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.
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.
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.
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.
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.
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
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.
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.
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.
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.
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.
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 .
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