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Cardiothoracic Information

Overview


​​SUNDAY, 23 FEBRUARY 2014
CARDIAC LECTURES
3:30-4:00pm 3D Echo use in TAVR (Transcutaneous Aortic Valve Replacement)
                 Ernesto Salcedo, MD
 
     Objectives
1.  Identify differences in 3D and 2D echo.  
2.  Identify capabilities of 3D echo in transcutaneous aortic valve replacement specifically.   
3.  Identify fine-tuning of echo "windows" for 3D TAVR imaging  
 
4:00-4:15pm Questions and Answers
                         Salcedo

 
SUNDAY, 23 FEBRUARY 2014
CARDIAC WORKSHOP
4:15-5:00pm    Group 1 - Hands on 3D demonstrations with models
Ernesto Salcedo, MD and Tamas Seres, MD, PhD 
Group 2 – Organizing and Utilizing a Hybrid OR
Ferenc Puskas, MD, PhD, Fadi Nasrallah, MD, MBA
 
        Objectives
1. Identify layout of a hybrid OR. 
2. Recognize limitations and anesthetic concerns with a hybrid OR. 
3. Analyze procedures ideally suited to hybrid OR
 
5:00-5:45pm    Group 1 – Hands on 3D demonstrations with models
                       Ernesto Salcedo, MD and Tamas Seres, MD, PhD
                       Group 2 – Organizing and Utilizing a Hybrid OR
                       Dr. Ferenc Puskas, MD, PhD/Fadi Nasrallah, MD, MBA
 
Objectives 
1. Identify layout of a hybrid OR. 
2. Rate the limitations and anesthetic concerns with a hybrid OR. 
3. Illustrate procedures ideally suited to hybrid OR

 
5:45-6:45 pm Panel with cases Challenging Hybrid, cath lab, and EP cases
                        Tamas Seres, MD, PhD, Fadi Nasrallah, MD, MBA, Ernesto Salcedo, MD
 
6:30-7:30pm  Opening Reception

 
MONDAY, 24 FEBRUARY 2014
CARDIAC FOCUS LECTURES
7:00-7:40am LVAD’s as Temporary and Permanent Therapy:  Where do We Stand?
                        Joseph Cleveland, MD
 
Objectives
1. Restate current indications for permanent and temporary VAD support
2. Identify VAD monitor metrics (ie. pulsatility index) and how to interpret the VAD monitor
3. Document  the post operative complications for VAD patients
4. Analyze considerations for patients presenting for non - cardiac surgery with VAD support
 
7:40-8:20am What 2D and 3D TEE can tell you and what they can’t
                         Ernesto Salcedo, MD
Objectives
1. Identify what 3D TEE can tell you that 2D cannot. 
2. Improve patient outcome by recognizing situations in which each modality is superior
        Improve  techniques  to obtain  optimal 3D TEE images
3. Provide outcome data for 3D vs. 2D TEE where available.  

 
8:20-9:00am Inotropes and Vasopressors:  Use and Abuse
                        Glenn Gravlee, MD
 
          Objectives
1.  Identify relative clinical pharmacology of commonly used inotropes 
2.  Analyze pros and cons of alpha-agonists versus vasopressin
3.  Understand limitations of milrinone.
4.       Identify interactions among various inotropes.  
5.       Improve patient outcome by choosing the most appropriate inotrope for management in differing situations
 
9:00-9:30am Questions and Answers 
                        Cleveland, Salcedo, Gravlee

 
MONDAY AFTERNOON
CARDIAC TRACK
4:00-4:45pm   ECMO (Extracorporeal membrane Oxygenation):  Here it comes again  
                        Ashok Babu, MD
 
Objectives
1. Identify indications for ECMO for pulmonary support
2. Outline outcomes for ECMO for pulmonary support
3. Understand cannulation techniques for ECMO support
4. Develop appropriate protocols for instituting ECMO  
 
4:45-5:30pm Lead Extraction:  The good, the bad, and the ugly 
                        Brian Ahlgren, MD
 
Objectives
1. Identify lead extraction technique, including mechanical sheaths, laser lead sheaths, and
         electorcautery lead extraction
2.      Outline ideal  lead extraction environment including team members, location, and tools needed
3.      Analyze risk factors for patients undergoing lead extraction
  
5:30-6:30pm   Cardiac Clinical Challenges:  VADs and noncardiac surgery
                        Joseph Cleveland, MD and Breandan Sullivan, MD, Bryan Ahlgren, MD
 
         Objectives
1. Analyze the clinical implications of a patient presenting for noncardiac surgery with a nonpulsatile VAD
         in place.  
2. Identify clinical challenges in patients with a temporary VADs undergoing surgery or interventional  
        cardiology procedures.
3. Identify anatomy and physiology of "permanent" and temporary VADs and anesthetic implications.
4. Identify ICU challenges with weaning inotropes and ventilators
5. Rate the  anesthetic challenges and options with LARIAT procedure

 
6:30-7:00pm Questions and Answers
                        Babu, Ahlgren, Cleveland, Sullivan, Ahlgren

 
TUESDAY, 25 FEBRUARY 2014
CARDIAC FOCUS LECTURES
7:00-7:40am Pulmonary Hypertension – A Growing Problem
                        Breandan Sullivan, MD
 
Objectives
1. Define pulmonary hypertension.
2. Analyze the risk factors for pulmonary hypertension.
3. Identify the complexities of anesthetic management of patient’s with pulmonary hypertension.
4. Understand medical management of pulmonary hypertension.

