28th Annual Meeting & Workshops

April 29 - May 3, 2006

Sheraton San Diego Hotel & Marina
San Diego, California

Learning Objectives

Refresher Courses

Saturday, April 29, 2006

Anesthesia for Minimally Invasive Thoracic Surgery: Testing the limits
At the conclusion of the lecture the participant will understand the procedures involved in video assisted thoracoscopy and the differences between open surgery and minimally invasive surgery. The conduct of major surgical procedures performed through a minimally invasive approach will also be reviewed.

Mitral Valve Repair: What can TEE do?
At the conclusion of the lecture the participant will have an understanding of the mechanisms of mitral regurgitation and the classification systems used to define mitral regurgitation. TEE images of mitral regurgitation will illustrate anatomy and function and the surgical repair of specific lesions will be discussed.

Update on Aneurismal Disease of the Ascending Aorta
At the conclusion of the lecture the participant will understand the disease processes that lead to aortic aneurismal disease. The participant will learn the diagnostic criteria used for aortic aneurysm and the criteria used to determine surgical eligibility.

Surgical Ventricular Restoration for Heart Failure: Historical perspective and current clinical trials
At the conclusion of the lecture the participant will understand the history and the evolution of the techniques used to treat heart failure due to ventricular aneurysm. The history of surgical ventricular restoration will be reviewed. Current clinical trials and indications for surgery will be discussed.

"The Big Cats" Cardiac Anesthesia Teams: Why cardiac anesthesiologists have become academic leaders
At the conclusion of the lecture the participant will gain insight into the unique field of cardiac anesthesia as a subspecialty in anesthesiology. The growth of academic leaders cultivated among cardiac anesthesiologists will be discussed. The evolution of cardiac anesthesia to cover areas like catheterization laboratories, ICUs, anesthesia-perfusion teams, etc, and the role of cardiac anesthesiologists in education with new learning techniques will be discussed.

Echocardiography: An Update of Practice Guidelines and Quality Care
At the conclusion of the lecture the participant will have gained an understanding of the issues in echocardiography that involve quality of care, consistency of examination, and basic clinical approach to echocardiography. The participant will learn of these issues through the president of the American Society of Echocardiography. Many of the clinical practice parameters that have been jointly derived and written by ASE and SCA will be highlighted.

Sunday, April 30, 2006

Critical Perioperative Issues in Valvular Heart Disease
Overall Learning Objective: After attending this session, the participant will understand the important variables involved in clinical decision making regarding: 1) the management of asymptomatic valvular heart disease; 2) the decision to perform mitral valve surgery in patients with impaired ventricular function; 3) the role of echocardiography for persistent post surgical mitral valve dysfunction; and 4) perioperative outcomes following valve surgery.

Management of Asymptomatic Valvular Heart Disease: When to Operate?
After attending this session, the participant will understanding the important variables involved in clinical decision making regarding the management of asymptomatic valvular heart disease.

Should Mitral Valve Surgery be Performed for Mitral Regurgitation with a Low Ejection Fraction?
After attending this session, the participant will understand the important controversies involved in clinical decision making regarding the performance of mitral valve surgery in patients with impaired ventricular function.

Intraoperative Echocardiographic Evaluation of the Patient with Persistent Valve Dysfunction following Valve Surgery
After attending this session, the participant will understand the important role of echocardiography in the diagnosis of persistent post surgical mitral valve dysfunction, and its impact on perioperative decision-making.

Long-Term Clinical Outcomes after Valve Surgery: Is there room for improvement?
After attending this session, the participant will understand those important variables which influence perioperative morbidity and mortality following valve surgery, and which strategies may be available to improve outcomes.

Session A: Advanced Topics in Valvular Heart Disease
Overall Learning Objective: At the conclusion of the session the participant will be able to state how TEE can be used to evaluation prosthetic valve function, describe how to use TEE to quantify mitral stenosis, list the hemodynamic consequences of dynamic outflow tract obstruction, and describe how TEE can be used to assess endocarditis.

Evaluation of Prosthetic Valve Function
At the conclusion of the session the participant will be able to describe the echo features of various types of valve prostheses, state the echo manifestations of prosthetic valve dysfunction and explain the advantages of TEE in evaluation of prosthetic valve.

