CME Information LEARNING OBJECTIVES TARGET AUDIENCE CREDIT DESIGNATION • Identify the increasing prevalence of adults with congenital heart disease and address some of the complications that can result from lifelong congenital heart disease. • Consult and coordinate with expert maternal-fetal medicine care for optimization of outcomes for mothers and babies and determining appropriate contraceptive options. This conference is intended for pediatricians, primary care physicians, internists, cardiologists and surgeons who specialize in both pediatric and adult CHD, electrophysiologists, anesthesiologists, nurses, nurse practitioners, geneticists, maternal fetal medicine specialists, obstetricians and gynecologists, radiologists and other health care professionals with a special interest in the evaluation, diagnosis and management of adults with congenital heart disease. MedStar Washington Hospital Center designates this live activity for a maximum of 12.5 AMA PRA Category 1 CreditsTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity. • • Appraise the catheter-based (interventional and electrophysiology) procedures in adults with congenital heart disease, and compare the risks and benefits of each modality and approach. Evaluate the relationship of ACHD patients with heart failure, pulmonary hypertension, and pursue advanced treatment options for this patient subset. CME ACCREDITATION This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of MedStar Washington Hospital Center and Children’s National Medical Center. MedStar Washington Hospital Center is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. DISCLOSURE OF FINANCIAL RELATIONSHIPS WITH ANY COMMERCIAL INTEREST As a sponsor accredited by the ACCME, it is the policy of MedStar Washington Hospital Center to require that everyone who is in a position to control the content of an educational activity disclose all relevant financial relationships with any commercial interest prior to the educational activity. The ACCME considers relationships of the person involved in the CME activity to include financial relationships of a spouse or partner. Any individual who refuses to disclose relevant financial relationships will be disqualified from participating in the CME activity. For an individual with no relevant financial relationship(s), the participants must be informed that no conflicts of interest or financial relationships exist. Due to advances in medical and surgical therapies for patients with Congenital Heart Disease (CHD), children and adolescents with CHD have over a 90% survival rate. As a result, the number of adults with CHD in the United States has now surpassed the number of children with these conditions. There are currently more than 1.3 million adults with CHD and this prevalence is expected to increase 5% annually. As a result, the hospital admissions for patients with adult congenital heart disease have risen by 101% between 1998 and 2005. Of these admissions, the number of admissions involving heart failure or pulmonary hypertension increased 83% and 66%, respectively. In addition, some CHD patients are diagnosed for the first time in adulthood often creating diagnostic and therapeutic dilemmas that may be difficult to approach. CHD represents a medical challenge that spans the life a patient from birth through adolescence and onto adulthood. This includes an increasing number of women with CHD who are in their childbearing years. Between 1998 and 2007, the number of annual deliveries in women with congenital heart disease rose by 35% as compared to a 21% increase in women with no CHD. Women with CHD are 8 times as likely to experience cardiovascular complications during pregnancy and have a 6 times higher risk of dying than women without CHD. Women with complex congenital heart disease are twice as likely to have cardiovascular complications compared to