Core Competencies in Pulmonary Hypertension Scientific Program

 

WELCOME AND OVERVIEW

Ryan J. Tedford, MD, Medical University of South Carolina, Charleston, SC, USA
 

SESSION 1 – LET’S START AT THE START! GENERAL INTRODUCTION TO RV PHYSIOLOGY AND PULMONARY HYPERTENSION

What is this New Pulmonary Hypertension? Definitions and Classifications
Bradley A. Maron, MD, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

Teaching/Discussion Points
  1. Definitions and hemodynamic classification of pulmonary hypertension
  2. WHO clinical classification
  3. Diagnostic evaluation
  4. Update from World Symposium 2018
     
Understanding RV Physiology and Coupling to the Pulmonary Circulation
Steven Hsu, MD, Johns Hopkins Hospital, Baltimore, MD, USA

Teaching/Discussion Points
  1. Normal RV morphology, physiology and function
  2. RV/PA coupling and ventricular interdependence
  3. RV adaptation to pressure overload
  4. Pathophysiology of RV failure and the right heart failure syndrome in PH
     
Right Heart Catheterization: Let’s Do It Right
Brian A. Houston, MD, Medical University of South Carolina, Charleston, SC, USA

Teaching/Discussion Points
  1. Pulmonary artery catheter and how to perform a diagnostic right heart catheterization
  2. Common mistakes and pitfalls with hemodynamic measures
  3. Indications and performance of vasoreactivity testing
  4. When to consider left heart catheterization for LVEDP assessment
     

SESSION 2 – THE TRUE PULMONARY VASCULAR DISEASE: GROUP 1 PAH

 
Understanding the History and Pathophysiology of PAH
Ioana Preston, MD, Tufts Medical Center, Boston, MA, USA

Teaching/Discussion Points
  1. Pathology and pathobiology of PAH
  2. Cellular and molecular pathways implicated in PAH
  3. Genetics of PAH
     
What Treatments Can I Give? Management Strategies and Pharmacotherapy
Robert Frantz, MD, Mayo Clinic College of Medicine, Rochester, Minnesota, USA

Teaching/Discussion Points
  1. Adjunctive therapies and calcium channel blockers
  2. Available PAH specific therapies
  3. Pivotal trials
  4. Updated treatment algorithm
     
How Do I Know When to Change Treatment? All About Risk
Mardi Gomberg-Maitland, MD, MSc, George Washington University Health and Medical Sciences, Washington, DC, USA

Teaching/Discussion Points
  1. Importance of risk assessment
  2. Key components of risk assessment and why they are important
  3. Utilization of risk assessment tools in the management of PAH
  4. When to assess risk and what to do about it therapeutically
     

SESSION 3 – BUT THE LV IS NORMAL SO IT CAN’T BE LEFT HEART FAILURE: UNDERSTANDING GROUP 2 PULMONARY HYPERTENSION

Pathophysiology and Diagnosis of Group 2 PH
Jean Luc Vachiery, MD, Erasme University Hospital, Brussels, Belgium

Teaching/Discussion Points
  1. Pathophysiology of pulmonary hypertension in left heart disease
  2. Epidemiology and impact of pulmonary hypertension in HFrEF, HFpEF, and valvular heart disease (including patients undergoing surgical and percutaneous, eg TAVR and MitraClip, valve interventions)
  3. Definitions and terminology of WHO group 2 PH
  4. Outcomes and risk predictors
     
Management and Treatment of Group 2 PH
Marco Guazzi, MD, PhD, San Paolo Hospital, Milan, Italy

Teaching/Discussion Points
  1. Therapeutic options
  2. Pivotal trial data
  3. Management guidelines
     
PH in LVAD and Transplant Candidates: Before, During and After
Robert Frantz, MD, Mayo Clinic College of Medicine, Rochester, Minnesota, USA

Teaching/Discussion Points
  1. Risks associated with pulmonary hypertension in heart transplantation
  2. Management of pulmonary hypertension in heart transplant candidates, including the role of PH specific therapies and LVAD implantation
  3. Management of right ventricular failure in LVAD recipients
  4. Bridging strategies
     

