BISMICS

Original Article: Left Atrial Appendage Closure or Medical Therapy in Atrial Fibrillation (CLOSURE-AF trial) nejm.org/doi/full/10.10… Editorial: Left Atrial Appendage Closure — Another Overused Method in Cardiology? nejm.org/doi/full/10.10… #Cardiology

All the explanations I’ve heard today for the negative CLOSURE-AF result—some so strained they’re almost impressive. 1) The devices were “outdated” and therefore responsible for excess complications (the usual argument that things only go wrong elsewhere). 2) DAPT was used after LAAO, which is now said to be obsolete because of bleeding concerns compared with DOAC-based strategies (a claim that is often repeated, less often demonstrated). 3) Stroke rates were similar, so the signal is attributed mainly to bleeding and procedural issues—as if that were a minor point. 4) The composite endpoint is criticized for mixing different mechanisms, although if anything it should have favored non-inferiority. 5) The early phase of enrollment is invoked to argue that complications are not representative of current practice (again, complications seem to belong to others). 6) And then there are the usual remarks about loss to follow-up, crossovers, and lack of blinding. What seems to be missed in this accumulation of arguments is straightforward: the burden of proof lies with LAAO, not with the control arm. The issue is the strength of the evidence supporting LAAO, not medical therapy, which remains the reference standard.

Oral anticoagulation after publication of the CLOSURE-AF trial and LAAC deemed “not non-inferior”. 😐

Deep dive into mitral repair surgery : Talk 1 | Endoscopic Cardiac Surgeons Club ecsclub.org/videos/deep-di…

Hot off the press today! Should we be more cautious about long term results of TAVI compared with surgery in low and intermediate risk patients ? gbr01.safelinks.protection.outlook.com/?url=https%3A%…

So why does the TAPSE drop after mitral valve repair? Is it the pericardial incision? We found that an endoscope guided procedure was better than a sternotomy. Cross clamp times did not matter. ⁦@dr_benoy_n_shah⁩ ⁦@NMerke⁩ ⁦@JGrapsa⁩ kwnsfk27.r.eu-west-1.awstrack.me/L0/https:%2F%2…

2 weeks ago the field of medicine lost a giant: Tom Fogarty, inventor of numerous devices, the balloon embolectomy catheter, AneuRx Endovascular Aortic Stent Graft, Hancock Tissue Heart Valve & many more. He held almost 200 patents, co-founded more than 45 medical technology companies, & created an institute to spur medical device innovation. Here's a short clip from my interview with him (from our archives). #AngioHistory

As we come to the end of a fabulous year for endoscopic cardiac surgery, we are pleased to announce the video competition details. All you endoscopic heart surgeons: record, edit, submit and repeat from now till the end of July. We look forward to seeing many new & old friends!!

It's over and out from the naughty elves at Millbrook. We'll be back 5th Jan refreshed and raring to go! It's been a pleasure to serve you all this year, but after 69 events, we need a break! We hope you all enjoy a wonderful holiday season with your families, and if you can, share the joy and Christmas spirit with those less fortunate. Take care, and here's to health, happiness and prosperity to all in 2026 💚 ☃️

Day two of @BISMICS is here, and it marks our final conference of 2025. But first, let’s look back at last night. The evening began with a pre-dinner presentation by M M Yusuf, discussing the future of minimally invasive cardiac surgery and whether that future is robotic.🤖The night rounded off with the announcement of the multimedia competition winner!🏆 Now, looking ahead to today, live on the Millbrook Hub is day two of BISMICS. For those with a Millbrook Hub account, simply log into the platform to view today’s presentations: millbrookhub.co.uk/mmc/login #BISMICS #MinimallyInvasiveCardiacSurgery #CardiacSurgery #MICS

#BISMICS2025 is now CPD accredited! The Royal College of Surgeons of England has awarded 13 CPD credits for this year’s programme. Registration closes Sunday! Join us 8–9 Dec at Convene, London (Hybrid) for two days of innovation in minimally invasive cardiac surgery. Register: millbrook-events.co.uk/event/BISMICS2…

