Case Studies in Structural Heart Disease and Intervention: From Clinical Diagnosis to Percutaneous...

Mayo School of Continuous Professional Development

2 ND ANNUAL CASE STUDIES IN STRUCTURAL HEART DISEASE

AND INTERVENTIONFrom Clinical Diagnosis to Percutaneous

Intervention and Robotically Assisted Surgery

Trump International on Miami BeachSunny Isles, FLhttp://www.trumpmiami.com/

Program Directors: Charanjit S. Rihal, M.D. Maurice E. Sarano, M.D.Charles J. Bruce, M.D.

January 24-27, 2013

REGISTER ONLINE NOW!

http://www.mayo.edu/cme/cardiovascular-diseases-2013R055

Case-Based Course on Innovative Approaches to Structural Heart Disease

New Location 2013!

Limited Attendance!

Case-Based Course on Innovative Approaches to Structural Heart Disease

Course DescriptionThis multidisciplinary, clinically oriented course will highlight innovations and recent developments in the exciting and emerging field of structural heart disease interventions. The course will review innovative and state-of-the-art treatments for aortic stenosis, mitral regurgitation, hypertrophic cardiomyopathy, and PFO/ASD. Other uncommon clinical problems, such as paravalvular regurgitation, left atrial appendage closure, and adult congenital interventions will also be highlighted. Expert faculty from Mayo Clinic and other academic centers will present in a case-oriented approach that will enable you to counsel patients in your practice on the latest diagnostic, interventional, and surgical techniques.

Teaching MaterialsThe course syllabus will be provided on a flash drive and distributed to attendees at the course. You are welcome to bring your computer for note taking during the course. A printed copy of the syllabus WILL NOT be available.

Course Learning ObjectivesUpon conclusion of this program, participants should be able to:• Review current strategies for repair or

replacement of the mitral valve;• Assess the need for aortic valve

replacement as well as state-of-the-art interventional procedure options for the treatment of aortic stenosis;

• Summarize management of the ascending aorta in aortic valve disease;

• Describe the latest diagnostic and management strategies for patients with pulmonary valve dysfunction;

• Identify appropriate hypertrophic cardiomyopathy patients for septal alcohol ablation;

• Describe current diagnosis and treatment of pericardial disease and who to select for surgery;

• Identify strategies for PFO and ASD closure; and

• Describe techniques to obliterate the left atrial appendage and percutaneously close paravalvular leaks.

Attendance at this Mayo course does not indicate nor guarantee competence or proficiency in the performance of any procedures which may be discussed or taught in this course.

Intended AudienceThe course would be of interest to cardiologists, interventionalists, cardiovascular surgeons, and internists who see patients with cardiovascular disease.

Credit College of Medicine, Mayo Clinic, is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

College of Medicine, Mayo Clinic, designates this live activity for a maximum of 24 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

A certificate of attendance will be provided to other health care professionals for requesting credits in accordance with state nursing boards, specialty societies, or other professional associations.

Grants and ExhibitsAt the time of this printing, a complete listing of commercial supporters (financial or in-kind) was not available. Appropriate acknowledgment will be given to all supporters at the time of the meeting.

Exhibits will be available for viewing at all scheduled breaks.

Date and LocationAll sessions will be held at Trump International, 18001 Collins Avenue, Sunny Isles Beach, FL 33160.

General Session: Ocean Ballroom, 3rd Floor

Exhibits/Breaks/Breakfast: Bay Room, 3rd Floor

Reception: Lower Pool Deck

Meeting site telephone: 305-692-5600

Fax: 305-692-5601

RegistrationTo register online, visit http://www.mayo.edu/cme/cardiovascular-diseases-2013R055. The registration fee includes tuition, comprehensive course syllabus, continental breakfasts, break refreshments, and welcome reception. Although it is not

Mayo School of Continuous Professional Development (CPD) policy to limit the number of registrants for a course, conference room facilities may necessitate closing of enrollment; therefore, early registration is advised. A letter of confirmation will be sent upon receipt of payment and completed registration form. Please present the confirmation letter when checking in at the meeting registration desk.

For additional information, contact:Mayo Clinic Cardiovascular Diseases200 1st Street SW/GO6-138SWRochester, MN 55905

Website: www.mayo.edu/cme/cardiovascular-diseases -2013R055

E-mail: [email protected]: 800-283-6296 or 507-266-6703Fax: 507-266-7403

Cancellation PolicyIf you cancel your participation in this course, your registration fee, less a $75 administrative fee, will be refunded when written notification is received by Mayo School of CPD before Thursday, January 10, 2013 ([email protected] or fax#: 507-266-7403). No refunds will be made on or after Thursday, January 10, 2013. Canceled registrations are non-transferable.