Quantification of Mitral Stenosis
At the conclusion of the session the participant will be able to describe how to measure mitral valve area with TEE, list the limitations of the pressure half time method of measuring valve area, and state the criteria for severe mitral stenosis.

Dynamic Outflow Tract Obstruction
At the conclusion of the session the participant will be able to explain the mechanism of mitral SAM, describe how to assess dynamic outflow tract obstruction with TEE, and list interventions that may improve dynamic outflow tract obstruction.

Infective Endocarditis
At the conclusion of the session the participant will be able to describe echo manifestations of endocarditis, list the indications for TEE to assess endocarditis, and state to relative sensitivities of TTE and TEE for diagnosing endocarditis.

Session B: Challenges in Hemostasis
Overall Learning Objective: At the conclusion of the panel, the participant will have been exposed to recent hematologic controversies such as the use of antifibrinolytics in cardiac surgery, the threshold for blood transfusion in cardiac surgery, Factor VII, and the management of a patient on anti-platelet agents during cardiac surgery.

Update on Safety of Antifibrinolytics
At the conclusion of the session, the participant will have an understanding of the questions of renal dysfunction in association with antifibrinolytic therapy. The recent literature and meta-analyses will be reviewed. Questions about combined use of antifibrinolytics will be addressed.

Optimal Hematocrit on CPB
At the conclusion of the talk, the participant will have an understanding of the risks of anemia during cardiopulmonary bypass. The risks of anemia versus the known risks of transfusion will be discussed along with a review of supporting literature.

Point-of-Care Testing of Platelet Function
At the conclusion of the talk, the participant will understand the physiology of platelet activity. Drugs known to inhibit platelet function will be reviewed and their mechanisms discussed. Tests that can be measured at the point of care for assessing platelet function will be introduced.

Case Presentations
At the conclusion of the talk, the participant will have participated in a case discussion of a patient with recent stent. Anti-platelet therapy will be reviewed and management options will be put forth.

Session A: DHCA: Are Adults and Children Really Different? Hct and Acid-base Management
Overall Learning Objective: At the conclusion of this session the attendee will be familiar with state of the art management of DHCA in both infants/children and adults. In particular, the attendee will be able to definitively delineate the similarities and differences in management of DHCA in infants/children and adults.

DHCA in the Adult
At the conclusion of this lecture the attendee will be familiar with the current best evidence regarding hematocrit and acid-base management in adults undergoing DHCA to facilitate cardiac surgery. In addition, the attendee will be able to apply these concepts to their clinical practice.

DHCA in the Infant/Child
At the conclusion of this lecture the attendee will be familiar with the current best evidence regarding hematocrit and acid-base management in infants/childre undergoing DHCA to facilitate cardiac surgery. In addition, the attendee will be able to apply these concepts to their clinical practice.

Session B: Vascular I: Optimal Perioperative Management of the High-risk Patient
Overall Learning Objective: At the conclusion of the session the participant will understand the potential roles of pharmacological agents, commonly used in chronic medical conditions, in the acute management of surgical patients.

With Beta Blockade, is Preoperative Testing Necessary at All?
At the conclusion of the session the participant will understand the potential role of beta blockers in the acute management of surgical patients, and the interaction of beta blockade with preoperative testing.

The Role of Statins in the Management of the High-risk Patient
At the conclusion of the session the participant will understand the potential role of statins in the acute management of surgical patients.

Monday, May 1, 2006

Monograph Session: Advances in the Management of Congestive Heart Failure
Overall Learning Objective: At the conclusion of the session the participant will have a greater appreciation and understanding for the underlying pathophysiology of chronic heart failure and for evidentiary basis for current treatment options.

Mechanisms of Heart Failure and Remodeling
At the conclusion of the presentation the participant will have a greater appreciation and understanding for the underlying pathophysiology of chronic heart failure, especially the remodeling process.

Systolic vs Diastolic Heart Failure
At the conclusion of the presentation the participant will have a greater appreciation and understanding for the differences among diastolic dysfunction, heart failure with preserved systolic function, and systolic heart failure.

Current Clinical Trials and Evidence-based Treatment
At the conclusion of the presentation the participant will have a greater appreciation and understanding of the evidence supporting current outpatient treatment recommendations for chronic heart failure.

