Short Syllabus     th 35 Annual International Symposium: Clinical Update in Anesthesiology, Surgery and Perioperative Medicine Marriott Resort Casa Magna, Cancun, Mexico January 15 – 20, 2017 The Department of Anesthesiology at the Icahn School of Medicine at Mount Sinai New York, NY, USA Complimentary workshops, including: One Lung Ventilation; Ultrasound-Guided Regional Block; Difficult Airway; Transthoracic Echocardiography. Course Directors: George Silvay, M.D., Ph.D., Marc Stone, M.D., Menachem Weiner, M.D., Andrew Goldberg, M.D. Course Assistant Directors: Christopher Curatolo, M.D., Bryan Hill, M.D. Course Administrators: Maria Galati, Margorie Fraticelli, Bob Williams Symposium Website: www.clinicalupdateinanesthesiology.org Pre- registration: Sunday, January 15, 2017 – 16:00-18:00 Maya Ballroom Foyer CME Credits—Certificates will be e-mailed to all faculty and meeting participants- please ensure that we have your correct e-mail address Please complete the daily evaluation forms Breakfast is included for registered guests in our group block @ the Caribbean Fountains area from 6:30am – 10:00 am Cocktail “Welcome” reception on Monday January 16th, 18:00-20:00 at La Isla Terrace A reception will follow the session:35th Year ANNIVERSARY. Memories from the First Annual International Symposium in Antiqua 1982 until present: history, interesting situations, quiz, best meeting on Thursday January 19th at 18:00 Short Syllabus     Educational Objectives The 35th Annual International Symposium: Clinical Update in Anesthesiology, Surgery and Perioperative Medicine is designed to help busy professionals advance their knowledge and keep current by providing a review of innovations, recent advances and best practices in cardiothoracic, vascular and general anesthesiology, surgery, perioperative medicine, and critical care. In addition, four workshops will be conducted for interested participants. At the conclusion of the symposium, participants will be able to: 1. Describe and implement new diagnostic modalities, therapeutic agents and management strategies in the fields of cardiothoracic, vascular and general anesthesia, surgery, critical care and perioperative medicine. 2. Recognize and implement best practice anesthetic management of patients with significant comorbidities. 3. Discuss the current and future management of patients with cardiac, thoracic and vascular pathophysiology. 4. Four WORKSHOPS: 1-One lung ventilation; 2-Regional block; 3-Difficult airway; 4- ECHO. Experts will demonstrate the latest techniques. Target Audience Anesthesiologists, cardiothoracic, vascular and general surgeons, cardiologists, intensivists, nurse anesthetists, physicians in-training, perfusionists, physician assistants, and nurses. Verification of attendance will be provided to all professionals Educational Methods • Didactic lectures and discussions by recognized leaders in their field. • Oral presentation of abstracts of relevant basic science research and interesting clinical cases. • Workshops: Hands-on one lung ventilation; ultrasound - guided regional anesthesia; difficult airway, ECHO. CME Accreditation Statement This activity has been planned and implemented in accordance with the Accreditation Requirements and Polices of the Medical Society of the State of New York (MSSNY) through the joint providership of the Westchester Academy of Medicine and Department of Anesthesiology, Icahn School of Medicine at 2 Short