*For medical professionals only
On October 12, 2021, the domestic channel of China Structure Week 2021 and the 5th China International Structural Heart Disease Conference arrived as scheduled! The smooth holding of the first day's online live broadcast activities continued to be held, and the next day's online live broadcast activities continued to output high-quality academic views and theoretical content for the majority of clinical practitioners. Among them, "TAVR Channel" and "Left Atrial Ear and Other Channels" rely on several diversified and individualized academic sessions, based on the premise of international cutting-edge academic theory, to transmit the practical operation skills of bilobite TAVR, simple aortic regurgitation TAVR and different forms of left atrial ear LAAC, etc., and at the same time, with dozens of live operations, to stimulate the enthusiastic discussion of participating experts, through the collision of views and the fusion of thinking. It fully demonstrates the exquisite practical skills and keen thinking ability of domestic clinical practitioners. Among the many wonderful, it is also known as the Guangdong Provincial Hospital of Traditional Chinese Medicine
Professor Chen Qiuxiong's team and Professor Luo Jianfang of Guangdong Provincial People's Hospital
One of the team's joint efforts to take advantage of the recoverability of the VenusA-PLUS valve delivery system to achieve the best prognosis for patients by adjusting the valve position multiple times was the most high-profile live operation. Next, let's pick up the wonderful moments in the meeting again and enjoy the style of domestic magicians together!
TAVR channel
SESSION 1: Bilobite and TAVR
CHINA STRUCTURAL WEEK 2021
The first section of the China Structure Week 2021 TAVR channel live broadcast the next day focused on the treatment of TAVR with a special bipolar aortic stenosis, which was hosted by Professor Bu Jun of Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Professor Zhou Daxin of Zhongshan Hospital Affiliated to Fudan University, Professor Zhao Xianxian of Changhai Hospital Affiliated to Naval Military Medical University, Professor Zhang Qi of Shanghai Dongfang Hospital, Professor Chen Tao of the General Hospital of the People's Liberation Army of Chinese, Professor Jiang Xiaofei of Zhuhai People's Hospital, Professor Jiang Yu of the Second Affiliated Hospital of Nanchang University, Professor Jin Xian of Shanghai Sixth People's Hospital, Professor Liu Suxuan of Changhai Hospital Affiliated to Naval Military Medical University, Professor Peng Xiaoping of the First Affiliated Hospital of Nanchang University, Professor Yang Wenyi of the First Affiliated People's Hospital of Shanghai Jiao Tong University, Professor Zhang Xiaochun of Zhongshan Hospital Affiliated to Fudan University, and Professor Zhang Yuan of Zhongshan Hospital Affiliated to Fudan University held in-depth discussions.
In the lecture brought by Professor Zhou Daxin, by analyzing the advantages and disadvantages of balloon dilation in TAVR surgery, the importance of standardized operation of balloon dilation was emphasized, and the characteristics of bicuspid valve lesions in domestic patients were explained in depth: The preparation before bulb expansion, the operation points and size selection of bulb expansion, and the treatment of related complications were explained in depth; followed by the team of Professor Jiang Lei of the Affiliated Hospital of Qingdao University and the team of Professor Dong Nianguo of Wuhan Union Valve Intervention Center. The VenusA-PLUS recoverable valve delivery system and the VitaFlow valve system were applied respectively to bring two wonderful LIVE TAVR surgeries for patients with severe stenosis of the bicupid aortic valve. With the heated discussion between online and offline guests on valve release techniques, Professor Chen Mao of West China Hospital of Sichuan University combined evidence-based evidence and clinical practice experience to share in detail the application problems, challenges, research progress and innovative technologies of TAVR in patients with bicusular stenosis, and Professor Zhu Zhengbin of Ruijin Hospital affiliated to Shanghai Jiao Tong University School of Medicine shared a Type 0 bicused aortic valve severe stenosis with the assistance of Snare. At the end of the conference, the high-risk TAVR surgery brought by Professor Wang Jian'an and Professor Liu Xianbao of the Second Affiliated Hospital of Zhejiang University School of Medicine provided clinical practitioners with valuable experience and guidance for the treatment of TAVR in patients with aortic valve dibble dibble malformation.
SESSION 2: Structure Youth Show - CT
The cultivation of young practitioners is the backbone of domestic academic development, in the second session of the China Structure Week 2021 TAVR channel live broadcast the next day, Professor Wang Moyang of Fuwai Hospital of Chinese Academy of Medical Sciences was invited as the host, and Professor Li Lanlan of the First Affiliated Hospital of The Air Force Military Medical University, Professor Niu Guannan of Fuwai Hospital of Chinese Academy of Medical Sciences, and Professor Zhao Zhengang of West China Hospital of Sichuan University were invited as guests to discuss the latest research progress and applications based on imaging technology and 3D printing technology. Show the outstanding style of young cardiovascular surgeons in our country.
