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  • A Tricky Mission for the PAH Clinician: A Case-Based Interactive Discussion on Prostacyclin Therapy Transitions

    Course ID: 3031
    Course Author: Laura Duvall
    Course Author: Kevin Kissling

    2017 PH Professional Network Symposium Thumbnail
    Though it’s not usually anticipated, there may be a variety of circumstances that necessitate a PH medication be changed to another agent. Transitioning prostacyclin therapies is a particularly challenging task given that consideration must be made to both the individual patient and drug specific factors. Unfortunately, there is limited published evidence and no commonly accepted guidelines available to steer clinicians through the process. This session will be an interactive discussion in which the faculty will present a series of patient cases highlighting challenging prostacyclin transition cases that emphasize patient characteristics, tolerability, response and drug attributes. Prior to revealing the outcome of the transition plan, the audience will be engaged to share their thoughts and experiences with active dialogue within each patient case.

  • Baby, We Can Handle This: PH Associated With Lung Disease in Infancy

    Course ID: 3030
    Course Author: Jennifer Beier
    Course Author: Emma Olson

    2017 PH Professional Network Symposium Thumbnail
    PH associated with lung disease in infancy is an increasingly recognized problem, specifically in the bronchopulmonary dysplasia (BPD) and congenital diaphragmatic hernia (CDH) populations. More and more infants are surviving past the neonatal period, and many more go on to have long-standing PH with pediatric providers, this educational activity will review up-to-date information about this growing population of PH patients, including background of overview of treatment options.

  • Breaking Bad: Methamphetamines and PH

    Course ID: 3032
    Course Author: Andrea Baird
    Course Author: Nimi Tarango

    2017 PH Professional Network Symposium Thumbnail
    Methamphetamine use is associated with the development of pulmonary arterial hypertension (PAH). The methamphetamine epidemic is widespread across the United States, accounting for more than 50 percent of the patient population at some PH centers. Treatment of these patients presents unique and significant challenges. Join this session to learn more about the link between PAH and methamphetamine abuse. Both challenges and successes in treating these patients in the context of complex psychosocial situations will be highlighted. You will be introduced to relevant screening tools and learn more about individually assessing patients for appropriate PAH therapies, particularly advanced therapies like IV prostanoids. Case studies will be reviewed, highlighting the value of an interdisciplinary treatment approach, including a PH program dedicated social worker.

  • CTEPH and CTED: Understanding the Spectrum of Thromboembolic Pulmonary Disease

    Course ID: 3054
    Course Author: Kim Kerr
    Course Author: David Poch

    2017 PH Professional Network Symposium Thumbnail
    CTEPH is a potentially curable form of PH. Unfortunately, because of a general lack of awareness of this disease and proper screening, most patients are symptomatic for more than two years before diagnosis of CTEPH is considered. This session will review the CTEPH diagnostic algorithm including key radiologic features of CTEPH and examples of CTEPH "imitators." Treatment options and indications including PTE surgery, balloon pulmonary angioplasty and medical therapy will be described.

  • Chronic Thromboembolic Pulmonary Hypertension (CTEPH): Finding, Treating, and Future Directions

    Course ID: 3025
    Course Author: Josanna Rodriguez-Lopez

    CTEPH Finding, Treating, and Future Directions - C
    WHO Group 4 PH (CTEPH, chronic thromboembolic pulmonary hypertension) is a form of PH due to chronic, organized pulmonary emboli. Screening for CTEPH is an important component of the PH diagnostic workup, as the disease can be potentially cured in some patients by a pulmonary thromboendarterectomy. At the conclusion of this CME accredited course by Josanna Rodriguez-Lopez, M.D., participants will be able to a) recognize patient populations at-risk for developing CTEPH; b) describe screening/diagnostic recommendations in patients with unexplained dyspnea; and c) summarize current treatment options, as well as risks and benefits of each, for patients with CTEPH.

