14th Annual Meeting

Agenda

Saturday, October 13, 2018

7:00 am	Registration
7:30 am – 8:20 am	Continental Breakfast/Poster Viewing/Exhibitors
8:20 am – 8:40 am	Welcome Susan Smyth, MD
8:40 am – 9:15 am	Presidential Speaker: Common Mistakes in Adult Congenital Heart Disease: What the Practitioner Should Know Carole A. Warnes, MD Mayo Clinic More Information 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
8:45 am – 9:50 am	Practice Management:Don’t Have a Heart Attack… What Every Practice Needs to Know about Government Audits and Investigations Jennifer L. Wintergerst, LLP More Information 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
9:15 am – 9:50 am	Distinguished Lecturer: New Devices and Medicines in Heart Failure: How to Improve Care Randall Starling, MD, MPH Cleveland Clinic More Information 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
9:50 am -10:10 am	Refreshment Break, Exhibits, Poster Viewing
10:10 am – 11:00 am	Honorable Maestro Speaker Deepak Bhatt, MD, MPH Bringham and Women's Hospital More Information Chairs: Susan Smyth, MD and Pat Withrow, MD
10:10 am – 11:10 am	Practice Management Lindy Lady Kentucky Medical Association More Information At the end of this session attendees will be able to: Share coverage/policy/legislative updates applicable to CPT Connect with KMA for help addressing policy issues and other barriers Participate in the KMA Public Health Commission Chair: Pat Horvat, RN
11:00 am – 11:10 am	Presentation of the 2018 Honorable Maestro Award Roberto Bolli, MD, FAHA, FACC presented by Juan Villafane, MD, FACC
11:10 am – 11:30 am	FIT Oral Abstract Presentations More Information 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
11:30 am – 12:00 pm	Box Lunch with Exhibitors
11:30 am – 12:00 pm	FIT Lunch
12:00 pm	Afternoon Announcements, Prizes, and National Speaker Chair: Linda Otavalro Orozco, MD
12:00 pm -12:20 pm	ACC Remarks Andrew Miller, MD, FACC, Chair, ACC Board of Governors
12:20 pm – 12:55 pm	ACC Speaker Claire Duvernoy, MD University of Michigan School of Medicine More Information Objectives: To discuss the ACC’s current and future strategic plan Current and future mission and vision Transition from the triple to the quadruple aim Role of innovation To discuss the ACC’s evolving core values Patient-centered Teamwork and collaboration Professionalism and excellence To discuss the ACC’s vision for diversity and equity Role of the Diversity Taskforce Action Items for DE&I for 2019 Role of the Women in Cardiology Section
1:00 pm – 2:20 pm	Concurrent Session: Echocardiography Echo Evaluation of Aortic Stenosis Michelle Bay, RDCS More Information 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. What to Do with Discrepant Numbers in Aortic Stenosis Quantification Mikel Smith, MD Low Flow Low Gradient and Normal Flow Low Gradient Severe AS Vedant Gupta, MD More Information Define Low Flow/Low Gradient and Paradoxical Low Flow/Low Gradient aortic stenosis. Identify echocardiographic parameters to make these diagnoses and common sources of error. Understand the management of this disease state in the age of transcatheter aortic valve implantation (TAVI) and the role of adjunct imaging. Post AVR Assessment Marcus Stoddard, MD Chairs: Larry Todd Breeding, MD and Sunil Mankad, MD Moderators: LT Breeding, MD and Sunil Mankad, MD