Surgical Options for Heart Failure
At the conclusion of the presentation the participant will have a greater appreciation and understanding for the science underlying surgical treatments of heart failure.

Session A: What's New in Thoracic Aortic Surgery
Overall Learning Objective: At the conclusion of this session, the learner will comprehend multiple facets of the perioperative care for patients with thoracic aortic disease including anesthetic, surgical and perfusion goals and approaches.

Surgical Treatment Options for Aortic Repair
At the conclusion of this lecture, the learner will: 1) be familiar with the various surgical approaches to aortic repair; 2) grasp the surgical decisions to be made preoperatively; and 3) delineate the preoperative concerns related to the type of surgery chosen.

Organ Protection and Monitoring
At the conclusion of this lecture, the learner will: 1) identify the organs at risk of failure during aortic surgery; 2) describe the monitoring necessary for detecting organ dysfunction; and 3) communicate the strategies for organ protection during aortic surgery.

Circulation Assist for Aortic Surgery
At the conclusion of this lecture, the learner will: 1) explain the need for circulatory assist devices during aortic surgery; 2) outline the various strategies for vascular perfusion; and 3) summarize the benefits and risks of various strategies for vascular perfusion.

Interactive Case Discussion
At the conclusion of this lecture, the learner will: 1) analyze an unknown case for monitoring decisions; 2) defend the methods used for organ protection in an unknown case; 3) reason the methods used for circulatory assistance in an unknown case; and 4) comprehend the surgical strategy used in an unknown case with respect to the intraoperative implications for monitoring and organ protection.

Session B: Anesthesia & Analgesia
Overall Learning Objective: At the end of this session the participants should have: 1) An understanding of the evidence-based results for OPCAB surgery in low-risk and high-risk patients on mortality, morbidity, and resource utilization; 2) an understanding of any potential benefits of different anesthetic management approaches for OPCAB surgery; 3) an understanding of the role of DNA sequence variants in explaining inter-individual patient variability in adverse perioperative outcomes; 4) be familiar with the strategies for incorporating genomic pattern information in perioperative risk stratification and decision making; and 4) familiarity with novel approaches for attenuating inflammatory pathways resulting from cardiac surgery and their potential benefit for patient outcomes.

Session A: Case Discussions - Clinical Dilemmas
Overall Learning Objective: This session will review common clinical problems faced by the cardiac anesthesiologist. Participants will be presented with a series of clinical dilemmas relating to the cardiac surgical patient. The speakers will provide expert opinion on potential solutions to these difficult cases.

Case I
This lecture will review the risks of hyperglycemia in the cardiac surgical patient. The potential benefits of tight perioperative blood glucose control and of discontinuing oral sulfonylurea prior to surgery will be discussed

Case II
The lecture will provide an overview of the controversies relating to the risks and benefits of repairing a PFO discovered on a routine TEE examination.

Case III
Absolute and relative contraindication to TEE probe placement will be reviewed. The use of epicardial echocardiography in the patient presenting for mitral valve surgery will be discussed.

Session B: Advanced Age: Implications of Perioperative Care for the Elderly
Overall Learning Objective: At the conclusion of the session the participant will have an understanding of the unique physiology of the geriatric population. Risks and illness specific to the elderly and documentation of safety will be addressed.

Etiology and Treatment of Atrial Fibrillation in the Elderly
At the conclusion of the talk, the participant will know the risk factors and incidence of atrial fibrillation. Prophylaxis and treatment options will be discussed.

Diastolic Dysfunction: A normal sequela of aging
At the conclusion of the talk, the participant will know the definition of diastolic dysfunction and how to measure it. Normal aging and diastolic function will be reviewed.

How is Stroke Risk Impacted by Aging?
At the conclusion of the talk, the participant will have an appreciation of the increased risk of stroke in the elderly. Causes of stroke in cardiac surgery and preventive measures will be discussed.

Report Cards: How do we score?
At the conclusion of the talk, the participant will understand how hospitals and medical centers record data for safety. Database records and performance measurements will be discussed. Tuesday, May 2, 2006

Best Practice Clinical Pathways to Improve Postoperative Outcomes in Cardiac Surgery
Overall Learning Objective: At the conclusion of this session, the participants will have learned of the latest best-practice clinical pathways to improve postoperative outcomes in cardiac surgical patients. These include (1) the pharmacology to reduce postoperative myocardial infarction; (2) point of care monitoring, antifibrinolytics and Factor VIIa to reduce perioperative bleeding; (3) cerebral physiologic monitoring and management to reduce postoperative CVA; (4) surgical risk reduction and cardiac surgery recovery model.