  • Clinically Important Pulmonary Vascular Phenotypes Across the Current WHO Categorization: The PVDOMICS Project

    Course ID: 3033
    Course Author: Heidi Erickson
    Course Author: Lillian Hansen
    Course Author: Franz Rischard

    2017 PH Professional Network Symposium Thumbnail
    Patients with PH have complex phenotypes influenced both by various forms of cardiac and pulmonary disease and by complex genetic, molecular and cellular processes. The NHLBI PVDOMICS protocol is a collaborative U.S.-based, cross-sectional research effort aimed at performing comprehensively advanced phenotyping and endophenotyping to define phenotypic similarities and differences. This session will describe the PVDOMICS research protocol, describe techniques and imaging tools used, provide case study examples and describe the relevance of this research to the PH community.

  • Comfort for the Messenger: Navigating Difficult Discussions in Pulmonary Hypertension

    Course ID: 3034
    Course Author: Rana Awdish
    Course Author: Carla Pies
    Course Author: Traci Stewart

    2017 PH Professional Network Symposium Thumbnail
    We all know the importance of palliative care in PH. But how do you actually incorporate palliative care into patient care? This session will provide strategies to give health care providers in the PH community the skills to have essential conversations with patients with PH. Through case studies, attendees will practice starting theses conversations and responding to challenges communicating with patients with chronic illness and their caregivers. Attendees will leave with a practical framework for holding these discussions.

  • Diagnosing PH: Testing and Imaging

    Course ID: 3063
    Course Author: Stephen Mathai

    Diagnosing PH Tile_600
    This educational activity will allow participants to a) Describe the role of, and specific measures analyzed, of echocardiography in screening for pulmonary hypertension; b) Differentiate the roles of V/Q scan and CT-angiogram in the identification of chronic thromboembolic disease; c) Explain the role of CT chest radiography in the identification of chronic lung disease and its impact on PH diagnosis; and d) Discuss the role of serology and blood work in the diagnosis of PH.

  • Early Screening and Detection in PAH with Patients with Connective Tissue Disease

    Course ID: 3035
    Course Author: Scott Visovatti
    Course Author: Amber Young

    2017 PH Professional Network Symposium Thumbnail
    PH is a frequent cause of morbidity and mortality in patients with systemic sclerosis (SSc, scleroderma). Three-year survival for SSc patients with PAH has been estimated to be 56 percent compared with 94 percent in those without PAH. Observational studies have demonstrated that mortality remains high in SSc patients with PAH despite current treatment options. Poor outcomes of PAH in SSc may be partially explained by disease-related comorbidities, but also by delay in diagnosis. Two novel, evidence-based algorithms for PAH detection in SSc have been developed as noninvasive tools to minimize missed diagnoses and identify earlier disease. The purpose of this session is to provide an overview of the Australian and Scleroderma Interest Group (ASIG) and DETECT screening methods, application of the algorithms from a large SSc and PAH center, novel biomarkers including exercise hemodynamics and describe the collaborative team approach to caring for these patients.

  • FDA-Approved Treatments for WHO Group 1 PH (PAH)

    Course ID: 2933
    Course Author: Vallerie McLaughlin

    WHO Group 1 PH Treatment Course Image
    Since 1995, more than a dozen WHO Group 1 PH (PAH, pulmonary arterial hypertension) targeted oral, inhaled, and infused therapies have been approved by the U.S. Food & Drug Administration. In this session, the mechanistic pathways of current FDA-approved targeted therapies, clinical considerations in selecting an initial PAH therapy, and goals of medical therapy will be discussed.

  • Health Disparities in Patients with PAH Roundtable

    Course ID: 3062
    Course Author: Evan Brittain
    Course Author: Vinicio de Jesus Perez
    Course Author: Tim Lahm
    Course Author: Arunabh Talwar

    Health Disparities in Patients with PAH Roundtable
    This educational activity will allow participants to a) Discuss the six major study topics that address the contribution of health disparities to PAH, outlined by the PH Care for All program; b) Review the currently published literature on health disparities in PAH patients so far and how researchers are measuring the impact on diagnosis and treatment; and c) Discuss current knowledge gaps in health disparities in PAH and opportunities for future research.