SESSION 4 – JUST TREAT THE LUNG DISEASE: UNDERSTANDING GROUP 3 PULMONARY HYPERTENSION

Diagnosis and Classification of Group 3 PH
Paul Corris, MB, FRCP, Freeman Hospital, Newcastle University, Newcastle upon Tyne, UK

Teaching/Discussion Points
  1. Epidemiology of Group 3 PH
  2. Prognostic significance of PH in COPD and ILD (including idiopathic pulmonary fibrosis and ILD related to connective tissue disease)
  3. Pathophysiology of PH in COPD and ILD, including pulmonary arterial and venous involvement and vasoactive and profibrotic mediators
  4. Significance of PH in advanced lung disease patients being considered for lung transplantation
     
Treatment of PH in Mild/Moderate/Severe Lung Disease with PH
Steven Nathan, MD, Inova Fairfax Hospital, Falls Church, Virginia, USA

Teaching/Discussion Points
  1. Review the therapeutic options based on clinical trial data in Group 3 PH
  2. Discuss the challenges of mixed PH classification patients
     

SESSION 5 – CLOTS AND ODDITIES? A BRIEF EXPLORATION OF CTEPH AND GROUP 5 PULMONARY HYPERTENSION

A Whistletop Tour of CTEPH: Current Managements and New Advances
Joanna Pepke-Zaba, PhD, FRCP, Royal Papworth Hospital, Cambridge, UK

Teaching/Discussion Points
  1. Epidemiology with a focus on incidence and risk factors
  2. Review what is known about the evolution from acute to chronic thromboembolic disease
  3. Describe the contribution small vessel arteriopathy plays in the development of CTEPH
  4. Describe the issues surrounding operability and PEA surgery
  5. Review the appropriate role for specific medical therapy and BPA in CTEPH
     
All You Need to Know About Group 5 PH
Dana P. McGlothlin, MD, Kaiser Permanente, San Francisco, CA, USA

Teaching/Discussion Points
  1. Review the causes of PH with unclear/multifactorial mechanisms
  2. Focus on epidemiology, mechanisms of PH and role of PH specific therapies in sarcoidosis and hematologic disorders
     

SESSION 6 – WHAT TO DO WHEN THE DRUGS STOP WORKING: ADVANCED PH MANAGEMENT, RV FAILURE AND TRANSPLANT

What To Do When the RV Stops Performing: Medical Management (How to Mend a Broken Right Heart)
John Granton, MD, University of Toronto, Toronto, Canada

Teaching/Discussion Points
  1. Review the precipitating factors
  2. Discuss management principles, including the role of pulmonary vasodilator therapies, oxygenation, volume management and inopressor use
     
What To Do When the RV Stops Performing: Mechanical and Surgical Management
Paul Corris, MB, FRCP, Freeman Hospital, Newcastle University, Newcastle upon Tyne, UK

Teaching/Discussion Points
  1. Indications for lung transplantation in PAH
  2. Timing and utilization of atrial septostomy
  3. Mechanical circulatory support indications and bridging strategies
     

SESSION 7 – MISCELLANEOUS CASES: PREGNANCY, PERIOPERATIVE AND NURSING

How to Nurse the Patient with End Stage PH
Denise J. Lewis, RN, BSN, George Washington University, Washington, DC, USA

Teaching/Discussion Points
  1. Approach to nursing care
  2. Palliative/hospice care
  3. Anticipatory care
  4. Quality of life assessments
     
Surgery, Pregnancy and PAH: The Unholy Alliance?
John Granton, MD, University of Toronto, Toronto, Canada

Teaching/Discussion Points
  1. Reported perioperative morbidity/mortality with cardiac and non-cardiac surgeries in PH patients
  2. Risks of anaesthesia and mechanical ventilation in PH patients
  3. Risks of certain operations in patients with PH (eg laparoscopy, lobectomy, orthopedic surgery)
  4. Preoperative considerations and planning (Principles of intra- and post-operative management)
  5. Risk and outcomes of PAH and pregnancy
     

SUMMARY / EVALUATION

Colin Church, BSC(hons), MBChB, FRCP, PhD, Golden Jubilee National Hospital, Glasgow, UK
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