Welcome to the 2O14 ISMICSScientific Meeting

Boston Welcomes the ISMICS Annual Meeting

2014 ANNUAL MEETING 28 - 31 May MARRIOTT COPLEY PLACE, BOSTON

MEETING HIGHLIGHTSWEDNESDAY

DON’T MISSPRESIDENTIAL ADDRESS

Friday, 15.45 - 16.30

Don’t Miss

the TWO live

issues of

the ISMICS

Insider,

available on

Thursday

and Friday,

and the post meeting issue that will

be available electronically.

(continued on page 3)

The ISMICS Annual Meeting is one of the foremost educational events forminimally invasive and forward-thinking thoracic and cardiovascular professionals.Boston, with its rich history and cutting-edge medical environment, provides the perfectsetting for an exceptional scientific meeting and outstanding social events.

In addition to the ISMICS Attendee Reception on Friday evening at the IsabellaStewart Gardner Museum, we encourage you to take full advantage of all that Bostonhas to offer. Obvious choices for the history aficionado are the Freedom Trail, FaneuilHall Marketplace and the Old State House. Boston is also well known for its worldclass museums, a thriving theater district, outstanding restaurants, and great localneighborhoods like the North End, Beacon Hill, and Back Bay. Boston is a walkingcity and you can experience most of the city’s highlights by putting on your comfort-able shoes and hitting the pavement. From the Marriott Copley Place, attendees arewithin steps of great shopping on Newbury Street, gastronomic delights for any taste,and a variety of entertainment options.

Almost as famous as Boston’s history are the city’s beloved sports teams andBoston’s teams have earned a reputation for excellence. Check out the Red Sox atFenway Park on Thursday evening when they take on the Atlanta Braves.

If you would just like to take a few minutes away from the rigors of the scientificsessions to enjoy the sights and sounds of the city, the Public Garden and BostonCommon are just a few blocks down Boylston Street.

Dear Colleagues;

It is my distinct pleasure to welcome you to the 2014 ISMICS Annual ScientificMeeting. This is an exciting opportunity to experience the newest and most innovativedevelopments in cardiac, vascular, and thoracic surgery. I am looking forward to thenext several days of outstanding scientific sessions and visiting with colleagues andfriends.

I am pleased to welcome Rory McDonald, PhD, MBA of the Harvard BusinessSchool as this year’s Keynote Speaker. Professor McDonald is an expert on DisruptiveInnovation and an authority on Competition and Innovation in Technology EnabledMarkets. His presentation will take place on Thursday morning at 11:15.

Please read the three issues of the ISMICS Insiderfor meeting highlights and coverage of the scientific andsocial events. Some of the sesions that I am particulatlyexcited to experience are the “Simulation-BasedTraining Program for Young Surgeons,” under thedirection of Drs. James Fann, Chrish Fernando, andDaniel Miller, which will take place today, and the highlyanticipated debate on “All Arterial OP-CAB VersusHybrid Revascularization” between ISMICS PastPresident Dr. John D. Puskas and Dr. Andrew C.Eisenhauer, will occur on Saturday.

We are excited to launch the Annual Meeting mobileapp for both Apple and Android based smart phones. This interactive guide to the meeting includesinformation on the program schedule, social events, exhibits, Sim City, posters, and more. If you have

Francis D. Ferdinand, MDThis is an excitingopportunity toexperience thenewest and mostinnovative devel-opments in car-diac, vascular, andthoracic surgery.

ISMICS MASTERS DAY

How I Do It Sessions

State of the Art Lectures

Focused Sessions on:

Endoscopic and Robotic

Coronary Revascularization

Innovations in TEVAR

Minimally Invasive and

Robotic Mitral Valve

New Innovations in LVAD

Treatment of Atrial

Fibrillation and Left Atrial

Appendage Management

Transcatheter Aortic and

Mitral Valve Technologies

Young Surgeons Track:

Simulation-Based Training

Program

Technical Challenges, Pitfalls& Disasters Dinner Session

Welcome Reception inExhibition Hall

OpportunityFind

in Change

Visit us at booth 404, and at Sim City where you can test your skills through hands-on simulation.

