Congenital Cardiac Anesthesia Society Annual Meeting 2023

•  Include: 2 videos + 1 pdf, size: 23.4 GB
•  Target Audience: anesthesiologists and other practitioners who care for children with any form of cardiac disease and adults with congenital heart disease

 Information:

 Topics:

*Note: these are continuous video recordings during the conference, they include individual lectures mentioned in the Detail section below

• CCAS 2023 Annual Meeting – Printable Program.pdf
  March 30 Part 1.mp4
  March 30 Part 2.mp4

* Detail:

THURSDAY, MARCH 30, 2023

6:00 AM – 5:00 PM Registration Location:
PBLD/ROUND TABLE SESSION with Breakfast: Offered IN-PERSON Only
6:15 AM – 7:15 AM PBLD 1: Anterior Mediastinal Mass in a 1 Kg Preterm Newborn Zachary Kleiman, MD; Chandra Ramamoorthy, MBBS, FRCA

Objectives:

Upon completion of this PBLD, the participant will be able to:

• * Discuss management of a 1 Kg 26-week preterm newborn with a mediastinal mass for emergent sternotomy and possible cardiopulmonary bypass.
  * Optimize communication and establish roles with multiple OR teams.
  * Understand Exit Procedure- Why or why not?
  * Understand vascular access- if, when, where – the risks and benefits.
  * Discuss trainee education in high-risk situations.

6:15 AM – 7:15 AM PBLD 2: Anesthetic Considerations in an Infant with Alagille Syndrome and Pulmonary Valve and Branch Pulmonary Artery Stenosis Undergoing Cardiac Repair Natalia Diaz-Rodriguez, MD; Dheeraj Goswami, MD
Objectives:

Upon completion of this PBLD, the participant will be able to:

• * Review the clinical characteristics of Alagille Syndrome, including most common congenital cardiovascular disease manifestations.
  * Recognize anesthetic concerns for children with Alagille Syndrome undergoing cardiopulmonary bypass surgery.
  * Review features of congenital cardiac disease associated with higher mortality risk following cardiac surgery.

6:15 AM – 7:15 AM PBLD 3: Is Trisomy 18 the Next “Baby Doe?”: PDA Ligation in a Neonate with Trisomy 18, Tetralogy of Fallot, and Necrotizing Enterocolitis Shawn Jackson, MD, PhD; Barry D. Kussman, MB, BCh
Objectives:

Upon completion of this PBLD, the participant will be able to:

• * Gain knowledge of the paradigm shift in the care of infants with Trisomy 18 with respect to the ethical considerations, technological interventions, and factors associated with increased quantity and quality of life.
  * Differentiate the typical ‘blue Tet’ from the ‘pink Tet’ vis-a-vis the pathophysiology and anesthetic considerations.
  * Understand the etiology, pathophysiology, and management of necrotizing enterocolitis in the current era.
  * Describe the non-pharmacologic management of PDA in the premature low birth weight infant and the pros and cons of each.

6:15 AM – 7:15 AM PBLD 4: “Not Afraid of Dying, but Damn Well Want to Live” – Cardiovascular Disease and Emerging Interventions in Hutchinson-Gilford Progeria Syndrome Mary Lyn Stein, MD; Katherine L. Zaleski, MD

Objectives:

Upon completion of this PBLD, the participant will be able to:

• * Appreciate the multisystem organ involvement in Hutchinson-Gilford Progeria Syndrome (HGPS) with a particular emphasis on the cardiovascular system.
  * Discuss the current and evolving approach to the management of cardiovascular disease in HGPS.
  * Formulate a safe, comprehensive periprocedural care plan for the patient for HGPS presenting for surgery (cardiac and non-cardiac).

