2 nd WORLD CONGRESS ON CARDIAC SCIENCES - 2020

April 16th & 17th - 2020

International Conference on Cardiology, Indian Institute of Science, Bengaluru, India.

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Robatic Cardiac Surgery



Hands-On Team Training in
Robatic Mitral Valve Repair,
Coronary Bypass & More

2019 Workshop on Robatic Cardiac Surgery

16th April 2020 at J.N.TATA Auditorium,
Indian Institute of Science, Bengaluru, Karnataka, India.

Day 1

Time: 11AM TO 2PM


Course Description

The Workshop on Robotic Cardiac Surgery will offer extensive hands-on procedural experience in a state-of-the-art robotics training facility. Specially designed for surgical teams—a surgeon and a bedside assistant or other surgical team member—the Workshop will put participants in a realistic, cardiac robotics simulation environment where they can hone their skills in mitral valve repair, coronary bypass, and other cardiac surgery procedures.

Learning Objectives

The participants should be able to:

  • Outline steps and discuss the finances needed to launch a robotic cardiac surgery program within a hospital setting
  • Coordinate surgical plans for robotic cardiac surgery procedures from beginning to end
  • Outline preoperative evaluation, patient selection, and postoperative care pathways
  • Describe the multidisciplinary components of building a robotic cardiac surgery program, including hospital administration and health care team personnel
  • Identify the ideal prerequisites for surgeon/team selection and the hospital/program selection for starting and sustaining a robotic cardiac surgery program
  • Carry out the basic steps to perform a robotic mitral valve repair procedure and a robotic-assisted coronary artery bypass procedure
Target Audience

The designed for the entire cardiac surgical team, including cardiothoracic surgeons with their bedside assistants, physician assistants, nurse practitioners, operating room staff, cardiac anesthesiologists, perfusionists, and others involved with cardiac robotic surgeries.

Program Director

Dr. Vivek Jawali, MBBS, MS, MCh, DNB,

Dr. Vivek Jawali is Chief Cardiothoracic & Vascular Surgeon and as a Chairman, he heads the Department of Cardio Vascular Sciences at Fortis Hospitals, Bangalore. He is a pioneer in Minimally Invasive Cardiac Surgery in India and has performed over 18, 000 Cardiothoracic & Vascular surgeries till date. He performed India's first beating heart bypass surgery in 1992 and performed India's first Minimally Invasive Bypass Surgery (MIDCAB) in Sept 199 Dr. Jawali did India's first Awake Cardiac Surgery (surgery without GA or Ventilator, done under continuous high thoracic epidural) in June 1999. He also performed world's 1st Awake Open Heart Surgery (on a 74 year patient who underwent triple bypass with aortic valve replacement without G. or a ventilator) in April 200 He is the founding member of the International Society of Minimally Invasive Cardiac Surgeons(ISMICS) and is the only Indian on the editorial board of its journal, Innovations in Cardiac Surgery. He is also the council member of the Asian Association of Cardiothoracic Surgeons.



Cardiomyocyte Biology



16th April 2020 at J.N.TATA Auditorium,
Indian Institute of Science, Bengaluru, Karnataka, India.

Day 1

Time: 3PM TO 6PM

Cardiomyocyte Biology

Cardiomyocytes, the working muscle cells of the heart, are terminally differentiated cells in the adult organism and regeneration is limited. This is a worrisome fact, since ischemia and cardiotoxic compounds can lead to cell death and irreversible decline of cardiac function. Our group is investigating the cardiotoxicity of old and new cancer therapies on the heart and survival pathways that exist in the organ.

As in vitro model, isolated organs and primary cells from rodents have been the standard in research and toxicology so far, but there is a need for better models. Therefore, we are developing a model comprising both the advantages of scaffold-free 3D cell culture and cardiomyocytes derived from induced pluripotent stem cells (iPSC) of human origin. Myocardial microtissues (MT) are generated by self-assembly in multi-well hanging drop cultures. In the hanging drop cultures, iPSC-derived cardiomyocytes formed MT’s within 4 days, and those were contracting up to 3 weeks and recorded by optical motion tracking. Morphological and functional characterization underline that this model might become a valuable tool for research on the mechanisms of cardiotoxicity of cancer therapies in the future