MICS Mitral Valve Repair and MICS CABG simulation: see the access and visualization you can achieve through a small thoracotomy and test your sewing skills for anastomosis or annular suturing.

CoreValve® Procedural Simulation: learn more about the CoreValve System, practice key imaging steps and test your skills on our virtual CoreValve deployment app.

CoreValve System: Please reference the Instructions for Use for more information regarding indications, warnings, precautions and potential adverse events. To download the complete Instructions for Use visit: manuals. Medtronic.com

CAUTION: Federal law (USA) restricts this device to sale by or on the order of a physician.

CoreValve is a registered trademark of Medtronic CV Luxembourg S.a.r.l.

UC201500159 EN © Medtronic, Inc. 2014. All Rights Reserved

Change is nothing new to Cardiac Surgeons

And with change comes opportunities…

opportunities that matter.

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201500159_EN.indd 1 5/8/14 1:01 PM

ISMICS INSIDER29 - 31 MAY

3www.ismics.org

Welcome from the President (continued from page one) A Message From Your ISMICS Executive Director

Aurelie M. Alger, JD

not yet downloaded it, please see the annoucement below and scan the barcode. Stay ontop of the latest news from the meeting.

Throughout the meeting we will be seeking your feedback via a text based Audi-ence Response System on some critical questions facing the organization, such as thefuture publication platform(s) for our journal Innovations, as well as topics for futureConsensus Statement Conferences. We value your feedback as we consider the future ofthese initiatives and strongly encourage you to reply when prompted.

INNOVATIONS, the official journal of ISMICS, has continued to grow along withISMICS. This year, ISMICS will again be presenting cash awards for the best manu-scripts submitted from papers selected for presentation. There is a $2,000 award for theBest Manuscript submitted before the Annual Meeting and a $1,000 award for the BestManuscript submitted within 60 days after the Annual Meeting. The recipients of thebest manuscripts submitted for the 2013 ISMICS Annual Scientific Meeting will beannounced during our Attendee Reception at the Isabella Stewart Gardner Museum.

Francis D. Ferdinand, MDPresident

The “Infamous” Theft at the Isabella Stewart Gardner Museum

Famous for its beautiful and extensive art collection, the Museum becamefront page news in 1990 when more than $500 million worth of priceless artworkswere stolen when two men disguised as Boston police officers talked their way intothe Museum and overpowered security guards. They escaped with what has beenreported as the greatest heist ever of stolen art, including Rembrandt’s Christ onthe Sea of Galilee; The Concert, one of only 34 definitive works by the Dutchmaster Johannes Vermeer; a Rembrandt etching; a Manet; and five Degas draw-ings. The thieves also took a Shang dynasty bronze beaker from China and aneagle-shaped finial from a Napoleonic flag.

The case has remained opened for the past 24 years and the FBI is stilloffering a $5 million reward for the return of the paintings. An update just lastweek reported that the agent heading the investigation says credible sources havetold the FBI they have recently seen some of the masterpieces.

Under the terms of Isabella StewartGardner’s will, the contents of her Italian-style palace on the Fenway must remain inthe arrangement she decreed, with nosignificant alternation. Therefore, theplaces where the stolen paintings hungremain empty.

Join ISMICS at the Isabella StewartGarder Museum on Friday evening forthe Attendee Reception and see if you canfind the spots where these masterpeicesonce hung.

ISMICS Members’ AnnualBusiness MeetingAll ISMICS members are requested toattend the Members’ Business Meet-ing, scheduled for Saturday morning,08.00-08.30 in the Grand BallroomSalon G-K.

It is with great pleasure that I welcome our ISMICSmembers and Annual Meeting Attendees to Boston.Having been born and raised in East Boston (think LoganAirport), and now living just a short distance north ofhere, it is always a joy to host people in our home city.Your ISMICS staff offices are located in Beverly, Massa-chusetts, and we are taking advantage of that proximity tohave several team members who work on ISMICS, butnever meet our members face to face, come into Boston

this year and see what ISMICS is about when we are all onsite. Please take a momentto stop by Registration or the ISMICS booth and meet the members of your ISMICSstaff team!