Pharmacology to Reduce Perioperative Myocardial Infarction
To review the evidence-based practice of perioperative pharmacology in reducing postoperative myocardial morbidity: Beta-Blocker, ASA/Clopidogrel, and Statins.

Best-Practice Management to Reduce Perioperative Bleeding
To discuss the evidence-based practice in reducing perioperative bleeding: risk factors, point of care monitoring, antifibrinolytics, and Factor VIIa.

Best-Practice Management to Reduce Postoperative CVA
To review the evidence-based practice in neuro-monitoring and management to reduce postoperative CVA: risk factors; epiaortic scan, cerebral saturation, and glucose level.

Best-Practices in Cardiac Surgery: An Institution Clinical Pathways
To present an institutional clinical pathways and cardiac program: cardiac risks, timing of surgery, conduit choice, on-off pump, infection prophylaxis, and postoperative model of recovery care.

Session A: Vascular II: Perioperative Management of Chronic Pulmonary Disease in the Patient with Cardiovascular Disease
Overall Learning Objective: At the conclusion of this session the participant will have an understanding of the perioperative management of patients with cardiovascular disease who have coexisting chronic lung disease.

Perioperative Management of the Patient with COPD and CV Disease
At the conclusion of this session the participant will have an understanding of: 1) the pathophysiology of chronic obstructive lung disease in the patient with preexisting cardiac disease; and 2) the pharmacologic and therapeutic management of these patients in the perioperative period.

Perioperative Management of the Patient with Obstructive Sleep Apnea and CV Disease
At the conclusion of this session the participant will have an understanding of: 1) the pathophysiology of obstructive sleep apnea with particular reference to the cardiovascular system; and 2) the perioperative management of these coexisting disease entities.

Session B: The Anesthesiologist's Role in Myocardial Protection during Heart Surgery
Overall Learning Objective: At the conclusion of the session the participant will have better insight on potential new anesthetic strategies such as inhibition of inflammatory processes and promotion of preconditioning, enabling the anesthesiologists to provide effective protection to the heart during open heart surgery.

Modulating the Inflammatory Response to Optimize Myocardial Contractility
At the conclusion of the session the participant will be able to describe the mediators of post-surgical inflammation, the role of inflammation in myocardial injury, and discuss current experimental and clinical strategies to prevent or limit inflammation-mediated myocardial injury.

Clinical Applicability of Anesthetic and Pharmacologic Preconditioning
At the conclusion of the session the participant will have a basic knowledge about the reconditioning mechanism and will understand how anaesthetic agents can interact through this mechanism with perioperative cardioprotection.

Session C: Pitfalls and Rewards of Investigators

Pitfalls and Rewards of Clinical Research
At the conclusion of this session, the participant will be familiar with difficulties in performing clinical research, including budgeting and contract negotiation, patient recruitment, protocol deviations, completion of data forms, and patient follow-up. The rewards inherent in becoming a clinical researcher will be discussed, including networking, knowledge, and opportunity for publications and career advancement.

Pitfalls and Rewards of Database Research
At the conclusion of this session, the participant will be familiar with best practices in database research, including the need for a specific research plan when designing a formal query for a database (broad objective and specific aims of the proposed analysis, primary and secondary hypotheses, inclusion and exclusion criteria, endpoints, and predictor variables). The participant will also become aware of methods typically used for statistical analysis and the limitations of observational databases. Potential impact upon the quality of health care gained by analysis of risk factors and complications will be discussed.

Pitfalls and Rewards of Laboratory Research
At the conclusion of this session, the participant will be familiar with difficulties in performing laboratory research, including negotiations for space and contracts, protocol design in animal models, animal welfare issues, and transferability of results to human disease processes. The academic rewards that come with success in basic research will be discussed.

Session A: Perioperative Complications: Old Challenges, New Tools
Overall Learning Objective: At the conclusion of this lecture, the attendee will gain perspective on novel pharmacologic interventions in the management of clinically significant postoperative problems, including arrhythmias, major bleeding and postoperative delirium.

