Sub Specialty Meetings

Interventional - PICS at the World Congress (Sun, Mon, Tues)

PEDIATRIC & ADULT INTERVENTIONAL CARDIAC SYMPOSIUM This meeting will follow a similar format to previous PICS meetings with live transmissions of interventional procedures from a number of cardiac catheter laboratories in Australia, New Zealand and elsewhere.

The provisional program includes breakout sessions and breakfast sessions:

Branch Pulmonary Artery Stenosis
1. Evaluation of patients: different diagnostic modalities.
2. Balloon Angioplasty: have we made any progress over the last 5 years?
3. Stent Implantation: Technical Considerations - Choice of stents & delivery systems
4. Long-term Outcome of Stents in PA's
5. Surgical techniques and Outcome
6. Intra-operative stenting

Coarctation of the Aorta
1. Pathology Demonstration
2. Imaging Evaluation: CT, MRI, Echo
3. Balloon Angioplasty: Technique & Long-term Outcome
4. Stent Implantation: Technique & Long-term Outcome -

Breakout Session: Nursing & Technologists
1. What does the Tech in the Hybrid Lab need to know?
2. Vascular Access devices & role of Nurses / Technologists in this area!
3. Role of Nurses/Techs in Clinical research in the Cath / Hybrid Lab
4. Role of Nurses in sedation in Cath / Hybrid Lab
5. Cath Lab Inventory Management! How to Stock the cath / hybrid Lab?

Workshop: The Atrial Septum (#1)
1. Anatomic correlation
2. Echocardiographic correlation
3. Erosions: Every Interventional Cardiologist nightmare!
a. The Amplatzer Device:
b. The BioStar/BioTrek:
c. The Cardia Atrisept Device:
d. The Helex Device:
e. The Figulla-Occlutech Device:
f. The PFM Device:
g. Newer Devices under investigation -

The Ventricular Septum
1. Anatomic correlation
2. Echocardiographic correlation

Debate: PMVSD:
Surgical closure of PM should be the standard!
Device closure of PMVSD in select patients is as good if not better than surgery!

1. Percutaneous Device closure of muscular VSD's
2. Perventricular Device Closure of VSD

Workshop: Comprehensive Intracardiac ehocardiography for the Interventionalists
1. How to interrogate the Atrial Septum in Patients with ASDs/PFOs
2. Advanced ICE Technique: Pulmonary valve replacement, Mitral valvuloplasty
3. Comparison between ICE & TEE to guide ASD device closure in Small children

How to:

  • Do Trans-septal puncture using regular Brockenbrough Needle vs RF
  • Perform Pericardiocentesis
  • Perform transhepatic cardiac catheterization
  • Be most efficient with limited resources

Structural Heart Disease Intervention
1. Percutaneous Aortic Valve Therapies: State of the art overview?
2. Mitral Valve Regurgitation: Percutaneous Therapies - State of The Art
3. Heart Failure Monitoring Devices: Where are we? Where are we heading?

Workshop: Percutaneous Pulmonary Valve Therapy
1. Who would benefit from this therapy? Indications & Evaluation for eligible patients
2. Melody Valve: Technical Considerations & Outcome
3. Edwards Sapien THV: Technical Considerations & Outcome

Catheter Closure of PDA
1. Devices
2. Coils including pfm Nit Occlud

The Sick Neonate
1. Evaluation of the sick neonate with pre and post cardiac intervention: Intensivist perspectives
2. Catheter intervention for left heart obstructive lesions
3. The Surgeon's Role in the above!

Critical PS-PA/IAS: State of the art
1. Diagnostic Evaluation Before Treatment: Decision Making
2. Indications and Interventional Management: results in Critical PS
3. Indications and Interventional Management: PA/IAS

Hybrid Management of HLHS
1. Pathology Demonstration
2. Echocardiographic Evaluation
3. Geographical Approach & Outcome
i. Giessen:
ii. Columbus:

The Coronary Arteries: What does the pediatric cardiologist need to know!
1. Angiographic Assessment of the coronary arteries
2. Post Kawasaki Disease

Embolization Therapy
1. Embolization therapy in patients with pulmonary AVMs
2. Management of APC's in the cath lab
3. Coronary AV fistulas: Closure technique & results
4. Retrieval of embolized foreign bodies!

