Developed from ISHLT2020 Session 34 (SYMPOSIUM)

This symposium will specifically focus on segmental and subsegmental disease in CTEPH. The management of segmental and subsegmental disease has evolved over the past decade. Pulmonary endarterectomy and balloon pulmonary angioplasty have been shown to be excellent therapeutic options for these patients. However, both options have not yet been widely adopted due to technical challenges.
 

Moderators: Joanna Pepke-Zaba, MD and Isabelle Opitz, MD

Welcome and Program Panel Introduction
Joanna Pepke-Zaba, MD, Papworth Everard, Cambridge, United Kingdom

Prevalence of Segmental/Subsegmental Disease in CTEPH: How To Overcome a Missed Diagnosis?
Kim M. Kerr, MD, UCSD Medical Center, La Jolla, CA, USA
This presentation will present an overview of the problem by presenting the prevalence of segmental and subsegmental disease in CTEPH. Evidence suggests that CTEPH is still largely underdiagnosed potentially due to the difficulty in detecting disease at that level.

What is the Most Reliable Way to Identify Segmental/Subsegmental Disease: Selective Pulmonary Angiography, CT, or MRI?
Micheal McInnis, MD, Toronto General Hospital, Toronto, ON, Canada
Imaging is a critical component for the diagnosis of segmental and subsegmental disease. VQ scan, CT, MR and pulmonary angiogram are part of the armamentarium to diagnose disease at a segmental and subsegmental level. This presentation will review the state-of-the-art in imaging to ensure that segmental and subsegmental disease is diagnosed and treated appropriately.

Surgical Techniques in Segmental CTEPH: Tips and Tricks
Michael M. Madani, MD, UCSD Medical Center, La Jolla, CA, USA
Pulmonary endarterectomy in segmental disease is feasible with excellent results in experienced centers. This presentation will review the process of patients’ selection and the technical aspect to successfully operate on patients with segmental and subsegmental disease.

BPA Techniques in Segmental CTEPH: Tips and Tricks
Aiko Ogawa, MD, Okayama Medical Center, Okayama, Japan
BPA has become part of the standard-of-care in managing patients with segmental disease. The procedure however can be associated with important risks. This presentation will take the audience on a step-by-step approach to BPA to achieve complete resolution of the pulmonary hypertension.

Global Perspective on Management of Segmental CTEPH: Medical Therapy, BPA, PEA
Julius Punnen, MD, Narayana Health, Bangalore, Karnataka, India
The diagnosis and management of patients with segmental disease is variable across the world. This presentation will focus on limitations in the management of distal disease in different countries and review potential differential diagnosis related to endemic conditions that may affect diagnosis and results.

Moderated Q&A Segment with All Speakers
Led by Isabelle Opitz, MD, University Hospital Zurich, Zurich, Switzerland

ISHLT Pulmonary Vascular Disease Interdisciplinary Network Update
Ioana Preston, MD, Tufts Medical Center, Boston, MA, USA
Chair, ISHLT Pulmonary Vascular Disease Interdisciplinary Network Steering Committee

ISHLT Announcements
Greg Schultz, CEO, ISHLT, Addison, TX, USA
 

Continuing Education Information

Learning Objectives – at the conclusion of this session, attendees will be able to discuss:

• How to overcome a missed diagnosis due to the difficulty in detecting disease at that level
• State of the art imaging to ensure that segmental and subsegmental disease is diagnosed and treated appropriately
• Step-by-step approach to BPA to achieve and subsegmental disease
• The limitations in the management of distal disease
   

Target Audience – The target audience for the October Plenary Session 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.