Arrhythmias and Amiodarone: Magic Bullet or Sledgehammer?
At the conclusion of this lecture, the learner will: 1) understand the incidence, known etiology and impact of arrhythmias during and after cardiac surgery; 2) be able to develop an algorithm for perioperative prophylaxis and management of common arrhythmias; and 3) learn the pharmacology, benefits and limitations of amiodarone in this context.

Massive Bleeding and Factor VIIa: Does the End Justify the Means?
At the conclusion of this lecture, the learner will: 1) understand the etiology and mechanisms of coagulopathy and bleeding after cardiopulmonary bypass; 2) be able to develop an algorithm of perioperative prophylaxis and management of postoperative bleeding; and 3) learn the pharmacology, benefits and limitations of activated Factor VII in this context.

Delirium and Dexmedetomidine: Is the Picture any Clearer?
At the conclusion of this lecture, the learner will: 1) understand the etiology and impact of delirium after cardiovascular surgery; 2) be able to develop an algorithm of perioperative prophylaxis and management of postoperative delirium; and 3) learn the pharmacology, benefits and limitations of dexmedetomidine in this context.

Session B: Vascular III: Aortic Stenting
Overall Learning Objective: At the conclusion of this session, the participant will acquire knowledge regarding many aspects of aortic stenting, including the current indications for aortic stenting in patients with abdominal and thoracic aortic aneurismal disease; the utility of CSF drains in the management of patients undergoing aortic stenting; and the appropriate anesthetic techniques for aortic stenting procedures, including advanced monitoring approaches.

Thoracic and Abdominal Aortic Stent Grafts: Current indications and patient outcomes
At the conclusion of this session, the participant will learn about the current indications for aortic stents in the management of aortic aneurismal disease.

CSF Drains for Thoracic Aortic Stent-Grafting: Are they indicated and what are the risks?
At the conclusion of this lecture, the participant will understand the role of CSF drainage in the management of thoracic aortic stenting and its efficacy in potentially reducing the risk of spinal cord injury.

Anesthetic Techniques for Stent-Graft Procedures: What's the fuss?
At the conclusion of this lecture, the participant will acquire knowledge about the various anesthetic techniques appropriate for aortic stenting procedures.

Is There a Role for Monitoring Gut Ischemia during Aortic Surgery/Stenting?
At the conclusion of this lecture, the participant will learn about the role of gut ischemia monitoring during aortic surgery and its ability to predict adverse outcomes.

Session A: Management of the Cardiac Patient for Non-cardiac Surgery
Overall Learning Objective: At the conclusion of the session the participant will understand perioperative management issues of patients with cardiac disease undergoing noncardiac surgery.

Biventricular Pacing: The troublesome left ventricular lead
At the conclusion of this lecture, the participant will understand the indications for chronic resynchronization therapy and anesthetic implications of lead placement via thoracotomy instead of percutaneous techniques.

Management of the Post-heart Transplant Patient for Non-cardiac Surgery
At the conclusion of this lecture the participant will understand the anesthetic management issues related to patients with a transplanted heart.

Anesthetic Considerations in the Adult Congenital Heart Patient for Non-cardiac Surgery
At the conclusion of this lecture the participant will understand anesthetic management issues related to care of adult patients with congenital heart disease (corrected and uncorrected) undergoing noncardiac surgeries.

Utility of TEE for Adults undergoing Non-cardiac Surgery
At the end of this lecture the participant will appreciate the many uses of TEE as a diagnostic and monitoring device for patients undergoing noncardiac surgery.

Session B: Regional Anesthesia and Pain Management in the Cardiovascular Patient

Alternatives for Postoperative Cardiac Surgery Pain Control
At the conclusion of this lecture, the participant will be able to apply alternative methods to control postoperative pain such as intrathecal morphine, the "pain ball" etc.

Beyond Epidural and Spinal Anesthesia for Lower Extremity Vascular Surgery
At the conclusion of this lecture the participant will understand the anatomy, localization techniques and drugs utilized in major lower extremity nerve blocks.