Foetal Intervention
1. Who would benefit from this therapy?
2. Follow-up & status of aortic valvuloplasty/perforation of IAS for HLHS
3. Therapeutic ultrasound for IAS in HLHS.

Surgical - 2nd Meeting of WSPCHS, at the World Congress (Mon, Tues)

World Society for Pediatric and Congenital Heart Surgery

The Stella van Praagh Memorial Lecture:
Anatomy of Common Atrioventricular Junction
1. Nomenclature and Classification of Common Atrioventricular Junction
2. Genetics of CAVC and common syndromes
3. Fetal evaluation
4. Diagnostic evaluation: Echocardiography and the role of Catheterization
5. Echo assessment of ventricular balance in CAVC
6. Intensive care and perioperative management
7. Anaesthesia for CAVC
8. Pre-op Challenges with CAVC in Developing Nations
9. Role of Surgical Palliation
10. The conduction system in CAVC

Unresolved controversies in repair of CAVC
1. Two-patch repair for CAVC
2. Single-Patch repair of CAVC
3. Patchless repair of CAVC
4. CAVC and aortic arch obstruction
5. Severely unbalanced CAVC

Anatomy of CAVC with complex associated lesions
1. Repair of CAVC and Tetralogy of Fallot
2. Repair of CAVC with DORV, TGA or Truncus

1. Lessons Learned form the STS Database
2. Lessons Learned form the EACTS Database

Challenging AV valve in CAVC
1. Reoperation for left AV valve regurgitation
2. Late Presentation of CAVC and role of PAB
3. Chronic Pulmonary Hypertension in CAVC
4. Post-op Challenges in CAVC in developing nations
5. Late outcome after repair of CAVC

Pediatric Cardiac Intensive Care (jointly organised with PCICS)

Pediatric Cardiac Intensive Care Society Congenital Cardiac Anaesthesia Society On Monday morning (22nd June) there will be separate meetings of the Anaesthesia and Perfusion groups.

Anaesthesia:
1. Training 1 - Aus / NZ perspective
2. Training 2 - USA perspective
3. Training 3 - UK perspective
4. Training 4 - German perspective
5. Expert Panel

Perfusion:
1. Minimising the inflammatory response to CPB
2. Ischaemic preconditioning to reduce organ injury after CPB
3. Anticoagulation Monitoring during CPB
4. The application of Selective Cerebral Perfusion during CPB
5. Monitoring Cerebral Oximetry During infant CPB
6. Acute Renal Failure following paediatric cardiac surgery
7. Perfusion strategies for the arterial switch
8. Vacuum assisted suction during CPB: the GOS experience

Monday afternoon will involve a combined meeting of the pediatric intensive care, anaesthesia and perfusion groups to discuss a range of topics and have debates on topics under the general title of "Risky business".

The Tuesday provisional program is:
1. Why should we monitor systemic oxygen delivery? The Brain Matters.
2. Monitoring end organ oxygen delivery. When to intervene?
3. How good was the surgery? Peri-operative cardiac assessment
4. Monitoring oxygen delivery after ICU discharge.
5. Manipulating systemic oxygen delivery: minimising the inflammatory response
6. Manipulation of afterload: the old and the new
7. Electrophysiology and CRT in the ICU.
8. Future techniques: Ischaemic preconditioning
9. Four decades of ECMO. What have we learnt?
10. Berlin heart
11. ECMO or VAD: which is best.
12. Rapid-deployment ECLS: Boston Experience
13. Optimising systemic oxygen delivery during ECLS
14. Clots and bleeds. Have we got any better?
15. Retrievals on ECLS
16. Newer indications and techniques for ECLS

Adult Congenital Heart Disease (2 days)

International Society for Adult Congenital Heart DiseaseMarfan / Aortopathies
1. Why wait beyond 40mm for surgery?
2. Drug therapies: What and when?
3. The extent of the problem.
4. Surgical management

Arrhythmias in Mustards / Fontans
1. Drug management
2. Ablation in Mustards / Fontans
3. SN function after Maze
4. Fontans: Why not convert all?

