Andre Luiz Tyszka

Cardiac Surgeon Dedicated to advancing of surgery by integrating innovations and research, to elevating clinical outcomes and adoption of modern techniques

[Andre Luiz Tyszka @TyszkaAndre]

For most, aortic annulus enlargement is considered too expensive to justify implanting a prosthesis that is only one size larger, and it is rarely used. This video demonstrates the surgical enlargement using a balloon catheter, which is a innovative technique that combines the knowledge of both TAVR and SAVR.
https://t.co/viRnW8TjQG

[Andre Luiz Tyszka @TyszkaAndre]

https://t.co/5PNffv9a7g

[Andre Luiz Tyszka @TyszkaAndre]

With the balloon surgical technique, the surgeon decides which size of prosthesis to implant in the aortic ring, not the other way around! The choice doesn't depend on the size of the annulus and there's no need for augmentation techniques which increase time and risk ... they're less effective and rarely used ... especially in minimally invasive approaches

[Andre Luiz Tyszka @TyszkaAndre]

https://t.co/yshnUT1oI7
You no longer need to measure the aortic annulus...
Using the balloon catheter technique, the surgeon determines the size of the prosthesis to be used.
For small patients we use a balloon and prosthesis number 23, for larger patients we use a balloon and prosthesis number 25... simple as that.
BSA > 2 sqm = 25mm
BSA < 2 sqm = 23mm.

[Andre Luiz Tyszka @TyszkaAndre]

"Rapid pacing" during a TAVI with a permanent cardiac pacemaker

- First check that the settings are normal. This includes the battery life, impedances, and threshold.

- In Threshold Test mode, program in VVI/VOO mode set for 175bpm.
- Program it so that the threshold test is set to 15 pulses (Medtronic) with a high threshold (5.0 mV) and will gradually reduce the stimuli with the desired heart rate (175 bpm).
- Programmers have no delay in this function (Medtronic) and end instantly

[Andre Luiz Tyszka @TyszkaAndre]

Hybrid approach for acute type A aortic dissection and occlusion of left main coronary.

During catheterization, cardiac arrest and underwent left main coronary angioplasty. Hemiarch repair the following day.

Post-op: moderate bleeding, extubated after 24 hours and no neurological complications

So far so good!

[Andre Luiz Tyszka @TyszkaAndre]

Which one do you recommend Tricuspid treatment options:
open Surgery
Tri-clip
Transcatheter Tricuspid valve replacement

[Andre Luiz Tyszka @TyszkaAndre]

https://t.co/d5T7YO3mZJ

[Andre Luiz Tyszka @TyszkaAndre]

Once again our article quoted by @CTSnet ...and @Innovationsjour
https://t.co/2QiOyy93lX

[Andre Luiz Tyszka @TyszkaAndre]

please leave your comments for further discussions.

[Andre Luiz Tyszka @TyszkaAndre]

I'd like to hear from our colleagues about CABG in patients with "dementia":

[Andre Luiz Tyszka @TyszkaAndre]

83 y/o - five years after conventional
#CABG (LIMA + saphenous vein)
no sternal issues
no aesthetic concerns
no upper limbs limitations
no angina to date

[Andre Luiz Tyszka @TyszkaAndre]

Scientific retrospective 2024

[Andre Luiz Tyszka @TyszkaAndre]

May your year 2025 be filled with joy and success, just like this beautiful anastomosis:

Find no obstacles to pass through...

Travel your way free for a long time...

Carry enough oxygen (energy) so that your heart can follow you on all the adventures you desire

... value your long-term satisfaction more than the temporary aesthetic benefit...

[Andre Luiz Tyszka @TyszkaAndre]

Clamp time- 224min CPB time-352min !! In a frail patient...😧 I hope she is doing well... https://t.co/b5Roj4LdBr

[Andre Luiz Tyszka @TyszkaAndre]

Spend the time necessary for
... a coronary anastomosis close to perfection
 ... implanting the largest aortic prosthesis and 
... mitral valve repair with the least residual reflux 
 but don't make your surgery indefinitely long because you're using an aesthetically better approach or because your colleagues are on the robotic trends ...

[Andre Luiz Tyszka @TyszkaAndre]

In my opinion ...
Cosmetic result
Short length of stay
Fast return to work
It shouldn't affect your surgical strategy...

We should value heart surgery more...
We shouldn't trivialize the complex surgeries we perform ...

I said My opinion and have a good weekend

[Andre Luiz Tyszka @TyszkaAndre]

This week on The Beat at CTSNet
How to surgically enlarge aortic annulus with a balloon catheter...
Editor-in-Chief Joel Dunning
discusses our paper... thanks for your comments and compliments...
#ctsnet @joeldunning

[Andre Luiz Tyszka @TyszkaAndre]

As a #cardiacsurgeon, I find it tough to accept a low-risk patient with a 12.5% mortality rate and 32.6% paravalvular reflux, no matter the technique used. We need to revisit some concepts. Perhaps it's time to take a step back and rethink traditional methods. That means open #AVR through #ministernotomy.
I'm looking for a procedure with almost no mortality or leak rate.