Mayo School of CPD reserves the right to cancel or postpone any course due to unforeseen circumstances. In the unlikely event Mayo School of CPD must cancel or postpone this course, Mayo School of CPD will refund the registration fee, but is not responsible for any related costs, charges, or expenses to participants, including fees assessed by airline/travel/lodging agencies.

Travel/TransportationAirlines:Miami International Airport – Approximately 30 minutes (13 miles)

Ft. Lauderdale International Airport – Approximately 25 minutes (11 miles)(Approximately $25 shuttle/$65 taxi)

Lodging AccommodationsTrump International Beach Resort is a world of indulgent pleasures waiting for you on the shores of beautiful Miami Beach. Ideally located in the exclusive enclave of Sunny Isles, this Miami Beach hotel masterpiece, created by Donald

Trump and Dezer Properties, rises as a striking landmark to luxury amidst the white sands of Miami Beach. Miami is also America’s fishing and diving capital. The concierge will arrange a deep-sea fishing charter, jet ski or kayak rental, Intracoastal Waterway sightseeing cruise, or snorkeling or diving excursion. For a list of additional things to do, please visit the below website and also visit concierge tips on this page for additional information: http://www.trumpmiami.com/things-to-do-miami/attractions/index.cfm

To secure your room at Trump International, please call 866-628-1197 and state that you will be attending the Mayo Clinic Cases program. The room rate is $269 single/double a night.

The resort fee is waived and includes: entrance to the Spa, utilization of the fitness center, use of the tennis center, complimentary local calls (up to 20 minutes per call), access fees waived for credit card and 800 calls, 10 pages of incoming faxes per day, in-room coffee replenished daily, morning newspaper, beach and pool chairs and umbrellas as well as pool and beach attendant gratuities, Planet Kids Club, and scheduled shuttle service to Aventura Mall, Bal Harbour Shops and South Beach.

The hotel room block is scheduled to be held until Wednesday, January 2, 2013, but may be sold out before this date. Therefore, we advise you to register for the program and reserve your lodging as soon as possible. All reservations will be guaranteed to a valid major credit card or by cash deposit of one night’s room rate and tax. Credit cards will not be charged at the time of reservation. Individual reservations canceled prior to January 2, 2013 will be released at no charge. When you make your reservation, please be sure to ask about any additional fees, early departure fees, or cancellation penalties.

Check-in Time: 4:00 p.m.Check-out Time: 11:00 a.m.

Lodging arrangements are the sole responsibility of the individual registrant.

Mayo School of CPD is not responsible for expenses incurred by an individual who is not confirmed and for whom space is not available at the meeting. Costs incurred by the registrant such as airline or hotel fees or penalties are the responsibility of the registrant.

ParkingParking overnight at the hotel is $30. Day parking is $15.

SOCIAL PROGRAMWelcome ReceptionThursday, January 24, 2013Attendees and their guest(s) are cordially invited to join the course faculty for the Welcome Reception on Thursday, January 24, 2013, from 6:30-7:00 p.m. on the lower pool deck lawn. This casual reception welcomes you to Florida, officially opens the course, and offers you the perfect opportunity to make connections with existing and new colleagues.

Future Program DatesNext year’s course will be held January 16-19, 2014 at Harbor Beach Marriott, Fort Lauderdale, FL on Miami Beach.

FacultyCourse Directors

Charanjit S. Rihal, M.D.Maurice E. Sarano, M.D.Charles J. Bruce, M.D.

Mayo Faculty

Harold M. Burkhart, M.D.Allison K. Cabalka, M.D.Hari P. Chaliki, M.D.Joseph A. Dearani, M.D.William K. Freeman, M.D.Kevin L. Greason, M.D.David J. Holmes, M.D.Joseph F. Maalouf, M.D.Joseph J. Maleszewski, M.D.Sunil V. Mankad, M.D.Verghese Mathew, M.D.Hector I. Michelena, M.D.Issam D. Moussa, M.D.Vuyisile T. Nkomo, M.D.Jae K. Oh, M.D.Sorin V. Pislaru, M.D.Guy S. Reeder, M.D.Robert D. Simari, M.D.Paul Sorajja, M.D.Rakesh M. Suri, M.D., D.Phil.John M. Stulak, M.D.Eric E. Williamson, M.D.

