First AATS Mitral Conclave a Success

The first-ever AATS Mitral Conclave was held on May 5^th and 6^th. The world’s leading experts in mitral valve disease convened to discuss management guidelines, imaging, pathology, minimally invasive procedures, percutaneous approaches, surgical techniques, devices, and long-term results.

"With 39 faculty and 250 presentations, including selected abstracts and videos, our goal was to have a comprehensive meeting focused on mitral valve disease that would allow attendees to gain exposure to all of the common approaches used in the top centers throughout the world," said Program Director David H. Adams, MD. "We continue to see tremendous progress in our understanding of mitral disease intervention, and a great interest among surgeons in learning and advancing mitral valve repair strategies," said Dr. Adams, chairman of the department of cardiothoracic surgery at the Mount Sinai Medical Center, New York.

More than 1,000 individuals – including about 800 physicians – from 66 countries participated. Industry support was provided by Edwards Lifesciences LLC (Premier Platinum), Metronic, Inc. (Platinum), Abbott Vascular (Gold), Sorin Heart Valves (Gold), and St. Jude Medical Inc. (Bronze).

"I figured we might get 250 physicians, and would have considered that a success. This is fantastic," said AATS President Irving L. Kron, MD.

Presentations included lectures, expert video sessions, and "Presentations on Demand," accessible on video screens positioned in the exhibit hall. In a plenary address, Robert O. Bonow, MD, said that current valvular heart disease guidelines are based largely on expert opinion rather than evidence from clinical trials. Referring to the 2008 revised joint guidelines from the American College of Cardiology/American Heart Association and the 2007 European Society of Cardiology guidelines, he said, "Unfortunately, the evidence base underpinning them is limited by an inadequate number of randomized clinical trials. We really need to provide more evidence-based information to devise true guidelines and performance measures."

The question of whether mitral valve repair should be considered in all patients with severe mitral valve regurgitation is still being debated.

"It’s at least likely that certain patient subsets would benefit, but current data are insufficient to determine which ones," said Dr. Bonow, of Northwestern University. As an example of ambiguity, U.S. guidelines recommend that patients considered eligible for repair be referred to an "experienced center," but don’t provide criteria for determining that status. Moreover, individual surgeon volume and experience clearly predict successful mitral repair outcomes, even within one institution.

Dr. Bonow is optimistic that useful data will come from two ongoing trials sponsored by the National Heart, Lung, and Blood Institute via the Cardiothoracic Surgical Trials Network.

Dr. Adams presented the Mitral Conclave Career Achievement Award to the legendary Alain F. Carpentier, MD, whose 1983 landmark paper, "Cardiac Valve Surgery – the ‘French Correction,’ " is credited with heralding the modern era of mitral valve reconstructive surgery. Professor Carpentier delivered the Conclave Honored Lecture.

A series of "mini debates" addressed controversies surrounding the use of annuloplasty rings (flexible versus remodeling versus no ring at all), minimally invasive surgery (for all patients versus for some), and the correct approach for specific clinical scenarios of tricuspid valve disease.

The next Aortic Symposium will be held April 26-27, 2012, and the next Mitral Conclave will take place May 2-3, 2013, both in New York. Proceedings from the 2011 Mitral Conclave will be published in an upcoming supplement to The Journal of Thoracic and Cardiovascular Surgery.n

The first-ever AATS Mitral Conclave was held on May 5^th and 6^th. The world’s leading experts in mitral valve disease convened to discuss management guidelines, imaging, pathology, minimally invasive procedures, percutaneous approaches, surgical techniques, devices, and long-term results.

"With 39 faculty and 250 presentations, including selected abstracts and videos, our goal was to have a comprehensive meeting focused on mitral valve disease that would allow attendees to gain exposure to all of the common approaches used in the top centers throughout the world," said Program Director David H. Adams, MD. "We continue to see tremendous progress in our understanding of mitral disease intervention, and a great interest among surgeons in learning and advancing mitral valve repair strategies," said Dr. Adams, chairman of the department of cardiothoracic surgery at the Mount Sinai Medical Center, New York.

More than 1,000 individuals – including about 800 physicians – from 66 countries participated. Industry support was provided by Edwards Lifesciences LLC (Premier Platinum), Metronic, Inc. (Platinum), Abbott Vascular (Gold), Sorin Heart Valves (Gold), and St. Jude Medical Inc. (Bronze).

"I figured we might get 250 physicians, and would have considered that a success. This is fantastic," said AATS President Irving L. Kron, MD.

Presentations included lectures, expert video sessions, and "Presentations on Demand," accessible on video screens positioned in the exhibit hall. In a plenary address, Robert O. Bonow, MD, said that current valvular heart disease guidelines are based largely on expert opinion rather than evidence from clinical trials. Referring to the 2008 revised joint guidelines from the American College of Cardiology/American Heart Association and the 2007 European Society of Cardiology guidelines, he said, "Unfortunately, the evidence base underpinning them is limited by an inadequate number of randomized clinical trials. We really need to provide more evidence-based information to devise true guidelines and performance measures."