6:15 AM – 7:15 AM PBLD 5: Child with Congenital Heart Disease and Obstructive Hydrocephalus (Offered in Spanish Only) Gladys Lejbusiewicz, MD; Valentina Peluas

Objectives:

Upon completion of this PBLD, the participant will be able to:

• * Discuss the management of a case with heart disease (ATRIAL SEPTAL DEFECT+ VENTRICULAR SEPTAL DEFECT) in a patient presenting for a ventriculoperitoneal shunt.
  * Propose a perioperative plan for the management of the patient with pulmonary hyper flow and intracranial hypertension.
  * Propose subsequent resolution of her heart disease: how long after neurosurgery: palliative or corrective?

6:15 AM – 7:15 AM RDT 1: High Risk Sternal Reentry Jane Heggie, MD; Edward Hickey, MD, FRCS

Objectives:

Upon completion of this Round Table Discussion, the participant will be able to:

• * Identify high-risk sternotomy ACHD patients.
  * Discuss the best strategies to avoid catastrophic cardiovascular injury on reentry.
  * Identify the indications of cardiopulmonary bypass initiation before sternotomy.
  * Review the massive transfusion protocols in the event of a tragic cardiovascular tear.

6:15 AM – 7:15 AM RDT 2: Enhanced Recovery After Cardiac Surgery (ERAS) in ACHD. Good Selection is Key for Success Richard Hubbard, MD; Alexander C. Mittnacht, MD

Objectives:

Upon completion of this Round Table Discussion, the participant will be able to:

• * Understand the importance of risk stratification in ACHD patients.
  * Identify the candidacy for ERAS in ACHD.
  * Discuss how to implement ERAS protocols in ACHD.

6:15 AM – 7:15 AM RDT 3: Management of Patients Undergoing Pulmonary Artery Reconstruction Amy M. Babb, MD; M. Gail Boltz, MD

Objectives:

Upon completion of this Round Table Discussion, the participant willl be able to:

• * Discuss the typical preoperative evaluation and planning for patients scheduled for pulmonary artery reconstruction surgery.
  * Learn about the intra-operative management of pulmonary artery reconstruction surgery using examples like tetralogy of fallot/pulmonary atresia and Williams syndrome.
  * Discuss expected immediate postoperative management and outcomes for pulmonary artery reconstruction patients.

Breakfast with Exhibitors
6:30 – 7:15AM
7:15 AM – 7:35 AM Welcome/Board of Directors Change/Outline of Educational Program Mark D. Twite, MD, BCh; Luis M. Zabala, MD; David F. Vener, MD

Session I: Prematurity and Congenital Heart Disease
Moderators: Nischal K. Gautam, MD; Zoel Quinonez, MD

7:35 AM – 7:55 AM Anesthesia and the Premature Patient: Challenges in the OR and Beyond Anshuman Sharma, MD, FFARCSI

Objectives:

Upon completion of this presentation, the participant will be able to:

• 1. Understand the relationship between gestational age, birth weight and congenital heart disease.
  2. Discuss preoperative optimization and surgical decision making.
  3. Discuss perioperative management of extremely young undergoing repair of congenital cardiac defects.
  4. Review postoperative care and outcomes.

7:55 AM – 8:20 AM Palliation in Prematurity: Non-CPB Cardiac Surgery vs. Cath intervention: New Challenges and New Solutions Kiran Mallula, MD

Objectives:

Upon completion of this presentation, the participant will be able to:

• 1. Identify some off-pump palliative surgeries and catheter interventions in premature infants.
  2. Describe these catheter interventions in detail.
  3. Learn about the pros and cons of each strategy.

8:20 AM – 8:50 AM Arthur Keats Lecture: The Artificial Womb and New Approaches to Extreme Prematurity Alan Flake, MD, FACS, FAAP

Objectives:

Upon completion of this presentation, the participant will be able to:

• 1. Describe the three primary components of the Extra-uterine Environment for Neonatal Development (EXTEND).
  2. Discuss the potential clinical applications of EXTEND.
  3. Describe the current status of EXTEND technology and the remaining obstacles to clinical application.

