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Course Information

Agenda

Thursday     Friday     

Thursday, September 19, 2019

7:30 am
Registration and Breakfast
8:00 am
Welcome and Introduction
Program Directors

Session I: Inside the Aorta

Moderators: Milind Desai, MD and Santi Trimarchi, MD
8:10 am
Aortic Embryology: Differences in segmental anatomy
Richard Drake, PhD
8:20 am
Pathophysiology and Etiology of Dissection
Carmela Tan, MD
8:30 am
Histology of Medial Degeneration and the Increasingly Important Role of Proteoglycan Deposition
Frank Cikach, MD
8:40 am
How do we counsel young at-risk patients preconception?
Eric M. Isselbacher, MD
8:50 am
Panel Discussion with Case Presentation
Kenneth Zahka, MD and Presenters

Session II: What Happened Before?

Moderators: Sean Lyden, MD and Alan C. Braverman, MD
9:05 am
Connective Tissue Disorders and Associated Risk of Dissection: What we don’t yet know about the role of genetics (VUS, etc.)
Rocio Moran, MD
9:15 am
Clinical Genetic Care and Screening Family Members: How we do it in our aortic clinic
Christine Rigelsky
9:25 am
Bicuspid Aortopathy and Associated Risk
Alan C. Braverman, MD
9:35 am
What can we do to slow progress in the genetically vulnerable patient?
Kenneth Zahka, MD
9:45 am
Panel Discussion with Case Presentation
Sagar Kalahasti, MD and Presenters
10:00 am
Break
10:20 am
OR Case: TEVAR for Sub-acute Dissection

Session III: The Moment of Reckoning

Moderators: Marc Moon, MD and Venu Menon MD
11:00 am
Aortic Awareness and Educating Teams in the ED
Bradford Borden, MD
11:10 am
Critical Care Transport Teams: Time is of the Essence
How to Build Your Own Critical Care Transport Team
Venu Menon MD
11:20 am
Classification: Acute vs Chronic Becomes Hyperacute, Acute, Subacute, and Chronic AND Stanford vs DeBakey vs DISSECT
Santi Trimarchi, MD
11:30 am
Panel Discussion with Case Presentation
Stephen Meldon, MD and Presenters
11:45 am
Lunch
12:15 pm
Fireside Chat: History of Thoracic Aortic Surgery with Lars G. Svensson, MD, PhD
Moderator: Eric E. Roselli, MD
12:45 pm
Break

Session IV: When the Patient Arrives

Moderators: Eric M. Isselbacher, MD and Anthony L. Estrera, MD
1:00 pm
Creating a Cardio-Aortic Triage Unit: Bringing the Team Together
Venu Menon MD
1:10 pm
Optimizing Medical Therapy for AAS IV Clevedipine vs Nipride and what’s next: A lesson in economics
Michael Militello, PharmD, RPh, BCPS
1:20 pm
Why don't we have a biomarker in acute aortic dissection?
Santi Trimarchi, MD
1:30 pm
Panel Discussion with Case Presentation
Penelope Rampersad, MD and Presenters

Session V: Seeing is Believing – Confirming the Diagnosis

Moderators: Alan C. Braverman, MD and Santi Trimarchi, MD

1:45 pm
What is the optimal imaging modality? Refining the order sets and acquisition protocols
Milind Desai, MD
1:55 pm
Tools for Remote Sharing of Images
Paul Schoenhagen, MD
2:05 pm
Role of Bedside Echocardiography
Paul Cremer, MD
2:15 pm
Evolving Understanding of High-risk Features of Type B Dissections and Differentiating IMH from Dissections
Santi Trimarchi, MD
2:25 pm
Panel Discussion with Case Presentation
Sagar Kalahasti, MD and Presenters

Session VI: Prepping the Field: Insights from the Ground Crew

Moderators: Milind Desai, MD and Marc Moon, MD
2:40 pm
Mobilizing the OR Team: Being available for emergencies cross training OR nursing teams for vascular, cardiac, and transcatheter procedures
Meghan Glanc, MSN, RN, CNOR
2:50 pm
Developing a Dedicated Vascular Radiology Tech Team
Brian Kolar, RT (R) (VI)
3:00 pm
Building the Modern Hybrid OR and Optimizing Utilization
Sean Lyden, MD
3:10 pm
Increasing #AorticAwareness: Creating Online Presence for Patient and Provider Education
Betsy Stovsky, RN, MSN
3:20 pm
Audience Group Photo for Twitter Posting: #AorticAwareness
All Attendees
3:30 pm
Break

Session VII: Treating Acute Ascending Dissection

Moderators: Venu Menon MD and Eric E. Roselli, MD
Starter
3:50 pm
Point Counter Point: Patient is S/P CABG and Arrives at Midnight
Operate now vs operate in the AM
Anthony L. Estrera, MD vs Marc Gillinov, MD
4:05 pm
Cath Lab Considerations When Doing Coronary Angiogram in Acute Dissection and the Iatrogenic Dissection Post Cath 
Samir Kapadia, MD
4:15 pm
Cannulation Strategy: Type A Presents with Brain Malperfusion
Eric E. Roselli, MD
4:25 pm
Prepping the OR for Rapid Induction and Possible Instability, CT Anesthesia Considerations: Quick Assessments and Proactive Reactions
Jennifer Hargrave, DO
4:35 pm
Type A Presents with Limb and/or Mesenteric Malperfusion, Timing and Strategy
Behzad Farivar, MD
Middle Relief
4:45 pm
Limited vs Extended Repair for Type A
Marc Moon, MD  vs Douglas Johnston, MD
5:00 pm
Managing the Aortic Root, When to Resuspend, When to Replace and How
Lars G. Svensson, MD, PhD
5:10 pm
Patient Needs AVR: Which valve, mechanical or bioprosthetic?
Anthony L. Estrera, MD
5:20 pm
The RCA is dissected: How do I manage it?
Faisal Bakaeen, MD
5:30 pm
Panel Discussion
Moderators and Presenters
5:45 pm
Adjourn