Workshops

Saturday, April 29, 2006 - Afternoon Workshops

TEE for the Practicing Anesthesiologist
Overall Learning Objective: At the conclusion of the workshop the participant will understand how the clinical application of TEE aides in important diagnostic and management decisions for common as well as complex cardiac surgical issues.

Mitral Valve Repair: Assessing Feasibility, Adequacy and Complications of Mitral Valve Reconstruction
At the conclusion of this lecture, the participant will have learned techniques of echocardiographic assessment of the mitral valve for mitral valve repair procedures. Complications of mitral valve repair as well as the evaluation of failed procedures will also be demonstrated.

Congenital Heart Disease: TEE Diagnosis in the Adult Cardiac Surgical Patient
At the conclusion of this lecture, the participant will be able to describe and echocardiographically demonstrate a number of examples of adult congenital abnormalities to enable the attendee to better identify these abnormalities in clinical practice.

Echocardiographic Diagnosis and Operative Implications of Restrictive and Constrictive Cardiomyopathy
At the conclusion of this lecture, the participant will be able to describe and demonstrate echocardiographic features of restrictive and constrictive cardiomyopathies. In addition, the epidemiology and operative implications of the cardiomyopathies will also be discussed.

The Thoracic Aorta: Identification of Aortic Aneurysms, Dissections, and Plaque
At the conclusion of this lecture, the participant will be able to echocardiographically identify abnormalities of the thoracic aorta. An echocardiographic guide to identification of aneurysms, dissections and varying degrees of atherosclerosis will be demonstrated.

Mechanical Assist Devices: The Role of TEE in the Placement and Assessment of Mechanical Support Devices
At the conclusion of this lecture, the participant will gain a better understanding of the variety of mechanical assist devices available in current clinical practice and to understand how echocardiography facilities the placement of these devices. An approach to echocardiographically identifying appropriate functioning devices will also be demonstrated.

Pediatric Cardiac Anesthesia
Overall Learning Objective: At the conclusion of this workshop the attendee will be able to define and compare current approaches for the management of patients with hypoplastic left heart syndrome. In addition, the attendee will be able to describe diagnostic modalities used to assess patients with congenital heart disease, specify indications for these different modalities and validate their use based on evidence presented by the speakers.

Current Controversies in the Treatment of HLHS: Phenoxybenzamine use
At the conclusion of this lecture the attendee will be able to summarize the advantages and disadvantages of phenoxybenzamine use in the intra- and post-operative management of neonates undergoing Stage I reconstruction. The attendee will be able to apply this information in the clinical care of their patients.

Sano vs Modified Blalock-Taussig Shunt
At the conclusion of this lecture the attendee will be able to summarize the relative short-term and long-term advantages and disadvantages of the MBTS versus the Sano shunt as a source of pulmonary blood flow in Stage I reconstruction. The attendee will be able to apply this information in the clinical care of their patients.

Staged Approach to the 2-ventricle Repair
At the conclusion of this lecture the attendee will be familiar with evolving strategies to achieve a staged two-ventricle repair in defined sub-sets of patients with HLHS. In addition, the attendee will be familiar with early outcome data in patients undergoing staged two-ventricle repair.

Current Indications for Diagnostic Use of Magnetic Resonance Imaging and Angiography, Echocardiography, and Cardiac Catheterization
At the conclusion of this lecture the attendee will be able to define overall indications for diagnostic magnetic resonance imaging and angiography, echocardiography and cardiac catheterization. He/she will be able to compare the modalities, summarize the indications for their use, and list the limitations and strengths of each. Upon return to his/her individual anesthetic practice, the attendee will be able to utilize the information presented to judge the appropriate use of the modalities discussed.

Evidence-based Use of Brain Natriuretic Peptide as a Prognostic Indicator and Marker of Clinical Outcome in Children with Heart Disease
At the conclusion of this lecture the attendee will be able to discuss neurohumoral activation and the mechanism of action of brain natriuretic peptide (BNP). He/she will be able to explain why BNP is used as a biochemical marker in children with cardiomyopathy and heart failure. In addition, following this lecture the participant will be able to critique the evidence for the use of BNP as a prognostic indicator and marker of clinical outcome in pediatric patients with congenital heart disease, especially those with structural abnormalities.

