When a Single Ventricle Support is Not Enough

Wednesday, September 30, 2020 8:00 – 9:30 a.m. EDT


 
Developed from ISHLT2020 Session 64 (SYMPOSIUM)

Biventricular failure is associated with high in-hospital mortality. The aim of this session is to explore the clinical utility of extra- and intracorporeal as well as percutaneous MCS for patients persisting biventricular failure. In this session the currently available devices for treating shock and heart failure and a look ahead within this developing field, including new devices and novel indications for established technology should be presented.
 

Scientific Program

Moderators: Emily K. Granger, MBBS (Hons), FRACP and Yaron Barac, MD

Welcome & Recognition of ISHLT/OH Frazier Award in MCS Translational Research, sponsored by Medtronic
Joseph Rogers, MD, Duke University Medical Center, Durham, NC, USA
Jordan R.H. Hoffman, MD, Assistant Professor in Cardiac Surgery at Vanderbilt University School of Medicine in Nashville, TN., receives the O.H. Frazier Award in MCS Translational Research sponsored by Medtronic. The $65,000 award will allow Dr. Hoffman to study complications that arise in some heart failure patients who rely on Left Ventricular Assist Devices (LVADs) for cardiac support.

Program Panel Introduction
Emily Granger, MBBS (Hons), FRACP, St. Vincent's Hospital, Sydney, Australia

Defining Biventricular Heart Failure
Cesar I. Guerrero-Miranda, MD, Baylor University Medical Center, Dallas, TX, USA
This talk will review current understanding of the definition of RV failure utilizing a combination of clinical assessment, invasive hemodynamic data and imaging, including 3D volumetric assessment of RV and TV and RV strain imaging.

Variety of Temporary Biventricular Support
Jamila Kremer, MD, University Hospital Heidelberg, Heidelberg, Germany
This talk will show possible combinations biventricular Impella vs ECMO vs Temp Bi-VAD (Levitronix). The presentation will include appropriate candidacy, indication, complications, advantage, disadvantages.

When Durable LVAD Alone is Not Enough: Short-Term Right Ventricular Mechanical Support in LVAD Patients
Sarah E. Scheuer, MD, St Vincent's Hospital, Sydney, Australia
This talk will review current state-of-art available RV temporary mechanical support, including but not limited to Protec Duo, RP Impella, TamdenHeart, and CentriMag, in the management of right ventricular cardiogenic shock.

Paracorporeal Devices Still Exist: Continuous Flow VADs in Combination with Paracorporeal Devices
Jan D. Schmitto, MD, PhD, MBA, FCCP, FRCS, Hannover Medical School, Hannover, Germany
This talk will review the insertion and management of surgically implanted paracorporeal devices in combinations with continuous flow pumps and the techniques to ensure prolonged support, minimize complications and discuss appropriate candidacy, advantages and disadvantages.

Which Device in Which Configuration for Biventricular Support: BiVAD vs Total Artificial Heart? How, Which and When?
Ivan Knezevic, MD, Univ Clinical Centre, Ljubljana, Slovenia
The speaker will discuss the total artificial heart including the Syncardia and Carmat devices.

Do It Both Ways: BiVAD vs. Bivad in a TAH Configuration
Evgenij V. Potapov, MD, PhD, Deutsches Herzzentrum, Berlin, Germany
This presentation will highlight the possibility of long-term biventricular support by continuous-flow BIVADs. After off-label use of 2 HeartWare VAD, now the use of 2 HeartMate 3 pumps has been described. The present should give some more insight into this new developing field of MCS support in biventricular failure.

Live Q & A Segment with All Speakers
Led by Yaron Barac, MD, PhD, Rabin Medical Center, Petah Tikva, Israel

ISHLT Mechanical Circulatory Support Interdisciplinary Network Update
Diyar Saeed, MD, PhD, Leipzig Heart Center, Leipzig, Germany
Chair, Mechanical Circulatory Support Interdisciplinary Network Steering Committee

ISHLT Announcements
Greg Schultz, CAE, Chief Executive Officer, ISHLT, Addison, TX, USA
 

Continuing Education Information

Learning Objectives – at the conclusion of this session, attendees will be able to:
  • Define Biventricular Heart Failure
  • Show possible combinations biventricular Impella vs ECMO vs Bi-Vad
  • Review current state-of-art available RV temporary mechanical support
  • Review the insertion and management of surgically implanted paracorporeal devices in combinations with continuous flow pumps and the techniques to ensure prolonged support.
  • Discuss total artificial heart devices
  • Review the possibility of long-term biventricular support by continuous flow BIVADS.
     
Target Audience – The target audience includes physicians, surgeons, scientists, pharmacists, nurses, transplant coordinators and other allied health and social science professionals engaged in the management and treatment of patients with advanced heart or lung disease, basic science or clinical research related to these fields, or other specialties which cause them to become involved in the treatment of patients with advanced heart or lung disease.

Activity Designed to Change – This activity is designed to change knowledge, competence and performance.

Learning Attributes   Patient Care and Medical Knowledge

Disclosures – Current guidelines state that participants in continuing medical and allied health professional education activities must be made aware of any affiliation or financial interest that may affect the program content or a speaker’s presentation. Planners, Faculty and Chairs participating in this meeting are required to disclose to the program audience any real or apparent conflict(s) of interest related to the content of their presentation or service as Chair/Planner. Disclosures will be distributed in the Learner Notification that you receive as a participant prior to the live virtual session. Additionally, all speakers have been asked to verbally disclose at the start of their presentation any financial interest or affiliations and to indicate if a product they are discussing is not labeled for the use under discussion or is still investigational.

Disclaimer – The information presented in this activity represents the opinion of the faculty and is not necessarily the official position of the ISHLT.

Documenting CME Credits – The ISHLT provides CME certificates to those who have participated in an ISHLT educational activity. The ISHLT does not submit credits to regulating bodies or certifying organizations on behalf of the participants. It is the participants responsibility to submit proof of credits on his or her own behalf.
 

ACCME Accreditation

Physicians

Accreditation Statement – The International Society for Heart and Lung Transplantation (ISHLT) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Credit Designation Statement – ISHLT designates this live virtual activity for a maximum of 1.5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Nurses and Pharmacists

In support of improving patient care, this activity has been planned and implemented by Amedco LLC and The International Society for Heart and Lung Transplantation (ISHLT). Amedco LLC is jointly accredited by the American Council for Continuing Medical Education (ACCME) the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC) to provide continuing education for the healthcare team.

Credit Designation Statement – Amedco LLC designates this live virtual activity for a maximum of 1.5 contact hours for nurses. Knowledge-based CPE contact hours for pharmacists are being reviewed for possible eligible credit.

Nurse Practitioners

The American Association of Nurse Practitioners (AANP) recognizes the Accreditation Council for Continuing Medical Education (ACCME) and the American Nurses Credentialing Center (ANCC) as approved accreditors and allow reciprocity for AANPCP continuing education.

Transplant Coordinators Credit

As a designated Approved Provider by the American Board for Transplant Certification (ABTC), the International Society for Heart and Lung Transplantation grants up to 1 Category 1 Continuing Education Points for Transplant Coordinators (CEPTCs) for this offering. CEPTC Approval Number: 221-08.