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

MEETING HIGHLIGHTSTHURSDAY

DON’T MISSKit Arom Lecture:Michael Mack, MD

Cardiac Master ClassesSuccessfully Kick off ISMICS 2014

W. Randolph Chitwood co-chaired “MinimallyInvasive and Robotic Mitral Valve.”

(continued on page 3)

Today’s Keynote Speaker: Rory McDonald

ISMICS Expanded Simulation Session

(continued on page 7)

The simulation-based training session on Wednesday, chaired by James Fann (Cardiac) and Hiran Fernando (Thoracic), pro-vided interactive, hands-on demonstration stations. Industry partners (who will also be participating in SIM City) included: ACUTEInnovations, AtriCure, Coviden, Edwards Lifesciences, Ethicon, Fehling Surgical Instruments, Intuitive Surgical, Karl Storz,Medtronic, Scanlan International, Siemens Healthcare, The Chamberlain Group, and Torax Medical.

Friday Morning10.00-11.00

ISMICS is excited to welcome Rory McDonald, PhD, as this year’s Keynote Speaker. ProfessorMcDonald is a Harvard Business School Professor, an expert on ‘disruptive innovation,” and an authorityon competition and innovation in technology-enabled markets. He will focus his presentation at 11.15today on “Creating New Growth through Disruptive Innovation.”

His research has won major awards and is consistently featured in top academic outlets, including theStrategic Management Journal. He received a 2014 Kauffman Junior Faculty Fellowship in Entrepreneur-ship Research, and was a finalist for best dissertation in Business Policy and Strategy by the Academy ofManagement. Drawing on in-depth fieldwork and archival data, Professor McDonald studies how

Cardiac Sessions Valve-Transcatheter

Therapies Revascularization Aortic & Endovascular

Thoracic Sessions Thoracic Master Class Lung Cancer Endoscopic Therapies for

the Thoracic Surgeon Mediastinum, Chest Wall

and Esophagus

Keynote Speaker:Rory McDonald, PhD

Lunch Symposia

ISMICS International Fellowsand Residents Luncheon -Trainees to Consultants

Exhibition Hall Reception

Poster Competition: Round 1

Jorg Kempfert and Francesco Maisano co-chaired “Transcatheter Aortic and Mitral ValveTechnologies.”

James Fann chaired the Simulation Sessionduring Wednesday’s Masters Day.

The ISMICS Masters Day program on Wednesday, launched the 2014 Annual Meeting with a standing room only crowd duringthe opening general session which included several state-of-the-art lectures and several “How I Do It” Live in a Box Video Presenta-tions. Following the opening session, the program split into three focused sessions and a hands-on simulation based training sessionfor young surgeons where several companies provided a unique and interactive session where participants could use equipment andperform complex procedures on live tissue.

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.

diac Surgeons

es opportunities…

ties that matter.

itration

lls fo

ocedmagin

p.

eference thrse events. T

ederal law (UValve is a reg

© Medtr

ardi

mes

nitie

raon

fo

edin

ths. T

(Uegi

tro

ittio

lls

roma

p.

refers

edVa

itration

lls fo

ro edma in

p.

eference therse events. T

ederal law (UValve is a reg

tr

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

ISMICS INSIDER29 - 31 MAY

3www.ismics.org

Master Classes on Wednesday Attracted “standing-room only” Audiences (continued from page one)

A Message From Your ISMICS Executive Director

Aurelie M. Alger, JD

Poster Competition: First Round Tonight at 17.00The ISMICS Poster Competition remains

one of the highlights of the Annual Meetingand provides attendees a unique opportunityto review their colleagues’ research. ThePoster Competition is a peer-reviewed sessionconducted in two rounds. The First Roundtakes place today from 17.00 - 18.00 withover 100 posters.

Topics include: Aortic & Endovascular Therapies, Arrhythmia Surgery,Imaging and Facilitating Technology for Cardiac Surgery, Congenital, Perfusion &Myxoma, Revascularization: Arterial & Left Side and Graft Strategies, ThoracicSurgery: Lung Cancer, Thoracic Surgery, Valve-Minimally Invasive: Aortic andMitral, and TAVI.

During these rapid-fire presentations, authors are allowed a maximum of threeminutes, with two minutes for discussion.Participants score each presentation on qualityof the presentation and significance of theresearch. Semi-finalists are selected for thefinal round and will be announced on Fridaymorning.

Final Rounds will be delivered from thepodium in the main scientific session on Fridayfrom 16.30 - 17.30. Presenters are again allowed a maximum of three minutes,followed by two minutes for audience questions and discussion. Judges will reviewand the winner will be announced on Friday evening during the Attendee Reception.

Good luck to all of the ISMICS poster presenters.Chief Moderator: Rex Stanbridge, MD

One of the pleasures we have with hosting theISMICS Annual Meeting here in Boston is the ability tobring in more members of our ISMICS team, as our homeoffices are located in Beverly, Massachusetts, about 20miles north of the city. Many of you know our “onsite”ISMICS team – consisting of me as your ExecutiveDirector, Elizabeth Chouinard as your Associate Execu-tive Director, Stan Alger as your Director of Marketingand Development, Yvonne Grunebaum as your Directorof Industry Relations, EJ Weldon as your MeetingDirector, Jillian West as your Meeting Manager andEmma Celeste as your Meeting Coordinator. But this

year we also have “on hand” your ISMICSInsider Managing Editor Lorraine O’Grady,your Membership Coordinator Adam Denhard, your Exhibit Manager Kim Derr, andMolly Canfield and Kristina Makoci, who work on ISMICS in membership support andindustry, respectively. Our Director of Technology, Max Rossin, also joined us onWednesday and met with our Board of Directors. And while I am introducing “theteam” – more of our staff back at the office includes Meg Bowen, Grants Specialist,Kerri Natale, CPA, Rhonda Harvey, Bookkeeper, Keri Cloak, Member InformationServices Specialist, Maria Favazza, Administrator, Samantha Gendron, Receptionist,and our extended technology team consisting of Olivera Afife, John Hintlian andAnthony Cucuzza.

