Society of Cardiovascular Anesthesiologists

10th Annual Update on Cardiopulmonary Bypass

March 13-18, 2005
Snowmass Convention Center

Sunday March 13, 2005

Workshop 1: Basic TEE Moderator: JS Shanewise

Workshop 2: Designing A Successful Platelet-Gel Service Moderator: A Stammers

Workshop 3: Perfusion for the Anesthesiologist and Surgeon Moderator: C Gruenwald

At the conclusion of this workshop the participants will have an overview of heart-lung machines, cardiopulmonary bypass circuit components, safety devices, and basic CPB techniques in an interactive hands-on format.

Monday March 14, 2005

A Ten-Year Retrospective of Teamwork in Operative Cardiac Care: Advances and Disappointments Moderators: BDSpiess/RD Weisel
Surgical Highs and Lows - RD Weisel, AS Wechsler, TE David
At the conclusion of this presentation the audience will learn of three to five advances in cardiac surgery that have occurred over the last 10 years. This will be contrasted with three to five new ideas that did not work out as successfully as hoped. Supporting evidence will be made behind each of the advances and failures.
Anesthesiology: Excitement and Sleepers - GP Gravlee
At the conclusion of this lecture the audience will have be aware of three to five major advances in cardiothoracic anesthesia as well as background supporting evidence. These advances will have improved patient care in some measurable manner. The audience will hear of contrasting ideas that were thought at their inception to be good ideas but did not succeed in improving patient care.
Perfusion: Pressures and Vacuums - RC Groom, A Stammers
The audience will hear of advances that have occurred in the perfusionists' realm over the last ten years. These may be pieces of technology or ways in which technology can be applied to help patients. Those advances will be contrasted with several decent ideas that never really made an impact or somehow failed to improve patient outcomes or advance the specialty.
Case Discussions
Speakers will present illustrative cases of surgical, anesthesia and perfusion advances over the last 10 years as well as be able to actively interact with the lecturers and ask questions. Cases will have some ethical focus.

Advances in Postoperative Intensive Transition/Care of the Cardiac Patient Moderators: D Rothenberg, CD Mazer
Perioperative Thermoregulation - HP Grocott
At the end of this lecture, the attendee will have gained knowledge about the mechanisms and pathophysiology of temperature regulation in the cardiac patient. The clinical consequences of active cooling and rewarming will have been reviewed. Strategies for optimal management of patient temperature will have been discussed.
Renal Failure in the ICU - D Rothenberg
At the conclusion of this lecture the participant: 1) will understand the physiology and pathophysiology of perioperative renal function and perioperative risk factors for developing acute renal failure as they apply to patients undergoing cardiovascular surgery; 2) will have received a thorough review of the differential diagnosis of perioperative oliguria and/or renal dysfunction in patients undergoing cardiopulmonary bypass and/or aortic cross clamping; and 3) will be able to discuss modalities for prevention and treatment of perioperative renal dysfunction.

Left Heart Failure and Cardiogenic Shock in the ICU - CD Mazer

Those who attend will build on their knowledge of the prediction, causes and therapeutic approaches to the patient with severe heart failure and shock. A team approach to management using pharmacologic and mechanical interventions will have been stressed.

Case Presentations: Focus on Blood Gases - D Rothenberg

At the conclusion of this lecture the participant: 1) will have received a thorough of the basic concepts of ABG interpretation; 2) will be able to discuss important acid-base disturbances as they apply to patients having undergone CPB and/or major vascular surgery; and 3) will have a logical approach to the use of bicarbonate therapy for patients with metabolic acidoses.

Tuesday March 15, 2005

Heart Failure #1: The Basics We Have to Deal with Today Moderators: AS Wechsler/RM Savage

At the conclusion of these lectures (listed below), the audience will: 1) be able to identify the primary causes of heart failure and describe the potential survival for patients with heart failure; 2) be able to identify the primary medical therapies for heart failure and understand the rationale for their use based on the pathophysiology of heart failure; 3) understand the role of intraoperative echocardiography in patients with heart failure; 4) be able to specifically identify the critical echocardiographic findings in heart failure that guide surgical therapies; 5) understand the choices for pharmacologic support of patients with heart failure undergoing cardiac operations; and 6) learn the transition points from pharmacologic to mechanical support for patients with heart failure undergoing operations.

Backgrounds in Heart Failure: Physiology, Epidemiology and Medical Management - AS Wechsler

Intraoperative TEE for the Patient with Heart Failure - GS Hartman

Weaning the Patient from Bypass with Heart Failure - JS Shanewise

Heart Failure #2: Evolution of Future Patient Care Moderators: AS Wechsler/RM Savage

At the conclusion of these lectures (listed below), the audience will: 1) understand the device options for the acute management of heart failure; 2) understand the device options for chronic management of heart failure; 3) know the primary complications associated with devices for heart failure; 4) understand the role of the mitral valve in patients with heart failure; 5) understand the pathophysiology of mitral regurgitation in heart failure; 6) be able to identify the criteria for selecting patients for ventricular remodeling operations; 7) learn the contraindications for ventricular remodeling procedures; 8) compare ventricular remodeling procedure outcomes with other treatments for heart failure; 9) understand the different biologic options for augmenting failing myocardium; 10) be able to identify the different stem cell alternatives for myocardial restoration; 11) be able to describe the results to date using stem cells for myocardial restoration; 12) understand the new (non-pump) devices used for surgical correction of heart failure; and 13) be aware of the recent clinical trial using the Acorn device.

