Partners

Founded by brigham and women's hospital and massachusetts general hospital

Office of Continuing Professional Development

The Corrigan Minehan Heart Center Symposium on Cardiothoracic Rescue: A Case-Based Approach to Mechanical Support for the Failing Heart and Lungs

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March 4 - 5, 2016

O'Keefe Auditorium
Massachusetts General Hospital
55 Fruit Street
Boston, MA 02114

Description

The specialty of cardiovascular surgery as well as the perioperative care of cardiac surgical patients is undergoing tremendous evolution. Patients presenting for coronary artery bypass grafting, valve repair and replacement, repair of complex aortic procedure, aneurysms, and dissections are older with more complex problems. Patients that have undergone procedures to correct congenital anomalies are now presenting as adults for additional surgery. Heart and lung transplantation techniques continue to improve. The acuity of cardiac surgical patients as well as a limited number of heart and lungs available for transplant has encouraged the rapid development of mechanical assistance to provide rescue, short term support during recovery, long term support for those awaiting transplantation, and destination therapy for those patients who are not suitable candidates for organ transplantation.

Cardiac surgeons, cardiologists, anesthesiologists, perfusionists, intensive care physicians, and nurses must now develop an understanding of the perioperative management of patients with a wide variety of mechanical support devices including temporary ventricular assist devices, extracorporeal membrane oxygenation (ECMO). Such devices are not managed in a vacuum by a single individual but by a multidisciplinary care team. The current model is that team members often understand such devices only in the context of their particular care area rather than how actions in their area may affect other management. Trainees in one discipline are not provided the vision of management in other specialties.

Learning Objectives

Upon completion of this activity, participants will be able to:

1. Review the history of mechanical support for the failing heart and lungs
2. Discuss the physiology of acute heart failure.
3. Identify options use and limitations of medical management of acute heart failure.
4. Differentiate the use and value of temporary percutaneous mechanical assist devices.
5. Review the use of temporary extracorporeal ventricular support devices.
6. Outline the history of extracorporeal membrane oxygenation (ECMO) and current start.
7. Demonstrate the functions of the ECMO console
8. Recognize and explain the different types of cannulae and cannulation strategies for patients undergoing ECMO support.
9. Recognize the selection criteria for ECMO
10. Illustrate the management of ECMO including flows, sweeps, and gases
11. Cite common complications associated with the institution of ECMO.
12. Describe the involvement of the nursing service in successful development and management of an ECMO program including education, trouble shooting, and patient care.
13. Interpret hemodynamic data for patients with ventricular assist devices.
14. Demonstrate function as a member of a multidisciplinary team caring for a patient requiring ECMO for heart and lung failure
15. Debate the involvement of pallative care in ventricular assist patients
16. Discuss problems in the intensive care unit with ventricular assist and ECMO.
17. Synthesize the appropriate methods for transfer of a patient on mechanical assist including communication, preparation, movement, and receipt.

Target Audience

This activity is intended for cardiac surgeons, cardiologists, intensive care physicians and nurses, general anesthesiologists, cardiac anesthesiologists, perfusionists, biomedical technologists, pharmacists, nurse anesthetists, as well as advanced practice nurses. Medical students and student certified nurse anesthetists may have interest.

Agenda

Friday Morning Session Acute Heart Failure

Time

Activity

Potential Presenter

10:00 AM-10:10 AM

Introduction

Michael G. Fitzsimons, M.D.

10:10 AM-10:30 AM

A 45 year old male presents with hypotension to the Emergency Department: Assessment of the Acute Heart Failure

Mauricio Villavicencio, M.D.

10:30 AM-11:15 AM

The Physiology of Acute Left Heart Failure

Greg Lewis, M.D.

11:15 AM- 12:00 PM

Medical Management and Optimization of the Patient with Acute Heart Failure

Marc Semigran, M.D.

12:00 PM 1:00 PM

Lunch

Friday Afternoon Session Introduction to Temporary Mechanical Assist

Time

Activity

Potential Presenter

1:00-1:15 PM

Introductory Remarks

Michael G. Fitzsimons

1:15 PM- 2:00 PM

Case

TBD

2:00 PM-3:00 PM

Temporary Percutaneous Mechanical Assist Devices

Igor Palacios, M.D.

3:00 PM-3:15 PM

Break

3:15 PM-4:00 PM

Temporary VAD support cases

Sunu Thomas, M.D.

4:00 PM-5:00 PM

Breakout sessions

Michael Fitzsimons, M.D.

Jarone Lee, M.D.

Gaston Cudemus, M.D.

5:00 PM

Adjourn

Saturday Morning Session Introduction to Temporary Mechanical Assist

Time

Activity

Potential Presenter

7:30 AM-8:00 AM

Breakfast

8:00 AM-8:10 AM

Introductory Remarks

Michael Fitzsimons, M.D.

8:10 AM-9:00 AM

Temporary Ventricular Assist: The Centrimag, pVAD

David D'Allesandro, M.D.

9:00 AM-10:00 AM

Breakout sessions

Archer Martin, M.D.

10:00 AM-10:15 AM

Break

Saturday Morning Session Introduction to Extracorporeal Membrane Oxygenation (ECMO)

Time

Activity

Potential Presenter

10:15 AM-10:45 AM

ECMO: Where we have been where are we now?