Guest Faculty

Ted E. Feldman M.D.Evanston Hospital, Evanston, IL

Howard C. Herrmann, M.D.Hospital of the University of Pennsylvania, Philadelphia, PA

David Reuter, M.D.Seattle Childrens Hospital, Seattle, WA

Carlos E. Ruiz, M.D., Ph.D.North Shore Long Island Jewish Health Systems, New York, NY

Gregg W. Stone, M.D.Columbia University Medical Center / New York-Presbyterian Hospital, New York, NY

Brian K. Whisenant, M.D.Utah Heart Clinic, Riverton, UT

Faculty DisclosureAs a provider accredited by ACCME, College of Medicine, Mayo Clinic (Mayo School of Continuous Professional Development) must ensure balance, independence, objectivity and scientific rigor in its educational activities. Course director(s), planning committee, faculty, and all others who are in a position to control the content of this educational activity are required to disclose all relevant financial relationships with any commercial interest related to the subject matter of the educational activity. Safeguards against commercial bias have been put in place. Faculty also will disclose any off-label and/or investigational use of pharmaceuticals or instruments discussed in their presentation. Disclosure of this information will be published in course materials so those participants in the activity may formulate their own judgments regarding the presentation.

Thursday, January 24, 20137:00 a.m. Registration and Continental Breakfast

7:45 a.m. Welcome and Audience Pre-Test

AORTIC VALVE: ANATOMY, IMAGING, AND HEMODYNAMIC ASSESSMENTModerators: Drs. Sarano, Sorajja, and Dearani

8:00 a.m. Anatomy of the Aortic Valve and Aortic Root – What the SHD Specialist Needs to Know – Dr. Joseph J. Maleszewski

8:20 a.m. Echo in Aortic Stenosis: What Data Should You Look For?

– Dr. Vuyisile T. Nkomo

8:35 a.m. CT in Aortic Stenosis: Why Is It Critical in the Era of TAVR?

– Dr. Eric E. Williamson

8:55 a.m. Aortic Stenosis Cases Low Output Low Gradient AS: How to Assess – Dr. Charles J. Bruce Paradoxic Low Flow AS: Is it for Real? – Dr. Sunil V. Mankad Where Is the Level of Obstruction: Above or Below the Valve? – Dr. Sorin V. Pislaru

9:25 a.m. Panel Discussion

9:35 a.m. Aortic Regurgitation After TAVR: A Conundrum Echo: Do We Really Know How to Assess Severity? – Dr. Jae K. Oh Are Aortography and Hemodynamic Assessment the Answer? – Dr. Guy S. Reeder


10:05 a.m. Refreshment Break

AORTIC VALVE INTERVENTIONSModerators: Drs. Bruce, Rihal, and Suri

10:30 a.m. TAVR: Current State-of-the-Art and Future Prospects – Dr. David J. Holmes

10:55 a.m. TAVR: Rapid Fire Illustrative Cases SAPIEN Transfemoral Technique – Dr. Verghese Mathew Paravalvular Regurgitation – Dr. Charanjit S. Rihal Valve Dislodgement – Dr. Paul Sorajja Core Valve Technique – Dr. Carlos E. Ruiz Transapical Technique – Dr. Kevin L. Greason Core Valve Complication – Dr. Carlos E. Ruiz Vascular Challenges – Dr. Kevin L. Greason Transaortic Approach – Dr. Rakesh M. Suri

12:55 p.m. Adjourn for the Afternoon

AFTERNOON SESSIONTRANSCATHETER AORTIC VALVE REPLACEMENTModerators: Drs. Bruce, Holmes, and Greason

4:00 p.m. Recorded “Live” TAVR Cases – Drs. Rihal, Suri, Greason, and Sorajja

4:30 p.m. In the Era of TAVR Is There Still a Place for Mechanical AVR? – Drs. Greason and Dearani

4:50 p.m. Can We Regrow an Aortic Valve? – Dr. Robert D. Simari

5:05 p.m. Panel Discussion

5:15 p.m. Workshops (30 minutes each rotating) 1. How to Set Up a TAVR Practice – Drs. Feldman, Mathew, Nkomo, and Herrmann Location: Ocean Ballroom, Main Ballroom

2. More Recorded “Live” TAVR Cases – Drs. Rihal, Suri, Greason, and Sorajja Location: Grove Room, 4th Floor

6:15 p.m. Adjourn

6:30 - Welcome Reception7:30 p.m. Lower Pool Deck, Grass Area Attendees, Faculty, Exhibitors and Their Guests Invited