Unwrap the Benefits of Attending @BISMICS🎁Give yourself an early Christmas present with top-tier education at #BISMICS Why join us? 🌍Hear from 50+ leading clinicians from across the globe 🏅CPD points applied for from the Royal College of Surgeons of England 🩺A programme for consultants, trainees and allied health professionals 🗣️Expert-led sessions on robotic and hybrid coronary surgery, ERAS, live MDTs (TAVI, TEER), valve disease and other key topics 💬Excellent networking in person or online, including the simulator village, conference dinner and digital business card exchange Register now: millbrook-events.co.uk/event/BISMICS2…

Collaboration in action. The #BISMICS2025 Live MDT brings together the best of cardiology and cardiac surgery for a joint look at TAVI & TEER. Moderated by Ishtiaq Ahmed and Alessia Rossi, with a panel including Mamta Buch, Jonathan Byrne, Madalina Garbi, and Anastasia Vamvakidou. Expect live case discussions, expert commentary, and the latest insights from across disciplines. Register now: millbrook-events.co.uk/BISMICS2025

The future of robotic & hybrid coronary surgery takes centre stage at #BISMICS2025! Hear from international leaders including Lognathan Balacumaraswami, Marc Ruel, Selvaraj Shanmuganathan, and Rashmi Yadav as they explore: 🔹 Robotic CABG and hybrid techniques 🔹 Imaging as an ally in minimally invasive coronary surgery 🔹 Transitioning MVST to robotic surgery Monday 8 December | 09:00–10:30 Convene, 133 Houndsditch, London (Hybrid) millbrook-events.co.uk/BISMICS2025 @BISMICS

We're very pleased to share news of the latest paper publication from the UK Mini Mitral trial Read now: doi.org/10.3310/PKOT23…. @EnochAkowuah1 @RebeccaHMaier

Is your work ready for a wider audience? @BISMICS invites you to submit abstracts, clinical cases or short videos for the multimedia competition. It’s a chance to highlight your clinical decision-making and share key learning points with leading experts and peers Submission details: • Abstracts: Word document, <500 words, with Introduction, Method, Results and Conclusion • Clinical cases or videos: PowerPoint slide deck or 2-minute video including patient presentation, assessment, imaging, clinical decision-making and outcome • Ensure all patient-identifiable information is removed and consent obtained Share your research, contribute to collective learning and take your place at BISMICS. Submissions need to be received by Friday 21st November 2025, good luck: bit.ly/41wEusl #BISMICS #MinimallyInvasiveCardiacSurgery #CardiacSurgery #MICS

1.6 million of tax payers money, 9 years of effort, 146 pages, 3 guideline impacting papers!Congratulations to @EnochAkowuah1⁩ and his team for a great trial, signed, sealed and delivered!👏🏾 the UK Mini Mitral multicentre RCT | NIHR Journals Library journalslibrary.nihr.ac.uk/hta/PKOT2391

Could you be the next @BISMICS winner? Showcase your expertise in minimally invasive cardiac surgery by entering the BISMICS 2025 multimedia competition. Submit your abstract, clinical case, or short video for a chance to present at this year’s heart team meeting. • Deadline: Friday 21 November 2025 • How: Upload your file when registering or email tilly@millbrookconferences.co.uk • The winner will be announced at the conference dinner on Monday 8 December (You must be registered to attend in person) Share your MICS work with the cardiac community for a chance to win in so many ways! bit.ly/41wEusl #BISMICS #MinimallyInvasiveCardiacSurgery #MICS #CardiacSurgery

Full house at the RSM today with ⁦@SCTSUK⁩ and ⁦@ACTACCUK⁩ colleagues discussing how we can make Minimally Invasive and Enhanced Recovery routine in UK cardiac surgery practice. ⁦@BISMICS⁩ ⁦@SCTS_Students⁩ ⁦@ACUSouthTees⁩ ⁦

Finally level 1 evidence of better outcomes with Endoscopic mitral surgery!