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An ISHLT 2020 Symposium
Summary: 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, Papworth Everard, Cambridge, United Kingdom
Isabelle Opitz, MD, University of Zurich, Zurich, Switzerland
Welcome and Program Panel Introduction
Joanna Pepke-Zaba, MD
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.
Q & A segment with all speakers
Led by Isabelle Opitz, MD
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
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