those with simple heart defects. Managing these patients through pregnancy safely can be extremely challenging. This challenge can be adequately met by a coordination of efforts from physicians and other healthcare providers amongst a variety of specialties. This conference will focus on several challenging aspects of CHD including the management of the pregnant patient, heart failure/pulmonary hypertension, and arrhythmia with emphasis on a multidisciplinary approach to the evaluation and treatment of these patients. For updated program information and to register online, please visit: CME.MedStarWashington.org/ACHD MEDSTAR WASHINGTON HOSPITAL CENTER MedStar Washington Hospital Center 100 Irving Street, NW, Suite 6D-21 Washington, DC 20010 PAID NON-PROFIT ORG. U.S. POSTAGE May 16 & 17, 2014 Bethesda North Marriott Hotel & Conference Center | Bethesda, MD Adult Congenital Heart Disease in the 21st Century Adult Congenital Heart Disease in the 21st Century May 16 & 17, 2014 Bethesda North Marriott Hotel & Conference Center | Bethesda, MD Course Director: Course Co-Directors: Anitha S. John, MD, PhD Washington Adult Congenital Heart Center Children’s National Medical Center Washington, DC Melissa H. Fries, MD MedStar Washington Hospital Center Washington, DC George Ruiz, MD Washington Adult Congenital Heart Center MedStar Washington Hospital Center Washington, DC Faculty COURSE DIRECTOR Anitha S. John, MD, PhD INVITED FACULTY Hassan A. Adeniji-Adele, MD Director, Washington Adult Congenital Heart Program Children’s National Medical Center MedStar Washington Hospital Center MedStar Heart Institute Washington, DC Attending Physician, Anesthesiology MedStar Washington Hospital Center Washington, DC Registered Nurse Clinician, The Heart and Vascular Center University of Virginia Health Medical Center Charlottesville, VA Director, Adult Congenital Heart Clinic Director, Sports Cardiology Program Vice Chief, Cardiology Outreach University of Virginia Health Systems Charlottesville, VA Interim Chairman, Department of OB/GYN Director, Genetics and Fetal Medicine MedStar Washington Hospital Center Washington, DC Nancy H. Klein, BSN Clinical Program Coordinator, WACH Children’s National Medical Center Washington, DC Charles I. Berul, MD George Ruiz, MD Director, Pulmonary Hypertension Program Washington Adult Congenital Heart Center MedStar Washington Hospital Center MedStar Heart Institute Washington, DC Chief, Division of Cardiology Co-Director, Children’s National Heart Institute Children’s National Medical Center Washington, DC Karen S. Kuehl, MD, MPH Stephen C. Cook, MD Dilip S. Nath, MD Director, Adolescent and Young Adult Congenital Heart Disease Center Children’s Hospital of Pittsburgh of UPMC UPMC Heart and Vascular Institute Pittsburgh, PA KEYNOTE SPEAKERS Leonard L. Bailey, MD Jane E. Crosson, MD Director, Pediatric Electrophysiology The Johns Hopkins Hospital Baltimore, MD Distinguished Professor, Cardiovascular and Thoracic Surgery and Pediatrics Department of Cardiovascular and Thoracic Surgery Loma Linda University School of Medicine Surgeon-in-Chief Loma Linda University Children’s Hospital Loma Linda, CA Director, Fetal Heart Program Director, Critical Care Delivery Service Director, Advanced Cardiac Imaging Fellowship Children’s National Medical Center Washington, DC Medical Director, Pulmonary Hypertension Clinic Aurora St. Luke’s Medical Center Milwaukee, WI Stacy D. Fisher, MD Director, Women’s and Complex Heart Diseases University of Maryland Medical Center University of Maryland School of Medicine Baltimore, MD Cardiologist, WACH George Washington University School of Medicine Washington, DC Attending Physician, Congenital Cardiac Surgery Children’s National Medical Center Washington, DC 8:00 AM Welcome and Introduction to the WACH Program & Faculty George Ruiz, MD SESSION I: ADULT CONGENITAL HEART DISEASE (ACHD) OVERVIEW Manisha S. Patel, MD Director, Adult Congenital Heart Disease Clinic Attending Physician, Pediatric Cardiology Greenville Health System Greenville, SC SESSION III: BREAKOUT SESSIONS 10:45 AM - 12:00 PM Attendees may attend one breakout session: A, B or C. Please see below for more details. 