Gaston Cudemus, M.D.

10:45 AM-11:15 AM

ECMO Console

Alex Legassy, RRT

11:15 AM-11:30 AM

Break

11:30 AM-12:00 PM

ECMO Circuitry: Cannulation and Devices

Natalie Roy, M.D.

12:00 PM-1:00 PM

Break and Lunch

Saturday Afternoon Session Practical ECMO

Time

Topic

Potential Presenter

1:00 PM 1:20 PM

Selection criteria for ECMO

Gaston Cudemus, M.D.

1:20 PM-2:00 PM

Management of ECMO: Flows, sweeps, gases, and labs

Ken Shelton, M.D.

2:00 PM-2:20 PM

Management of ECMO: Complications and Challenges

David D'Allesandro, M.D.

2:20 PM-2:45 PM

Bedside management of ECHO from a nursing perspective

Jennifer Carr-Loveland, RN

2:45 PM-3:00 PM

Break

Saturday Afternoon Sessions ECMO Cases

Time

Topic

Potential Presenter

3:00 PM-3:30 PM

A 22 year old female with SBE who underwent AVR/root enlargement, closures of VSD and tricuspid annuloplasty develops refractory pulmonary edema after bypass

Jock McCoullough, M.D.

3:30 PM-4:00 PM

A 36 year old female presents with respiratory failure after a voyage to the Far East

Mauricio Villavicencio, M.D.

4:00 PM-4:30 PM

A 45 year old male who was placed on VV ECMO after a perioperative aspiration and has progressed to VA ECMO due to cardiac failure: Difficult Discussions and The Exit Strategy; The Role of Palliative Care

Sunu Thomas, M.D.

4:30 PM-4:45 PM

Break

Saturday Afternoon Closing Sessions

Time

Topic

Potential Presenter

4:45 PM-5:15 PM

Communication, Preparation, and Transportation of the ECMO Patient;

Panel Discussion

Q&A

Ken Shelton, M.D.

Natalie Roy, M.D.

David D'Allesandro, M.D.

Ken Shann

5:15 PM-6:00 PM

Creating a successful ECMO Network

Network and Closing Remarks

Panel Discussion

Q&A

Mauricio Villavicencio, M.D.

David D'Allesandro, M.D.

Thor Sundt, M.D.

6:00 PM

Adjourn

Faculty

Michael G. Fitzsimons, M.D.
Director, Cardiac Anesthesia
Assistant Professor
Harvard Medical School
DACCPM
Massachusetts General Hospital

Michael Andrawes, M.D.
Director, Fellowship in Adult CT Anesthesia
Instructor in Anesthesia
Harvard Medical School
DACCPM
Massachusetts General Hospital

Kenneth Shelton, M.D.
Instructor in Anesthesia
Division of Cardiac Anesthesia
MGH Heart Center ICU
DACCPM
Massachusetts General Hospital

Gaston Cudemus, M.D.
Instructor in Anesthesia
Division of Cardiac Anesthesia
MGH Heart Center ICU
DACCPM
Massachusetts General Hospital

Ken Shann, CCP
Director, Perfusion Services
Cardiac Surgery Division
Massachusetts General Hospital

Natalie Roy, M.D.
Instructor in Surgery
Cardiac Surgery Division
MGH Heart Center ICU
Massachusetts General Hospital

Archer Martin, M.D.
Mayo Clinic
Jacksonville, FL

Sunu S. Thomas, MD, MSc
Instructor in Medicine, Harvard Medical School
Cardiology Division, Massachusetts General Hospital

Jennifer Carr-Loveland, RN
Critical Care Nurse
Blake 8 CSICU
Mass General Hospital


Greg Lewis, M.D.
Cardiology Divsion
Department of Medicine
Massachusetts General Hospital

Registration Fees

General Admission: $75

Cancellation Policy

Cancellation requests received via email to partnersCPD@partners.orgon or before February 26 will be refunded, less a $15 administrative fee. Cancellations received after February 26 will not be honored.

Contact

For questions regarding this activity, please contact Sherri Murray at sgmurray@partners.org.

For questions regarding registration, please contact Partners Office of Continuing Professional Development at partnerscpd@partners.org.

Additional Requests

Our course coordinator can assist you with any special needs (i.e. physical, dietary, etc). Please contact Sherri Murray prior to the live event at sgmurray@partners.org.

Provided by:

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CME Information

Accreditation
Partners HealthCare System is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Partners HealthCare System designates this live activity for a maximum of 15AMA PRA Category 1 CreditsTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Nursing

Participation Certificate available for Nurses who attend this program with a certificate of attendance that indicates the title of the program, dates and the number of CE as calculated by the Massachusetts Board of Registration in Nursing (BORN) regulations on Nursing Continuing Education found at 244 CMR 5.00 (link attached). For more information, please refer to the link below:

http://www.mass.gov/eohhs/docs/dph/regs/244cmr005.pdf

Perfusionist

The American Board of Cardiovascular Perfusion has approved this program and will allot the following Category I CEU to those who attend the meeting:

Friday, March 3rd, 2016 --- 6.6
Saturday March 4th, 2016 - 9.4
Total Possible- 16.0