Pregnancy in ACHD
1. Physiology and Risk Stratification
2. Management of the Cyanotic Pt.
3. Anticoagulation
4. Selecting Contraception

ACHD Imaging
1. Novel Methods for RV echo assessment
2. What can MRI add in complex ACHD

ACHD around the World
1. The Chennai Experience
2. Egypt and ACHD Surgery
3. ACHD in Asia-Pacific
4. Lessons learnt

Ebstein's Anomaly
1. When to refer the Ebsteins patient to the surgeons: Should we refer earlier?
2. Ebsteins Surgery in the real world

Pulmonary Hypertension in ACHD
1. Should all Eisenmengers pts be treated with pulmonary vasodilators?
2. Drug Treatment of PHT in ACHD: New and Combination Therapies
3. Raised Resistance in Fontans: Do pulmonary vasodilators help?
4. Lessons from Basic Science

Paediatric electrophysiology / arrhythmia (2 days)

Pediatric and Congenital Electrophysiology Society Pedirhythm There will be a combined EP / Genetics / Cardiomyopathy session with the Cardiomyopathy / transplant group, which will take place during the morning on Monday June 22nd.

Genetics, myocardial disease and electrophysiology are increasingly intertwined
1. Cardiomyopathy and the rhythmonome are inseparable
2. Electrophysiology and myocardial disease: from mouse to man
3. Genetics of cardiomyopathy; intellectual process or clinically useful?
4. Brugada, CPVT, ARVC and conduction system disease; why the overlap?

The program for the rest of the meeting is expected to be:

ICD's
1. Debate:(aff) In children & teenagers CRT for DCM should always come with a Defibrillator
2. Debate:(neg) In children&teenagers CRT for DCM should always come with a Defibrillator
3. ICD disasters; revisions and extractions
4. How can we decrease ICD complications in children

Resynchronisation; the new panacea
1. Indications for CRT
2. Assessing synchrony : how to do it and what's important
3. CRT for the LV
4. CRT for the RV and the single V
5. Optimal sites for single ventricular lead placement; endocardial and epicardial
6. Debate (affirmative): QRS duration has become irrelevant in prescribing CRT
7. Debate (negative): QRS duration has become irrelevant in prescribing CRT
8. Tuning AV and VV interval post CRT implant; methods and importance

Ablation
1. Anatomy for the paediatric electrophysiologist; normal heart and CHD re surgery
2. EP anatomy: post surgical; knowledge is everything!
3. Practical lessons from the basic science; RF, Cryo and new energy sources
4. Children and their ablation toys; Robots and 4D; do we need them?
5. Debate(affirmative) In 2009 any child/ teenager having ablation for AVNRT should have initial modification with cryo-energy
6. Debate(negative) In 2009 any child/ teenager having ablation for AVNRT should have initial modification with cryo-energy
7. VT ablation in paediatrics and congenital heart disease
8. Tips and tricks for the unexpected difficult ablation/unusual substrate

Chanellopathies
1. SQT/LQT: is gene specific therapy now a reality?
2. CPVT: sneaky as they come but we are getting smarter!
3. Investigating the PM negative young sudden death- integrating the genetic & family Ix
4. Brugada syndrome: Management and ICD indications in Children
HYPOTHETICAL: Barbie almost drowns in a pool...