I am also delighted to be able to announce an ISMICS record – this year we havepassed all prior meeting pre-registration numbers, surpassing last year’s record pre-registration set in Prague. As I write this the weekend before our meeting, we have atotal of 493 professional registrations and 11 social registrations, for a total pre-registration of 504. And this does not even include our industry partners – so we arewell on the way to a new attendance record for the society.

Once again, we have many new features for ISMICS, including a significantlyexpanded “Sim City” which will offer not only continual training during our traditional

meeting, but a specially focused session on Wednes-day, aimed at providing a full day of hands-onexperience for our attending Residents and Fellows.We have also made outreach to the many medicalschools in the Boston area, to encourage theirstudents to come and see what our vibrant society canoffer.

Another new feature for ISMICS this year is acontinued expansion of our daily paper, and so I am“spreading the message” across our issues to allowfor more coverage of our day to day activities.

This year, your President Dr. Francis Ferdinandhas been a tireless advocate for ISMICS, bringing theISMICS message globally to several continents, aswell as here in North America. I first met Francis atour Annual Meeting in San Francisco in 2003, and hehas always worn his devotion to ISMICS on hissleeve. From his work on the Scientific Program, to

his service on the Board as a Director and then as Treasurer, he has never stoppedworking to advance the society. I want to offer a personal thank you to Dr. Ferdinandfor his energy, his dedication, his friendship, and his focus. It has been a busy, full, andbest of all, very fun year. Have a wonderful first day here in Boston!

~ Aurelie

Welcome Reception Tonight

Don’t miss theISMICS

Welcome ReceptionExhibition Hall

(Salons E-F)17.00 - 19.00

...your President Dr.Francis Ferdinand hasbeen a tireless advo-cate for ISMICS, bring-ing the ISMICS mes-sage globally to sev-eral continents, as wellas here in NorthAmerica..... he hasalways worn his devo-tion to ISMICS on hissleeve.

ISMICS INSIDER 2O14 ANNUAL MEETING

Marriott Copley Place, Boston4

2O14 ISMICS EXHIBITORSATRICURE, INC. Booth 4056217 Center Park DriveWest Chester, Ohio 45069 USA

www.atricure.comAtriCure is intent on reducing the global Afib epi-demic and healing the lives of those affectedthrough clinical science, education and innova-tion. We are a leading Afib solutions partner withthe only FDA-approved surgical treatment for Afiband most widely implanted occlusion device forleft atrial appendage management.

CORMATRIXCARDIOVASCULAR, INC.

Booth 3111100 Old Ellis Road, Roswell, GA 30076

www.cormatrix.comCorMatrix® Cardiovascular markets its ECM®Bioscaffold devices for carotid repair, pericardialrepair and reconstruction, and cardiac tissue re-pair, and is currently conducting preclinical stud-ies to evaluate future applications in other cardioand vascular applications.

COVIDIEN Booth 410555 Long Wharf DriveNew Haven, CT 06511

www.covidien.comCovidien is a leading global healthcare productscompany that creates innovative medical solu-tions for better patient outcomes and deliversvalue through clinical leadership and excellence.Please visit www.covidien.com to learn more.

DAVOL, A BARD COMPANYBooth 221

100 Crossings BoulevardWarwick, RI 02886

www.davol.comBARD is the market leader in comprehensive softtissue reconstruction. In addition to this exten-sive suite of products, our BioSurgery franchiseis delivering a growing line of enhanced seal-ants and hemostatic products to complementsurgical techniques across thoracic, cardiovas-cular, and other surgical specialties. This fran-chise is committed to serving our surgeons andclinicians by leveraging unique & proprietarymaterials science and continuing Bard’s focuson improving clinical outcomes.

EDWARDS LIFESCIENCESBooth 205

One Edwards Way, Irvine, CA 92614www.edwards.com/eu

Our cardiac surgery systems product line offersmarket-leading technologies that facilitate on-pump cardiac surgery procedures throughsmaller incisions. The Edwards Lifesciencesminimally invasive valve surgery system is com-prised of soft tissue retractors, venous and arte-rial cannulae, aortic occlusion, venting, and coro-nary sinus catheters, as well as reusable instru-ments for performing minimally invasive valvu-lar procedures.

