Session to Show Cutting-Edge Congenital Procedures

SURGICAL SYMPOSIUM: CONGENITAL CARDIAC SURGERY MÉLANGE

Sunday

1:00 p.m. – 4:30 p.m.

Room 350DEF

Learning cutting-edge approaches to treat congenital cardiac conditions can be a challenge. Increasingly, surgeons are using a variety of educational modes, including videos, interactive discussions of clinical scenarios, and lectures, to smooth out the learning curve.

“We have feedback from prior STS symposia on the educational approaches surgeons like the most and are using that to present innovative techniques that have had a bit of road testing,” said Jonathan M. Chen, MD, co-moderator of a Sunday afternoon session that will feature those approaches in 12 presentations.

The program contains three basic formats: complex case discussion, invited lecture, and short technique video. A variety of topics will be covered, including pulmonary vein stenosis, dilated cardiomyopathy, damaged heart valves, complex airway disease, and trisomy 13/18.

Fellows and junior faculty from different centers will present the complex cases with at least three therapeutic options. The surgeon who performed the operation will then defend the chosen therapy and present the result.

“Experts will give their opinions about why they would choose one option or another,” said Dr. Chen, of the University of Washington in Seattle. “It should have lively interaction because the cases chosen are intentionally controversial.”

Following each discussion will be a lecture. First up will be “Should We Offer Operations to Patients With Trisomy 13 or 18?” by Aarti Bhat, MBBS, of Seattle Children’s Hospital.

“These infants have a high mortality simply from their native disease, so there is a clinical conundrum as to whether one should even operate on these children,” Dr. Chen said. “It is a big ethical problem we all face, but most of our clinical protocols are based on historical anecdotal impressions, which may or may not be true in the current era. Dr. Bhat will address both the ethical aspects and the hard data on survival.”

Iki Adachi, MD will present “Pulmonary Artery Banding for Dilated Cardiomyopathy: North American Experience.” Dr. Adachi, of Baylor College of Medicine in Houston, is a leader in the use of a pulmonary artery band to manage the condition.

“This simple operation has turned out to work quite successfully in selected cases. Interestingly, Dr. Adachi’s first presentation of these data was at the congenital symposium 2 years ago as a complex case discussion. Fast forward 2 years, and it is an innovative procedure with preliminary data worldwide from which we can all learn,” Dr. Chen said.

Shigeyuki Ozaki, MD will discuss “Aortic Reconstruction With Autologous Pericardial ‘Neo-Cusps,’” a procedure he has demonstrated at major children’s hospitals. Dr. Ozaki is from Toho University Ohashi Hospital in Tokyo.

“With the Ozaki technique, a surgeon can replace the aortic valve with a valve created out of the patient’s pericardium,” Dr. Chen said. “It works quite well, and Dr. Ozaki has incredible data out to 8 years with remarkable rates of success.”

By measuring the size of a patient’s natural valve opening with templates created by Dr. Ozaki, surgeons can determine the size of the replacement valve.

Christopher A. Caldarone, MD, of the University of Toronto, will explain the science behind “What’s New in the Management of Pulmonary Vein Stenosis.” He helped lead the development of a commonly used stenosis procedure.

“More recently, the focus has been on the basic science behind the disease process, so his talk will be a mix of science and clinical applications,” Dr. Chen said.

Sitaram M. Emani, MD will present a video demonstrating how to implant a Melody valve in infants.

Sitaram M. Emani, MD will present a video demonstrating how to implant a Melody valve in infants.

The first of four video presentations will be “Novel Use of Expandable Valves.” Sitaram M. Emani, MD, of Boston Children’s Hospital, will demonstrate Melody valve implantation in infants.

“It is a very technical video that focuses on the implant, specifically where to put the suture that anchors the device in the left ventricle. I look forward to this because it’s a chance to ask the technique questions I always want to ask,” Dr. Chen said.

Scott M. Bradley, MD, of the Medical University of South Carolina in Charleston, will present “Repair of Atrioventricular Valves in Single Ventricle Patients.”

“These are children with one dominant valve that is often very distorted and abnormal, and it is a real challenge to repair them. The degree of success with such a repair can be the difference between successful single ventricle palliation and transplantation,” Dr. Chen said.

Christopher E. Mascio, MD, of the Children’s Hospital of Philadelphia, will show “Advanced HeartWare Techniques.” “He will have tips and tricks on how you implant a ventricular assist device that was not made to be put into a child,” Dr. Chen said.

Michael E. Mitchell, MD, of the Children’s Hospital of Wisconsin in Milwaukee, will present “Aortopexy in Complex Airway Disease.” “For people who are not used to seeing these techniques, it is going to be really interesting and helpful,” Dr. Chen said.

Dr. Chen’s co-moderators are Dr. Mascio and Glen S. Van Arsdell, MD, of the University of Toronto.

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