14th Annual Meeting: Agenda

Dr. Warnes is a Professor of Medicine and a consultant in the Department of Cardiovascular Diseases and Pediatric Cardiology at Mayo Clinic in Rochester, Minnesota.

She received her medical degree from Newcastle upon Tyne University in England and then after general medical training pursued cardiology training in London at the National Heart Hospital. Here she developed an interest in adult congenital heart disease (ACHD) after working with Jane Somerville. She then took a research position at National Institutes of Health (NIH) in the United States before returning to the National Heart Hospital in London for another two years as a British Heart Foundation Scholar and Senior Registrar working in ACHD.

Mayo Clinic
She joined the Department of Cardiovascular Diseases at Mayo Clinic in 1987, where she began the Adult Congenital Heart Disease Clinic.

Honors & Awards
Cardiovascular Teacher of the Year 8 times

Extramural
Founding member of International Society for Adult Congenital Heart Disease (ISACHD)

Objectives:

• Recognize some common clinical errors in the management of adult congenital heart disease.
• Recognize common echocardiographic mistakes in adults with congenital heart disease.
• Delineate some of the common residua and sequelae encountered in adults with repaired congenital heart disease.

Session Chair: Majd Makoul, MD

This presentation will provide attendees with an overview of the relevant fraud and abuse laws that impact healthcare providers, will discuss recent developments in the area of fraud abuse, including highlights from recent cases involving cardiology, and will provide practical tips for dealing with government investigations or responding to government inquiries.

Session Chair: Pat Horvat, RN

Heart failure is a growing global epidemic. Millions of people have heart failure globally; there are over 1 million hospitalizations yearly in the USA. Heart failure mortality and morbidity are among the highest of all chronic diseases. The new changes in the heart failure guidelines will be presented. Unfortunately despite the availability of guidelines and evidence based therapies many patients do not receive the proper medications at the ideal doses. Process improvement and techniques to improve utilization of life saving medications will be reviewed. Updates for HF with reduced and preserved ejection fraction and new clinical trials in progress will be reviewed. About 10% of the heart failure population have advanced heart failure or stage D. Stage D patients consume tremendous resources, are frequently hospitalized and have highest mortality. Impactful new and emerging therapies for stage D heart failure will be presented.

Objectives:

• Learn about the new changes in the heart failure guidelines
• Utilize Process of Care approaches to optimize care of HFrEF and HFpEF patients
• Understand the current therapies for Stage D Heart Failure

Session Chair: Navin Rajagopalan, MD

Chairs: Susan Smyth, MD and Pat Withrow, MD

At the end of this session attendees will be able to:

1. Share coverage/policy/legislative updates applicable to CPT
2. Connect with KMA for help addressing policy issues and other barriers
3. Participate in the KMA Public Health Commission

Chair: Pat Horvat, RN

A Retrospective Analysis of Dual Anti-Platelet Therapy vs Aspirin Plus Oral Anticoagulation following Transcatheter Aortic Valve Replacement (TAVR) Nicholas Hornbuckle, PharmD, MBA

Early vs Delayed Catheter-Directed Thrombolytic Therapy in Management of Submassive Pulmonary Embolism Sara Klinger, DO

Using the 4th Versus 5th Generation Troponin Assay to Predict In-Hospital Mortality Levi May, MD

Session Chair: Khaled Ziada, MD

Objectives:

1. To discuss the ACC’s current and future strategic plan
   1. Current and future mission and vision
   2. Transition from the triple to the quadruple aim
   3. Role of innovation
2. To discuss the ACC’s evolving core values
   1. Patient-centered
   2. Teamwork and collaboration
   3. Professionalism and excellence
3. To discuss the ACC’s vision for diversity and equity
   1. Role of the Diversity Taskforce
   2. Action Items for DE&I for 2019
   3. Role of the Women in Cardiology Section

Objectives:

• Understand the disease process of AS
• Refresh our memories on accurate AS measurements
• Understand how aortic stenosis cases in our labs impact our accreditation.

1. Define Low Flow/Low Gradient and Paradoxical Low Flow/Low Gradient aortic stenosis.
2. Identify echocardiographic parameters to make these diagnoses and common sources of error.
3. Understand the management of this disease state in the age of transcatheter aortic valve implantation (TAVI) and the role of adjunct imaging.

