welcome

Welcome from the Program Chair

By Mark D. Twite, MA, MB, BChir, FRCP
Program Chair

Welcome to the 11th Annual Meeting of the Congenital Cardiac Anesthesia Society (CCAS) and the wonderful state of Colorado! The annual meeting is being held at The Broadmoor, a historic hotel that first opened in 1918. The Broadmoor is the longest-running consecutive winner of both the AAA Five-Diamond and Forbes Travel Guide Five-Star awards.  It is located in Colorado Springs, at the southern edge of the Rockies, in an area of stunning natural beauty. The area lies in the shadow of Pikes Peak Mountain. Over 100 years ago, Katharine Lee Bates was so inspired by the majestic views from atop Pikes Peak she wrote ‘America the Beautiful’.  This outstanding hotel and location will perhaps inspire a sense of adventure in everyone, to explore both the surrounding natural beauty and the art and science of congenital cardiac anesthesiology being presented at this meeting.

This annual meeting preserves most of the successful format of past meetings, but it also embarks on a new adventure, introducing afternoon workshops. The day begins with some basic science and its clinical application. Colorado, the ‘mile high’ state, represents the perfect opportunity to learn about high altitude science and how it may affect patients with congenital heart disease. The life expectancy of children with complex congenital heart disease has increased dramatically and as these children progress into adulthood and participate in activities in common with healthy adults, clinicians are often faced with the task of evaluating the safety of such endeavors in light of the patient’s underlying cardiopulmonary abnormalities. The second part of this session will highlight the challenges of neuroprotection in patients undergoing complex repairs involving circulatory arrest. It is essential for clinicians to understand the underlying cellular mechanisms so that steps may be taken in the clinical setting to best protect the brain.

The second morning session is an audience favorite, learning about current advances and controversies in clinical care. It often requires teamwork to survive in difficult terrains such as the mountains. Such collaborative teamwork between colleagues at different centers may be essential to further improve outcomes for our patients. In this session we will also learn about coagulation factor concentrates as well as alternatives to heparin for cardiopulmonary bypass.

The third session before lunch, is the familiar and popular ‘Focus on a Lesion’, which has a new earlier time and a slightly shorter format. The lesion this year is ‘Transposition of the Great Arteries’ whose perioperative and surgical management will be discussed. This lesion represents the historical changes of our specialty. The ‘arterial switch’ has replaced the early ‘atrial switch’ surgery. This means many of us help adult patients from an earlier surgical era who have different physiology and complications compared to younger patients with this congenital heart lesion.

After lunch, the top three scientific abstracts will be presented. This is a great opportunity for researchers in our specialty to highlight their hard work and for us all to keep up with the changing scientific landscape. The session which follows is on adult congenital heart disease. As our patients with complex congenital heart disease survive into adulthood, they often develop problems such as arrhythmias and heart failure. As anesthesiologists familiar with the physiology of complex congenital heart disease, we are well positioned to explore this new territory with our patients. The audience will learn about the perioperative journey of congenital heart disease from newborn to adulthood, and hear first-hand from a patient how congenital heart disease impacts their life.

Following the afternoon coffee break, a new adventure begins! For the first time, participants will have the option to register for a workshop or attend a ‘fireside chat’. The workshops offer participants the opportunity to explore our specialty in a ‘hands-on’ environment and to interact with other sub-specialists who are also committed to caring for patients with congenital heart disease.  Fireside chat is a term originally used to describe a series of radio addresses given to the nation by President Franklin Roosevelt, who also stayed at The Broadmoor. The fireside chat will be a more relaxed, intimate and interactive session with the ‘key note’ guest speakers from earlier in the day.

There are four workshops being offered this year. The first workshop is ‘cardiopulmonary bypass’. This workshop will help participants understand the cardiopulmonary bypass machine and give them insight to problems encountered during bypass so they may be best positioned to help the perfusionist during a case. Different bypass techniques and anesthetic implications will be discussed. The second workshop is extracorporeal membrane oxygenation and ventricular assist devices. This workshop will help participants understand how these technologies work and in what clinical situations they may be used. Common problems encountered while using these techniques will be discussed as well as the implications for the anesthesiologist. The third workshop is cardiac morphology. The goal of this workshop is to help participants develop a systematic approach to describing the normal and abnormal heart. This should help facilitate discussion with cardiology and cardiac surgical colleagues about complex congenital heart lesions. This systematic approach to describing the heart will be demonstrated by each participant dissecting a normal heart. The fourth workshop is about the perioperative management of pacemakers and implantable cardiac devices. Participants will have the opportunity to use temporary pacemakers and learn about different pacing modes. In addition, permanent pacemakers and implantable defibrillators will be shown and their perioperative implications discussed.  These new workshops will foster new friendships and will be great fun!  There will be limited space for the workshops in order facilitate small group learning, so remember to register for them early.

The end of the day will bring everyone together again for ‘professor poster rounds’. These poster rounds will consist of three groups, with five scientific abstracts being presented in each group. The moderators are all established experts in our field, who will help facilitate dialogue between participants, to foster new understanding and ideas. Please stay around afterwards to spend time with colleagues and build new friendships. The congenital cardiac anesthesia community is a small but welcoming one. The greatest resource we have is learning from and supporting each other.

At this year’s meeting, you will have the opportunity to reinforce your knowledge base, learn new concepts and share ideas with others. This meeting has an outstanding national and international faculty who will present both the scientific foundation and clinical relevance of congenital cardiac anesthesiology for anesthesiologists with a wide range of practice experience. Anesthesiologists and other health care professionals are encouraged to attend, whether your practice is predominantly congenital heart disease or caring for children and adults with cardiac issues on a less frequent basis.

This program is the combined effort of several individuals who are passionate about congenital cardiac anesthesiology. It has also been crafted out of the formal and informal, highly valuable input that many of you have provided. My sincere thanks to the meeting co-chairs, Scott Walker and Luis Zabala, for their hard work and innovative solutions. I also want to thank the CCAS Board of Directors for their support of this meeting as it embarks in a new direction. A huge thank you to Kim Battle, Dana Gibson and others at our association management company, Ruggles Service Corporation, whose expert planning and support make these meetings possible.

I am confident that this meeting in the ‘mountain majesties’ will leave you intellectually refreshed and reinvigorated for your clinical work.

Enjoy the meeting!