In the field of cardiovascular imaging, CT measurement based on supraval structure has long had many academic problems, Professor Niu Guannan pointed out that for the unique morphological differences and calcification distribution characteristics of patients with structural heart disease in China, the CT measurement of supraval structure is of great significance and guiding role for the design and selection of valves, but how to quantify the measurement of supraval structure and the direction of bifoliar valve opening has yet to be studied; while Professor Zhao Zhengang combines the clinical cases of adverse events after actual TAVR surgery. In-depth discussion on the significance and application value of CT after TAVR surgery for valve thrombosis. At the same time, Professor Li Lanlan pointed out that the advanced science and technology represented by 3D printing can bring major innovations to the field of cardiovascular intervention, which can not only meet the individual needs of patients, but also effectively improve the success rate of surgical operations in the form of actual simulation, bringing practical benefits to patients.
SESSION 3: Pure reflux TAVR and cross-lobe techniques
With the development of TAVR technology, the application of a new generation of valve devices and valve devices specifically applied to simple aortic regurgitation (AR) valve devices have been introduced, and ar minimally invasive treatment has increasingly shown better clinical effects. The third session of the second day of china structure week 2021 TAVR channel focused on the TAVR treatment of simple AR patients, and invited Professor Zhang Ruiyan of Ruijin Hospital Affiliated to Shanghai Jiao Tong University, Professor Pan Wenzhi of Zhongshan Hospital Affiliated to Fudan University, Professor Mei Ju of Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine as moderators, Professor Bai Ming of the First Hospital of Lanzhou University, Professor Chen Wei of Shanghai Tenth People's Hospital, Professor Du Run of Ruijin Hospital Affiliated to Shanghai Jiao Tong University, Professor Yang Yining of Xinjiang Autonomous Region People's Hospital, Professor Liang Xiangwen of the First People's Hospital of Yulin City, Professor Gao Liming of Shanghai Dongfang Hospital, Professor Fang Jun of Union Hospital Affiliated to Fujian Medical University, Professor Song Zhigang of Changhai Hospital Affiliated to Naval Military Medical University, Professor Xu Jizhe of the First Hospital of Lanzhou University, and Professor Zhu Zhengbin of Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine attended the session as guests of discussion.
In the lecture for patients with aortic regurgitation, Professor Zhang Juan of Nanjing First Hospital explained in detail the mechanism and adverse effects of cardiac remodeling caused by aortic regurgitation, and combined with a large number of evidence-based evidence and practical cases, emphasized the effectiveness and safety of TAVR in the treatment of AR patients, as well as the importance of reversing rational remodeling of heart disease. The flexible mastery of cross-valve techniques can effectively shorten the surgical time and reduce the risk of surgery for surgeons, in this topic, Professor Pan Wenzhi combined his own experience to explain the operation skills and complications of TAVR in the operation of the guide filament, helping more clinical practitioners master the TAVR surgical process.
In the live broadcast of the operation and the case sharing session, the team of Professor Yuan Yiqiang of Henan Chest Hospital found that the patient had suspected active vegetations or large blood clots on the coronary sinuses through esophageal ultrasound during the operation, and after intense discussion between online and offline experts, they believed that the operation was risky and might cause adverse postoperative results, and the operation was terminated after communicating with the family. Subsequently, Professor Wang Bin of the Affiliated Cardiovascular Disease Hospital of Xiamen University brought a case of TAVR surgery recording and sharing of a patient with severe aortic stenosis and mild reflux. During the operation, valve release and collateral protection are smoothly carried out under precise and standardized surgical procedures, so as to achieve good prognosis results.
The different anatomy of patients will bring different cross-valve challenges to the surgeon, and in the live broadcast of the operation of Professor Chen Mao's team of West China Hospital of Sichuan University, it shows how to perform TAVR surgery for patients with small left ventricular chest cavity and lengthy valves, reflecting his superb guide filament transvalvulus and valve selection and delivery skills. Due to the special anatomy, the difficulty of valve anchoring and release during the treatment of TAVR for rheumatic valvular disease is much higher than that of other valvular diseases, and in the live broadcast of surgery brought by the team of Professor Chen Qiuxiong and Professor Wang Xia of Guangdong Provincial Hospital of Traditional Chinese Medicine, Professor Luo Jianfang and Professor Li Jie of Guangdong Provincial People's Hospital were specially invited to the catheter room, and the recoverable characteristics of the VenusA-PLUS valve delivery system were used to make full use of the repositionable function, without causing other adverse postoperative effects. The successful release of the valve in the most suitable position fully demonstrates the surgeon's exquisite surgical skills and accurate grasp of the recoverable valve system.