Cardiovascular disease is the leading cause of death worldwide. As such, there is great interest in identifying novel mechanisms that govern the cardiovascular response to disease-related stress. First described in failing hearts, autophagy within the cardiovascular system has been widely characterized in cardiomyocytes, cardiac fibroblasts, endothelial cells, vascular smooth muscle cells, and macrophages. In all cases, a window of optimal autophagic activity appears to be critical to the maintenance of cardiovascular homeostasis and function; excessive or insufficient levels of autophagic flux can each contribute to heart disease pathogenesis. In this Review, we discuss the potential for targeting autophagy therapeutically and our vision for where this exciting biology may lead in the future.


Cardiac Myocyte Biology

Investigators in the Division of Cardiology have rigorous research programs focused cardiac myocyte biology. Their research programs examine:

  • Molecular and cell biology of cardiac myocytes
  • Cardiac regeneration/repair through cardiac progenitor cells, iPS cells or bone marrow derived progenitor cells
  • Cardiac renin-angiotensin system
  • Cardiac development and congenital heart disease
  • Innate inflammation in ischemia-reperfusion injury
  • Genetics of heart failure


Program Director

Rong Tian

Univercity of Washington, USA

Biography

My lab develops new tools to manipulate and assess cell metabolism and mitochondrial function in living systems. Our goal is to improve cellular resistance to environmental stresses and diseases through engineering metabolism.

Our laboratory is interested in identifying and targeting the key regulators of cell metabolism and mitochondrial function for the treatment of cardiovascular and metabolic diseases. We take multidisciplinary approaches to manipulate and interrogate the cellular metabolic network. For example, we perturb the metabolic network by altering its key element using bioengineered cells or animals and determine the metabolic and functional outcomes using multi-nuclear NMR spectroscopy and metabolomics. Using this strategy, we are studying the remodeling of cardiac metabolism during the development of pathological hypertrophy which is an abnormal growth of the heart that eventually leads to heart failure.

Another focus of our research is to develop mitochondria based cell protection. We recently revealed an important role of redox-sensitive protein acetylation in modulating mitochondrial protein interactome that in turn dictates cellular sensitivity to stress. We are now developing novel technologies with our collaborators, e.g. biosensors, quantitative proteomics and high throughput screening, to determine and target the nodal points of mitochondria-originated injury pathways.

Education

PhD (pharmacology), University of Aarhus, Denmark, 1992
MD, West China University of Medical Sciences, 1986



Yoga Therapy for Heart Diseases



17th April 2020 at J.N.TATA Auditorium,
Indian Institute of Science, Bengaluru, Karnataka, India.

Day 2

Time: 11AM TO 2PM

Yoga Therapy for Heart Diseases

The heart is one of the most important organs in the human body. The heart pumps the blood, which carries all the vital materials which help our bodies function and removes the waste products that we do not need.

The brain requires oxygen and glucose, which, if not received continuously, will cause it to lose consciousness. Muscles need oxygen, glucose and amino acids, the proper ratio of sodium, calcium and potassium salts to contract normally. Glands need sufficient supplies of raw materials from which to manufacture specific secretions. If the heart ever ceases to pump blood, the body begins to shut down and after a very short period of time will die.

Yoga Therapy

Many forms of heart disease can be prevented or treated with healthy lifestyle choices. Yoga practice is the best way to keep the heart healthy. Asana prepares the entire physical functioning of the body, while pranayama improves the physiology of the body.

Standing poses strengthen the cardiac reserve. Forward bends soothes the nerves and brings down the heart rate. Inverted pose improves the contractility. Back bending poses lengthen the cardiac muscle and the septum. This improves the contraction of heart and improves the quality to pump blood in and out. Twisting pose stretches the wall of the heart. The diaphragm is squeezed and the endurance of the heart is increased.

Pranayama, on the other hand, constantly changes the shape of the heart, thereby preventing blockage in the heart. Prana is the vital energy distributed by the nervous channel (Nadis). Pranayama improves the rhythm of the heart. One who practise pranayama consistently can reduce or increase the heart rate at will. Hence, one gains control over the involuntary mechanism of the body.