ETHICON Booth 2154545 Creek Road, Cincinnati, Ohio 45242

www.ethicon.comEthicon US LLC , a Johnson & Johnson com-pany, commercializes a broad range of innova-tive surgical products, solutions and technolo-gies used to trat some of today’s most prevalentmedical issues, such as: colorectal and thoracicconditions, women’s health conditions, hernias,cancer and obesity. Learn more atwww.ethicon.com, or follow us on Twitter@Ethicon.

FEHLING INSTRUMENTSGMBH & CO. KG Booth 201509 Broadstone Lane, Acworth, GA 30101

www.fehling-instruments.de/enMinimal Access with Full Success! Possible withthe Fehling Minimally Invasive Cardiac SurgerySystem and CERAMOâ Micro Instruments. AllNEW Innovative Instrumentation and Retractorsare available now. Also take our new MICS MVRSimulator for a spin to refine your manual / tac-tile skills on a “Dummy”!

EXHIBITION HALL HOURS

EXHIBITION HALL - GRAND BALLROOM - SALONS E-F

Wednesday 28 May 17.00 – 19.00 (Welcome Reception at 17.00)

Thursday 29 May 07.30 – 11.30 &13.30 – 18.30 (Exhibit Hall Reception at 17.15)

Friday 30 May 07.00 – 10.30 & 13.30 – 16.00

MEALS & BREAKS

In addition to scheduled breaks, continuous beverage service is avail-able during the hours above. Continental breakfast is available in theExhibition Hall on Thursday and Friday mornings.

EXHIBITION HALL HOURS

MEALS & BREAKS

ISMICS INSIDER29 - 31 MAY

5www.ismics.org

2013-2014 BOARD OF DIRECTORS

PresidentFrancis D. Ferdinand, MD

Past PresidentAlan H. Menkis, MD

President-ElectVolkmar Falk, MD

Vice PresidentGregory P. Fontana, MD

SecretaryPaul F. Grundeman, MD, PhD

TreasurerVinod H. Thourani, MD

DirectorsNiv Ad, MDTohru Asai, MDJohannes Bonatti, MDAnson Cheung, MDChangqing Gao, MDMattia Glauber, MDYoung Tae Kim, MD, PhDFrancesco Maisano, MDDaniel L. Miller, MDSimon C. Moten, MDL. Wiley Nifong, MDRobinson Poffo, MDRalph A. Schmid, MDPiotr Suwalski, MD, PhD

Editor, INNOVATIONSRalph J. Damiano, Jr., MD

Managing Editor, INNOVATIONSCarol Blasberg

ISMICS InsiderThe official newspaper of the ISMICS

2014 Annual MeetingExecutive Director

Aurelie J. Alger, JDAssociate Executive Director

Elizabeth ChouinardIndustry Relations

Stan AlgerYvonne Grunebaum

Meeting DirectorE.J. Weldon

Meeting ManagerJillian West

Meeting CoordinatorEmma Celeste

Membership CoordinatorAdam Denhard

Managing Editor, ISMICS InsiderLorraine M. O’Grady

© Copyright 2014 International Society for MinimallyInvasive Cardiothoracic Surgery, 500 CummingsCenter, Suite 4550, Beverly, Massachusetts 01915,USA.Produced and distributed by ISMICS. All rights re-served. No part of this publication may be repro-duced or transmitted in any form, by any means, with-out written permission from ISMICS. The opinionsexpressed in this publication are those of the pre-senters and authors and do not necessarily reflectthe views of the Society.

GENESEE BIOMEDICAL, INC. Booth 317

1308 S. Jason Street, Denver, CO 80223www.geneseebiomedical.com

Design Beyond Standard. Genesee BioMedical,Inc. provides unique devices for cardiothoracicsurgery including sternal/thoracic valve retrac-tors for adult, adult congenital and pediatric car-diac surgery, instruments for MICS, coronarygraft markers, suture guards, retraction clips andaortic valve repair. Denver, CO USAwww.geneseebiomedical.com

INTUITIVE SURGICAL, INCBooth 204

1266 Kifer Rd, Bldg 101Sunnyvale, CA 94086

www.intuitivesurgical.comIntuitive Surgical is the global leader in minimallyinvasive, robotic-assisted surgery. Its da Vinci®System – with a 3D-HD vision system andEndoWrist® instrumentation – enables surgeonsto offer a minimally invasive approach for a rangeof complex procedures. da Vinci is used in morethan 2,500 hospitals around the world.