8:50 AM – 9:10 AM Q & A Discussion
Coffee Break with Exhibitors

9:10 – 9:40AM Session II: Adult Congenital Heart Disease (ACHD) Moderators: Pablo Motta, MD; Bridget Pearce, MD
9:40 AM – 10:00 AM Assessing Risk in the Adult Cardiac Patient Prior to Anesthesia Jane Heggie, MD

Objectives:

Upon completion of this presentation, the participant will be able to:

• * Identify predictors of adverse outcome in the ACHD cardiac surgery patient.
  * Discuss peri-operative consultation to manage and/or mitigate red flag issues. The Team Matters.
  * Understand the role of the substitute decision maker and explanation of risk to patient and family.

10:00 AM – 10:20 AM ACHD in the CVOR: More Than Just Conduit Replacements Edward Hickey, MD, FRCS

Objectives:

Upon completion of this presentation, the participant will be able to:

• 1. Raise awareness of case complexity of ACHD surgery.
  2. Introduce strategies for risk-containment in ACHD surgery.
  3. Introduce heart failure surgical strategies for ACHD surgery.

10:20 AM – 10:40 AM Optimizing for Success in the Congenital Catheterization Laboratory Abhay Divekar, MD

Objectives:

Upon completion of this presentation, the participant will be able to:

1. 1. Understand the team approach requires familiarity and trust between providers, know your own limitations.
   2. Recognize the importance of pre-procedure huddle and exit strategy.
   3. Identify complex ACHD Case Examples highlighting team interaction based on patient complexity for optimal patient outcomes.
   4. Change plans on the fly and think outside the box.
   10:40 AM – 10:55 AM Q & A Discussion

Session III: Perioperative Care at the Extremes Moderators: Jamie McElrath Schwartz, MD; Rajeev Wadia, MD
11:00 AM – 11:20 AM Preterm Perioperative Care: Challenges and Optimization Riva Ko, MD

Objectives:

Upon completion of this presentation, the participant will be able to:

1. 1. Discuss the challenges in the perioperative management of preterm infants undergoing cardiac surgery.
   2. Provide an overview of the model of a dedicated neonatal cardiac intensive care unit, and specifically contrast the model with the traditional model of care.
   3. Review the morbidity and mortality outcomes of a dedicated neonatal cardiac intensive care unit.

11:20 AM – 11:40 AM Optimizing Outcomes for Adults with Congenital Heart Disease within a Children’s Hospital Cameron Dezfulian, MD
Objectives:

Upon completion of this presentation, the participant will be able to:

• 1. Distinguish key differences in perioperative management of adults vs children with congenital heart disease (CHD).
  2. Describe a series of perioperative interventions enacted to optimize outcomes within a dedicated ACHD inpatient unit.
  3. Assess the impact of these interventions based on the associated patient outcomes.

11:40 AM – 11:55 AM Q & A Discussion
Lunch with Exhibitors

Session IV: Best Posters and Research Award Update Moderators: Laura Downey, MD; Gregory J. Latham, MD
12:50 PM – 1:20 PM Best Posters (Five Best)
1:20 PM – 1:30 PM Research Award Updates Stephanie N. Grant, MD
1:30 PM – 1:45 PM Lifetime Achievement Award – Chandra Ramamoorthy, MBBS, FRCA Manchula Navaratnam, MD

Session V: Minimizing Morbidity in the CVOR and Beyond Moderators: Faith J. Ross, MD; David F. Vener, MD
1:45 PM – 2:10 PM PCICS Lecture – Too Much of a Good Thing: Oxygen Therapy in the Cardiac OR and ICU Douglas B. Atkinson, MD

Objectives:

Upon completion of this presentation, the participant will be able to:

• 1. Describe the beneficial and harmful effects of hyperoxia during cardiopulmonary bypass.
  2. Discuss appropriate oxygen targets for cardiopulmonary resuscitation and ECMO.
  3. Examine the impact of hyperoxia on outcomes after cardiac surgery.

