This is the 3rd dimension - increasing array of therapeutic options for patients. He highlighted the multitude of options for aortic & mitral valve interventions available today
Next was a presentation by former ESC President and multi-modality cardiac imager Dr Jeroen Bax, who discussed the role and place of the Heart Team in the guidelines
Dr Bax explained the changes between the 2017 & 2021 ESC guidelines on VHD...explaining the reasons for including Heart Team discussions - usually for the most complex cases or ones in which several treatment options exist
A great flowchart showing the flow of care between networks
Last year, the @BrHeartValveSoc produced its Blueprint which discussed the importance of network-based care. Not all hospitals / centres have all options and expertise - and they don't all need to!
Then a very interesting talk (for me!) on whether imaging still leads to best decisions for patients - pleased to hear early on a resounding Yes from Dr Unbehaun!
Great example relating to V-in-V TAVI...imaging can tell you likelihood of coronary obstruction and thus whether the #BASILICA technique will be required
Over 70 transcatheter devices on the market; none suitable for all patients...and no Dr can be expert in all of these...so, have to select the right device for the right patient to be done by right operator(s) in the right centre...and that'll need a Heart Team
First talk from Prof Takkenberg, who needs no introduction to any of you. A very important talk in which she questioned the primacy of RCTs and spoke up on the importance of 'real world' registry data, often dismissed as poor quality
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 π§΅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
#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
This is a 𧡠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.