Case Moderators

Jens Garbade, MD, PhD, MHBA, University of Leipzig, Leipzig, Germany
Finn Gustafsson, MD, PhD, Rigshospitalet, Copenhagen, Denmark
Scott Silvestry, MD, Florida Hospital Transplant Network, Orlando, FL, USA
Melana Yuzefpolskya, MD, New York-Presbyterian/Columbia University Medical Center, New York, NY, USA

Case Discussants

Peter Eckman, MD, Minneapolis Heart Institute, Minneapolis, MN, USA
Kelsey Flint, MD, University of Colorado, Aurora, CO, USA
P. Christian Schulze, MD, PhD, University Hospital Jena, Jena, Germany
Vivek Rao, MD, PhD, Toronto General Hospital, Toronto, ON, Canada

The MCS Master Class is designed for clinicians with higher levels of expertise in MCS (completed the core curriculum course on MCS and/or primary practice in MCS (≥ 5 years)). The course format is intended to generate highly interactive discussion among experienced users of these technologies, in order to tackle the most complex nuances of managing these complex patients. Rather than didactic lectures, this course will employ the concept of “convergent discussion” composed of small groups. Faculty moderators and case discussants will engage the audience by focusing on areas with gaps in knowledge and absence of consensus in the field. The case-based format will allow moderators and discussants to use real-world complex situations in order to lead the group through active audience participation, towards specific answers designed to address the practice gaps and learning objectives.

1. The outcomes of cardiogenic shock have remained poor, large randomized trials are scarce and the management of these patients remains challenging. Comprehensive clinical expertise of advanced usage of evolving MCS options including patient and device selection and transition to next step therapies continue to constitute major limitations in the care of these critically ill patients. Knowledge in this area is rapidly evolving and frequent updates are necessary.
2. The diagnosis and management of complex and combined adverse events such as cerebrovascular hemorrhagic accidents, device thrombosis and gastrointestinal bleeding is challenging and practitioners often face difficulties in developing effective strategies to appropriately identify and treat these adverse events. Recent improvements in device technology have eliminated thrombosis and new anticoagulation strategies continue to evolve.
3. The diagnostic and therapeutic approaches for early and late right ventricular failure in MCS patients has been evolving with the introduction of new diagnostic criteria and new technologies/therapeutic options. Such practice gaps in specialist knowledge and clinical skills constitute major limitations in the care of MCS patients.
4. The implantation of results from large clinical studies such as MOMENTUM 3 and ENDURENCE supplement into clinical practice is still lagging. The Master Academy will review the information from those studies and discuss their use in daily practice.

This course has been developed for cardiac and mechanical circulatory support surgeons, advanced heart failure cardiologists, VAD Coordinators, and allied health professionals with at least 5 years of experience in the field of mechanical circulatory support or who have attended a prior ISHLT core competency course in mechanical circulatory support. While all members are invited to enroll, Master Classes are primarily designed to be of benefit for health care professionals who are beyond the training stages of their careers. This may be professionals who are seeking additional proficiencies, who wish to understand current areas of controversy, or who desire an update on the current advanced topics of the field. The information presented is intended to provide insights beyond core competencies established in the specialty.

Mechanical circulatory support is a rapidly growing and rapidly evolving therapy for advanced heart failure. There are now several options approved for use to support patients both acutely in the short term, as well as for durable support. Optimizing outcomes and survival in these complex patients requires mastery of the identification of cardiogenic shock phenotypes, knowledge of device choice and timing, as well as pre-operative optimization of these patients. Multidisciplinary teams are an essential part of modern day mechanical circulatory support management. This Class is designed to meet the target audience’s need for an advanced learning opportunity that explores and seeks to address the unique clinical challenges faced by specialists and developing experts in the field of MCS for treatment of heart failure patients.

After completion of this Class, participants will have improved competence and professional performance in their ability to:
 

1. Identify patients with cardiogenic shock, including complex presentation, appropriate devices for short-term mechanical circulatory support, and factors impacting transition to longer term support platforms.
2. Understand the management of durable MCS patients with complex hemo-compatibility related adverse events, including recurrent GI bleed, bleeding in the setting of thrombosis, or the patient with a history of confounding events (i.e. bleeding and thrombosis).
3. Review predictors of early and late right ventricular failure post LVAD implantation, understand the utility of presently available risk scores, and identify management strategies.
4. Understand the implications of the Momentum 3 and Endurance clinical trials for clinical practice.

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

Credit Designation Statement - ISHLT designates this live activity for a maximum of 4.25 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Nurses
In support of improving patient care, this activity has been planned and implemented by Amedco and the International Society for Heart & Lung Transplantation. Amedco 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 activity for a maximum of 4.25 contact hours for nurses. Learners should claim only the credit commensurate with the extent of their participation in the activity.

Current guidelines state that participants in CME 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 presentations or service as Chair/Planner. Please refer to the Participant Notification document for a list of all disclosures. Additionally, all speakers have been asked to verbally disclose at the start of their presentation if a product they are discussing is not labeled for the use under discussion or is still investigational.