The Beat With Joel Dunning Ep. 162: Lifetime Management of Aortic Valve Disease

This week on The Beat, CTSNet Editor-in-Chief Joel Dunning spoke with Dr. Isaac George, CTSNet Board Member and Co-Director of the Structural Heart and Valve Center, Surgical Director of Structural Heart Disease, and Co-Director of the Mitral and Tricuspid Center at Columbia University Medical Center/NewYork-Presbyterian, NY, USA, about the lifetime management of aortic valve disease.

Chapters

00:00 Intro

02:11 AATS-CTSN Randomized Trials

04:37 JANS 1, Consensus Statement ALAD

10:28 JANS 2, Lung Re-Transplantation Outcomes

12:19 JANS 3, Aortic Homografts, EURECAH

15:15 JANS 4, Lobectomy Cost Analysis

18:10 Video 1, Anomalous L Coronary Artery

19:38 Video 2, Pulm Valve Replacement Reop

21:38 Video 3, Giant Pulm Artery Aneurysm

23:28 Dr. George Discussion

33:18 Upcoming Events

34:05 Closing

They explored the expansion of transcatheter aortic valve replacement (TAVR), emphasizing the crucial role of the heart valve team in this process. The discussion highlighted the necessity for surgeons to be actively involved in the decision-making process surrounding TAVR, particularly in the early stages. They also addressed the importance of lifetime management of the valve, selecting the appropriate valve, and valve durability. Additionally, they discussed the significance of providing patients with multiple surgical options, the Ross procedure, mechanical valves, and explored which procedures patients are choosing.

Joel also highlights recent JANS articles on the ISHLT consensus statement on acute lung allograft dysfunction, aortic homografts for native and prosthetic aortic valve and root endocarditis, how outcomes after lung re-transplantation for restrictive allograft syndrome have not improved over two decades, and the financial burden of postoperative adverse events following lobectomy.

In addition, Joel explores the surgical repair of an anomalous left coronary artery from the right pulmonary artery, minimally invasive pulmonary valve replacement in reoperative settings, and surgical management of giant pulmonary artery aneurysm using a T-shaped graft-valve strategy.

Before closing, Joel highlights upcoming events in CT surgery.

JANS Items Mentioned

1. ISHLT Consensus Statement on Acute Lung Allograft Dysfunction (ALAD): Definition, Etiology, Diagnostic and Therapeutic Approaches, and Research Priorities
2. Aortic Homografts for Native and Prosthetic Aortic Valve and Root Endocarditis: Results From the EUropean REgistry of Cryopreserved Aortic Homografts EURECAH
3. Outcomes After Lung Re-Transplantation for Restrictive Allograft Syndrome Have Not Improved Over Two Decades
4. Financial Burden of Postoperative Adverse Events Following Lobectomy: Cost Analysis From 10 High-Volume Canadian Hospitals

CTSNet Content Mentioned

1. Surgical Repair of an Anomalous Left Coronary Artery From the Right Pulmonary Artery
2. Minimally Invasive Pulmonary Valve Replacement in Reoperative Settings