  • How to Follow Up with Your Patient

    Course ID: 2938
    Course Author: Peter Leary

    How to Follow-up with Your Patient Course Image
    This educational activity will allow participants to a) summarize risk stratification for the PH patient; b) describe recommended measures used in clinic to monitor disease progression; and c) summarize guideline recommendations on follow-up of the low-, moderate-, and high-risk patient.

  • How to Know When to Escalate PAH Therapy

    Course ID: 2960
    Course Author: Ronald Oudiz

    How to Know When To Escalate Therapy - Ron Oudiz,
    At the conclusion of this CME educational activity, participants will be able to describe recommended measures used to monitor disease progression; describe risk stratification in PAH; compare initial treatment strategies for low-, moderate-, and high-risk patients; and compare two expert consensus recommendations on PAH clinical management.

  • How to Know Your Patient Is Optimally Managed

    Course ID: 2949
    Course Author: Zeenat Safdar

    Optimal Management of PH Course Image
    Despite the robust therapeutic development since the 1990s, pulmonary hypertension (PH) remains a progressive, incurable disease. In this CME educational activity, Zeenat Safdar, MD, MS, reviews a) the clinical measures correlated with PH disease progression; and b) summarizes expert recommendations for following a stable PH patient.

  • Interpreting Statistical Data: Making Sense of the Latest PH Research

    Course ID: 3029
    Course Author: Trushil Shah

    2017 PH Professional Network Symposium Thumbnail
    For the past 20 to 30 years, we have enjoyed considerable progress in the treatment of PH, from no available treatments to multiple treatment options today. During the same period, our treatment goals have changed and clinical trial methodology in PH clinical trials have evolved. As we continue to make progress, it is of the utmost importance that we understand the statistical data presented in these trials and make the best decision for our patients. This educational activity will focus on interpretation of common statistical data in the latest and landmark clinical trials in PH.

  • Lung Transplantation for WHO Group 1 PH (PAH)

    Course ID: 3061
    Course Author: Oksana Shlobin

    Lung Transplantation_tile_600
    This educational activity will allow participants to a) Explain risk assessment in advanced pulmonary arterial hypertension (PAH) and the role of lung transplantation in medically refractory disease; b) Examine changing trends in lung transplantation in the U.S. and specifically in the PAH disease state; c) Interpret the components of the Lung Allocation Score (LAS) and when PH patients should be considered for lung transplantation; and d) Identify absolute contraindications and complications of lung transplantation.

  • Making Every Breath Count: Pulmonary Rehabilitation and Oxygen Therapy

    Course ID: 3037
    Course Author: Melisa Wilson
    Course Author: Tonya Zeiger

    2017 PH Professional Network Symposium Thumbnail
    We have all been taxed with the challenges of trying to give our patients the ability to live life to its fullest. How do we provide appropriate oxygen therapy and still give them mobility? How do we keep them active in a safe manner? Come explore the options that are available, and learn more about where to find the resources required for the most challenging patients’ needs.

  • Management of PH in the ICU

    Course ID: 2935
    Course Author: Todd Bull

    Management of PH in the ICU by Todd Bull, MD Cours
    WHO Group 1 PH (PAH, pulmonary arterial hypertension) is a rare, progressive disease characterized by increased pulmonary artery pressure and pulmonary vascular resistance (PVR). Increases in PVR places great stress on the right ventricle, normally a thin-walled, trabeculated, roughly triangulated structure. It is designed to pump into a low-impedance, high-capacitance pulmonary circulation system, which is not the case in PAH. Acutely ill patients need to hemodynamic compromise addressed quickly and effectively, to restore oxygenation, treat volume overload, and restore organ perfusion. Frequently employed strategies—including systemic blood pressure, cardiac output, hypervolemic, arrhythmia, ventilator management—should be approached differently given the high-impedance, low-capacitance nature of the diseased pulmonary circulation to improve patient outcomes. This session will review the normal function of the pulmonary vascular bed; describe the impact of sudden increases in RV after load on cardiac output; describe the impact of hypercarbia, hypoxia, and mechanical ventilation on PVR; discuss two common cardiac arrhythmias that can contribute to critical illness in patients with PAH; and discuss strategies to enhance RV-pulmonary artery interaction in critical illness.