Syllabus     Mount Sinai, New York. The Westchester Academy of Medicine is accredited by the Medical Society of the State of New York (MSSNY) to provide Continuing Medical Education for physicians. The Westchester Academy of Medicine designates this live activity for a maximum of 18 hours AMA PRA Category I Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Disclosure Statement The Westchester Academy of Medicine and the Medical Society of the State of New York relies upon planners and faculty participants in its CME activities to provide educational information that is objective and free of bias. In this spirit and in accordance with the guidelines of MSSNY and the ACCME, anyone with the potential to control the content of a CME activity are expected to disclose the existence of any relevant financial interest or other relationship the faculty member (spouse or partner) or provider has with the manufacturer of any commercial product discussed in an educational presentation. The planners and faculty participants do not have any financial arrangements or affiliations with any commercial entities whose products, research or services may be discussed in these materials. No commercial funding has been accepted for this activity. Zika safety from the Center for Disease Control: No vaccine exists to prevent Zika. Prevent Zika infection by avoiding mosquito bites through using Insect Repellent and wearing long-sleeved shirts and long pants. Mosquitoes that spread Zika virus bite during the day and night. Mosquitoes that spread Zika virus also spread dengue and chikungunya viruses. Zika can be passed through sex from a person who has Zika to his or her sex partners. Condoms can reduce the chance of getting Zika from sex. 3 Short Syllabus     th SUNDAY, JANUARY 15 , 2017 16:00 – 18:00 PRE-REGISTRATION (FINAL COLLECTION OF SLIDES). th MONDAY, JANUARY 16 , 2017 
 07:30 – 08:30 REGISTRATION 08:00 – 08:20 WELCOME AND ANNOUNCEMENTS George Silvay, New York, NY, USA 08:20 – 11:00 TIMELY TOPICS IN ANESTHESIA, SURGERY AND PERIOPERATIVE MEDICINE Moderators: Joel Kaplan, San Diego, CA, USA Joe Szokol, Evanston, IL, USA 08:20 – 08:30 Induced Pluripotent Stem Cells for Precision Medicine Zeljko Bosnjak, Milwaukee, WI, USA Keywords: Stem cell biology, patient-derived cells, cardiac electrophysiology 08:30 – 08:40 Socioeconomic Position and Impact on Outcomes Brigid Flynn, Kansas City, MO, USA Keywords: socioeconomic position, vascular surgery, cardiac surgery, Hemoglobin A1c References: 1. Socioeconomic position is not associated with 30-day or 1-year mortality in demographically diverse vascular surgery patients. Mazzeffi M, Lin HM, Flynn BC. J Cardiothorac Vasc Anesth. 2012 Jun;26(3):420-6. 2. Finger B, Brase J, Wirtz K, He J, Flynn BC. Elevated HbA1c levels are associated with lower socioeconomic position (SEP) and postoperative infections in cardiothoracic surgical patients. Annals of Thoracic Surgery 08:40 – 08:50 Inotropic Therapy from Cell to the Patient Philippe Housmans, Rochester, MN, USA Keywords: Inotropy, cellular physiology, calcium sensitizers, catecholamines, acute heart failure 08:50 – 09:00 Ultrastructural Changes in Mitochondria of Diabetic Patients 4 Short Syllabus     Pastor Luna, Mexico City, Mexico Keywords: Diabetes, mitochondria 09:00 – 09:10 Impact of Ebola Virus on the Surgical Setting Janet Martin, London, Ontario, Canada Keywords: Ebola outbreak - Surgery - Anesthesia - Transmission Risk 09:10 – 09:20 