Left atrial ear channel
SESSION 1: Blocking strategies for different forms of heart and ear
In addition to the TAVR channel, the left heart ear and other channels are also wonderful, in the first section of the next day's live broadcast of the left heart ear and other channels in China Structure Week 2021, Professor Jin Zening of Beijing Tiantan Hospital affiliated to Capital Medical University, Professor Liu Haitao of Xijing Hospital Affiliated to Air Force Military Medical University, Professor Wu Dongliang of Xiangyang Hospital of Yan'an University, Professor Xie Dujiang of Nanjing First People's Hospital, Professor Yu Bo of the First Affiliated Hospital of China Medical University, Professor Zhong Jingquan of Shandong Qilu Hospital were invited to host, Professor Bai Yuan of Changhai Hospital Affiliated to Naval Military Medical University, Professor Ding Haifeng of the Second People's Hospital of Baoji City, Professor Guo Fei of the First Affiliated Hospital of the University of Science and Technology of China, Professor Han Ke of the First Affiliated Hospital of Xi'an Jiaotong University, Professor Wang Yubin of Xuanwu Hospital of Capital Medical University, and Professor Zheng Wenqing of Weihai Central Hospital were the guests to explore the blocking strategies of different forms of the left atrial ear.
During this meeting, the team of Professor Cai Heng of The General Hospital of Tianjin Medical University shared two LAAC operations in the form of surgical recording, in the first operation, although the operation was very cautious and careful, the cauliflower-type left atrial ear still caused certain difficulties for the release of the sealing umbrella, and finally achieved the perfect sealing of the left atrial ear by changing the size and release position of the sealing umbrella; in the second operation, the former was fully learned and the surgical strategy was optimized, thus ensuring the smooth completion of the operation in a short period of time. In the heated discussion of the participating experts, the team of Professor Wang Zulu and Professor Sun Mingyu of the General Hospital of the Northern Theater and the team of Professor Liu Haitao of Xijing Hospital Affiliated to the Air Force Military Medical University each brought a case of radiofrequency ablation combined with one-stop surgery of left atrial appendage occlusion, and the imaging technical guidance for surgical strategies such as instrument selection was discussed in depth during the operation, and finally successfully completed the positioning and release of the blocker under the guidance of imaging tools such as ICE and transesophageal ultrasound.
Patients with cauliflower-type left atrial appendage not only have the highest rate of ischemic stroke complications, but also pose many challenges for surgery. Professor Li Yaodong, Professor Zhou Xianhui and Professor Li De of the First Affiliated Hospital of Xinjiang Medical University and Professor Li De's team of the General Hospital of the Western Theater of the Chinese People's Liberation Army respectively demonstrated a case of laAC of the cauliflower type left atrium, the former using one-stop cryoablation combined with left atrial appendage occlusion, while the latter adopted a simple left atrial appendage occlusion, under continuous exploration and discussion, the surgeon was able to successfully complete the release of the blocker by optimizing the surgical strategy and careful surgical operation.
AS a new technology applied to LAAC in recent years, ICE can help surgeons observe the internal structure of the heart more intuitively, and clearly demonstrated how to guide the laAC operation in the whole process of LAAC guided by ICE in the live operation of professor Chu Huimin's team of The First People's Hospital of Ningbo City, while the team of Professor Huang Weijian and Professor Xiao Fangyi of the First Affiliated Hospital of Wenzhou Medical University used TEE as an imaging guidance tool under the condition that patients tolerateDEE, and further explored the advantages and disadvantages of ICE and TEE. Together, it provides a demonstration of the LAAC surgical process with accurate imaging technology for the majority of surgeons.
SESSION 2: Left Atrial Ear Roundtable – Discussion of Left Atrial Appendage Techniques
Left atrial appendage occlusion is the preferred non-pharmacological treatment for atrial fibrillation stroke, and can be improved to a higher level if the occlusion strategy can be optimized, the details of the occlusion can be emphasized, and the operation technique can be improved. During the left atrial ear roundtable, Professor Zhang Xiaochun of Zhongshan Hospital Affiliated to Fudan University presided over the meeting, and invited Professor Chen Wei of Shanghai Tenth People's Hospital, Professor Li Yansong of Shanghai Songjiang District Central Hospital, Professor Ning Zhongping of Zhoupu Hospital Affiliated to Shanghai Health Medical College, Professor Zhong Wei of Meizhou People's Hospital and other well-known experts to conduct in-depth discussions on left atrial appendage sealing techniques.