The question of whether mitral valve repair should be considered in all patients with severe mitral valve regurgitation is still being debated.

"It’s at least likely that certain patient subsets would benefit, but current data are insufficient to determine which ones," said Dr. Bonow, of Northwestern University. As an example of ambiguity, U.S. guidelines recommend that patients considered eligible for repair be referred to an "experienced center," but don’t provide criteria for determining that status. Moreover, individual surgeon volume and experience clearly predict successful mitral repair outcomes, even within one institution.

Dr. Bonow is optimistic that useful data will come from two ongoing trials sponsored by the National Heart, Lung, and Blood Institute via the Cardiothoracic Surgical Trials Network.

Dr. Adams presented the Mitral Conclave Career Achievement Award to the legendary Alain F. Carpentier, MD, whose 1983 landmark paper, "Cardiac Valve Surgery – the ‘French Correction,’ " is credited with heralding the modern era of mitral valve reconstructive surgery. Professor Carpentier delivered the Conclave Honored Lecture.

A series of "mini debates" addressed controversies surrounding the use of annuloplasty rings (flexible versus remodeling versus no ring at all), minimally invasive surgery (for all patients versus for some), and the correct approach for specific clinical scenarios of tricuspid valve disease.

The next Aortic Symposium will be held April 26-27, 2012, and the next Mitral Conclave will take place May 2-3, 2013, both in New York. Proceedings from the 2011 Mitral Conclave will be published in an upcoming supplement to The Journal of Thoracic and Cardiovascular Surgery.n

The first-ever AATS Mitral Conclave was held on May 5^th and 6^th. The world’s leading experts in mitral valve disease convened to discuss management guidelines, imaging, pathology, minimally invasive procedures, percutaneous approaches, surgical techniques, devices, and long-term results.

"With 39 faculty and 250 presentations, including selected abstracts and videos, our goal was to have a comprehensive meeting focused on mitral valve disease that would allow attendees to gain exposure to all of the common approaches used in the top centers throughout the world," said Program Director David H. Adams, MD. "We continue to see tremendous progress in our understanding of mitral disease intervention, and a great interest among surgeons in learning and advancing mitral valve repair strategies," said Dr. Adams, chairman of the department of cardiothoracic surgery at the Mount Sinai Medical Center, New York.

More than 1,000 individuals – including about 800 physicians – from 66 countries participated. Industry support was provided by Edwards Lifesciences LLC (Premier Platinum), Metronic, Inc. (Platinum), Abbott Vascular (Gold), Sorin Heart Valves (Gold), and St. Jude Medical Inc. (Bronze).

"I figured we might get 250 physicians, and would have considered that a success. This is fantastic," said AATS President Irving L. Kron, MD.

Presentations included lectures, expert video sessions, and "Presentations on Demand," accessible on video screens positioned in the exhibit hall. In a plenary address, Robert O. Bonow, MD, said that current valvular heart disease guidelines are based largely on expert opinion rather than evidence from clinical trials. Referring to the 2008 revised joint guidelines from the American College of Cardiology/American Heart Association and the 2007 European Society of Cardiology guidelines, he said, "Unfortunately, the evidence base underpinning them is limited by an inadequate number of randomized clinical trials. We really need to provide more evidence-based information to devise true guidelines and performance measures."

The question of whether mitral valve repair should be considered in all patients with severe mitral valve regurgitation is still being debated.

"It’s at least likely that certain patient subsets would benefit, but current data are insufficient to determine which ones," said Dr. Bonow, of Northwestern University. As an example of ambiguity, U.S. guidelines recommend that patients considered eligible for repair be referred to an "experienced center," but don’t provide criteria for determining that status. Moreover, individual surgeon volume and experience clearly predict successful mitral repair outcomes, even within one institution.

Dr. Bonow is optimistic that useful data will come from two ongoing trials sponsored by the National Heart, Lung, and Blood Institute via the Cardiothoracic Surgical Trials Network.

Dr. Adams presented the Mitral Conclave Career Achievement Award to the legendary Alain F. Carpentier, MD, whose 1983 landmark paper, "Cardiac Valve Surgery – the ‘French Correction,’ " is credited with heralding the modern era of mitral valve reconstructive surgery. Professor Carpentier delivered the Conclave Honored Lecture.

A series of "mini debates" addressed controversies surrounding the use of annuloplasty rings (flexible versus remodeling versus no ring at all), minimally invasive surgery (for all patients versus for some), and the correct approach for specific clinical scenarios of tricuspid valve disease.

The next Aortic Symposium will be held April 26-27, 2012, and the next Mitral Conclave will take place May 2-3, 2013, both in New York. Proceedings from the 2011 Mitral Conclave will be published in an upcoming supplement to The Journal of Thoracic and Cardiovascular Surgery.n