12:15 PM Lunch and Visit the Exhibits 9:40 AM Questions and Discussion Panelists: H. Adele, M. Donofrio, M. Fries, A. John 2:50 PM Indications for Pacemaker/ICD Therapy in the ACHD Patients with Heart Failure Maully Shah, MBBS 9:55 AM Break and Visit the Exhibits 3:15 PM Roundtable Discussion Panelists: D. Nath, G. Ruiz, M. Shah 3:30 PM Closing Remarks Anitha S. John, MD 3:45 PM Adjourn BREAKOUT SESSIONS BREAKOUT SESSION A: ELECTROPHYSIOLOGY CONSIDERATIONS IN ACHD Moderator: Anitha S. John, MD, PhD 11:35 AM Outpatient Management and Medical Staff Education Nancy H. Klein, BSN 10:45 AM Sudden Death in ACHD – What are the Risk Factors? Ali N. Zaidi, MD 12:00 PM Roundtable Discussion Panelists: V. Freedenberg, N. Klein, D. Pearson BREAKOUT SESSION C: INNOVATIVE TOOLS AND TECHNIQUES IN CONGENITAL HEART DISEASE Moderator: Christopher Talluto, MD 11:35 AM Exercise Guidelines and Recommendations in ACHD Patients Robert W. Battle, MD 10:45 AM 3D Printing - How to Hold Your Heart in Your Hand Laura Olivieri, MD 12:00 PM Roundtable Discussion Panelists: R. Battle, J. Crosson 11:10 AM BREAKOUT SESSION B: THE ROLE OF THE ADVANCED PRACTITIONER IN ACHD CARE Moderator: Adrienne Garo , RN 10:45 AM Mindfulness Based Stress Reduction: Strategies to Reduce Stress and Anxiety Vicki Freedenberg, MSN, PhD 11:10 AM Research Initiatives by Advanced Practitioners in ACHD Disty Pearson, PA-C Radiation Free MRI Cardiac Catheterization Kanishka Ratnayaka, MD 11:35 AM Defibrillator Implantation in Complex CHD When You Can’t Get There from Here Charles I. Berul, MD 12:00 PM Roundtable Discussion Panelists: C. Berul, L. Olivieri, K. Ratnayaka Registration Information REGISTRATION FEES CANCELLATION POLICY Registration Type Full Meeting One Day Physician $250 $140 Resident/Fellow $175 $95 Nurse $175 $95 Allied Health Professional $175 $95 ONLINE REGISTRATION PREFERRED Please visit our secure website at http://cme.medstarwashington.org/ACHD for updated program and registration information. We are unable to accept registrations or cancellations by telephone. If you wish to pay your registration fee by check, please download and print a registration form and mail it to the address on the registration form with your check. All registrations will be confirmed by email only. Please use an email address that you check regularly. If you have questions regarding registration or do not receive an email confirmation of your registration within 1-2 business days, please contact us at WHCCME@gmail. com or 202-877-7808. SESSION I: CONSIDERATIONS IN CARDIAC DISEASE Moderator: Manisha S. Patel, MD Surgical and Immunological Considerations in ACHD Transplantation Dilip Nath, MD 2:25 PM Management of Atrial Tachycardias in ACHD Jane E. Crosson, MD Welcome and Introduction Melissa H. Fries, MD Diagnosis and Coordination of Care for the Fetus with Congenital Heart Disease Mary T. Donofrio, MD Medical Therapy of Heart Failure in ACHD and When to Consider Transplantation George Ruiz, MD 11:10 AM 7:50 AM 9:15 AM 2:00 PM 10:15 AM Break and Visit the Exhibitors Director, Adult Congenital Heart Disease Program Montefiore Einstein Center for Heart and Vascular Care The Children’s Hospital of Montefiore Bronx, NY Contraception Recommendations in Patients with CHD Melissa H. Fries, MD Questions and Discussion Roundtable Discussion Panelists: S. Cook, P. Sinha, M. Slack Ali N. Zaidi, MD 8:50 AM 1:50 PM 9:50 AM Director, Adult Congenital Cardiology Clinic Physician, Pediatric Cardiology Child Cardiology Associates Arlington, VA Anesthesia Management in the Pregnant CHD Patient Hassan A. Adeniji-Adele, MD Keynote Address: History of Transplantation in Congenital Heart Disease and Outcomes of Long-Term Survivors Leonard L. Bailey, MD Considerations for Re-Operation in Patients with TOF: What Does the Surgeon Need to Know? Pranava Sinha, MD Christopher J. Talluto, MD 8:25 AM 1:20 PM 9:30 AM Senior Pediatric/Congenital Interventional Cardiologist Children’s National Heart Institute Founder & Director, Adult Congenital/Structural Interventional Catheterization Program MedStar Washington Hospital Center Washington, DC Physiology of Pregnancy and Delivery Anitha S. John, MD Questions and Discussion Percutaneous Interventions in the Post-Operative TOF Patient Michael C. Slack, MD Director, Electrophysiology Program The Children’s Hospital of Philadelphia Philadelphia, PA 8:00 AM 8:30 AM 9:05 AM Maully J. Shah, MBBS Agenda Saturday, May 17 SESSION IV: TRANSPLANT AND HEART FAILURE Moderator: Pranava Sinha, MD Management of TOF Patients: Does “Repaired Mean Repaired?” Stephen C. Cook, MD Attending Physician, Interventional Pediatric Cardiology Children’s National Medical Center Washington, DC Michael C. Slack, MD Director, Cardiovascular 3D Printing Program Sheikh Zayed Institute for Surgical Innovation Attending Physician, Cardiac MRI, Echocardiography Children’s National Health System Washington, DC ACHD: Past, Present, and Future Anitha S. John, MD, PhD 8:40 AM Clinical Director, Third Floor Operating Room Attending Physician, Anesthesiology MedStar Washington Hospital Center Washington, DC Attending Physician, Pediatric Cardiac Surgery Children’s National Medical Center Washington, DC Director, Cardiac Genetics Center MedStar Washington Hospital Center MedStar Heart Institute Washington, DC 8:05 AM SESSION II: TETRALOGY OF FALLOT (TOF) Moderator: Karen S. Kuehl, MD, MPH Daniel I. Perlin, MD Pranava Sinha, MD Susan O’Donoghue, MD Agenda Friday, May 16 Senior Physician Assistant The Boston Adult Congenital Heart and Pulmonary Hypertension Service Boston Children’s Hospital Boston, MA Kanishka Ratnayaka, MD Laura Olivieri, MD Mary T. Donofrio, MD Dianne L. Zwicke, MD Disty Pearson, PA-C Nurse Clinician, Electrophysiology Children’s National Medical Center Washington, DC Adrienne Garo, RN, MSN Robert W. Battle, MD COURSE CO-DIRECTORS Melissa H. Fries, MD Vicki Freedenberg, PhD, RN Cancellations made in writing by Thursday, April 3, 2014 will be subject to a 50% penalty. No refunds will be given after Thursday, April 3, 2014. Cancellations will not be accepted by telephone. In the unlikely event that the course is canceled, MedStar Washington Hospital Center will refund the registration fee, but is not responsible for any travel costs. Please call 202-877-7808 or email WHCCME@gmail. com if you any questions or need any additional information. Venue Information BETHESDA NORTH MARRIOTT HOTEL & CONFERENCE CENTER 5701 Marinelli Road North Bethesda, MD 20852 (301) 822-9200 SESSION II: CASE BASED LEARNING – MANAGEMENT OF COMPLEX CONGENITAL HEART DISEASE Moderator: George Ruiz, MD This session will focus on the management of several common, complex congenital heart lesions followed by a multidisciplinary panel discussion. Cases will review the management of anticoagulation in pregnancy, left sided obstructive lesions, and common right sided lesions such as tetralogy of fallot. 10:10 AM Case 1 10:45 AM Case 2 11:20 AM Case 3 12:00 PM Lunch and Visit the Exhibits SESSION III: SPECIAL CONSIDERATIONS – MANAGEMENT OF HIGH RISK PREGNANCY Moderator: Melissa H. Fries, MD 1:05 PM Keynote Lecture: Pulmonary Hypertension Dianne L. Zwicke, MD 1:30 PM Peripartum Cardiomyopathy George Ruiz, MD 1:55 PM Coronary Artery Disease and Pregnancy Stacy D. Fisher, MD 2:20 PM Management of Arrhythmias During Pregnancy Susan O’Donoghue, MD 2:45 PM Questions and Discussion Panelists: S. Fisher, S. O’Donoghue, G. Ruiz, D. Zwicke 3:00 PM Closing Remarks George Ruiz, MD 3:15 PM Adjourn