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Innovation at the 2018 ISMICS Annual Meeting
The 2018 Annual Meeting of the International Society for Minimally Invasive Cardiothoracic Surgery (ISMICS) took place in Vancouver, Canada, in June. Among the meeting sessions were the Subramanian Innovation Award Presentations, where three finalists presented minimally invasive cardiothoracic surgery innovations in competition for $5,000 to support the implementation of their innovation. The Subramanian Innovation Award was established in 2016 through a generous donation to the ISMICS Research and Education Fund from Dr Valavanur Subramanian, Past President of the Society and founding ISMICS member. The innovations were evaluated by a three-judge panel, with a fourth vote taken from a live poll of the audience. Points were awarded on a multicategory scale, which considered, among other aspects, the importance of the problem being addressed and the realistic nature of innovation implementation.
The session began with an update from 2017 awardee Muralidhar Padala of Emory University in Atlanta, Georgia, USA. His innovation was an implantable device designed to extend the edge of valve leaflets to treat functional mitral and tricuspid regurgitation. He has been working on the development of guide and delivery catheters for the device and showed in vivo feasibility with device deployment in a pig model.
The first innovation vying for the 2018 award was presented by Enrico Ferrari of the Cardiocentro Ticino Foundation in Lugano, Switzerland. Observing that patients who need both their aortic valve and aortic root replaced have only surgical options available to them, he presented the early development of a transcatheter aortic root replacement. Dr Ferrari and his colleagues have compared different synthetic materials, evaluated ideal techniques for connecting the device to the coronary arteries, and completed preliminary hydrodynamic tests in a prototype device. The second innovation was presented by Luigi Pirelli of Lenox Hill Hospital in New York City, New York, USA. He presented triple fusion imaging, which integrates echocardiography, magnetic resonance imaging, and fluoroscopy for guidance in percutaneous structural heart interventions. Though he demonstrated the application of triple fusion imaging with a relatively simple atrial septal defect closure, Dr Pirelli emphasized that the imaging guidance would be most useful for more challenging procedures.
The final innovation and ultimate winner of the 2018 Subramanian Innovation Award was perhaps the most simple of the three submissions. Faouzi Safadi of Dubai Hospital in the United Arab Emirates presented the Dubai sliding stitch, which more easily ensures accurate length of artificial chords in mitral repair. The chord length can be adjusted after the knot is placed; once accurate length is confirmed, the knot is locked.