Friday, January 25, 20137:00 a.m. Continental Breakfast

7:55 a.m. Welcome

MITRAL VALVE: ANATOMY, IMAGING, AND HEMODYNAMIC ASSESSMENTModerators: Drs. Sarano, Herrmann, and Suri

8:00 a.m. Anatomy of the Mitral Valve and Mitral Apparatus – What the SHD Specialist Needs to Know – Dr. Joseph J. Maleszewski

8:15 a.m. Imaging of the Mitral Valve – Dr. Sunil V. Mankad

8:30 a.m. Mitral Regurgitation Cases Acute Severe MR – Dr. Sorin V. Pislaru Asymptomatic Severe Degenerative MR – Dr. Vuyisile T. Nkomo Why Are the ERO and Regurgitant Volume Discordant? – Dr. Hector I. Michelena Ischemic MR – Dr. Sunil V. Mankad Multi-Flail Leaflets – Repairable? – Dr. Maurice E. Sarano



MITRAL VALVE INTERVENTIONSModerators: Drs. Feldman, Sorajja, and Suri

10:30 a.m. Mitral Regurgitation: Morphologic Assessment Etiology Governs Therapeutic Strategy – Dr. Maurice E. Sarano

10:55 a.m. MV Repair: The Standard – Dr. Rakesh M. Suri

11:15 a.m. Transcatheter MV Repair: Technology Update and Outcomes – Dr. Ted E. Feldman

11:35 a.m. Transcatheter MV Repair Cases Patient Selection eClip – Dr. Howard C. Herrmann Cardiac Dimensions Mitral Annuloplasty – Dr. David Reuter Guiding the eClip – Dr. Howard C. Herrmann Double Clip – Dr. Ted E. Feldman

12:35 p.m. Rationale and Design of the COAPT Study – Dr. Gregg W. Stone

12:55 p.m. Discussion


AFTERNOON SESSIONTRANSCATHETER APPROACH TO PARAVALVULAR REGURGITATIONModerators: Drs. Bruce, Rihal, and Suri

4:00 p.m. Workshops (30 minutes each rotating) 1. Imaging and Assessment of Paravalvular Regurgitation – Dr. Joseph F. Maalouf Location: Ocean Ballroom, Main Ballroom

2. Antegrade Transseptal Approach and Results –Dr. Paul Sorajja Location: Sunny Isles A Room, 4th Floor

3. Transapical Approach and Results – Dr. Carlos E. Ruiz Location: Sunny Isles B Room, 4th Floor

4. Complications Workshop – Drs. Herrmann and Whisenant Location: Key Biscayne Room, 4th Floor

6:00 p.m. Adjourn

Saturday, January 26, 2013

7:00 a.m. Continental Breakfast

7:55 a.m. Welcome

HYPERTROPHIC CARDIOMYOPATHY: ANATOMY, IMAGING, AND HEMODYNAMIC ASSESSMENTModerators: Drs. Freeman and Sorajja

8:00 a.m. Anatomy and Hypertrophic Cardiomyopathy

– Dr. Joseph J. Maleszewski

8:20 a.m. Hypertrophic Cardiomyopathy Cases Echo: Why Morphology Matters – Dr. William K. Freeman MRI: Morphology and More – Dr. Eric E. Williamson

8:50 a.m. Hypertrophic Cardiomyopathy and Hemodynamics Cases How Much Obstruction Is There? – Dr. William K. Freeman Is the Obstruction Due to HCM – Dr. Hari P. Chaliki Is the MR All Due to SAM? – Dr. Hector I. Michelena If There Is No Obstruction, Provoke It! – Dr. Vuyisile T. Nkomo When Invasive Testing Is Needed – Dr. Paul Sorajja The Value of Exercise – Dr. Guy S. Reeder



HYPERTROPHIC CARDIOMYOPATHY INTERVENTIONModerators: Drs. Oh, Sorajja, and Stulak

10:30 a.m. Interventional and Surgical Cases Alcohol Septal Ablation – Dr. Paul Sorajja Surgical Myectomy – Dr. John M. Stulak Guiding the Procedure: What to Look For – Dr. Joseph F. Maalouf

PERICARDIAL DISEASEModerators: Drs. Oh and Stulak

11:30 a.m. Multimodality Imaging in Pericardial Disease

– Dr. Eric E. Williamson

11:50 a.m. Pericardial Disease Cases Pericardial Constriction: How Do You Diagnose It? – Dr. Jae K. Oh Pericardial Constriction: Is Surgery Always the Answer? – Dr. John M. Stulak Cardiac Tamponade in the Interventional Environment: Diagnosis and Treatment – Dr. Sorin V. Pislaru Atypical Presentation of Cardiac Tamponade: Clues to Diagnosis – Dr. Vuyisile T. Nkomo



