Congenital Cardiac Anesthesia Society Annual Meeting 2022
Format: 4 videos + 1 pdfs, size: 2.64 GB
Course Audience: anesthesiologist
General Session I (Video MP4 Format)
General Session II – III (Video MP4 Format)
General Session IV – V (Video MP4 Format)
General Session VII (Video MP4 Format)
Program (PDF Format)
*** Detail:
THURSDAY, MARCH 31, 2022
6:00 AM – 5:00 PM Registration
Location: JW Marriott – Tampa Bay Ballroom South – PreFunction – Level 4
Session: PBLDs/Round Tables – PBLDs and Round Tables Offered Virtually
6:15 AM – 7:15 AM PBLD 1: Mommy and Me Anesthesia: Caring for the Pregnant Patient with Adult Congenital Heart Disease
Viviane G. Nasr, MD; Katherine L. Zaleski, MD
Objectives:
Upon completion of this PBLD, the participant will be able to:
* Appreciate the “normal” physiological changes of pregnancy, with an emphasis on the cardiovascular system.
* Discuss risk stratification for the pregnant patient with congenital heart disease.
* Formulate a safe, comprehensive periprocedural care plan for the pregnant patient with adult congenital heart disease.
6:15 AM – 7:15 AM PBLD 2: Patent Ductus Arteriosus (PDA) Stent Placement in Neonate with Pulmonary Atresia and Intact Ventricular Septum (PA-IVS)
Mikel Gorbea, MD; Faith J. Ross, MD
Objectives:
Upon completion of this PBLD, the participant will be able to:
* Review the spectrum of morphologies and unique physiologic features associated with pulmonary atresia with intact ventricular septum.
* Discuss the preoperative evaluation and anesthetic considerations unique to transcatheter ductal stent placement in infants with ductal dependent circulation.
* Identify the key perioperative challenges encountered in managing neonates presenting for interventional transcatheter procedures in the cardiac catheterization suite.
* Describe appropriate consultation, preoperative planning, anesthetic risks, and palliative options for infants scheduled for interventional transcatheter placement of ductal stents.
6:15 AM – 7:15 AM PBLD 3: Anesthesia for the Hybrid Procedure for HLHS Nina Deutsch, MD; Andrew T. Waberski, MD
Objectives:
Upon completion of this PBLD, the participant will be able to:
* Discuss the indications for and timing of the hybrid procedure as compared to the Norwood palliative procedure.
* Develop an anesthetic plan for a neonate undergoing a hybrid procedure.
* Simulate therapies for anticipated complications from the hybrid procedure.
6:15 AM – 7:15 AM RT 1: So You Like Blue Babies? – Entering the Field of Congenital Cardiac Anesthesiology
Megan L. Albertz, MD; Nicholas M. Houska, DO
Objectives:
Upon completion of this Roundtable Discussion, the participant will be able to:
* Discuss the current state of congenital cardiac anesthesia workforce and the occupational outlook for the future of the specialty.
* Describe training pathways in congenital cardiac anesthesia and how ACGME accreditation will impact fellowship training.
* Recognize the challenges in transitioning from trainee to attending and examine resources to improve personal and professional outcomes in the first-year post-training.
6:15 AM – 7:15 AM RT 2: ERAS in CV Surgery
Calvin Kuan, MD; Zoel Quinonez, MD
Objectives:
Upon completion of this Roundtable Discussion, the participant will be able to:
* Understand pathophysiologic considerations for appropriateness of ERAS in the pediatric and adult patient with CHD.
* Name three evidence based ERAS interventions you can implement in your institution.
* Describe logistical barriers to implementation of ERAS and how you can overcome them.
6:15 AM – 7:15 AM RT 3: The Royal Treatment: Perioperative Hemostatic Management for Pediatric Patients with Severe
Hemophilia
Laura Downey, MD; Nina A. Guzzetta, MD
Objectives:
Upon completion of this Roundtable Discussion, the participant will be able to:
* Understand the pathophysiology and treatment of severe hemophilia and the implications for congenital cardiac surgery requiring cardiopulmonary bypass.
* Learn about new treatments for hemophilia patients and how this affects heparin management on CPB.
* Discuss the perioperative management of hemophilia patients for cardiac surgery with CPB.
* Practice interpreting VET and determining appropriate hemostatic treatment in patients with complex bleeding disorders.
