World Cardiology and Cardiologist Meeting September 11-12, 2018 Quality Hotel Globe Stockholm, Sweden

Biography:

Ovidio A García Villarreal is the Founder and present President of the Mexican College of Cardiovascular and Thoracic Surgery. He is the immediate past President of the Mexican Society of Cardiac Surgery. He is a Cardiac Surgeon retired from the social medicine, now focused exclusively on private practice in Monterrey, México.

He is member of the Mexican Society of Cardiac Surgery, Mexican College of Cardiovascular and Thoracic Surgery, Society of Thoracic Surgeons, European Association of Cardiothoracic Surgery, and of the National Association of Cardiologists of Mexico. He has published more than 50 articles indexed in PubMed, and many others in non-indexed journals. He is the Founder and present Editor-in-Chief of Cirugía Cardiaca en México, official journal of the Mexican Society of Cardiac Surgery since 2015. He is Reviewer in many prestigious international journals, as Annals of Thoracic Surgery, European Journal of Cardio-thoracic Surgery, Arch. Cardiol. Mex., and many other open access journals. He is the Precursor and the highest extensive experienced in the field of atrial fibrillation surgery (maze procedure), mitral valve repair, and aortic valve sparing-operations (David procedure, Yacoub procedure) in México. He was awarded with the National Prize in Surgery 2000 “Fernando Montes de Oca” from the Mexican Academy of Surgery, the highest prize for surgery in México.

Abstract:

Mitral regurgitation (MR) can be addressed by means of “French Correction” principles described by Carpentier. Remodelling on a frame plays a central role in this strategy. The annuloplasty ring forces leaflet coaptation, distributes evenly all the tensional forces in the repair. Moreover, it avoids any further annulus dilation. It has been demonstrated that the lack of the annuloplasty ring is one of the most powerful predictors for failure after MVR (mitral valve repair). Edge-to-Edge technique is the basis of the MitraClip therapy. Hence, it is not the exception to this rule. Several studies have made very clear that, in this context, the longer the follow-up, the higher the recurrence of the MR after MVR. This is especially true after 10 years follow-up. With this framework, the fact that constantly calls our attention is why the annuloplasty ring is not taken into consideration at the moment to install the MitraClip device. Rules do not become different depending on a given specific surgical or percutaneous approach. The answer has become more than evident by the surgical group. When analyzing the trials concerning the MitraClip, follow-ups are not long enough in order to get strong conclusions about ringles MitraClip.

EVEREST-II trial is a 5-year follow-up. However, the achieved results could not be reproduced by others. Current indication based on the current approval device in USA is exclusively on the primary/degenerative MR patients with high-risk for operation with no adequate response to optimal medical therapy. The main indication in Europe for MitraClip is functional MR; in USA as well as Europe, current indication for this kind of procedure is IIb, level of recommendation B or C, respectively. COAPT trial has been designed to test the MitraClip usefulness in functional MR. Results are still on the way. Nevertheless, rules do not change at all. Restrictive annuloplasty is the most common technique to address the functional MR. Even though there is an overoptimistic belief about MitraClip all alone could be sufficient in order to treat MR; everything seems to indicate just the opposite. Annuloplasty with a ring is an absolute must. Cardioband or Millipede IRIS can offer some solution to cope with all these shortcomings

Biography:

Nikolaos Bourmpoulis is the Director of Catheterization Laboratory in the Department of Interventional Cardiology, Korgialenio - Benakio Red Cross Hospital Athens, Greece.

Abstract:

Patent foramen ovale (PFO) has been considered as the main cause of paradoxical embolism in the absence of open communication between left and right circulation. On the other hand, PFO itself, with its slow flow between the atrial septum primum and secundum can form thrombus which potentially can be the source of emboli to systematic circulation. Three randomized, open label trials, Gore REDUCE (closure device versus antiplatelet therapy alone compared to the combination of both), CLOSE (closure devise or anticoagulants versus antiplatelet therapy to prevent recurrence of stroke), and RESPECT (closure device versus standard treatment) showed that the risk of stroke was lower with patent foramen ovale closure than with medical treatment alone.

Despite the speculations for these trials and their limitations, it seems that in the near future the treatment of cryptogenic stroke is going to change, a fact that will be probably reflected to the guidelines. The more aggressive approach of interventional cardiologists will balance the more conservative approach of neurologists and will give new fields for investigation, answering questions as how urgently must we intervene after the first stroke to prevent subclinical strokes shown by MRI, or if there is field for primary prevention when a PFO is diagnosed before a paradoxical embolism.

Biography:

Dolina Gencheva has completed her Graduation in Medicine in 2014 at Medical University, Plovdiv, Bulgaria and is currently specializing in the field of Cardiology at the University Hospital Sv. Georgi-Plovdiv. She is the first author of one article, published in a referenced medical journal, co-author of several other journals with impact factors.

Abstract:

The case report concerns a 12 year old boy with genetically diagnosed compound heterozygous form of familial hypercholesterolemia, who first presented with xanthomas on both knees and elbows and a family history of early coronary artery disease and sudden cardiac death. Before the initiation of lipid lowering treatment at the age of 11, the patient’s level of total and LDL cholesterol were 18 mmol/l and 15 mmol/l, respectively. Over the course of several months, the treatment with a statin and a cholesterol absorption inhibitor achieved a 50% decrease of LDL cholesterol level without reaching the absolute recommended target of 3.5 mmol/l. Additional tests of the boy showed initial fibro-degenerative changes of his mitral valve annulus and aortic valve, while his intima media thickness and cardio-pulmonary test were normal. Considering the high risk of early onset atherosclerosis and cardiovascular mortality as well as the unavailability of LDL-apheresis, the patient’s case was reviewed by a national committee, consisting of a cardiologist, a pediatrician and an endocrinologist and approved for adjuvant treatment with a PCSK 9-inhibitor with the consent of his parent.=

Biography:

Abstract: