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Sleepless in San Diego: Reflections on the 2017 ISHLT Sessions from the Perspective of Pulmonary Hypertension

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Amresh Raina, MD, FACC
Allegheny General Hosptial
Pittsburgh, PA, USA

Late nights and early mornings; evening poster sessions and sunrise symposia; a conference so energetic that it never seems to rest. All this on the backdrop of picturesque and perennially sunny San Diego meant that for those of us from other time zones, sleep was at a premium. If these were my initial memories of the meeting, they were also colored by thoughtful conversations with colleagues, collaborators and mentors, not just during the sessions, but over coffee or at many of the affiliated events. I think that all participants left the meeting with a sense of satisfaction.

On secondary reflection, this year's ISHLT sessions were perhaps among the most significant from the perspective of pulmonary hypertension. The week began with the PH Masters Academy, an engaging forum for the discussion of complex and controversial cases in pulmonary hypertension. There are very few PH forums like this internationally, where participants can discuss complex management decisions with world experts in pulmonary hypertension in a small group setting!

Beyond the Masters Academy, this year's meeting was also particularly memorable for developments in Chronic Thromboembolic Pulmonary Hypertension (CTEPH). This year marked the formation of the CTEPH Council at the ISHLT, led by Dr. William Auger, and the first CTEPH council meeting. We also heard preliminary insights from the US CTEPH Registry by Dr. Kim Kerr, a colorful presentation of the assessment of right heart function in CTEPH by Dr. Paul Forfia and evaluation of the REVEAL risk score in CTEPH patients by Dr. Raymond Benza.

Dr. Benza also presented data on an updated REVEAL risk calculator in PAH with changes in the included variables to better delineate mortality risk in patients previously deemed moderate risk by the original calculator. Once again, we had a vibrant session on mechanical circulatory support in PH patients, with Elie Fadel discussing peripheral vs. central ECMO in PAH patients.

Dr. Ryan Tedford chaired a key session in cardiopulmonary hemodynamics and discussed the importance of right ventricular reserve in patients with PH. Finally, as always, some of the most memorable sessions were the 'great debates' in pulmonary hypertension, with a variety of spirited debates (even when the combatants were not always familiar with each other) involving treating or not treating PH due to interstitial lung disease (Dr. Steven Nathan vs. Dr. Marius Hoeper), treating or not treating borderline PAH (Dr. Bradley Maron vs. Dr. Jean-Luc Vachiery) and adding combination therapy to a stable patient on monotherapy (Dr. Rogerio Souza vs. Dr. Veronica Franco). I leave it to those present to judge the winners!

I look forward to seeing everyone in Nice 2018! ■

Disclosure Statement: The author has no conflicts of interest to disclose.

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