  • New Frontiers in Lung Transplantation

    Course ID: 3038
    Course Author: Pablo Sanchez
    Course Author: Fernando Torres

    2017 PH Professional Network Symposium Thumbnail
    This session will focus on the new frontiers in lung transplantations. We will provide an overview of new patient types being studied which were not previously considered as transplant candidates, new bridge-to transplant technologies in development and clinical trials, and treatments to increase the number and health of donor grafts.

  • Nightmares in PH: What Else Can Happen, You Ask?

    Course ID: 3039
    Course Author: Scarlett Harden
    Course Author: Martha Kingman

    2017 PH Professional Network Symposium Thumbnail
    Patients with pulmonary arterial hypertension can experience a variety of life-threatening complications requiring hospitalization. We will review two challenging "nightmare" cases involving rare etiologies and provide suggestions on how to avoid high-risk surgical complications.

  • PAH Jeopardy: How Do You Stack Up?

    Course ID: 3040
    Course Author: Amy Kimber
    Course Author: Abby Poms
    Course Author: Robert Schilz
    Course Author: Melisa Wilson

    2017 PH Professional Network Symposium Thumbnail
    Test your knowledge by playing along with our panel in a game of Jeopardy. Categories will range from side effects to hemodynamics. This will be a lively survey of breadth of quickly accessible knowledge ranging from the simple to the more complex. Join us for an entertaining survey of the elements of diagnosis, pathophysiology, and therapy that we all need to know in the care of patients with PAH.

  • PH In Its Most Common Forms: Clinical Vignettes for WHO Groups 1, 2, and 4

    Course ID: 2915
    Course Author: Vinicio de Jesus Perez
    Course Author: Bonnie Hudak
    Course Author: Tim Lahm

    This information-intensive, clinical vignette provides an overview of pulmonary hypertension as it most commonly presents itself using clinical case studies. This previously recorded live webinar presents and examines WHO Groups I, II, and IV, offering an interesting perspective on topics in health care barriers, common diagnostic pitfalls, and the complexities of pediatric PH.

  • Please Wake Me: Nightmares in Pediatric PH

    Course ID: 3042
    Course Author: Michelle Cash
    Course Author: Delphine Yung

    2017 PH Professional Network Symposium Thumbnail
    Not everything is straightforward when managing the pediatric PH patient, and sometimes managing these fragile patients requires detective skills and quick thinking. In this session, pediatric panelists will share their nightmare cases in PH and how they navigated them.

  • Pulmonary Function Testing in PH

    Course ID: 2971
    Course Author: James Lamberti

    Pulmonary Function Testing in PH Course Image
    Pulmonary function testing is a series of tests that measure how well the lungs take in and exhale air, and how efficiently they transfer oxygen into the blood. Following participation in this webinar, hosted by PHA Online University, participants will be able to understand the role of pulmonary function tests in the evaluation of a patient with PH, classify pulmonary function test abnormalities as obstructive or restrictive, and define the typical abnormalities of pulmonary function in patients with idiopathic PAH.

  • Pulmonary Hypertension and RV Failure in the ICU

    Course ID: 2972
    Course Author: Steven Pugliese

    Pulmonary Hypertension and RV Failure in the ICU C
    Following participation in this webinar, hosted by PHA Online University, participants will be able to utilize techniques to determine etiology of shock state; understand the roles of inotropes, vasopressors, and pulmonary vasodilators in acute right heart failure; discuss an approach to arrhythmias and mechanical ventilation in decompensated right heart failure; and discuss the role of mechanical circulatory support in right heart failure.

  • Short-term Use of Prostacyclin Analogs to Improve Surgical Candidacy for Patients with Pediatric Heart Disease

    Course ID: 3044
    Course Author: Elizabeth Colglazier

    2017 PH Professional Network Symposium Thumbnail
    Patients with pulmonary arterial hypertension (PAH) associated with congenital heart disease (CHD) represent a challenging subpopulation. CHD remains one of the most common causes of PVD worldwide, and the best therapy for PVD associated with CHD is definitive early surgical correction. Unfortunately, in the developing world, many patients with CHD continue to be referred late for corrective surgery and many are considered "inoperable" at presentation. However, in patients with initially unfavorable hemodynamics for surgical correction, it is possible to undertake a strategy of initiating advanced PH therapies with a plan for repeat preoperative catheterization. Some patients may have improvement in hemodynamics such that operative repaid may be considered. Two cases of patients with significant PVD and CHD will be presented. These patients underwent a "treat and repair" strategy.