AFTERNOON SESSIONTHE AORTA AND LEFT ATRIAL APPENDAGEModerators: Drs. Maalouf, Feldman, and Stulak

4:00 p.m. Aortic Root Dilatation: When to Intervene? – Dr. Hector I. Michelena

4:20 p.m. Anatomy and Multimodality Imaging of the LAA – Dr. Joseph F. Maalouf

4:40 p.m. Will PREVAIL Prevail or SentreHeart Steal Your Heart: An Update on Percutaneous LAA Obliteration – Dr. Ted E. Feldman

5:05 p.m. LAA Closure Cases (Watchman, SentreHeart, Aegis) – Drs. Rihal, Feldman, and Bruce


6:00 p.m. Adjourn

Sunday, January 27, 20137:00 a.m. Continental Breakfast

7:45 a.m. Post-Test

ASD’s, PFO’s, and VSD’sModerators: Drs. Reeder, Cabalka, and Burkhart

8:00 a.m. Anatomy of the Atrial Septum – Dr. Joseph J. Maleszewski

8:15 a.m. Illustrative Cases Cryptogenic Stroke: Should We Close a PFO? – Dr. Issam D. Moussa Migraine: Any Role for PFO Closure? – Dr. Brian K. Whisenant Percutaneous Atrial Septal Defect Closure: Complications – Dr. Guy S. Reeder Robotic ASD Closure – Dr. Harold M. Burkhart Post MI VSD: Approach to Treatment – Dr. Allison K. Cabalka



THINKING OUTSIDE THE BOX: NOVEL APPROACHES TO STRUCTURAL HEART PROBLEMSModerators: Drs. Cabalka, Rihal, and Burkhart

10:00 a.m. Severe TR: Is There a Minimally Invasive and Percutaneous Option? – Dr. Harold M. Burkhart

10:15 a.m. Percutaneous Melody Valve Implantation for Pulmonary Regurgitation – Dr. Allison K. Cabalka

10:30 a.m. Novel Percutaneous Approaches to Cardiac Pseudoaneurysms – Dr. Charanjit S. Rihal

10:45 a.m. Coronary Artery Fistulae – Indications and Techniques For Closure – Dr. Allison K. Cabalka

11:05 a.m. AR After LVAD Implantation – Dr. Charanjit S. Rihal

11:20 a.m. Case of Prosthetic Valve Thrombosis: When to Lyse, When to Operate? – Dr. Sorin V. Pislaru

11:35 a.m. Failing Mitral Bioprostheses: Novel Approach to Treatment – Dr. Charanjit S. Rihal


12:00 p.m. Adjourn

REGISTRATIONRegister online:

http://www.mayo.edu/cme/cardiovascular-diseases-2013R055

Registration Fee:

Course Registration (MD, PhD, DO, PharmD) $795.00

Course Registration (Residents, Physician Assistants, NP, RN) $695.00

One Day Registration (no refunds given) $300.00(note, this fee is good for only one day of the program)

Mayo Clinic Division of Cardiology has recently implemented an online conference registration system. If this is your first time using the online system, you will need to create a profile and login account.

Register by entering the url: http://www.mayo.edu/cme/cardiovascular-diseases-2013R055 and click on Register Now. The system will guide you through the profile and login process. An e-mail address is required upon registration. A letter of confirmation will be forwarded to this address upon receipt of payment and submitted registration. Present this letter of confirmation when checking in at the meeting registration desk.

The registration fee includes tuition, electronic course syllabus, continental breakfasts, break refreshments, and reception. Although it is not Mayo School of Continuous Professional Development (CPD) policy to limit the number of registrants for a course, conference room facilities may necessitate closing of enrollment; therefore, early registration is advised. Enrollment for this program is limited. A letter of confirmation will be e-mailed upon receipt of payment. Please present the confirmation letter when checking in at the meeting registration desk.

For additional information, contact:

Cardiovascular Continuing Education200 First Street SW – Gonda 6-472Rochester, MN 55905

E-mail: [email protected]

Phone: 800-283-6296 or 507-266-6703

Website: www.mayo.edu/cme/cardiovascular-diseases-2013R055

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Case Studies in Structural Heart Disease and Intervention: From Clinical Diagnosis to Percutaneous...

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