The Essentials of Cardiopulmonary Bypass for the Anesthesiologist
Overall Learning Objective: This workshop will provide an overview of the cardiopulmonary bypass circuit and the practical information the cardiothoracic anesthesiologist must know when caring for the patient on cardiopulmonary bypass. At the conclusion of the workshop, the participant will gain an understanding of present and past cardiopulmonary bypass circuits. New technologies and common problems while on cardiopulmonary bypass will be specifically addressed. The workshop will provide information in an interactive lecture based format supplemented by hands-on demonstrations in small groups.

Historical Perspectives on Cardiopulmonary Bypass
At the conclusion of this lecture, the participant will understand to the workshop objectives and a brief historical overview of the techniques of cardiopulmonary bypass.

Contemporary Cardiopulmonary Bypass Circuits: The Basic Components
At the conclusion of this lecture, the participant will gain a working understanding of the contemporary components of extracorporeal circuits, how these systems interact, the safety devices employed in these systems, and what the anesthesiologist must know regarding the operation of these systems.

Complications During Cardiopulmonary Bypass: Incidence, Diagnosis, and Management
At the conclusion of this lecture, the participant will understand the common complications seen during cardiopulmonary bypass. The incidence, diagnosis and treatment of these conditions will be reviewed. Specific emphasis will be placed on what role the anesthesiologist must play in the identification and resolution of cardiopulmonary bypass related complications.

Management Controversies in Extracorporeal Circulation
At the conclusion of this lecture, the participant will be able to evaluate areas of management controversy in extracorporeal circulation including a discussion of optimum hematocrit and perfusion pressure during bypass.

Saturday, April 29, 2006 - Late Afternoon Workshops

Hand-held Ultrasound: The New Frontier?
Overall Learning Objective: At the conclusion of this workshop, the participants will be able to: 1) recognize the importance and utility for ultrasound in their everyday practice; 2) interpret and obtain basic transthoracic cardiac images; 3) understand the importance of ultrasound guided vascular access and be able to obtain images of the internal jugular vein and radial artery; and 4) obtain images of the upper and lower extremity nerves and use these images to help guide successful regional anesthesia.

Transthoracic Echocardiography
At the conclusion of this session, the learner will: 1) accept the benefit of perioperative transthoracic ultrasound; 2) describe the methods used to obtain transthoracic ultrasound images; and recognize the common normal and abnormal transthoracic ultrasound images.

Ultrasound for Regional Anesthesia
At the conclusion of this session, the learner will: 1) accept the benefit of ultrasound guidance for performance of regional anesthesia; 2) describe the use of ultrasound to visualize common nerve structures; and 3) recognize the common views used to perform various nerve blocks.

Ultrasound for Vascular Access
At the conclusion of this session, the learner will: 1) accept the benefit of ultrasound guidance for vascular access; 2) describe the use of ultrasound to visualize common vascular structures; and 3) recognize common vascular structures in ultrasound images.

Clinical Case Discussions in Advanced Intraoperative Echocardiography
Overall Learning Objective: This case-based workshop is designed for those practitioners who are utilizing intraoperative echocardiography in their practice on a regular basis. At the conclusion of the workshop, the participant will have been exposed to a variety of common intraoperative dilemmas. At the conclusion of the workshop, the participant will be able to: 1) assess the repaired mitral valve for new and continuing pathology; 2) evaluate normal and abnormal prosthetic valve function; 3) recognize and quantify aortic stenosis and mitral regurgitation in a variety of complicated settings; and 4) identify common atrial septal abnormalities.

Mechanical Assist Devices: Perioperative Issues and Management
Overall Learning Objective: At the conclusion of the session the participant will be able to describe the role mechanical assist devises in the management of patients with cardiovascular disease, list their limitations, and state how future advances may improve patient outcome.

Indications and Intraoperative Considerations for VAD Placement
At the conclusion of the session the participant will be able to list the indications for VADs, describe hemodynamic considerations during VAD implantation, and state some of the issues related to weaning a VAD patient from CPB.

TEE Evaluation of VAD Placement and Function
At the conclusion of the session the participant will be able to describe the echo features of various mechanical assist devices, state how to assess VAD function with TEE, and list other uses of TEE during VAD implantation.