Xenon Anesthesia for Cardiac Surgery Thomas Kotulak, Prague, Czech Republic Keywords: Cardiac anesthesia - Xenon - Cardiac surgery - Organ protection 09:20 – 09:30 Revisiting the EUROSCORE Based on Frailty Indices Isabelle Michaux, Yvoir, Belgium Keywords: cardiac surgery, elderly patients, frailty, perioperative care 09:30 – 09:40 Advanced Strategies for End-Stage Heart Failure Jorge Catrip, Mexico City, Mexico Keywords: Heart failure, surgical treatment, heart assist devices 09:40 – 09:50 3D Functional Modeling of the Mitral Valve Daniel Bainbridge, London, Ontario, Canada Keywords: Mitral valve, 3-D echocardiography 09:50 – 10:00 Exposure to Anesthesia is Associated with Development of Dementia Juraj Sprung, Rochester, MN, USA Keywords: Anesthesia, surgery, Alzheimer's dementia, dementia, minimal cognitive impairment 10:00 – 10:10 Perioperative Use of Statins Joe Szokol, Evanston, IL, USA Keywords: Stains, Pleiotropic effects 10:10 – 10:20 Glycocalyx and its Relevance for Anesthesia Practice Vladimir Cerny, Prague, Czech Republic Keywords: Endothelial glycocalyx - General anesthesia - Regional anesthesia 10:20 – 10:30 Optimizing Perioperative Care in the Face of the Changing Guidelines Concerning “Beta-Blockers” Miklos Kertai, Durham, NC, USA Key words: Perioperative beta-blocker use-perioperative guidelines- postoperative cardiovascular complications References: 1. Kertai MD, Esper SA, Akushevich I, Voora D, Ginsburg GS, Stafford-Smith M, Grichnik K, Newman MF, Fontes ML, Smith P, Podgoreanu MV, Mathew JP. Preoperative CYP2D6 metabolism-dependent beta-blocker use and mortality after coronary artery bypass surgery. J Thor Cardiovasc Surg 2014; 147:1368- 1375 5 Short Syllabus     2. Oprea A, Fontes ML, Onaitis M, Kertai MD. Comparison between the 2007 and 2014 ACC/AHA Guidelines on perioperative evaluation for noncardiac surgery: based on a case report. J Cardiothor Vasc Anesth 2015; 29: 1639-1650 10:30 – 10:40 Perioperative Information Systems Jesse Ehrenfeld, Nashville, TN, USA Key words: informatics, patient safety, outcomes References: 1. Electronically Mediated Time-out Initiative to Reduce the Incidence of Wrong Surgery: An Interventional Observational Study. Rothman BS, Shotwell MS, Beebe R, Wanderer JP, Ehrenfeld JM, Patel N, Sandberg WS. Anesthesiology. 2016 Jun 6 2. A perioperative consult service results in reduction in cost and length of stay for colorectal surgical patients: evidence from a healthcare redesign project. McEvoy MD, Wanderer JP, King AB, Geiger TM, Tiwari V, Terekhov M, Ehrenfeld JM, Furman WR, Lee LA, Sandberg WS. Perioper Med (Lond). 2016 Feb 5;5:3. doi: 10.1186/s13741-016-0028-1. eCollection 2016. 10:40 – 11:00 SPECIAL LECTURE Introduction: George Silvay, New York, NY, USA Cardiac Anesthesia Education Assessment with TEE Minoru Nomura, Tokyo, Japan Keywords: Cardiac anesthesia, education, TEE 11:00 – 11:30 DISCUSSION & COFFEE BREAK 11:30 – 13:00 CARDIOLOGY, CARDIAC ANESTHESIOLOGY AND SURGERY Moderators: Robert Michler, New York, NY, USA Davy Cheng, London, Ontario, Canada 11:30 – 11:45 Update on Atherosclerosis Allen Unger, New York, NY, USA Keywords: Keywords: Update in lipid management; When statins are not enough; Review of PCSK9 inhibition 11:45 – 12:00 The 10 Year STICH Trial Robert Michler, New York, NY, USA Keywords: Ischemic Heart Disease, Coronary Artery Disease, Heart Failure 12:00 - 12:15 Anesthetic Considerations for Open Thoracic Aortic Aneurysm Repair Yianni