2:10 PM – 2:30 PM Update on Coagulation: Blood, Drugs and Monitors Laura Downey, MD

Objectives:

Upon completion of this presentation, the participant will be able to:

• 1. Review recent studies regarding recommended blood product transfusions thresholds.
  2. Discuss new pharmaceutical medications and their role in perioperative hemostasis.
  3. Discuss new devices to monitor intraoperative coagulation parameters.

2:30 PM – 2:50 PM Beyond Function and Residual Lesions: What can Echo Say Today and Tomorrow to the CV Anesthesia Team? Asif Padiyath, MBBS

Objectives:

Upon completion of this presentation, the participant will be able to:

• 1. Review the current status of perioperative echocardiography use for congenital cardiac surgical patients.
  2. Review the recent advances in 3-dimensional imaging for perioperative care of congenital cardiac surgical patients.
  3. Review the novel modalities of perioperative imaging for intraprocedural and intraoperative guidance.

2:50 PM – 3:05 PM Q & A Discussion
Ice Cream Break with Exhibitors
3:05 – 3:35PM

Session VI A: WORKSHOP SESSION
3:15 PM – 5:15 PM WORKSHOP: Regional Anesthesia for Congenital Cardiac Surgery Coordinator: Chris Denny, MD
Walid Alrayashi, MD; Michael A. Evans, MD; Carine Foz, MD; John G. Hagen, MD, MBA, FAAP, FASA; Cassandra
Hoffmann, MD; Alexander C. Mittnacht, MD; Zoel Quinonez, MD; Lauren Smith, MD; Kevin Spellman, MD; Karla WyattThompson, MD, MS

Objectives:

Upon completion of this workshop, participants will be able to:

• * Introduce different regional techniques including relevant innervation and anatomy currently in use for congenital cardiac surgery.
  * Discuss which surgical procedures would be appropriate for regional anesthesia.
  * Define relevant anatomy for various truncal blocks using ultrasound.
  * Provide hands-on education on optimizing ultrasound views and tips on patient positioning and approach to various truncal blocks.

Location: Meeting Room 201 – 202: 2nd Floor

3:15 PM – 5:15 PM WORKSHOP: Patient Blood Management: When One Size Doesn’t Fit All – What’s New in Hemostasis and Coagulation Management for Congenital Cardiac Surgery Patients
Coordinator: Laura Downey, MD; Alexander Schmidt, MD
Warwick A. Ames, MBBS, FRCA; Dheeraj Goswami, MD; Stephanie N. Grant, MD; Manchula Navaratnam, MD; Dominik Ochocinski, D.O.; Peggy Vogt, MD

Objectives:

Upon completion of this workshop, participants will be able to:

• * Review preoperative, intraoperative and post-operative optimization of hemostasis in congenital cardiac surgery patients.
  * Discuss transfusion decisions made based on hemoglobin thresholds and physiologic parameters to determine risk and benefit of red blood cell transfusions.
  * Discuss the risk and benefits of non-red blood cell transfusions in pediatric cardiac surgery patients.
  * Discuss blood product alternatives to optimize hemostasis and minimize risk in congenital 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

Location: Meeting Room 211 – 212: 2nd Floor
3:15 PM – 5:15 PM WORKSHOP: Extracorporeal Life Support: VAD Options, Decisions, and Management Coordinator: Pablo Motta, MD
Andres Bacigalupo Landa, MD; Erica P. Lin, MD; Ashraf Resheidat, MD; Sana Ullah, MB, ChB, FRCA

Objectives:

Upon completion of this workshop, participants will be able to:

• * Identify various forms of VAD support utilized in the pediatric patient population.
  * Understand the difference between ECMO and VAD physiology.
  * Explain the transition from CPB to VAD support.