1:00 pm – 2:20 pm	Concurrent Session: Updates in Advanced Heart Failure (+/- Pulm HTN) Current Pathology Spectrum of Native End Stage Heart Disease and Post Transplant William O'Connor, MD More Information Objectives: Successfully compare normal cardiac segmental anatomy with TGA examples to understand the concept of ventriculoarterial discordance. Recognize TGA associated atrial septal, ventricular septal , subvalvar and coronary artery anatomy. Understand route of post surgical blood flow in specimens with atrial switch/Mustard procedure Top-Five Basic Tricks When Seeing a Patient with CRT John Mandrola, MD Setting Up a Cardio MEMS Program Peggy Hardesty, MSN, APRN More Information Objectives: Participants will be able to define patients appropriate for Cardiomems implant and monitoring Participants will be able to state benefits of remote monitoring Participants will be able to state basic requirements for implementing a Caridomems program Setting Up an ECMO Program at a Community Based Hospital Julia Jones, MD More Information 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. Chairs: Steven Press, ACNP and Navin Rajagopalan, MD Moderators: Navin Rajagopalan, MD and Steve Press, ACNP
1:00 pm – 2:20 pm	Concurrent Session: Congenital Heart Disease; Transposition of the Great Arteries; From Fetus to Adulthood Echocardiographic Assessment of TGA Lucinda Wright, MD More Information 3 objectives: Review echocardiographic findings in the fetus with TGA Review echocardiographic findings in the newborn with TGA. Review common echocardiographic findings after arterial switch operation for repair of D-TGA. Surgical Interventions for TGA Through the History James Quintessenza, MD More Information Be familiar with the current surgical operation for TGA Understand factors that affect surgical outcomes for TGA patients Hands on and Pathology Review of TGA Real Life Specimens William O’Connor, MD More Information Objectives: Successfully compare normal cardiac segmental anatomy with TGA examples to understand the concept of ventriculoarterial discordance. Recognize TGA associated atrial septal, ventricular septal , subvalvar and coronary artery anatomy. Understand route of post surgical blood flow in specimens with atrial switch/Mustard procedure Session Chairs: Majd Makhoul, MD and Douglas Schneider, MD
1:00 pm – 2:20 pm	Concurrent Session: Improving CV Care and Preventing CV Disease (Quality) Stroke Encounter Quality Improvement Project (SEQIP) After 5 years: How a System of Care Works in Kentucky? Kerri Remmel, MD, Ph D Appropriateness of PCI: What Has Changed From 2012 to 2017? Divyesh Bhatka, MD More Information Session objectives: Origins and rational for AUC in PCI, Design and use of AUC criteria, Changes in AUC guidelines from 2012 to 2017. STEMI networks – Process and Impact on Outcomes in Kentucky Khaled Ziada, MD Contribution of Women Heart Health Centers to Quality of Care Gretchen Wells, MD Chairs: Chris McIntyre, MD and Khaled Ziada, MD
2:20 pm – 2:40 pm	Refreshment Break, Poster Viewing
2:40 pm – 4:00 pm	Concurrent Session: Echocardiography ACI in Valvular Heart Disease (Mitral Regurgitation) Arash Seratnahaei, MD More Information Objectives: Provide an overview of advanced cardiovascular imaging in the evaluation of mitral regurgitation Discuss the importance of identifying the etiology and quantification of mitral regurgitation Explain CMR techniques used to assess mitral regurgitation Mitral Valve Masses John Kotter, MD More Information Discuss mitral valve anatomy Differentiate common mitral valve masses Mitral Regurgitation Quantification Saretta Craft, RDCS More Information At the conclusion of this presentation, the audience should be able to: Describe the key mechanism of MR Identify causes of chronic and acute MR Discuss how 2D, Color Flow, and spectral Doppler measurements are used to assess severity of MR. The Emerging Role of 3D Echo in the Assessment of Mitral Valve Disease Sunil Mankad, MD More Information Objectives: Describe the emerging role of 3D echocardiography in the evaluation of mitral stenosis and mitral balloon valvuloplasty. Utilize the 3D echocardiography to better guide surgical mitral valve repair. Apply 3D echocardiographic principles and techniques to better comprehend the complexities of mitral annular dynamics. Chairs: John Kotter, MD and Brian Lea, MD Moderators: Brian Lea, MD and John Kotter, MD