Augoustides, Philadelphia, PA, USA Keywords: aneurysm; clinical registry; locus; imaging; etiologies; 6 Short Syllabus     classifications; complications; guidelines; surgical triggers; neuroprotection; hypothermic circulatory arrest; antegrade cerebral perfusion; hybrid arch repair; left heart bypass; spinal drains; lung isolation; echocardiography; transfusion rescue References: 1. MacKnight BM, Maldonado Y, Augoustides JG, Cardenas RA, Patel PA, Ghadimi K, Gutsche JT, Ramakrishna H. Advances in Imaging for the Management of Acute Aortic Syndromes: Focus on Transesophageal Echocardiography and Type-A Aortic Dissection for the Perioperative Echocardiographer. J Cardiothorac Vasc Anesth. 2016 Jan 13 [Epub ahead of print] 2. Ghadimi K, Gutsche JT, Setegne SL, Jackson KR, Augoustides JG, Ochroch EA, Bavaria JE, Cheung AT. Severity and Duration of Metabolic Acidosis After Deep Hypothermic Circulatory Arrest for Thoracic Aortic Surgery. J Cardiothorac Vasc Anesth. 2015 Dec;29(6):1432-40. 3. Augoustides JG, Desai ND, Szeto WY, Bavaria JE. Innominate artery cannulation: the Toronto technique for antegrade cerebral perfusion in aortic arch reconstruction--a clinical trial opportunity for the International Aortic Arch Surgery Study Group.J Thorac Cardiovasc Surg. 2014 Dec;148(6):2924-6. 4. Gutsche JT, Ghadimi K, Patel PA, Robinson AR 3rd, Lane BJ, Szeto WY, Augoustides JG. New frontiers in aortic therapy: focus on deep hypothermic circulatory arrest. J Cardiothorac Vasc Anesth. 2014 Aug;28(4):1159-63 5. Augoustides JG, Stone ME, Drenger B. Novel approaches to spinal cord protection during thoracoabdominal aortic interventions. Curr Opin Anaesthesiol. 2014 Feb;27(1):98-105. 12:15 - 12:30 TAVR and the Expanding Role of the Anesthesiologist Allan Stewart, New York, NY, USA Keywords: TAVR, Anesthesia, echocardiography, TTE 12:30 - 12:45 What is New in CABG Surgery? Richard Daly, Rochester, MN, USA Keywords: coronary artery disease - bilateral IMA grafts - arterial revascularization – CABG and PCI 12:45 – 13:00 DISCUSSION 7 Short Syllabus     th TUESDAY, JANUARY 17 , 2017 07:30 – 09:30 REGISTRATION 08:00 – 09:30 ***One Lung Ventilation – Workshop Edmond Cohen, New York, NY, USA; Dawn Desiderio, New York, NY, USA; Javier Campos, Iowa City, IA, USA; Harleena Gulati, Winnipeg, Canada; Bob WiIliams, New York, NY, USA *** Difficult Airway – Simulation Workshop Brian Hill, New York, NY, USA; Ian Sampson, New York, NY, USA; Theresa Gelzinis, Pittsburgh, PA, USA; Bob Williams, New York, NY, USA 09:30 – 11:00 THORACIC SURGERY AND ANESTHESIA Moderators: Dawn Desiderio, New York, NY, USA Jeffery Vender, Evanston, IL, USA 09:30 – 09:40 Preoperative Evaluation of Thoracic Patients Alessia Pedoto, New York, NY, USA Key words: Non cardiac thoracic surgery - preoperative testing - exercise tolerance - consultation 09:40 – 09:50 Hypoxia During One Lung Ventilation – What’s New? Javier Campos, Iowa City, IA, USA Key words: Hypoxemia, Thoracic surgery, One-lung ventilation, ECMO extracorporeal membrane oxygenator. Reference: Campos JH: Hypoxemia during thoracic surgery: practical advice for the anesthesiologist. ASA Refresher Courses 2013;41:38-46 09:50 – 10:00 The EZ Blocker for One-Lung Ventilation Martin Dworschak, Vienna, Austria Keywords: One-lung ventilation, EZ-blocker 10:00 – 10:10 Tracheal Resection: Sharing The Airway Dawn Desiderio, New York, NY, USA Key Words: Shared Airway, Preoperative assessment, Jet ventilation, Communication Reference: Chen A, Ochroch EA; Tracheal Resection In Fleisher LA, Roizen MF, eds. Essence of Anesthesia Practice, 3rd edition 2015, Elsevier Saunders, pg 547. 