Learn from the Leaders Promedica International CME
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DVDs of ACTS 2007 Live Surgical Teleconference for 15 CME Hours of Credit!
by Promedica International CME
We are excited to announce that a set of 8 DVDs of the ACTS 2007 symposium is now available on our website for purchase and CME credit. This DVD collection was filmed using the latest state-of-the-art HDTV technology and contains six live cases, didactic lectures from internationally known leaders in the field and video presentations showcasing advancing techniques and technology as they were presented in May.
Focus was placed on the most recent advances in the surgical treatment of Heart Valve and Coronary Artery Disease, Chronic Atrial Fibrillation and Diseases of the Aorta with emphasis on less invasive approaches, including percutaneous techniques. This DVD set is designed for cardiologists, cardiac surgeons, interventional cardiologists, internists, perfusionists and health care professionals involved in the field of coronary artery disease.
View a video clip from the DVDs below.
To purchase the set of 8 DVDs, click here.
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Important Updates on the Ross Procedure
by William F. Northrup III, MD
The Ross procedure has been set aside by some surgeons because of unpredictable long-term autograft function reported in some series. We believe that there are important technical reasons for these results, which can be modified. Professor Yacoub has identified the critical success factors for a predictable life-long lasting functional autograft, which he will share with us at our live teleconference in October. Moreover, he has data to suggest that the Ross Procedure, if done correctly, can restore expected survival. If so, it is now the second valve operation, along with mitral valve repair to have this capability.
William F. Northrup III, MD
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The Clinical Use of Stem Cells for the Treatment of Heart Failure
by Federico Benetti, MD
Rosario, Argentina
5 million patients suffer from heart failure in EEUU, 500,000 new patients every year, and the expected survival is 35% (class3/4) at 5 years .The current treatment options include medications, cardiac resynchronization therapy, destination VAD therapy and cardiac transplantation.
In March 2003 we started the first clinical trial to compare patients with an OPCAB operation alone vs. OPCAB plus autologous stem cells (CD 34+ CD45-) implanted by direct surgical application. At 6 months, we found that the second group improved their ejection fraction more than 30% compared with the patients that received OPCAB alone. In the next series, we used direct surgical application of autologous stem cells (CD 34 + CD 45 -) not only by sternotomy but also minimally invasively through a scope. Additionally in January 2005 we did another trial in 10 patients where we used for the first time direct surgical implantation of embryofetal stem cells between 5 to 12 weeks of gestation.
The operative mortality for the 29 patients that received autologous stem cells from different approaches was 1 patient. In the embryofetal group, the operative mortality was zero.
In the long term at 4 years, the mortality for the autologous group was 4 patients: 3 from cardiac causes and 1 from pulmonary infection. The initial average EF was 30% and, at 4 years, 38% for the ischemic patients and 27% and 36% for the patients with idiopathic cardiomyopathy. The survival at 4 years was 90% for the total series.
In the group of patients who received embryofetal stem cells, the initial mortality was 0 % and in the long term 4 patients died: 3 for cardiac causes and 1 from diabetes complications The average initial EF was 26% and at 2 years and 7 months increased to 37% The survival is 60%.
In conclusion, direct surgical stem cell implantation is an alternative for heart failure patients. Both types of cells work, apparently for different mechanisms: the autologous cells by a paracrine effect and angiogenesis and the embryofetals by making new cells (in 4 of the embryofetal cell patients we achieved total remodeling of the ventricle in 3 months).
More studies are needed to confirm these initials observations and learn more about the type of cell in each situation, but without doubt we can say that both improve myocardial function and cellular activity. Surgical epicardical injection in the beating heart also improves the clinical symptoms of angina and heart failure, is safe and non-arrhythmogenic with sustained improvements of the EF in the long term. In conclusion, we think that direct surgical injection of stem cells is an alternative for many patients with heart failure.
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Learn From the Leaders
by Promedica International CME
Over the years, we at Promedica International CME have been privileged to work with the world’s leading physicians as Program Directors and Faculty to produce major educational activities to help improve the quality of healthcare you can offer your patients. Now we are delighted to add to your educational opportunities through this unique web blog entitled “Learn from the Leaders”. We hope you will appreciate the following opportunities:
- Learn about emerging techniques and technologies at an early stage, directly from the source.
- Share comments and ask questions in an informal environment
- Discover new ideas years before they can be published in the journals
- A forum for sharing tips and subtle nuances of techniques
We are proud to launch “Learn from the Leaders” with Dr. Federico Benetti sharing his clinical experience to date using stem cells for the treatment of heart failure.