2:40 pm – 4:00 pm	Concurrent Session: Updates in Advanced Heart Failure (+/- Pulm HTN) Pulmonary Hypertension John McConnell, MD More Information Review World Health Organization Classifications for Pulmonary Arterial Hypertension Understand the diagnostic workup for patients with suspected Pulmonary Arterial Hypertension Discuss the three treatment pathways for Pulmonary Arterial Hypertension Treatment options for Pulmonary Arterial Hypertension Review Risk Assessment tools for Pulmonary Arterial Hypertension Approach to Common LVAD Complications Gregory F. Egnaczyk, MD More Information Learning Objectives: Review the common complications of LVAD therapy Learn an approach to an LVAD patient with neurologic symptoms? Learn an approach to an LVAD patient with gastrointestinal bleeding? Learn an approach to an LVAD patient with shortness of breath? Recognize the alarms from an LVAD device that require immediate attention? Cardio-Oncology Maya Guglin, MD More Information Objectives: To understand the difference between anthracycline and trastuzumab-induced cardiomyopathy To realize the potential of pharmacologic prevention of cardiotoxicity To analyze the evidence for and against cardiac monitoring and pharmacologic prevention of cardiotoxicity Chairs: Navin Rajagopalan, MD and Peggy Hardesty, MSN, APRN Moderators: Peggy Hardesty, MSN, APRN and Steve Press, ACNP
2:40 pm – 4:00 pm	Concurrent Session: Congenital Heart Disease; Transposition of the Great Arteries; From Fetus to Adulthood The Tale of Two Switches Craig Alexander, MD More Information Objectives: Understand the basic hemodynamic condition of the Mustard or Senning Atrial Switch Operation Understand the basic hemodynamic condition of the Jatene Arterial Switch Operation Review the Most Common Issues associated with both atrial switch and arterial switch operations Advanced Cardiac Imaging in TGA Preeti Ramachandran, MD Interventional Catheterization in TGA Andrew Leventhal, MD & Ryan Leahy, MD More Information This lecture will focus on indications for cardiac catheterization in patients with TGA and special techniques and equipment for successful diagnostic and interventional catheterization. Common Arrhythmias in Palliated TGA; Diagnosis and Management Kelvin Lau, MD and Shaun Mohan, MD More Information Objectives are: Understanding and recognizing the common arrhythmias in palliated TGA. Knowing the post-surgical anatomy and relevance to planning an ablation in palliated TGA. Knowing the importance of lifelong surveillance for arrhythmias Session Chairs: Brian Holland, MD and Juan Villafane, MD, FACC
2:40 pm – 4:00 pm	Concurrent Session: Improving CV Care and Preventing CV Disease (Prevention) Cardiac Rehabilitation – Value and Place in the Continuum of Care Jacob Stone Lipid Lowering Therapy Beyond Statins - What We Need to Know Mary B Covell, PharmD, MPH, BCPS What Cardiologists Need to Know About New Anti-Diabetic Therapies J. Scott Hayes, Pharm.D., BCPS More Information Objectives: Summarize the new ADA treatment guidelines Determine which diabetes medications are most appropriate for use in relation to cardiovascular risks in a patient Identify potential risk associated with diabetes medications or classes of medications. Effect of New Hypertension Guidelines on Cardiology Practices Stacy Taylor, Pharm.D., MHA, BCPS More Information Objectives: Describe the epidemiologic impacts of the 2017 ACC/AHA Hypertension Guidelines on hypertension diagnoses in the United States. Compare and contrast the 2017 ACC/AHA Hypertension guidelines with previous hypertension guidelines. Describe basic approaches to pharmacologic management of HTN in the general adult population, blacks and non-blacks, and in patients with chronic kidney disease. Chairs: Christopher Betz, PharmD and Khaled Ziada, MD
4:00 pm - 4:10 pm	19 ACC Award Winners/ Prize Giveaways
4:10 pm - 5:00 pm	FIT Jeopardy Sunil Mankad, MD