KLS MARTIN GROUP Booth 309PO Box 16369, Jacksonville, FL 32245

www.klsmartin.comKLS-Martin, a responsive company, is focusedon the development of innovative products for oral,plastic and craniomaxillofacial surgery. New prod-uct developments in our titanium osteosynthesisplating systems allow these products to be usedfor rapid sternal fixation and reconstruction.

LSI SOLUTIONS Booth 2117796 Victor-Mendon Road, Victor, NY, 14564

www.lsisolutions.comCOR-KNOT® delivers instant security with au-tomated knotting and integrated suture trimmingin one easy step. COR-KNOT® may reducecardiopulmonary bypass and cross-clamp timein your OR. Visit LSI SOLUTIONS® at booth211 to learn more.

MAQUET MEDICAL SYSTEMS,USA Booth 30545 Barbour Pond RoadWayne, NJ 07470

www.maquet.comMAQUET Medical Systems is a market leaderfocused on improving patient care and quality oflife. We offer a comprehensive portfolio of inno-vative products designed to meet the needs ofclinical professionals in the areas of:cardiothoracic and vascular surgery, thoracicdrainage, cardiac intervention, perfusion, anes-thesia and respiratory.

MEDISTIM Booth 31014000 25th Ave N. Ste. 108Plymouth, MN 55447

www.medistim.comMedistim offers validated technologies that re-duce post-CABG MACCE. The VeriQ C™ pro-vides a novel combination of our proven transittime flow assessment along with a 15 MHz ul-trasound probe, specifically designed forepiaortic and epicardial imaging.

MEDTRONIC, INC. Booth 404710 Medtronic Parkway NEMinneapolis, MN 55432

www.medtronic.comFind opportunity in change and considerMedtronic’s intuitive solutions in structural heartdisease, including tissue, mechanical andtranscatheter valves; irrigated RF and cryo sur-gical ablation devices; OPCAB, MICS CABG,cannulae, and perfusion products.

NCONTACT Booth 4141001 Aviation Pkwy, Ste.400Morrisville, NC 27560

www.ncontact.usnContact has taken a leadership position in thedevelopment of arrhythmia management programsto improve healthcare system savings. nContact’smission is to transform the underserved arrhyth-mia market through a multidisciplinary approachand the advancement of comprehensive, less in-vasive ablation alternatives.

PACIRA PHARMACEUTICALS, INC.Booth 214

5 Sylvan Way, Parsippany, NJ 07054www.pacira.com

Pacira Pharmaceuticals, Inc. is a specialty phar-maceutical company focused on the develop-ment of products that meet the needs of acutecare practitioners and their patients. Its lead prod-uct, EXPAREL® (bupivacaine liposome inject-able suspension), was launched in 2012.EXPAREL utilizes the Pacira proprietary deliv-ery technology DepoFoam®. For more informa-tion, visit www.pacira.com.

SCANLAN INTERNATIONAL,INC. Booth 401One Scanlan Plaza, Saint Paul, MN, 55107

www.scanlaninternational.comHighest quality surgical products designed andmanufactured by the Scanlan family since 1921.Over 3,000 titanium and stainless steel precisioninstruments including: VATS / MIS thoracoscopicinstruments, SCANLAN® Caliper and MEMORYinstruments, SCANLAN® LEGACY titaniumneedle holders and forceps. Single-use productsinclude SCANLAN® Aorta/Vein Punch, VASCU-STATT® bulldog clamps and graft markers.

SONTEC INSTRUMENTS, INC.Booth 416

7248 South Tucson Way, Centennial, CO 80112www.sontecinstruments.com

Sontec offers a comprehensive selection of ex-ceptional hand held surgical instruments, head-lights and loupes available to the discriminatingsurgeon. There is no substitute for quality, ex-pertise and individualized service. Sontec’s vastarray awaits your consideration at our booth.

