Congenital Cardiac Anesthesia Society Annual Meeting 2022

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