Breakfast with Exhibitors
6:30 – 7:20 AM
7:20 AM – 7:35 AM Welcome and Outline of Educational Program
Gregory J. Latham, MD; Mark D. Twite, MD, BCh
Location: JW Marriott – Tampa Bay Ballroom 1-4 – Level 4
Session I: Controversies in the Approach to the Child and Family with CHD
Moderators: Stephanie N. Grant, MD; Gregory J. Latham, MD
7:35 AM – 8:00 AM Severe Chromosomal Abnormalities and CHD: Is There One Correct Answer?
Lawrence I. Schwartz, MD
Objectives:
Upon completion of this lecture, the participant will be able to:
* Review characteristics of severe chromosomal abnormalities, including congenital heart anomalies.
* Understand the anesthetic implications of severe chromosomal abnormalities for surgical repair of congenital heart disease.
* Examine the ethical dilemmas with reparative congenital heart disease surgery for patients with severe chromosomal abnormalities.
8:00 AM – 8:25 AM When to Cannulate? ECMO and Neurodevelopmental Outcomes
Melania Maria Bembea, MD, PhD, MPH
Objectives:
Upon completion of this lecture, the participant will be able to:
* Describe the epidemiology and outcomes of children with CHD requiring ECMO support.
* Discuss ECMO initiation considerations for the child with single ventricle physiology.
* Discuss neurodevelopmental outcomes after ECMO and future directions for clinical follow-up programs and research.
8:25 AM – 8:50 AM The What, Why and How of Palliative Care in CHD
Katie Moynihan, MD
Objectives:
Upon completion of this lecture, the participant will be able to:
* Understand the current landscape of end of life care for children with CHD and differences with other life threatening disease processes.
* Appreciate the dispelled myths and benefits of palliative care in children with CHD.
* Propose some communication tools for applying palliative care principles in difficult peri-operative conversations.
8:50 AM – 9:10 AM Q & A Discussion
Coffee Break with Exhibitors
9:10 – 9:40 AM
Session II: Focus on a Lesion: HLHS – Part 1
Moderators: Anne Elisa E. Cossu, MD; Jamie McElrath Schwartz, MD
9:40 AM – 10:05 AM Dolly D. Hansen, MD Lecture: Evolution of Surgical Management on Hypoplastic Left Heart Syndrome – A
Historical Perspective
Marshall L. Jacobs, MD
Objectives:
Upon completion of this lecture, the participant will be able to:
* Understand the early efforts to address HLHS surgically that preceded Norwood’s innovative approach.
* Understand the nature of some of the obstacles to broader early acceptance of Norwood’s approach to palliation of HLHS.
* Understand the contemporary staged approach to surgical reconstructive surgery for HLHS and the role for transplantation in the current era.
10:05 AM – 10:25 AM Joint Lecture with PCICS – Contemporary Considerations in the Preoperative Management of Hypoplastic Left
Heart Syndrome
Andrew Smith, MD, MSCI, MMHC
Objectives:
Upon completion of this lecture, the participant will be able to:
* Identify factors apparent in the prenatal period that may predict perioperative instability.
* Recognize preoperative management considerations of premature and VLBW infants with HLHS.
* Understand preoperative patient-specific factors that may predict challenges in management of intra and postoperative hemodynamics.
10:25 AM – 10:40 AM Q & A Discussion
Session III: Focus on a Lesion: HLHS – Part 2
Moderators: Chinwe C. Unegbu, MD; David F. Vener, MD
10:40 AM – 11:00 AM What Do I Need To Know: Anesthesia for the Norwood
Rebecca Scholl, MD
Objectives:
Upon completion of this lecture, the participant will be able to:
* Evaluate the anesthetic management of HLHS patients – what’s new!
* Appreciate how anesthesia decisions impact Stage I outcomes.
* Future direction? Explore the anesthetic challenges for biventricular staging and repair.
11:00 AM – 11:20 AM Joint Lecture with AmSECT – STARting Single Ventricles Out Right: A Perfusion Technique to Eliminate
Ischemic Time and Hypothermia during Norwood Operation
Travis Siffring, CCP
Objectives:
Upon completion of this lecturen, the participant will be able to:
* Describe STAR (Sustained Total All-Region) perfusion.
* Discuss the application of this technique.
* Highlight the similarities and differences in the Norwood operation with STAR vs traditional perfusion.
* Discuss outcomes of STAR vs traditional perfusion at a single center.