Objectives:

1. Successfully compare normal cardiac segmental anatomy with TGA examples to understand the concept of ventriculoarterial discordance.
2. Recognize TGA associated atrial septal, ventricular septal , subvalvar and coronary artery anatomy.
3. Understand route of post surgical blood flow in specimens with atrial switch/Mustard procedure

Objectives:

1. Participants will be able to define patients appropriate for Cardiomems implant and monitoring
2. Participants will be able to state benefits of remote monitoring
3. Participants will be able to state basic requirements for implementing a Caridomems program

This session will review necessary personnel and infrastructure required in order to initiate an extracorporeal membrane oxygenation program. Review will include need for institutional commitment, identification of necessary equipment, documentation and reimbursement, establishment of protocols, staff education, and patient identification and selection.

3 objectives:

1. Review echocardiographic findings in the fetus with TGA
2. Review echocardiographic findings in the newborn with TGA.
3. Review common echocardiographic findings after arterial switch operation for repair of D-TGA.

1. Be familiar with the current surgical operation for TGA
2. Understand factors that affect surgical outcomes for TGA patients

Objectives:

1. Successfully compare normal cardiac segmental anatomy with TGA examples to understand the concept of ventriculoarterial discordance.
2. Recognize TGA associated atrial septal, ventricular septal , subvalvar and coronary artery anatomy.
3. Understand route of post surgical blood flow in specimens with atrial switch/Mustard procedure

Session objectives:

1. Origins and rational for AUC in PCI,
2. Design and use of AUC criteria,
3. Changes in AUC guidelines from 2012 to 2017.

Objectives:
1. Provide an overview of advanced cardiovascular imaging in the evaluation of mitral regurgitation
2. Discuss the importance of identifying the etiology and quantification of mitral regurgitation
3. Explain CMR techniques used to assess mitral regurgitation

1. Discuss mitral valve anatomy
2. Differentiate common mitral valve masses

At the conclusion of this presentation, the audience should be able to:

1. Describe the key mechanism of MR
2. Identify causes of chronic and acute MR
3. Discuss how 2D, Color Flow, and spectral Doppler measurements are used to assess severity of MR.

Objectives:

1. Describe the emerging role of 3D echocardiography in the evaluation of mitral stenosis and mitral balloon valvuloplasty.
2. Utilize the 3D echocardiography to better guide surgical mitral valve repair.
3. Apply 3D echocardiographic principles and techniques to better comprehend the complexities of mitral annular dynamics.

1. Review World Health Organization Classifications for Pulmonary Arterial Hypertension
2. Understand the diagnostic workup for patients with suspected Pulmonary Arterial Hypertension
3. Discuss the three treatment pathways for Pulmonary Arterial Hypertension
4. Treatment options for Pulmonary Arterial Hypertension
5. Review Risk Assessment tools for Pulmonary Arterial Hypertension

Learning Objectives:

1. Review the common complications of LVAD therapy
2. Learn an approach to an LVAD patient with neurologic symptoms?
3. Learn an approach to an LVAD patient with gastrointestinal bleeding?
4. Learn an approach to an LVAD patient with shortness of breath?
5. Recognize the alarms from an LVAD device that require immediate attention?

Objectives:

1. To understand the difference between anthracycline and trastuzumab-induced cardiomyopathy
2. To realize the potential of pharmacologic prevention of cardiotoxicity
3. To analyze the evidence for and against cardiac monitoring and pharmacologic prevention of cardiotoxicity

Objectives:

1. Understand the basic hemodynamic condition of the Mustard or Senning Atrial Switch Operation
2. Understand the basic hemodynamic condition of the Jatene Arterial Switch Operation
3. Review the Most Common Issues associated with both atrial switch and arterial switch operations

This lecture will focus on indications for cardiac catheterization in patients with TGA and special techniques and equipment for successful diagnostic and interventional catheterization.

Objectives are:

1. Understanding and recognizing the common arrhythmias in palliated TGA.
2. Knowing the post-surgical anatomy and relevance to planning an ablation in palliated TGA.
3. Knowing the importance of lifelong surveillance for arrhythmias

Objectives:

1. Summarize the new ADA treatment guidelines
2. Determine which diabetes medications are most appropriate for use in relation to cardiovascular risks in a patient
3. Identify potential risk associated with diabetes medications or classes of medications.

Objectives:

1. Describe the epidemiologic impacts of the 2017 ACC/AHA Hypertension Guidelines on hypertension diagnoses in the United States.
2. Compare and contrast the 2017 ACC/AHA Hypertension guidelines with previous hypertension guidelines.
3. Describe basic approaches to pharmacologic management of HTN in the general adult population, blacks and non-blacks, and in patients with chronic kidney disease.