So while you may see 6 or 7 of us throughout the year, as you can tell – yourISMICS staff team is a large one. We all hope that ISMICS 2014 is turning out to beeverything you hoped for! Aurelie

Michael Halkos chaired the sessionon Endoscopic and Robotic CoronaryRevascularization which included asession on “How to Develop a HybridProgram” by Francis Sutter. Dr. Sutteropined that surgeons and cardiologists canbe a team and that “cardiologists arechomping at the bit to do a hybridprogram.” He further defined the require-ments for a successful program includinga cardiologist champion, administratorswho believe in the program, adequatetraining and preparation for the team, andletting go of the philosophy that you haveto bypass everything.

Wilson Szeto chaired the session onInnovations in TEVAR which included sixpresentations on various repairs andtreatments for aortic dissection. Thesession concluded with an interactivedialogue between the presenters and theaudience, reviewing a series of cases anddiscussion of current, real-world practices.

A capacity crowd filled the session onMinimally Invasive and Robotic MitralValve, chaired by W. Randolph Chitwood,Jr. and Tomislav Mihaljevic. The sessionincluded why and when discussions, aswell as a review of the perils and pitfallsof both MI and robotic surgery.

During the afternoon session onTreatment of Atrial Fibrillation and LeftAtrial Appendage Management, co-chaired by Gorav Ailawadi and TimoWeimar, James Cox presented to a fullroom as he dispelled the confusion relatedto the Maze-Principle. Dr. Cox discussed

the problems and unintended conse-quences with procedures I, II, and III andreviewed the evolution to the current IV.In summary, he noted that a maze patternis the only proven method of interruptingall potential macro -reentrant circuits inthe atrium while leaving the atriumcapable of resuming a normal sinusrhythm and while there are a number ofmaze patterns that will accomplish bothgoals, many are fraught with un-suspecteddetrimental consequences.

The focused session on New Innova-tions in LVAD Therapy, co-chaired by JanGummert and Mark Slaughter, discussedthe various new devices and develop-ments in ventricular assist devices. ArntFiane reviewed his institution’s experi-ence and results using Heartware andpreviewed other minimally invasivedevices and the future of the technology,noting “that surgeons are very creativeand when given the tools, we will findways to make it better.”

Jorg Kempfert and FrancescoMaisano co-chaired the focused sessionon Transcatheter Aortic and Mitral ValveTechnologies. Brief presentations wereinterwoven with discussions and how-topresentations including most of thecurrent, state-of-the-art devices. During areview of the JenaValve Cathlete and

Cathlete Plus, Ardawan Rastan presentedthe results of the JUPITER Registry andsummarized the safety and effectivenessof the JenValve TAVI Plus System, citingthe low incidence of significant PVL andstroke, excellent hemodynamic perfor-mance, improved results, and sustainedsurvival.

Husam Balkhy presented “AnastomoticConnectors in Robotic Assisted CABG

Arnt Fiane presented “Heartware - A TrueMinimally Invasive Approach”

G. Chad Hughes (podium) Wilson Szeto, chair,“Innovations in TEVAR.”

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

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

EXHIBITION HALL HOURS

MEALS & BREAKS

In addition to scheduled breaks,continuous beverage service isavailable during the hours above.Continental breakfast is availablein the Exhibition Hall on Thursdayand Friday mornings.

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

McDonald Presents Keynote (continued from page one)

executives develop viable strategies,navigate disruptive threats and opportuni-ties, and acquire resources that improvetheir chances for success.

“Business has to have one foot in thereal world and another in the world ofideas,” explains Rory McDonald, Ph.D.It’s what inspires and drives his workwithin new markets, at the intersection ofstrategy, entrepreneurship and technologymanagement.

Industry leaders can get blindsided bydisruptive innovations because they focustoo much on their most profitable custom-ers and businesses. Rather than beingdestroyed by them, Professor McDonaldshows companies how to create their owndisruptions, discover and nurture the bestideas and create entirely new markets. He

studies how firms compete in newmarkets—examining both stalwarts andstartups—and offers leaders a new way ofthinking about market forces and competi-tive strategy.

Before joining Harvard BusinessSchool, Professor McDonald was on thefaculty at the University of Texas atAustin where he received the CBAFoundation Teaching award. He has alsotaught courses for executives, businessstudents and engineers at HarvardUniversity and Stanford University.Though Professor McDonald’s passion isin teaching, he is a member of the boardof YCG Funds, an Austin-based mutualfund company, and an advisor to severalbusiness ventures.

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

Sacha P. Salzberg, MD and Maximilian Y. Emmert, MD, PhDConcern about peri-operative stroke remains the main factor for the decreased

Acceptance 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.

Scan for more informationand to register

Attend the MAQUET sponsored luncheon

symposium at ISMICS 2014

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