  • The Cath to Diagnosis: Right Heart Catheterization and Advanced Hemodynamic Monitoring

    Course ID: 3046
    Course Author: David Booth
    Course Author: Javier Jimenez
    Course Author: Amresh Raina

    2017 PH Professional Network Symposium Thumbnail
    Discussion of the importance of standard RHC, limitations of RHC and the various hemodynamic monitors trialed in patients with PAH, and a description of the CardioMEMS device, which has been employed in a pilot feasibility study at Allegheny General Hospital (AGH). This includes some cases with regards to the utility of this device in managing patients with PAH.

  • The Hole Picture: Atrial Septal Defect Creation in the Pediatric Patient With PH

    Course ID: 3047
    Course Author: M. Zussman

    2017 PH Professional Network Symposium Thumbnail
    Young children with hemodynamically significant PH are a specific clinical dilemma to the clinician. Initial vaso-dilator therapy is difficult to administer, and anesthesia and cardiac catheterization are high risk. Our institutional practice has been to perform ASD creation during the first diagnostic cardiac catheterization to augment LV preload and provide a safety net for these patients. We review our institutional experience and the outcomes after early ASD creation.

  • The Liver-Lung Connection: Understanding and Treating Portopulmonary Hypertension

    Course ID: 3048
    Course Author: Hilary DuBrock
    Course Author: James Runo

    2017 PH Professional Network Symposium Thumbnail
    Portopulmonary hypertension (POPH) is a poorly understood pulmonary vascular complication of liver disease associated with significant morbidity and mortality. Due to the presence of comorbid liver disease and the lack of clinical trials that include patients with POPH, treatment of POPH can be challenging. This session will provide an overview of the diagnosis and management of POPH with a focus on unique considerations for treatment in the setting of liver disease.

  • WHO Group 1 PH (PAH)

    Course ID: 2937
    Course Author: Anna Hemnes

    WHO Group 1 PH (PAH) Course Image
    Pulmonary arterial hypertension (PAH) is a rare form of pulmonary hypertension (PH) characterized by increases in both pulmonary arterial pressure and pulmonary vascular resistance (PVR). This educational activity will help participants a) differentiate PAH from other forms of PH; b) integrate diagnostic tests to improve accuracy in PAH diagnosis; c) describe risk factors for developing PAH; and d) recognize outcome differences between associated PAH and idiopathic/heritable PAH.

  • WHO Group 2 PH: A Retrospective

    Course ID: 3053
    Course Author: Kathy Galvin
    Course Author: William Hopkins

    2017 PH Professional Network Symposium Thumbnail
    Because of the rapid growth of left ventricular diastolic dysfunction and heart failure with preserved ejection fraction, World Health Organization (WHO) Group 2 pulmonary hypertension (PH) is the fastest growing group of patients with PH. Yet, there is a poor understanding of the hemodynamics and pathophysiology of PH in these patients. The reactive vasculopathy in the pre-capillary circulation is often characterized as "out of proportion" to the left heart filling pressure and misdiagnosed as WHO group 1 pulmonary arterial hypertension (PAH). PAH targeted therapy is often prescribed for these patients despite lack of efficacy data and the possibility of adverse patient outcomes. Looking back at the research done during the previous 75 years provides great insight into the pathophysiology and natural history of patients with WHO group 2 PH.

  • WHO Group 3 PH

    Course ID: 3059
    Course Author: Robert Schilz

    WHO Group 3 PH tile_600
    This educational activity will allow participants to a) Identify the incidence and magnitude of significant pulmonary hypertension in WHO Group 3 diseases, including COPD, pulmonary fibrosis and sleep apnea; b) Review current evaluation of PH in these processes; c) Discuss currently available data regarding attempts at treatment of WHO Group 3 Disease; and d) Review 5th World Symposium on Pulmonary Hypertension framework for PH that occurs in the setting of significant parenchymal lung abnormalities.