SORIN GROUP Booth 31214401 W. 65th Way, Arvada, CO 80004

www.sorin.comSorin Group is a world leader in the treatment ofcardiovascular diseases. Our innovative prod-uct portfolio includes aortic and mitral valve re-placement and repair, perfusion equipment, can-nula and MICS instruments. For more informa-tion visit our web site at www.sorin.com.

ST. JUDE MEDICAL Booth 3151 St. Jude Medical DriveSt. Paul, MN 55117

www.sjm.comSt. Jude Medical is dedicated to transforming thetreatment of some of the world’s most expen-sive, epidemic diseases by creating cost-effec-tive medical technologies that save and improvelives of patients around the world. For more in-formation, please visit sjm.com.

TRANSONIC SYSTEMS INC. Booth 408

34 Dutch Mill RoadIthaca, NY 14850

www.transonic.comTransonic, the company that invented transit timeflow measurement, just created the next inno-vation for minimally invasive surgery. The newprobe enables you to measure and documentthe actual flow you have restored, even withinthe tight confines of a closed chest. Eliminateguesswork, and know your true graft flow.

VITALITEC Booth 21010 Cordage Park Circle, Ste. 100/200,Plymouth MA 02360

www.vitalitecusa.comVitalitec Geister is presenting SLS TM and 9TMLigation Clip Systems, Intrack? AtraumaticClamps, Cygent? Flexible Clamps. TheGreyhoundTM, NovaclipTM and SofiaTM bull-dogs as well as highlighting Enclose II Anasto-mosis Assist Device. The Geister? open andValveGate? MIS CV instrumentation. Innovative,high quality products with excellent service.

WEXLER SURGICALBooth 200

11333 Chimney Rock Road, Suite #110,Houston, Texas 77035

www.wexlersurgical.comWexler Surgical designs and manufactures avariety of titanium and stainless steel specialtysurgical instruments and products for Cardiac,Vascular, Thoracic, and Micro Surgery. Come seeour VATS/MICS instruments and ask about ourOptimus Series. Visit us online atwww.wexlersurgical.com for more informationabout our products and the services.

WOLTERS KLUWER HEALTHBooth 400

2001 Market StreetPhiladelphia, PA 19103

www.wolterskluwerhealth.comWolters Kluwer Health & First Choice for infor-mation, tools, and solutions to help profession-als deliver quality results more efficiently. Ourcustomer promise is to be the preferred globalprovider of information-enabled solutions to helpprofessionals manage processes and drive re-sults effectively.

ISMICS INSIDER29 - 31 MAY

7www.ismics.org

ISMICS 2014 Late Breaking News PresentationThursday, 11.00-11.15

Company: LSI SOLUTIONS®

Titanium Knots in Cardiac Surgery: The First Eight YearsDr. Candice Y. Lee

OVERVIEW: Since the pioneering study of titanium knot fasteners to secure sutures inheart surgery began at Lankenau Hospital in Philadelphia in March of 2007, over 800,000mechanical fasteners have been successfully placed in more than 50,000 cardiac pa-tients throughout the world. From securing annuloplasty rings to closing apical accesssites, over twenty-five different beneficial MICS and open applications have been re-ported. This review highlights many of the innovative uses of this emerging technologyand explores its potential to further enhance cardiac patient surgical outcomes.

MAQUET EDITORIAL: Can Routine Left Atrial Appendage Closure DuringOpen Heart Surgery Reduce Peri-Operative Stroke?

Sacha P. Salzberg, MD and Maximilian Y. Emmert, MD, PhD

Concern about peri-operative stroke remains the main factor for the decreasedAcceptance of coronary artery bypass grafting (CABG) despite its well documentedlong-term superiority in patients with three vessel disease and left main stenosis. Animportant technical advance has been the avoidance of aortic manipulation to reducestroke; yet, approximately half of CABG-related strokes occur in the post-operativeperiod surgery, and are most often related to new- onset atrial fibrillation (AF).1,2-4

New-onset AF is a common complication, occurring in close to 20% patientsfollowing CABG.2 Recent studies have documented increased incidence of stroke withnew-onset AF after CABG surgery. In a recent study of 16169 consecutive isolatedCABG patients with no prior history of AF, postoperative stroke risk was significantlygreater for patients who developed new-onset AF vs. those who did not (3.2% vs. 1.3%,p<0.001). Further, new postoperative AF was associated with a 21% relative increase inmortality over a mean follow up of 6 years, even after controlling for 32 covariates.