Honorable Maestro

University of Louisville cardiologist and researcher, Roberto Bolli, M.D., is director of U of L’s Institute of Molecular Cardiology and serves as scientific director of the Cardiovascular Innovation Institute at the university. He is also a professor and chief of the Division of Cardiovascular Medicine at the School of Medicine. In the past year, he received one of the largest grants ever for medical research at the University of Louisville, to study a promising new type of adult cardiac stem cell that has the potential to treat heart failure. He also led the Stem Cell Summit at the annual meeting of the American Heart Association in Anaheim, California.

Dr. Bolli’s research focus has been on how to repair the heart and cure heart failure using a patient’s own stem cells. It is an approach that could revolutionize the treatment of heart disease.

Continuing Education

The Southern Kentucky Area Health Education Center is accredited by the Kentucky Medical Association (KMA) to provide continuing medical education for physicians. The Southern Kentucky AHEC designates this live activity for a maximum of (eight and one-half (8.5) credits) AMA PRA Category 1 Credit(s).™ Physicians should only claim credit commensurate with the extent of their participation in the activity.

All persons participating in continuing medical education programs sponsored by the Southern AHEC are expected to disclose any real or perceived Conflict of interest related to the content of their presentations. The Southern Kentucky AHEC office of Continuing Medical Education presents this activity for educational purposes only. Participants are expected to use their own expertise and judgment while engaged in the practice of medicine. The content of the presentation is provided solely by presenters who have been selected for presentations because of recognized expertise in the field.

KBN Approval: Rockcastle Regional Hospital, Inc. has been approved as a provider of continuing education by the Kentucky Board of Nursing (KBN). Provider #4-0059. Expiration Date December 31, 2018. Kentucky Board of Nursing approval of an individual nursing education program does not constitute endorsement of program content. Receiving Credit: In order to receive contact hours, you need to attend the offered sessions and complete the evaluation. Participants should only claim those hours of credit actually spent in the educational activity.

OFFERING ANNOUNCEMENT
Participants shall be provided with essential information prior to registration in the form of an offering announcement. The following information must be included:

Learner outcomes
Content overview
Date, time, and presentation schedule
Presenter
Number of contact hours
Fee and refund policy
Target audience and any prerequisites

Conflict of Interest Disclosure Statements

The following speakers have disclosures:

Divyesh Bhatka, MD
Honorarium/Speakers Bureau – Amgen

Deepak Bhatt, MD, MPH
Research Funding – Abbott, Amarin, Amgen, AstraZeneca, Bayer, Boehringer Ingelheim, Bristol-Myers Squibb, Chiesl, Elsai, Ethicon, Forest Laboratories, Idorsia, Ironwood, Ischemix, Lilly, Medtronic, PhaseBio, Pfizer, Regeneron, Roche, Sanofi Aventis, Synaptic, The Medicines Company

Gregory Egnaczyk, MD
Speakers Bureau– Abbott

Peggy Hardesty, MSN, APRN
Speaker/Consulting Teaching – Abbott

J. Scott Hayes, PharmD, BCPS
Stock Options/Employment – Humana

John McConnell, MD
Speakers Bureau/Advisory Board/Consulting – Actelion, Bayer; Speakers Bureau – Genentech; Consulting – Reata; Advisory Board/Consulting – United Therapeutics

Randall Starling, MD, MPH
Research– Novartis & Abbott (Research Grant)

None of the other planners, speakers, authors, reviewers, and staff members had anything to disclose.

Faculty Disclosure Statement:
All planners, speakers, authors, reviewers, and staff members involved with content development for continuing education activities sponsored by the Southern Kentucky Area Health Education Center (AHEC) are expected to disclose any real or perceived conflict of interest related to the content of the activity. Detailed disclosures will be included in participant materials or given prior to the start of the activity.

Disclaimer
Southern Kentucky Area Health Education Center (AHEC) presents this activity for educational purposes only. Participants are expected to utilize their own expertise and judgment while engaged in the practice of medicine. The content of the presentation is provided solely by presenter(s) who have been selected for presentations because of recognized expertise in their field.