11:20 AM – 11:40 AM What’s on the Horizon? — Challenges, Innovations and Unanswered Questions in HLHS
Marshall L. Jacobs, MD
Objectives:
Upon completion of this lecture, the participant will be able to:
* Become familiar with the status of “regenerative medicine” in the form of stem cell therapy as it pertains to HLHS.
* Become familiar with approaches to improving the efficiency and durability of the Fontan circulation, including the possibility of mechanical support/enhancement of Fontan physiology.
* Become familiar with “cutting edge” strategies of mitigating the risks associated with intact atrial septum/highly restrictive atrial septum in HLHS, including the potential role of fetal and transitional interventions.
11:40 AM – 11:55 AM Q & A Discussion
Lunch with Exhibitors
11:55 AM – 12:55 PM
Session IV: Best Posters/Oral Presentations
Moderator: David Faraoni, MD, PhD, FAHA
12:55 PM – 1:25 PM Best Posters
Objectives:
Upon completion of this session, the participant will be able to:
* Discuss the latest scientific studies that are being performed in pediatric cardiac anesthesia to advance the specialty.
* Discuss the advantages and disadvantages of new techniques and data related to pediatric cardiac anesthesiology studies.
* Understand specific lessons learned from the literature as they relate to various aspects of pediatric cardiac anesthesia.
CCAS Lifetime Achievement Award
1:25 PM – 1:40 PM Presentation of the CCAS Lifetime Achievement Award
Session V: Failing Hemodynamics
Moderators: Destiny F. Chau, MD; Rodrigo Lopez Barreda, MD
1:40 PM – 2:05 PM RV Function and RV Failure in CHD/HLHS
Mark Friedberg, MD
Objectives:
Upon completion of this lecture, the participant will be able to:
* Review normal RV function and how we assess it by echocardiography.
* Identify mechanisms leading to RV failure in HLHS.
* Identify the impact of the left ventricle on RV function in HLHS.
2:05 PM – 2:25 PM The Failing Glenn Circulation
Sana Ullah, MB, ChB, FRCA
Objectives:
Upon completion of this lecture, the participant will be able to:
* Understand the common etiological factors leading to Glenn failure.
* Describe the clinical features of the failing Glenn.
* Understand the therapeutic options for a failing Glenn.
2:25 PM – 2:45 PM Identifying the Failing Fontan
Lindsey Loveland Baptist, MD
Objectives:
Upon completion of this lecture, the participant will be able to:
* Describe common clinical findings that indicate a failing Fontan circulation.
* Differentiate between early and late Fontan failure.
* Describe common assessments and their findings used to understand the degree of dysfunction including laboratory, catheter-based assessment, echo, MRI.
* Predict declining function of the Fontan circulation based on hemodynamic assessment.
* Understand risk stratification in Fontan physiology.
2:45 PM – 3:00 PM Q & A Discussion
Ice Cream Break with Exhibitors
3:00 – 3:30 PM
Session VI: Workshops (Optional & In-Person Only)
3:15 PM – 5:15 PM WORKSHOP: Extracorporeal Life Support: Ventricular Assist Device (VAD); Options, Decisions and
Management (In-Person Only)
Coordinator: Pablo Motta, MD
Erica P. Lin, MD; Travis Siffring, CCP; Sana Ullah, MB, ChB, FRCA
Objectives:
Upon completion of this workshop, the participant will be able to:
* Identify various forms of VAD support utilized in the pediatric patient population.
* Explain the transition from CPB to full VAD support physiology.
Location: JW Marriott – HB Plant Ballroom B – Level 2
3:15 PM – 5:15 PM WORKSHOP: When One Size Doesn’t Fit All: What’s New in Hemostasis and Coagulation Management for
Congenital Cardiac Surgery Patients? (In-Person Only)
Coordinator: Laura Downey, MD
Destiny F. Chau, MD; Anne Elisa E. Cossu, MD; David Faraoni, MD, PhD, FAHA; Nischal K. Gautam, MD; Stephanie N.Grant, MD
Objectives:
Upon completion of this workshop, the participant will be able to:
* Understand the prevalence and management of preoperative anemia in congenital cardiac surgery patients and how this affects patient outcomes.
* Discuss the risks and benefits of non-red blood cell transfusions in pediatric cardiac surgery patients.
* Discuss the use of transfusion algorithms for optimizing hemostasis and reducing donor exposures in congenital cardiac surgery.
* Demonstrate proficiency of interpreting VET and determining appropriate hemostatic treatment.