As with other forms of AF, the primary mechanism of stroke secondary to postop-erative AF is believed to originate from within left atrial appendage (LAA). In anotherrecent report (2067 patients, 81% CABG), postoperative AF was associated with anearly three-fold increase in stroke (OR=2.79). Among patients who developedpostoperative AF, those who had undergone concomitant LAA ligation had significantlylower risk of stroke than those who had not (0.0% vs. 6.1%, p=0.003)4

Shortcomings of past surgical approaches to LAA exclusion using sutures orstaples include risk of injury and incomplete closure. Further, neither sutures nor staplesprovide complete electrical isolation of the LAA, which has recently been confirmed asa trigger in the induction and maintenance of AF5 as well as AF recurrence followingcatheter ablation.6

New epicardial clip devices have been shown to provide easy, reliable, safe anddurable exclusion during cardiac surgery procedures, without leaks or significantresidual LAA cavity. 7,8 An additional benefit of epicardial device-enabled LAA iselectrical isolation.9 Silencing the LAA may be crucial in certain patients, underscoringthe incremental advantage of isolation of the LAA provided by epicardial clip ap-proaches.

Despite earlier conceptions as benign, postoperative AF carries significant risk forlate cerebral injury following non-eventful cardiac surgery. LAA closure may be animportant adjunct to all cardiac procedures to reduce the risk of postoperative AF-related cerebrovascular accident in selected patients. The current generation of epicar-dial LAA closure devices may make routine concomitant management of LAA easier,safer and more effective than past approaches.References1. Tarakji KG et al. JAMA. 2011 Jan 26;305(4):381-90.2. Almassi GH et al. Ann Surg. 1997 Oct;226(4):501-113. El-Chami MF et al. J Am Coll Cardiol. 2010 Mar 30;55(13):1370-6.4. Kim R et al. J Thorac Cardiovasc Surg. 2013 Feb;145(2):582-9;5. Hocini M et al. Heart Rhythm. 2011 Dec; 8(12):1853-61.6. Di Biase L et al. Circulation. 2010 Jul 13; 122(2):109-18.7. Emmert MY et al. Eur J Cardiothorac Surg. 2014 Jan;45(1):126-31.8. Slater AD et al. Ann Thorac Surg. 2012 Jun;93(6):2035-89. Salzberg SP et al. Ann Cardiothorac Surg. Jan 2014; 3(1): 75–77.

Focusing on innovative therapy solutions, MAQUET provides you with the highest quality products to enhance patient care, promote OR workflows, and help achieve optimal outcomes. Our comprehensive portfolio includes:

MAQUET is a registered trademark of MAQUET GmbH. ELITE-i is a trademark of MAQUET GmbH.

�� HYBRID OR

�� ELITE-i™ Dual Lumen Catheters

�� MIRA-i CS System for Minimally Invasive Cardiac Surgery

�� TIGERPAW® System II LAA Occlusion System

�� CARDIOHELP System

�� HEARTSTRING III

�� ACROBAT® System for Off-Pump Cardiac Surgery (OPCAB)

�� VASOVIEW HEMOPRO® 2 Endoscopic Vessel Harvesting

Dedicated to healthcare innovation for over 175 years.

AT ISMICS 2014, VISIT MAQUET BOOTH #305 www.maquetusa.com

PIONEER OF

THE PAST...

INNOVATOR OF

THE PRESENT.

MAQUET USA will donate $250 to Make-A-Wish® for any single purchase order of $50,000 or more (before tax, shipping and install) received between March 1, 2014 and February 28, 2015, with a minimum guaranteed contribution of $50,000, up to a maximum of $150,000. For more information about Make-A-Wish visit wish.org.

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symposium at ISMICS 2014

Seating is limited, register today!maquetevents.com/ismics-lunch-2014