic, very fit & active. Phys exam revealed a prominent systolic murmur, no other abN findings.
1/ I know some of us have already had a brief discussion about this, but this is the most astonishing presentation I have seen in a long time.
We should discuss!
I must stress, I have *not* seen the actual presentation, I've seen the slides & write up on TCTMD only
2/ This study is derived from the TVT registry, looking at TAVIs with the Sapien 3/Ultra between 2015-2020
Of 159661 TAVIs, 37660 were in low risk patients (STS score <3%) & 3243 had bicuspid AV. They've propensity score matched to compare TAVI in BAV vs trileaflet AV valves
3/ Almost all the BAV pts made it into the propensity score-matched group (3168/3243 = 97.7%)