* Understand risk of bleeding and thrombotic risks in pediatric patients presenting with COVID-19 and appropriate treatments
Location: JW Marriott – Manatee – 4th Floor
3:15 PM – 5:15 PM WORKSHOP: Quality Improvement Methodology and Safety In A High Risk Environment: Congenital Cardiac
Anesthesia (In-Person Only)
Coordinator: Morgan L. Brown, MD, PhD
Phillip S. Adams, DO; Stephen J Gleich, MD, FAAP; Jennifer Hernandez, MD; Martina Richtsfeld, MD
Objectives:
Upon completion of this workshop, the participant will be able to:
* Review quality improvement methodologies to improve your local practice through demonstration and group discussion.
* Examine handovers and the role they play in creating a safe culture in your practice.
* Discuss the management of medication errors through an apparent cause analysis.
Location: JW Marriott – Adamo – Level 3
3:15 PM – 5:15 PM WORKSHOP: Academic Career in Pediatric Cardiac Anesthesia: Trials and Tribulations (In-Person Only)
Coordinator: Chandra Ramamoorthy, MBBS, FRCA
James A. DiNardo, MD; Nina A. Guzzetta, MD; Zoel Quinonez, MD
Objectives:
Upon completion of this workshop, the participant will be able to:
* Identify challenges in forging an academic career in anesthesiology.
* Understand whether easier or more difficult in Pediatric Cardiac Anesthesiology.
* Discuss traditional research pathway.
* Identify newer academic opportunities.
* Understand publishing and flourishing.
* Identify other forms of recognition for academic work.
Location: JW Marriott – Aremenia – Level 3
Session VII: New Developments in CHD
Moderators: Rania K. Abbasi, MD; Jimmie E. Colon, MD
3:30 PM – 3:50 PM Pediatric Interventional Cardiology: Innovations and Complications
David Nykanen, MD
Objectives:
Upon completion of this lecture, the participant will be able to:
* Identify barriers to innovation in the development of new treatment strategies.
* Anticipate complications in transcatheter closure of a PDA in a premature neonate.
* Identify etiology of hemodynamic instability during transcatheter rehabilitation of the RVOT in Tetralogy of Fallot.
3:50 PM – 4:10 PM Clinical Innovations in Electrophysiology for Pediatric Congenital Heart Disease
Manchula Navaratnam, MD
Objectives:
Upon completion of this lecture, the participant will be able to:
* Identify advances in implantable devices and cardiac resynchronization therapy for pediatric cardiac and congenital heart disease.
* Discuss implications for anesthesia and peri-operative management.
4:10 PM – 4:30 PM Optimal Hgb – From Preop Anemia Clinic Through the ICU
Dheeraj Goswami, MD
Objectives:
Upon completion of this lecture, the participant will be able to:
* Evaluate the peri-operative risk factors for pediatric cardiac patients that may affect optimal hemoglobin through the peri-operative period.
* Review the recent literature regarding blood utilization.
* Discuss the novel concepts and therapies that may guide blood utilization in the coming years.
4:30 PM – 4:50 PM The High-Risk Transplant – Anesthetic Perspective
Christopher T. McKee, DO
Objectives:
Upon completion of this lecture, the participant will be able to:
* Describe factors that predispose patients to intraoperative risk.
* Identify strategies to optimize pre-transplant management.
* Formulate intraoperative strategies to mitigate risk in the post-operative period.
4:50 PM – 5:10 PM Q & A Discussion
Session IX: Professor Poster Rounds
Moderators: Rania K. Abbasi, MD; Morgan L. Brown, MD, PhD; James A. DiNardo, MD; Laura Downey, MD; David Faraoni, MD, PhD, FAHA; Nina A. Guzzetta,
MD; Gregory J. Latham, MD; Jamie McElrath Schwartz, MD; Viviane G. Nasr, MD; Manchula Navaratnam, MD; Mark D. Twite, MD, BCh; David F. Vener, MD
5:15 PM – 6:15 PM Professor Poster Rounds
Objectives:
Upon completion of this session, the participant will be able to:
* Discuss the latest scientific studies that are being performed in pediatric cardiac anesthesia to advance the specialty.
* Discuss the advantages and disadvantages of new techniques and data related to pediatric cardiac anesthesiology studies.
* Understand specific lessons learned from the literature as they relate to various aspects of pediatric cardiac anesthesia.
CCAS Reception
6:15 – 7:30 PM