Yoga can be done by any one at any age at any health problems. The body system is taken care of, with all the internal organs functioning together to improve the cardiovascular efficiency. Any practitioner can benefit from the practice – whether as preventive, improvement or reverting to normal condition.

A daily Yoga practice leads to a healthy lifestyle. It changes the overall character of a practitioner, controls high blood pressure and diabetes. The effect is more significant with a proper diet. Pranayama gives proper relaxation to reduce and manage stress. A conscious breathing rhythm regulates the heart beat.

Program Director

Vishnudevananda Saraswati

Hatha Yoga Professor

Hatha Yoga Professor


The Early Years

Swami Vishnudevananda was born in the south Indian state of Kerala on December 31, 1927. After completing school he entered the Engineering Corps of the Indian Army. It was while he was in the army that he first met Swami Sivananda, one of the great saints of modern times.

After being discharged from the army, Swamy Kuttan Nair, as he was then known, was a schoolteacher in his native Kerala for a short while, before leaving his life behind and entering the Sivananda Ashram in Rishikesh in 1947. Within a year, he took the monastic vow (sannyas) with the name of Swami Vishnudevananda.

Swami Sivananda saw in his young disciple special tendencies towards Hatha Yoga. With his training directed towards this discipline he became an expert, mastering many of the most difficult and advanced Hatha Yoga techniques (asanas, pranayamas, mudras, bandhas and kriyas). How did he learn these ancient practices which to a great extent had been lost in modern India? He often said, "My Master touched me and opened my intuitive eye. All this knowledge returned to me from past lives".

Remaining at the Ashram for ten years, he was appointed as the first Professor of Hatha Yoga at the Yoga Vedanta Forest Academy. He held a number of other positions at the Ashram, including personal secretary to Swami Sivananda.


How Swami Vishnudevananda met his Master

Swami Vishnudevananda remembers his very first contact with Swami Sivananda:

"I first heard about Swami Sivananda in a strange way. Looking in the waste paper basket for a lost paper, I found one small pamphlet called Sadhana Tattwa. His teachings were so simple and straightforward, ‘an ounce of practice is worth a ton of theory.’i

I got a couple of days’ leave of absence from the army and went to see him. There was no kind of religious hypocrisy, no sitting on a tiger skin with ashes smeared all over his body. He had an extraordinary spiritual glow. The second time I saw him, Swami Sivananda was coming up the stairs in my direction.

I didn’t want to have to bow my head to him. I was young and arrogant and never wanted to bow my head to anybody. But it is the tradition that you should bow your head to a holy man. To avoid the situation, I just moved out of his path. Master saw me and headed in my direction. He asked me who I was and where I was coming from. Then he bowed down and touched my feet!! My whole body began to shake violently.

With all my heart, with all my life and love, I learned to bow without any type of reservation. He touched my heart not with miracles or shows of holiness, but with his perfect egoless nature. He didn’t consider that I was just a stupid boy standing there, although I was just that. He touched my heart and broke that egoism in me. I didn’t think anything else in this world would have broken this ego. That was my first lesson, and if I could attain one millionth of the state of egolessness of the Master, it is His Grace."



ARE YOU AT RISK OF HEART DISEASE ?



17th April 2020 at J.N.TATA Auditorium,
Indian Institute of Science, Bengaluru, Karnataka, India.

Day 2

Time: 3PM TO 6PM


ARE YOU AT RISK OF HEART DISEASE ?