Left Ventricular Devices Now and Tomorrow - A Grigore

Issues in Mitral Valve Heart Failure - M Borger, TE David

Ventricular Remodeling Procedures - AS Wechsler

Stem Cell Therapy: Will They Take? - RD Weisel

Evolving Devices in Heart Failure - AS Wechsler

Wednesday March 16, 2005

Valvular Heart Disease Moderators: RD Weisel/KE Glas

Aortic Valve Repair and Replacement - M Borger and T David

At the conclusion of this lecture the participant will: 1) be able to identify the important surgical issues during aortic valve replacement and repair surgery; 2) understand the echocardiographic and anatomic determinants of aortic valve repair; and will have reviewed the long-term outcomes for aortic valve replacement versus repair.

The Tricuspid Valve: Repair or Leave it Alone? - M Borger and T David

At the conclusion of this lecture the participant will: 1) understand the indications for tricuspid valve repair surgery; understand echocardiographic and anatomic features of tricuspid valve repair; and 3) will have reviewed the long-term outcomes for tricuspid valve repair surgery.

Techniques to Prevent Cerebral Emboli - KE Glas

At the conclusion of this lecture, the audience will understand the role of the ascending aorta in embolic phenomenon during cardiac surgery. They will be aware of new techniques and devices that can be used to reduce these embolic phenomenon.

Perfusion for Valvular Heart Surgery - RC Groom

At the conclusion of this lecture, the audience will understand the different perfusion techniques needed for valvular heart surgery versus CABG. They will understand risks and benefits of antegrade and retrograde cardioplegia in the valvular heart surgery population.

Pediatric Cardiac Surgery Moderators: LK Davies, C Gruenwald, RA Jonas

Challenges related to Hemostasis/Thrombosis in Children during CPB or ECMO - C Gruenwald

At the conclusion of this lecture, the audience will: 1) have an appreciation of developmental hemostasis in infants; 2) understand alterations in normal hemostasis during CPB; 3) discuss current management strategies for anticoagulation and monitoring during CPB; and 4) appreciate the risks of thrombosis during CPB.

Real-time Monitoring of Safe Duration of Deep Hypothermic Circulatory Arrest - RA Jonas

At the conclusion of this lecture the audience will have an understanding of the application of near infrared spectroscopy in monitoring the safe duration of hypothermic circulatory arrest. Information will be presented regarding the impact of bypass conditions such as temperature, hematocrit and pH on the safe duration.

Novel Markers of Brain Injury - P Bokesch

At the conlusion of this lecture the audience will be able to differentiate which blood biomarkers are useful for monitoring brain injury before, during and after heart surgery.

Thursday March 17, 2005

Heparin-induced Thrombocytopenia: An Epidemic and a Challenge Moderators: A DeAnda/H McCarthy

At the conclusion of the lectures listed below, the audience will: 1) understand the incidence and challenges of heparin-induced thrombocytopenia; 2) understand the diagnosis criteria and dilemmas; and 3) consider different methods of anticoagulation to avoid HIT/HITT as well as to treat patients with HIT.

Unfractionated Heparin: Little Known Facts - BD Spiess

HiTT: Physiology and Epidemniology - L Shore-Lesserson

New Therapeutic Options: Argatroban, Bivalirudin, Tirofiban/Heparin - L Shore-Lesserson

Perfusionists' Concerns: HiTT and New Drugs - H McCarthy

Surgical Vigilance: HiTT and New Drugs - G Aldea

Case Presentation - G Aldea

Blood Transfusion Issues Moderators: L Shore-Lesserson/A Stammers

Oxygen Transport: Fresh Blood versus Stored Blood - BD Spiess

At the conclusion of this lecture, the audience will be able to discuss critical aspects of oxygen delivery in the transfused patient. Critical hemoglobin levels and transfusion practices will be discussed.

Designing a Blood Transfusion Redction Strategy - G Aldea

At the conclusion of this lecture, the audience will discuss teChniques And Pharmacologic Interventions That Can be used to reduce blood transfusion. A multidisciplinary approach to reducing transfusions will be discussed.

Contemporary Risks of Transfusion - L Shore-Lesserson

At the conclusion of this lecture, the audience will be able to describe the risks of transfusion therapy that go beyond transmission of viral illness. The adverse effects of transfusions and the benefits of leukocyte reduction will be highlighted.

Case Discussions - Jehovah's Witness and Heart Surgery - Panelists: M McKneally, D Rothenberg

At the conclusion of this lecture, the audience will discuss, from case demonstrations of the various blood conservation techniques, the impact of religious objections to transfusion. Interactive discussion will be stressed.

Friday, March 18, 2005

Deep Hypothermic Circulatory Arrest: Modern Thinking Moderators: JS Shanewise/A DeAnda

The Physiology of Deep Hypothermia and Historical Perspectives - JS Shanewise

At the conclusion of this lecture, the audience will understand the rationale for deep (and moderate) hypothermia during surgery.
Pediatric Cases of DHCA: Different or the Same as Adults? - RD Jonas

At the conclusion of this lecture, the audience will understand the similarities and differences between circulatory arrest in the pediatric patient as compared to the adult patient

Spinal Cord Protection: How Aggressive? - A DeAnda

At the conclusion of this lecture, the audience will consider the methods for organ preservation, including cerebral, cardiac, renal and spinal cord.

DHCA and Strategies for Selective Cerebral Perfusion - RC Groom

At the conclusion of this lecture, the audience will learn different techniques and approaches to circulatory arrest

Difficult Cases - Team Interactions and Ethics Moderators: LK Davies/RC Groom

At the conclusion of the lectures listed below the audience will have a better appreciation for the importance of team interaction and cooperation. The audience will have an opportunity for discussion of management options for complex cases, with emphasis on perfusion, surgery, and anesthesia issues

Anesthesiology Cases - GS Hartman

Perfusion Cases - A Stammers

Surgical Cases - RA Jonas

Ethics Summary - M McKneally

Back to the Meeting Table of Contents