  • WHO Group 4 PH (CTEPH Treatment): Surgical vs. Medical

    Course ID: 2936
    Course Author: Richard Channick

    WHO Group 4 PH (CTEPH) Treatment: Surgical vs. Med
    For more than two decades, WHO Group 4 PH (CTEPH, chronic thromboembolic pulmonary hypertension) has been treated surgically through pulmonary thromboendarterectomy (PTE). In late 2013, riociguat was approved by the U.S. Food & Drug Administration (FDA) for the treatment of inoperable or PH occurring post-PTE. Following this approval, expert consensus guidelines on the diagnosis and treatment of PH have incorporated medical management of these specific PH patients into the treatment algorithm. However, PTE remains the recommended intervention in patients deemed operable as it can hemodynamically stabilize correctly selected patients. These guidelines, however, remain vague about the definition of operability as it relies on the technical abilities of the surgical and medical multidisciplinary teams and a paucity of long-term, multi-center outcomes data. This session seeks to a) describe the role of CT angiography in assessing surgical accessibility in CTEPH patients; b) discern operable versus inoperable CTEPH; interpret the surgical classification system for CTEPH; d) explain the benefits of PTE; and e) discuss the therapeutic options for those patients with inoperable or recurrent CTEPH, including PH-targeted medical therapy and/or balloon pulmonary angioplasty.

  • WHO Group 4 PH (CTEPH)

    Course ID: 2934
    Course Author: William Auger

    WHO Group 4 PH (CTEPH) Course Image
    WHO Group 4 PH (CTEPH, chronic thromboembolic pulmonary hypertension) is a rare disease characterized by a mean pulmonary artery pressure (mPAP) = 25 mmHg, pulmonary artery occlusion pressure = 15 mmHg, and chronic, organized emboli in the pulmonary artery. In this session, the CTEPH clinical definition, the role of screening in all PH patients, risk factors for developing CTEPH, and treatment options will be discussed.

  • Walk The Line: Benefits to Using Sub-Maximal Cardiopulmonary Exercise Training as a More Comprehensive Approach to Care

    Course ID: 3050
    Course Author: Julie Tracy

    2017 PH Professional Network Symposium Thumbnail
    As therapy evolves for PH, appropriate screening, assessment and follow-ups are more important than ever. Cardiopulmonary exercise testing (CPET) is a valuable tool in quantifying pulmonary vascular pathophysiology, but is not widely utilized. This topic will explore the benefits of sub-maximal CPET in PH practice.

  • We're All in This Together: Multidisciplinary Care for Complex PH Patients

    Course ID: 3051
    Course Author: Jaclyn Doyle
    Course Author: Allyson Rupp

    2017 PH Professional Network Symposium Thumbnail
    PH patients have a life-limiting condition that typically presents with complex co morbid conditions, often including psychosocial challenges. These challenges and limitations often inhibit PH patients from achieving full benefits of medical therapies. This presentation is designed to review real-life complex cases that required multi-disciplinary collaboration to optimize medical management, as well as provide a venue of discussion around problem-solving within complex PH cases. With the goal of expanding options and improving care delivery to patients challenged by unique (and often multiple) psychosocial circumstances, this session is intended to be a venue for peer-to-peer discussion and problem solving via real-life case studies.

  • What’s Old is New Again: The Role of the Potts Shunt in Pediatric PH

    Course ID: 3052
    Course Author: Michelle Cash
    Course Author: R. Mark Grady

    2017 PH Professional Network Symposium Thumbnail
    Children with refractory PH on maximal medical therapy traditionally have had few options outside of lung transplantation. Recently, several papers have demonstrated that a surgically-placed Potts shunt, i.e. a left pulmonary artery to descending aorta anastomosis can 1) increase overall survival, 2) improve functional status, 3) eliminate the need for intravenous infusions, and 4) delay the need for lung transplantation. Given the encouraging findings in treating some of the sickest children, we feel that a discussion of the Potts shunt will be of interest to all those who help care for children with PH.