Imaging (including Fetal Echocardiography / MRI and CT) (2 days)

3D Echocardiography
1. 3D imaging - clinical utility
2. 3D echocardiography in the operating room and guiding catheter interventions.
3. AV valve regurgitation
4. 3D assessment of extracardiac structures

MIR
1. Principles and pitfalls in paediatric CMR
2. Structure, function and paediatric heart disease
3. MRI and heart failure
4. Risk stratification / prognosis HOCM

Current Issues in Imaging
1. Tailored cardiovascular CT to minimise radiation dose in children
2. Fusion/future directions
3. Discussion - Fusion technology - is it the future?
4. 3D assessment of the AV valve is mandatory prior to mitral valve surgery
5. A $50,000 echo machine is adequate for the diagnosis and management of paediatric heart disease

Fetal Cardiology
1. Growth and development of the fetal heart - normal and abnormal anatomy
2. Fetal 4D imaging
3. First Trimester Imaging
4. Strategies to improve prenatal detection rates
5. Fetal Interventions
6. Planning management of difficult fetal heart disease
7. Prenatal counselling - the surgeon's role
8. Cardiac and vascular implications for SGA

Cardiac and Vascular Mechanics
1. Cardiac mechanics - from structure to function
2. Torsion/diastolic function/suction
3. Synchrony - prognostic implications
4. Dyssynchrony and congenital heart disease
5. Ventricular vascular interaction
6. Arterial dynamics and ventricular load

Nursing (2 days)

Getting Patients through the Maze I …Hospital care
1. Role of the nurse after a fetal diagnosis
2. The sick neonate without a fetal diagnosis
3. Clinical care of The Sick neonate… what the nurse needs to know.
4. Care Management
5. Ethical Issues in multidisciplinary decision-making.
6. Fast-tracking… Does he really need an ICU bed?
7. The Long Stay patient, nursing, family and system stresses.
8. A parent's experience… what it's really like

Getting Through the Maze II…Beyond Four walls
1. Transitioning the fragile neonate to the community
2. Adaptation of the child and family to life with a chronic illness
3. The Independent Family… cutting the apron strings
4. Specialist care and the community… chronic pulmonary hypertension
5. Preparing families for hospital admission
6. Cross-cultural care
7. Care at a distance… the remote patient
8. The other side of the fence. What we really want

Getting Through the Maze III……Good to Go
1. Can I be a normal teenager?
2. Improving Compliance in the rebellious teenager
3. Community Palliative Care
4. Who should care for adults with CHD anyway?
5. Preparing the patient for transition to adult services
6. Logistical issues in transitioning to adult services
7. Purple Heart

Nurses as Leaders
1. The Search For Excellence
2. Multiskilling vs Jack of all trades, The Specialist Cardiac Nurse
3. The role of the nurse practitioner in a Paediatric cardiac program.
4. How to Build a Nursing Leadership team around patient needs
5. Developing nurses in the brain drain.
6. The nurse as a research leader
7. Giving over power, what the doctor has to lose.

Paediatric cardiomyopathy / transplant (Mon) : Pulmonary Hypertension (Tue)

Paediatric Cardiomyopathy
1. The diagnostic workup of children with cardiomyopathy
2. What have we learned from registries - NACCS
3. What have we learned from registries - PCMR
4. Medical management of dilated cardiomyopathy in children

Heart and lung transplantation
1. Indications, contraindications and results
2. Managing the high risk recipient
3. Anthracycline cardiomyopathy
4. Mechanical support
5. Dealing with late complications of heart transplantation
6. Surgical considerations in paediatric heart transplantation
7. The current status of paediatric lung transplantation

Pulmonary Hypertension (Tuesday)
1. Pathophysiology of pulmonary hypertension
2. Genetics of pulmonary hypertension
3. Gene therapy for pulmonary hypertension
4. Diagnosis and assessment
5. From bench to bedside
6. Current therapies
7. Assessing the efficacy of therapy
8. Emerging therapies
9. Pulmonary hypertension in the newborn
10. Pulmonary hypertension and chronic lung disease
11. Nursing considerations in the management of pulmonary hypertension
12. Pulmonary hypertension in the ICU
13. Results from the Aust/NZ paediatric pulmonary hypertension registry