 
7:40 -8:20am Modern Era Interventional Cardiology, Electrophysiology and the Implications
                        for the Anesthesiologist
                        Nathaen Weitzel, MD
 
        Objectives
1. Analyze key risk factors for patients undergoing interventional cardiac procedures;
2. Differentiate among critical monitoring techniques based on interventional procedure type
3. Illustrate the advantages of  general anesthesia in elctrophysiology procedures
4. Illustrate disadvantages of  general anesthesia in electrophysiology procedures
5. Identify uses and management of percutaneous LV support devices
6. Develop a list of indications for LARIAT device
7. Identify non-LARIAT left atrial appendage closure devices

 
8:20-9:00am VATS and One Lung Anesthesia Management
                        Javier Campos, MD
 
          Objectives:
1.       Give the incidence of hypoxia/hypoxemia during one-lung anesthesia.
2.        Identify techniques for prevention of hypoxia. 
3.       Analyze different approaches  to the  management of hypoxia during one-lung ventilation. 
4.       Illustrate risk factors for hypoxemia during one-lung anesthesia

 
9:00-9:30am Questions and Answers
                        (30) Jazaeri, Weitzel, and Campos

 
TUESDAY AFTERNOON
CARDIAC PANEL DISCUSSION
4:00–4:45pm Difficult Clinical Scenarios in Thoracic Anesthesia
                        Javier Campos, MD
 
         Objectives
1. Identify options for placing a Double Lumen  tube in a patient with a difficult upper airway
2. Demonstrate and Identify common types and applications of bronchial blockers
3. Analyze management options and intervention threshold during hypoxemia with one-lung anesthesia
4. Identify scenarios where lung isolations is optional rather than mandatory

 
4:45-5:30pm Multimodal Analgesia for Thoracic Surgery Workshop
                       Ferenc Puskas, MD
 
Objectives
1. Identify advantages and disadvantages of thoracic epidural for thoracic surgery. 
2. Identify advantages and disadvantages of paravertebral blocks for thoracic surgery.
3. Understand and apply techniques including ultrasound for paravertebral blocks.
4. Identify non-opioid intravenous techniques for multimodal analgesia.  
 
5:30-6:15pm Lung Isolation Hands-on Workshop:  Normal and  Difficult Airways 
                        Javier Campos, MD, Ferenc Puskas, MD, Glenn Gravlee, MD
 
Objectives
1. Demonstrate technique for insertion of double-lumen tubes.
2. Demonstrate technique for insertion of bronchial blockers.
3. Identify tracheo-bronchial anatomy relevant to double-lumen tubes.
4. Identify tracheo-bronchial anatomy relevant to bronchial blockers.
5. Analyze approaches to difficult intubation when lung isolation is needed.  

 
6:15-7:00pm Questions and Answer
                        Campos, Puskas, Gravlee

 
WEDNESDAY, 26 FEBRUARY 2014
CARDIAC LECTURES
7:00-7:40am The Adult with Congenital heart Disease:  When to Worry
                        Joseph Kay, MD
 
Objectives
1. Identify incidence and demographics of adult congenital heart disease.
2. Understand the new problems created from adult congenital heart disease.
3. Illustrate situations where pregnancy is ill-advised with adult congenital heart disease. 
4. Illustrate some "red flag conditions" for anesthesiologists from a pediatric cardiologist's perspective.

 
7:40-8:20am Making Sense of Complex repairs 20 years Later
                        Mark Twite, MD
 
Objectives
1. Identify the "plumbing" and anatomy of common complex congenital heart repairs 20 years later. 
2. Differentiate uncomplicated from complicated situations with respect to anesthetic management
3.     Analyze the implications of Eisenmenger’s syndrome in a patient undergoing anesthesia Eisenmenger
        physiology and anesthetic implications.
4.     Analyze the implications of  Fontan physiology in a patient undergoing anesthesia

 
WEDNESDAY AFTERNOON
CARDIAC PANEL DISCUSSION
4:00-4:30pm EVAR and TEVAR: Anesthetic Perspective (endovascular abdominal aortic 
                       repair and thoracic endovascular aortic repair)  
                       Ferenc Puskas, MD, PhD
 
Objectives
1. Discuss risks vs. benefits of general anesthesia vs regional anesthesia vs sedation for EVAR.
2. Develop protocols for the most appropriate management of a patient undergoing TEVAR.
3. Identify hemodynamic monitoring for TEVAR and EVAR.
4. Identify neuromonitoring for TEVAR.  
   
4:30-5:15pm Challenging Cases in Endovascular and Open Vascular Surgery 
                        Ferenc Puskas, Omid Jazaeri, MD, PhD
 
Objectives
1. Identify surgical and anesthetic options for emergency rupturing abdominal aortic aneurysm
2. Explain surgical and anesthetic approaches to carotid artery stenosis
3. Demonstrate and explain common problems and approaches to lower extremity 
        revascularization below the inguinal ligament   

 
5:30-6:45 pm Challenging clinical scenarios:  Congenital Heart Disease
                        Joseph Kay, MD and Mark Twite, MD
 
         Objectives
1.      Identify pros and cons of spontaneous vs controlled ventilation with adult congenital heart disease
        and various lesions/repairs.  
2. Identify indications for endocarditis prophylaxis in adult congenital heart disease. 
3. Identify management of some difficult labor and delivery scenarios with corrected and uncorrected
        congenital heart disease