The Unplanned Plan B: SAVR After TAVR

In this episode, we are joined by Dr. Emile Bacha to discuss the emerging field of partial heart transplantation. The conversation explores the history of the concept, its reintroduction in recent years, and how techniques such as domino procedures are being developed to expand donor availability. Dr. Bacha explains the practical challenges of regulation, organ procurement, and immunosuppression, as well as early outcomes seen in paediatric patients. With reflections on valve durability, patient growth, and the future potential of this approach, this episode offers a detailed look into a promising area of congenital cardiac surgery and beyond.

In this episode, our hosts are joined by Sabine Bleiziffer and Augusto D’Onofrio to discuss SAVR after TAVR - exploring key decision-making factors, including valve selection, explantation techniques, and patient-specific risk profiles. The guests share experiences with challenging cases, technical tips, and thoughts on how procedural volume, planning, and shared decision-making can impact outcomes. We also consider the future of lifetime valve management and what young surgeons need to know as this field continues to evolve.

This month’s episode focuses on the complex management of acute aortic dissection. Our hosts are joined by Florian Schoenhoff and Chris Malaisrie to discuss current strategies in surgical planning and intraoperative decision-making. Topics include CT-based assessment, cannulation techniques, malperfusion management, and valve preservation. The conversation also considers how to optimise outcomes, the role of conservative management in select cases, and the potential future impact of endovascular approaches. Listen for a practical overview of key considerations in this complex procedure.

Recorded at the AATS annual meeting in Seattle, our hosts are joined by Dr. El-Hamamsy & Dr. Ouzounian to explore the resurgence of the Ross procedure. The discussion covers the evolving evidence base, training requirements, and technical considerations surrounding this increasingly prevalent operation. Dr. El-Hamamsy and Dr. Ouzounian share their own learning curves, views on centralising care, and the importance of surgical volume for patient outcomes. Listeners will also hear about best practices in patient selection, graft support strategies, and the future of Ross—including potential innovations to expand access globally.

In this thought-provoking discussion, our hosts explore the multifaceted world of leadership in cardiac surgery. Joined by Shirin Bemelmans-Lalezari and Volkmar Falk, we delve into how leadership styles evolve, the balance between authority and empathy, and the importance of team dynamics. Learn of the real-life challenges in managing surgical teams and navigating hierarchy. With insights from both clinical and coaching perspectives, this episode offers valuable reflections for anyone considering or currently in a leadership role within cardiothoracic surgery.

We are pleased to announce the first of a new series of upcoming episodes, titled ‘Pulse Check – Key Papers at a Glance’. Our host Can discuss two recent and impactful EJCTS articles on infective endocarditis. Joined by the renowned, Michael Borger and Torsten Doenst, we explore firstly the implications of preoperative septic cerebral embolism for patients undergoing valve surgery. Then followed by an exploration into the use of haemoadsorption therapy, addressing the key issue of controlling inflammation during cardiac surgery for endocarditis. Listen to gain rapid insight into the associated articles: Effect of haemoadsorption during cardiac surgery for Staphylococcus aureus endocarditis: a REMOVE trial post hoc analysis Outcomes following heart valve surgery in patients with infective endocarditis and preoperative septic cerebral embolism: insights from the CAMPAIGN study group'

Are you curious about the origins and future of aortic root enlargement surgery? In this episode, our hosts discuss the surgical horizons of this underutilised technique. Featuring the well-respected Bo Yang, Can Gollmann-Tepeköylü and Miia L Lehtinen explore the creation of this innovative technique, as well as its reputation and utility in the surgical community. Listeners can expect to hear firsthand how Dr Yang discovered his esteemed procedure, as well as detailed comparisons to similar interventions and how patient suitability is assessed.

Are you looking to deepen your understanding of perioperative medication? Join us for the first episode of 2025, where we offer listeners an author insight into the recently published ‘2024 EACTS Guidelines on perioperative medication in adult cardiac surgery’. With working group members Anders Jeppsson and Emma Hansson, our host Miia L Lehtinen explores the fundamental intricacies considered to ensure these diverse guidelines are current and clinically applicable. Discussions include how the varied specialities of clinical intervention contribute to individual patient needs, including indication specific medication schedules, and the nuanced effects these bring to patients. We also encourage our listeners to view the recently published perioperative guidelines here: https://academic.oup.com/ejcts/advance-article/doi/10.1093/ejcts/ezae355/7815986?searchresult=1&login=false

In our final episode of the year, our hosts discuss the notorious complexities of the tricuspid valve, joined by specialists Nikos Bonaros and Victoria Delgado. Join Miia L Lehtinen and Can Gollmann-Tepeköylü in their exploration of the increasing relevance of tricuspid valve interventions, analysing the dynamic considerations of diagnostics, imaging, anatomy, cardiology and surgical interventions. Listeners can expect to learn of the fundamental principles of tricuspid disease, as well as how experts navigate nuanced challenges faced in challenging cases.

Join our hosts Can Gollmann-Tepeköylü and Miia L Lehtinen for their late-breaking trials highlights presented at the 38th EACTS Annual Meeting in Lisbon, including: (0:39 - 4:31) Long-term mortality after PCI or CABG in patients with diabetes and multivessel coronary artery disease: A SWEDEHEART study by Dr Emma C Hansson (4:32 - 8:33) Long-term (>10 years) results of transcatheter Mitral valve-in-valve implantation for degenerated surgical mitral bioprosthesis: Italian MItral VIV registry (MIVIV registry) by Dr Edoardo Zancanaro  (8:34 - 11:55) Personalized multimodal teleprehabilitation in elective cardiac surgery: results from the Digital Cardiac Counselling multicentered randomized Controlled Trial (ClinicalTrials.gov number, NCT04393636.) by Dr Bart Scheenstra   (11:55 - 16:15) 5-Year Results on Aortic Remodeling in the Dissected Aorta Repair Through Stent (DARTS) Implantation Trial by Dr Ryaan EL-Andari (16:16 - 19:49) Clinical impact of continuous postoperative pericardial flushing on bleeding-related complications after cardiac surgery by Dr Robert Klautz