PCR London Valves 2019 best clinical cases - Diego Gaia
“First-in-man Endo-Bentall procedure for endovascular treating ascending aorta, aortic root and aortic valve at the same time”
41-year-old Brazilian Diego Gaia is a winner of both the Top 3 cases and the best-graded submission from the Americas! He is a Professor of cardiac surgery and PhD programme tutor at the Federal University of Sao Paulo in Brazil, where he trained in general and cardiovascular surgery. A proctoring trainer of multiple surgical teams, he is extensively involved in the development of transcatheter valves and also has expertise in health management at public and private institutions.
Discover his replies to questions about his winning case, and his advice to others for preparing and presenting a successful submission.
Could you give a short summary of your winning case?
Conventional management for concurrent aortic valve and ascending aorta disease is known as Bentall procedure. We present a less invasive first-in-man alternative for inoperable patients, the Endo-Bentall. The 64-year-old patient presented with non-infected cutaneous-aortic fistula, ascending aorta pseudoaneurysm and failed stenotic bioprosthetic aortic valve, after conventional aortic valve replacement 4 years earlier. Porcelain aorta contraindicated conventional management. A custom prosthesis was designed (compassionate use) combining a transcatheter valve and a stent body with two branches for coronary arteries. The patient did well after the procedure with no complications at 6 months follow-up.
What would you say is the key take-home message of your case?
Endo-Bentall is feasible at this moment in selected cases (based on anatomy and risk profile). It is the first proof of the concept with good follow-up results up to 9 months now. We still have a lot of unsolved issues including: best anti-aggregating/anti-coagulation protocol, best connecting stent, risk of coronary stent thrombosis and patient selection.
What is the main reason you submitted to a PCR Course?
PCR is certainly the main meeting to present new technologies and ideas. The meeting congregates the best thinking minds in the cardiovascular field from all over the world. So being at a PCR Course is the perfect opportunity to share and discuss our research.
What impact do you expect this recognition to have on your career?
Recognition of our advance in the area will certainly ignite the spread of the idea in multiple teams from different centres around the world. Different perspectives and ideas will certainly arise promoting further improvement of the concept and the development of better models able to overcome the actual limitation of the technology. Being selected for such a high distinction will for sure improve my career goals, increase network opportunities and improve contact with other developers around the world. Also being able to offer treatment opportunities to patients with no other option is absolute import during all development phases of a new medical device.
What is your advice to others for preparing and presenting their cases?
Be visual in the presentation; use multiple videos and photos to make crystal clear your main idea. Use the “audience hat” when preparing your slides. If you are watching your own presentation ask yourself questions such as: Is the main message clear? Is it a pleasant and attractive presentation? Should I add more visual information to help explain the concept? Like infographics, animations, 3D? Tell a story, not just a case in the usual academic format! Storytelling is much more attractive! All of that in 7 minutes!
A new PCR initiative rewards the submitter of the best case from each of 5 world regions with free participation to the Course. What effect do you think this will have?
This is a fundamental improvement from the past years. The initiative engages more participation from different world regions that also have a lot to contribute to the cardiovascular field.