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Friday, September 20, 2019

8:00 am
Welcome
8:10 am
Horizon Breakfast: Device Pipeline Presentation and Panel Discussion (Non-CME)
Cook: Jarin Kratzberg
Gore: Mike Nilson
Medtronic: Randy Bassett, PhD
TerumoAortic: Scott Rush

Session VII (continued): Treating Acute Ascending Dissection

Moderators: Venu Menon MD and Eric E. Roselli, MD
Closer
9:10 am
Post Pump Ventricular Dysfunction: How common is it and what’s the role for MCS?
Edward Soltesz, MD, MPH
9:20 am
Intraoperative Coagulopathy: What’s the best strategy?
Nikolaos Skubas, MD
Extra-Innings
9:30 am
The Role for Ascending Stent Grafting in Acute Ascending Dissection
Eric E. Roselli, MD
9:40 am
Post-op Considerations in the ICU: Rewarming, Neuro Assessment, Vent Management, Renal Assessment, and Managing Pain
Steven Insler, DO
9:50 am
Do we have to operate on the patient who refuses blood transfusion and presents with acute dissection? 
Allen Bashour, MD
10:00 am

Panel Discussion
Moderators and Presenters 

10:10 am
Break

Session VIII: Treating Acute Distal Dissection

Moderators: Sean Lyden, MD and Eric M. Isselbacher, MD
Hyperacute and Acute Phase (symptomatic)
10:25 am
Acute Dissection with Descending Rupture
TEVAR is Best  
David Hardy, MD
Open Repair Still has a Role
Faisal Bakaeen, MD
10:40 am
Endo Options for Mesenteric Ischemia 
10:50 am
Treatment Options for Limb Ischemia at Presentation
Lee Kirksey, MD
11:00 am
When do recurring pain and difficult to control hypertension become indications to intervene?
Christopher Smolock, MD
11:10 am
Making the Transition from IV to Oral Meds when Medical Therapy is the Initial Choice for Treatment
Donald Hammer, MD
11:20 am
OR Case: Frozen elephant trunk
11:50 am
Lunch
SubAcute Phase
12:30 pm
Early TEVAR: Clinically Stable Type B Dissection, Rationale for Subacute TEVAR
Francis Caputo, MD
12:40 pm
Medical Tx: What should that first follow-up visit include? When, who to see and what testing?
Alan C. Braverman, MD
12:50 pm
Should we consider early FET for Type B too?
Santi Trimarchi, MD
1:00 pm
If TEVAR, do we cover the whole thoracic aorta or cover the tear plus bare stenting?
1:10 pm
Managing the Spinal Cord Risk: Drains, perfusion pressure, role for adjuncts?
Sean Lyden, MD  
1:20 pm
Panel Discussion
Moderators and Presenters

Session IX: We Survived, Now What?

Moderator: Eric M. Isselbacher, MD
1:35 pm
What is the fate of the untreated aorta?
Eric M. Isselbacher, MD
Back to Life
1:45 pm
Risk of PTSD and Acute Heart Disease: Are dissection patients at risk? How do we screen them?
Leopoldo Pozuelo, MD
1:55 pm
What we know and don’t know about strenuous activity and risk
Dermot Phelan, MD
2:05 pm
Lifelong Imaging Follow-up: How often, what studies, and what about family members?
Milind Desai, MD
2:15 pm
Panel Discussion
Moderators and Presenters
2:30 pm
Break

Session X: Treatment in the Chronic Phase

Moderator: Anthony L. Estrera, MD
2:50 pm
When is it time to operate? Should we lower the size threshold in dissection?  And how much growth is too rapid?
Richard Grimm, DO
3:00 pm
What is the best anti-hypertensive regimen in the chronic phase? 
Donald Hammer, MD

Session XI: Point Counter Points

Moderator: Milind Desai, MD
3:10 pm
Residual Type A with Arch Dissection and Descending Aneurysm: Best treatment is:
  1. Clamshell Open Single Stage Repair 
    Marc Moon, MD
  2. Redo Sternotomy and Conventional Elephant Trunk Followed by Open Completion 
    Douglas Johnston, MD
  3. Redo Sternotomy and Frozen Elephant Trunk Followed by TEVAR 
    Santi Trimarchi, MD
  4. Total Endo with a Branched Arch Device
    Francis Caputo, MD
3:50 pm
Type B/IIIB Dissection with Proximal Descending Aneurysm (handling the LSA, tips and tricks):
  1. TEVAR with Carotid-Subclavian Bypass and Bare Stenting Through the Abdominal Aorta 
    Francis Caputo, MD
  2. TEVAR with Laser Fenestration or Single Branched Device 
  3. Open Repair as First Choice
    Anthony L. Estrera, MD
4:20 pm
Type B/IIIB Dissection S/P TEVAR with Retrograde False Lumen Perfusion and More Growth:
  1. Endo TEVAR Extension with False Lumen Adjuncts
    Eric E. Roselli, MD
  2. Endo TEVAR Extension with Branched Device
    Sean Lyden, MD
  3. Hybrid Open Completion Repair 
    Patrick Vargo, MD
4:50 pm
Closing Comments
5:00 pm
Adjourn

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