Postoperative Management and Outcomes Following VAD Placement
At the conclusion of the session the participant will be able to describe the prognosis of patients after VAD implantation, list the factors predicting successful recovery after VAD implantation, and state important post operative considerations in VAD patients.

Destination Therapy: The Future of Cardiac Surgery?
At the conclusion of the session the participant will be able to describe the indications for destination VAD implantation, state the current results for destination VAD implantation, and explain the potential for growth in destination VAD implantation as a treatment for end stage CHF.

Evening Sessions

Sunday, April 30, 2006

Professional Development: Managing the Business of Cardiothoracic and Vascular Anesthesiology
Overall Learning Objective: Business management and professional career development of the cardiothoracic and vascular anesthesiologist are as important as medical knowledge. In this workshop the participant will acquire information and specific tools to enhance service, patient safety and revenue in a cardiothoracic anesthesiology practice. At the conclusion of this workshop the participant will be better prepared to negotiate with hospital administrators, evaluate payer contracts, manage liability, and formulate political action strategies for his or her own practice environment.

Cardiac Anesthesiology 2006: Revenue Center or Cost Center?
At the conclusion of this lecture the participant will have an understanding of the current distribution of health care dollars spent on cardiovascular services. The lecturer will provide specific information to enhance a strong negotiating position when evaluating cardiothoracic anesthesiology services in a hospital system.

Hospital Stipend Negotiations: Practical and Legal Considerations
At the conclusion of this lecture the participant will understand important considerations when approaching hospitals for financial assistance, with a focus on better understanding why hospital raise objections to paying stipends and how best to respond to those objections.

Rejecting a Bad Payer Contract: Tales from the Frontline
At the conclusion of this lecture the participant will better understand recent anesthesiology payer contract negotiations and the impact on group practice when a bad contract is rejected. Strategies for evaluating payer contracts and dealing with inadequate contracts will be outlined.

Looking Forward: The SCA Committee on Economics
At the conclusion of this lecture the participant will have practical information to on the political and legislative agenda of the SCA Committee on Economics. At the end of the session the participant will gain a clear understanding of the political climate surrounding reimbursement issues and what specific actions a practicing anesthesiologist can take to enhance professional revenue and practice structure.

Thoracic Anesthesia
Overall Learning Objective: At the conclusion of this workshop, the learner will be able to improve their skill with all types of intubation for thoracic surgery and thoracic epidural placement. The participant will become familiar with the use of para-vertebral nerve block in thoracic surgery patients.

Dual Lumen Endotracheal Intubation
At the conclusion of this demonstration, the learner will: 1) describe the proper placement of a dual lumen endotracheal tube; 2) explain how a dual lumen endotracheal tube may fail to achieve ventilatory lung separation; and 3) use dual lumen endotracheal tubes correctly for thoracic anesthesia.

Thoracic Epidural Placement
At the conclusion of this demonstration, the learner will: 1) accept the benefit of thoracic epidural analgesia for thoracic surgery patients; 2) describe the placement of a thoracic epidural catheter; and 3) become familiar with the common challenges in placement of epidural catheters.

Para-vertebral Nerve Block
At the conclusion of this demonstration, the learner will: 1) accept the benefit of para-vertebral analgesia for thoracic surgery patients; 2) describe the placement of para-vertebral nerve blocks; and 3) recognize common problems in placement of para-vertebral nerve blocks.

Workshop

Wednesday, May 3, 2006

TEE Review Course
Overall Learning Objective: This is a comprehensive and interactive review of perioperative transesophageal echocardiography, addressed to those with a working knowledge of perioperative echocardiography. The topics are chosen to represent a broad overview of TEE, important to the practicing clinician, and particularly to those preparing for certification in echocardiography. At the conclusion of the session, the participant will be able to: 1) understand the basic physics of echocardiography; 2) utilize 2D and blood/tissue Doppler echocardiographic measurements to assess hemodynamics; 3) assess global LV and RV systolic function; 4) become familiar with the evaluation of all degrees of diastolic dysfunction; 5) recognize the anatomy and diagnose normal and pathological valvular function; 6) identify basic anatomic artifacts and pitfalls; 7) recognize the most frequent adult congenital heart disease lesions; and 8) provide diagnosis for life-threatening, emergency situations. The attendee will have the opportunity for self-assessment with specific interactive questions and case presentations.

Table of Contents




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