10:10 – 10:20 Tracheal Resection: Surgical View Svetozar Harustiak, Bratislava, Slovakia Key Words: Tracheal stenosis, tracheal resection 8 Short Syllabus     10:20 – 10:30 Perioperative Analgesia for Thoracic Surgery Stelian Serban, New York, NY, USA Keywords: Pain control, Thoracic epidural, Paravertebral, Intercostal block 10:30 – 10:40 Lung Cancer – Screening Raja Flores, New York, NY, USA Keywords: Lung cancer, low-dose CT screening, NLST, I-ELCAP 10:40 – 10:50 Robotic Assisted Thoracic Surgery Paul Waters, Greenwich, CT, USA Keywords: robotic surgery, thoracic surgery, DaVinci 10:50 – 11:00 Future of Thoracic Surgery and Anesthesia Edmond Cohen, New York, NY, USA Keywords: Lung separation, Awake VATS 11:00 – 11:30 DISCUSSION & COFFEE BREAK 11:30 – 11:50 SPECIAL LECTURE Introduction: George Silvay, New York, NY, USA Minimally – Invasive Cardio-thoracic Surgery: Are Clinical Outcomes Significantly Better than Conventional Surgery? Davy Cheng, London, Ontario, Canada Keywords: Minimally invasive, outcomes 11:50 – 13:00 CARDIOVASCULAR INNOVATIONS Moderators: Joerg Ender, Leipzig, Germany Arie Blitz, McAllen, TX, USA 11:50 – 12:00 Cardiac Devices and the Anesthesiologist Sheela Pai Cole, Palo Alto, CA, USA Keywords: ventricular assist devices, preoperative optimization, echo in VAD patients 12:00 - 12:10 Anesthetic and Echocardiographic Management in the Mitral Clip Operation Joerg Ender, Leipzig, Germany Keywords: Mitral clip, Percutaneous, Transeptal puncture SPECIAL LECTURES: 12:10 – 12:30 Introduction: George Silvay, New York, NY, USA Update on Mechanical Circulatory Support 2016 9 Short Syllabus     Arie Blitz, McAllen, TX, USA Keywords: Mechanical Circulatory Support, VAD 12:30 – 12:50 Introduction: Menachem Weiner, New York, NY, USA Near-Infrared Spectroscopy in Cardiac Surgery Andre Denault, Montreal, Quebec, Canada Key words: near-infrared spectroscopy, cardia surgery, bedside ultrasonography, transesophageal echocardiography References: 1.Deschamps A, Hall R, Grocott H, et al. Cerebral Oximetry Monitoring to Maintain Normal Cerebral Oxygen Saturation during High-risk Cardiac Surgery: A Randomized Controlled Feasibility Trial. Anesthesiology.2016;124(4):826-836. 2.Denault AY, Couture P, Beaulieu Y, et al. Right Ventricular Depression After Cardiopulmonary Bypass for Valvular Surgery. Journal of cardiothoracic and vascular anesthesia. 2015;29(4):836- 844. 3.St-Pierre P, Deschamps A, Cartier R, Basmadjian AJ, Denault AY. Inhaled milrinone and epoprostenol in a patient with severe pulmonary hypertension, right ventricular failure, and reduced baseline brain saturation value from a left atrial myxoma. Journal of cardiothoracic and vascular anesthesia. 2014;28(3):723-729. 4.Denault A, Lamarche Y, Rochon A, et al. Innovative approaches in the perioperative care of the cardiac surgical patient in the operating room and intensive care unit. Can J Cardiol. 2014;30 (12 Suppl):S459-477. 5.Deschamps A, Lambert J, Couture P, et al. Reversal of decreases in cerebral saturation in high-risk cardiac surgery. J CardiothoracVasc Anesth. 2013;27(6):1260-1266. 6.Mailhot T, Cossette S, Lambert J, Cournoyer A, Denault AY. Cerebral oximetry as a biomarker of postoperative delirium in cardiac surgery patients. J Crit Care. 2016;34:17-23. 12:50 DISCUSSION 10