Do you currently smoke?
  1. No
  2. Not now, but used to smoke
  3. Only socially about once or twice a week
  4. Yes
What age range are you?
  1. Under 30 years
  2. 30 – 44 years
  3. 45 – 60 years
  4. Over 60 years
How many servings of vegetables (including fresh, frozen and tinned) do you eat each day?
  1. Five or more servings
  2. Three or four servings
  3. One or two servings
  4. None, I don’t eat vegetables
How many servings of fruit (including fresh, frozen and tinned) do you eat each day?
  1. Three or more servings
  2. Two servings
  3. One serving
  4. None, I don’t eat fruit
Have you been told by a doctor you have high blood pressure?
  1. No
  2. I don’t know
  3. Yes, but more than five years ago
  4. Yes
Does anyone in your family have heart disease or had a heart attack?
  1. No
  2. Yes, distant relative
  3. Yes, close relative (e.g. uncle, aunt, cousin)
  4. Yes, someone in my immediate family (e.g. mother, father, brother, sister, grandparent)
Have you spoken to your GP or other health professional about your heart health?
  1. Yes
  2. Yes, but more than two years ago
  3. Yes, but more than five years ago
  4. Never
Have you had a heart attack or angina?
  1. No
  2. Yes, but more than five years ago
  3. Yes, three to five years ago
  4. Yes, within the past three years
In a typical week, on how many days would you do moderate or vigorous physical activity for at least 30 minutes?
  1. Every day
  2. Four or five days a week
  3. Two or three days a week
  4. No more than once a week
How often do you eat deep fried or fatty foods?
  1. Never
  2. Occasionally (no more than once a week)
  3. Now and again (two or three times a week)
  4. Most days
Have you been told by a doctor you have high cholesterol?
  1. No
  2. I don’t know
  3. Yes, but more than five years ago
  4. Yes
Are you on any medicines to treat high blood pressure, high cholesterol, diabetes or heart disease?
  1. No
  2. Not now, but have been in the past
  3. Yes, have started in the past year
  4. Yes, have been on medication for more than a year

YOUR SCORE

12 – 20

You are managing your heart health well and doing many of the right things to minimise your heart disease risk. Keep up the good work.

21 – 30

You have a few risks of heart disease. If you have family history, are over 45 or haven’t spoken to your GP recently, book in a time to get a heart health check.

31 – 40

You have some risk factors for heart disease which need to be managed.

There is no single cause of heart disease, but having multiple risk factors may increase your chance of developing it. If you aren’t already talking to your GP about your personal risks, why not book in a time to get a heart health check today.

41 – 48

You have significant risk of heart disease and may already be living with the disease. Check back on the questions where you logged a high number, and identify what changes you might be able to make to your lifestyle to improve your heart health. See your GP regularly to manage your heart disease risks.


CARDIOVASCULAR QUIZ



17th April 2020 at J.N.TATA Auditorium,
Indian Institute of Science, Bengaluru, Karnataka, India.

Day 2

Time: 3PM TO 6PM

CARDIOVASCULAR QUIZ

1. What part of the intrinsic conduction system starts the heart beat?
  1. The atrioventricular node
  2. The Bundle of His
  3. The Perkinje fibers
  4. The sinoatrial node
2. A surgeon opens the thoracic cavity and finds a membrane covering the mediastinum. This membrane is called the
  1. Visceral pericardium
  2. Parietal pericardium
  3. Visceral peritoneum
  4. Parietal peritoneum
3. The muscular layer of the heart that is responsible for pumping is the
  1. Endocardium
  2. Epicardium
  3. Myocardium
4. This chamber of the heart is much thicker than the others because it pumps to the entire body
  1. Right atrium
  2. Right ventricle
  3. Left atrium
  4. Left ventricle
5. Why is the mitral valve different from the other three valves of the heart?
  1. It only has 1 flap
  2. It only has 2 flaps
  3. It only has 3 flaps
6. The correct pathway that an erythrocyte would travel during systemic circulation is
  1. Arteriole--aorta--vein--venule--capillary
  2. Capillary--venule--vein--artery--aorta
  3. Aorta--arteriole--capillary--venule--vein
  4. Venule--vein--capillary--arteriole--aorta
7. The vessel layer that is fibrous and responsible for support is the
  1. Tunica externa
  2. Tunica intima
  3. Tunica media
8. The softer "dupp" sound of the heart is from
  1. The closing of the atrioventricular valve
  2. The closing of the semilunar valve
  3. The opening of the semilunar valve
9. The umbilical cord has a vein that carries
  1. Nutrients and oxygen rich blood to the baby
  2. Wastes from the mom
  3. Carbon dioxide and metabolic materials to the baby
10. You can check the pulse n your neck using the
  1. Brachial artery
  2. Jugular vein
  3. Carotid artery
  4. Popliteal vein
11. Which would be indicative of hypotension?
  1. 120/80
  2. 170/120
  3. 80/65
12. You can tell when you cut a vein because the blood
  1. Flows
  2. Spurts
  3. Will not come out
  4. Is blue

Program Director

George J. Despotis, MD

Washington University School of Medicine

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