Under the guidance of imaging, left atrial appendage occlusion has a very high surgical success rate and safety, but the special anatomy of the left atrial appendage will still bring greater surgical pressure to patients. In order to enrich the theoretical knowledge of the majority of clinical surgeons on the treatment strategy of special left atrial ear, Professor Ning Zhongping, Professor Chen Wei and Professor Li Yansong combined their own experience and actual cases, starting from the anatomy and surgical strategy of a variety of left atrial appendages, respectively, for how to apply different types of occlusors for patients with shallow left atrial appendage, open large heart ear and chicken wing left atrial ear laAC, which is of great significance to promoting the left atrial appendage occlusion technology of domestic surgeons and promoting more practitioners to join the left atrial appendage occlusion cause.
SESSION 3: LAAC blocker operation tips
In the third special session of China Structure Week 2021 Left Heart Ear and other channels broadcast live the next day, Professor Ding Haifeng of the Second People's Hospital of Baoji City, Professor Liu Xiongtao of Tangdu Hospital of Air Force Military Medical University, Professor Zeng Guangwei of Xi'an International Medical Center Hospital were invited to host, professor Qian Guoquan of Huzhou Central Hospital, Professor Xie Xuegang of the First Affiliated Hospital of Xi'an Jiaotong University, etc. were invited to conduct in-depth discussions on the operation skills of different types of LAAC blockers.
The one-stop radiofrequency ablation + LAAC surgery live broadcast brought by the team of Professor Jiang Xiaofei of Zhuhai People's Hospital adopts the segmented double adjustable curved left atrial appendage plugging guidance system independently developed in China to provide a personalized delivery program for the LAmbre left atrial appendage occlusion device, thus effectively simplifying the surgical operation of LAmbre left atrial appendage occlusion and improving the safety of surgery. The live operation of Professor Li Yan's team at Tangdu Hospital affiliated to the Air Force Military Medical University explored in depth how to perform LAAC surgery for patients with high stroke risk and bleeding risk under the guidance of ICE, and brought a wonderful one-stop operation of coronary angiography + radiofrequency ablation + LAAC under the superb operation of the surgeon and the professional guidance of the participating experts. Immediately after that, the team of Professor Yuan Yiqiang of Henan Chest Hospital brought a case of LAAC surgery of the chicken wing type left atrium, the surgeon was experienced and the anatomy of the left atrial appendage was appropriate, the operation progressed efficiently and rapidly, and the release process of the left atrial appendage occlusion umbrella was perfectly demonstrated; the live broadcast of the operation brought by the team of Professor Hu Hao and Professor Sun Shougang of the Second Hospital of Lanzhou University showed how to perform LAAC for the wind vane type left atrium with oval opening. At the same time, during the intraoperative operation, the experts attending the meeting were discussed in depth around the selection of the type of occlusion umbrella and the puncture site of the atrial septum.
Finally, in the live operation of professor Xu Yawei's team of Shanghai Tenth People's Hospital and professor Qin Yongwen team of Changhai Hospital affiliated to naval military medical university, the intervention of non-pulmonary vein trigger lesions or stromas can be realized in detail on the basis of pulmonary vein isolation, and the clinical benefits and problems brought by the correct use of cryoablation combined with left atrial appendage occlusion were discussed in depth for patients with persistent atrial fibrillation, while the team of Professor Fan Youqi of the Second Affiliated Hospital of Zhejiang University School of Medicine used 3D technology to reconstruct the left atrial opening and left ventricle. Provides important data support for radiofrequency ablation + LAAC one-stop surgery.
One-day overview
At the second day of the academic conference of china Structure Week 2021, the domestic "TAVR Channel" continued to explore the TAVR treatment strategy of patients with bipolar aortic valve and pure reflux, and conducted in-depth discussions on the experience of cross-valve in TAVR surgery and cutting-edge science and technology, while the "Left Atrial Ear and Other Channels" focused on the sealing strategy of different forms of the left atrial ear, and through dozens of live surgical demonstrations, showed the operation skills of the left atrial appendage occlusion clinical practice to the majority of surgeons. With the smooth convening of the first two days of the conference, China Structure Week will also continue to walk in the forefront of academic innovation and cultivate talents as a high-quality large-scale academic feast with global radiation scale; in the next few days, the domestic channel of China Structure Week 2021 will continue to be wonderful and reproduce miracles, looking forward to the presence and attention of more clinicians across the country to witness the daily live broadcast of Structure Week!
Source: Clinic Clinic New Horizons