Location: Meeting Room 205 – 2nd Floor

3:15 PM – 5:15 PM WORKSHOP: Staying Alive: Professional Development and Well-being for Career Sustainability Coordinator: Laura K. Berenstain, MD, FASA
Nina A. Guzzetta, MD; Anna J Hartzog, MD; Nicholas M. Houska, DO; Lindsey Loveland Baptist, MD

Objectives:

Upon completion of this workshop, participants will be able to:

• * Explore and articulate key values that provide purpose and meaning for their definition of whole life (personal and  professional) success.
  * List steps for building and maintaining professional support structures.
  * Understand the differences between mentorship, sponsorship, and coaching relationships.
  * Practice skills central to mindful communication with a view to enhancing professional relationships.

Session VI B: WORKSHOP SESSION
3:15 PM – 4:45 PM WORKSHOP: Toward Safe Transport for Children with Complex Critical Illness and /or CHD Requiring Ventilatory Support
Coordinator: Wenyu Bai, MD; Wilson Chimbira, MD, FRCA; Prabhat Koppera, MD
Morgan L. Brown, MD, PhD; Bridget Pearce, MD; Lori Q. Riegger, MD; Lisa Vitale, MD; Raza Zaidi, MD

Objectives:

Upon completion of this workshop, participants will be able to:

• * Recognize the likely causes and manage ventilation-related adverse events occurring during transport including barotrauma, hypo- and hyperventilation, unrecognized accidental extubation, and use of inappropriate FiO2.
  * Familiarize participants with newly developed ventilatory equipment such as HFNC, infant T-piece resuscitator, and transport ventilator which are increasingly utilized in pediatric ICU and during intrahospital transport.
  * Formulate a reliable and safe transport check list including employing safe respiratory care strategies to optimize ventilatory support.

Session VII: Cardiac Anesthesia: The Present and the Future
Moderators: Mark D. Twite, MD, BCh; Luis M. Zabala, MD
3:35 PM – 3:55 PM Important Articles of the Past Year in Congenital Heart Care: What Have We Learned? Rania K. Abbasi, MD

Objectives:

Upon completion of this presentation, the participant will be able to:

1. 1. Review noteworthy pediatric cardiac anesthesia literature published in 2022.
   2. Identify key themes in pediatric cardiac anesthesia clinical research.
   3. Recognize knowledge gaps for future areas of clinical research in pediatric cardiac anesthesia.

3:55 PM – 4:15 PM Pediatric Cardiac Anesthesia Workforce: An Update Viviane G. Nasr, MD

Objectives:

Upon completion of this presentation, the participant will be able to:

• 1. Understand the current status of pediatric cardiac anesthesia training.
  2. Define the workforce of pediatric cardiac anesthesia in the United States.
  3. Recognize the important factors for recruitment and retention.

4:15 PM – 4:45 PM Peer Support: Small Effort, Big Impact Renee N. Kreeger, MD
Objectives:

Upon completion of this presentation, the participant will be able to:

• 1. Understand the need for peer support as part of caregiver well-being.2 Describe the foundational principles of peer support.
  3. Consider opportunities for peer support implementation in their institution.

4:45 PM – 5:10 PM Q & A Discussion

Session VIII: Professor Poster Rounds
Moderators: Rania K. Abbasi, MD; Elena Ashikhmina, MD, PhD; Laura Downey, MD; Nischal K. Gautam, MD; Stephen J Gleich, MD, FAAP; Dheeraj Goswami, MD; Nina A. Guzzetta, MD; Edmund Jooste, MB, ChB; Gregory J. Latham, MD; Pablo Motta, MD; Viviane G. Nasr, MD; Manchula Navaratnam, MD; Faith J. Ross, MD; Jamie McElrath Schwartz, MD; David F. Vener, MD; Luis M. Zabala, MD
5:15 PM – 6:15 PM Professor Poster Rounds
CCAS Reception
6:15 – 7:30PM