48th Annual Cardiology Teaching Day Wednesday, October 24, 2018 | 7:30AM-4:00PM ​The Grandview, 176 Rinaldi Blvd., Poughkeepsie, NY 12601

Live Case Presentations

Focus on TAVR and Mitral Clip procedures

Presenters : Z Jafar MD, N Narayan MD, S Gorwara MD

 

GAP: Lack of referral of high risk cardiac patients with  severe mitral regurgitation and aortic stenosis leads to excess heart failure, myocardial infarction and death.

 

Need: High  risk cardiac patients with aortic stenosis and mitral regurgitation are not receiving state art care.Educational efforts to improve patient selection are needed.

 

Objectives:

 

Aortic stenosis is a common problem in the elderly presenting with angina, heart failure and syncope. Although surgical aortic valve replacement has been the traditional approach to this problem, many patients fall into high risk categories that would make surgery prohibitively dangerous. TAVR offers an option for care of these patients with equivalent outcomes and at lower risk.

Severe mitral regurgitation leads to a downhill spiral in patients with congestive heart failure. Previous approaches using surgical mitral valve replacement have had mixed results in high risk individuals. Percutaneous approaches to mitral valve repair have offered remarkable improvement in morbidity and mortality.

Both techniques will be demonstrated with live cases from the cath lab.

 

1. To understand the role of TAVR (Trans aortic valve replacement) in symptomatic patients with aortic stenosis.
2. To review guideline based management of severe mitral regurgitation.
3. To understand the percutaneous approach to both TAVR and Mitra Clip procedures.

 

 

Medical vs Interventional Management of CAD ( coronary artery disease)

Focus on appropriate patient selection

Presenter: A Patrello MD

 

GAP: Failure to use appropriate medical and percutaneous treatments of CAD leads to both

Under and over utilization of percutaneous coronary interventions.

 

Need: To review guideline directed care of CAD patients with a critical review of the current literature.

 

Objectives:

Both scientific and lay medical news sources have been critical of the using of invasive cardiac procedures for the treatment of CAD. This lecture will present a clear review of the complementary approach to patient care.

1. To list guideline directed medical therapies for CAD
2. To compare outcomes of select CAD subgroups with medical and interventional management.
3. To review real world experience in the care of CAD patients.

 

 

CT-FFR (CT scan derived Fractional Flow Reserve)

What is it? Can it help me?

Focus : screening for CAD

Presenter M  Yen MD

 

GAP: Current tools  for risk stratification of CAD patients fail to accurately identify high and low risk subgroups.

 

Need: To develop better techniques to risk stratify CAD patients.

 

Objectives:

 

Despite sophisticated techniques such a SPECT (Singe Photon Emission Cardiac Tomography), many patients are brought to the cath lab only to be found to have non obstructive CAD. And conversely false negative screening studies lead to failure in finding high risk patients. New developments in CT software now hold promise to help guide the clinician in refining current

Screening techniques.

1. To understand flow dynamics as a basis for interventional treatment of CAD
2. To review the shortfalls of current stratification tools.
3. To describe the use of CT FFR as a potential new tool for risk stratification.

 

 

 

Surgical Management of Thoracic Aortic Aneurysm

Focus: Screening and Repair

Presenter: J Sperling MD

 

GAP: Aortic Dissection continues to be highly fatal disease in need of better treatment.

 

Need: Better education on screening, genetics and surgical repair.

 

Objectives:

 

Thoracic aortic dissection remains a fearsome complication of aortic disease. Clinical and genetic makers can help in identifying high risk individuals. The presence of co existing aortic valve disease influences the natural history of the disease as well the surgical approach to the patient.

1. To review clinically applicable genetic markers
2. To use risk scores for management of patients with thoracic aortic aneurysms.
3. To understand current best surgical care.

 

 

ECMO - Advanced Therapies for Heart Failure and Shock

Focus: What can we offer our patients on the local level?

 

GAP: Shock and heart failure carry high mortality. Supportive measures are underutilized.

 

Need: To understand the role ECMO in the critically ill shock patient.

 

Objectives:

 

Cardiogenic shock remains a high risk condition.  New mechanical devices offer a bridge to survival if implemented early and aggressively. Changes in the paradigm of care offer the opportunity for improved survival.

 

1.  To define shock and review the indications for mechanical support.
2. To list different methods of mechanical support
3. To review VBMC data on the use of mechanical support devices

 

 

The Weekend Warrior: Enhancing Wellness

Focus: VO2 max measurements

Presenter: S Patel MD, Z Jafar MD, J Friedman MD

 

GAP: Understanding exercise capacity measurements in the healthy population will help safety in the athletic population.

 

Need: To understand the role of screening and the use of performance measures to help guide amateur athletes in competitive sports.

 

 

Objectives:

Beyond risk stratification, this lecture will present a critical overview of the use of cardiac performance characteristics that are useful in improving athletic performance. Elite athletes can benefit from individually derived measures of  cardiac performance .

 

1.  To list appropriate screening measures for individual wanting to start an exercise program.
2. To understand cardio-pulmonary physiology during peak physical exertion.
3. To understand VO2 max and exercise performance measures.