Preliminary programme
Session A
Why do we need Physiology in the cath lab?
Jaydeep Sarma
08.50Introduction and overview: UK perspective , why is it important to use adjunctive technology in the cath lab.
Key points: Importance of coronary physiology in revascularisation
European vs. global practice
UK perspective
Matthias Schmitt
09.00Imaging of the heart in CAD: epicardial topographic data vs: functional perfusion imaging
Key points: The evolution of non-invasive cardiac imaging
Current state of the art
The use of anatomical and functional imaging in CAD
Saqib Chowdhary
09.15Is angiography redundant in modern coronary intervention?
Key points:
The limitations of angiography in coronary revascularisation (both CABG and PCI)
How intra-coronary imaging aids revascularisation strategy and techniques
New developments in intra-coronary imaging
Bernard de Bruyne
09.30The need for functional evaluation
Coronary artery physiology primer
Key points:Basic principles of coronary flow
Overview of the concepts and derivation of FFR
Application of FFR in the cath lab
Session B
Practical issues in evaluating coronary physiology in the cath lab
Chairs: Faz Fath-Ordoubadi / Neal Uren
Key points: General (2min) introduction to the use of
Mobile and on-table analysers
Pre-packaged drugs
Technician and non-physician cath lab worker familiarity with techniques
Ganesh Manoharan
09.45Setting up FFR in your cath lab: the ideal world
Key points: Patient preparation, access choices
Guide catheter selection and technique
Wire calibration and equalisation
Engagement and wire technique
Use of analyser software and data acquisition
Andreas Baumbach
10.0Pharmacology
Key points:Concepts behind drugs used for FFR evaluation
Vessel preparation
Drug choices
Drug delivery routes
Drug infusion rates
Phil MacCarthy
10.15Pitfalls, artefacts and caveats in physiological assessment
Key points:
Difficult areas: Severe LV dysfunction, Cardiomyopathy, Hypertrophy
Ostial damping
Drift
Contribution of collaterals
Session C
The use of coronary physiology in real-life Clinical Practice
Special anatomy
10.35Saqib ChowdharyLeft Main Stem
Key points: Use of IVUS vs. FFR. Does LMS flow allow for FFR measurements? Is IVUS more reliable? Are IVUS criteria always relevant?
10.45Doug FraserBifurcations.
Key points: Use of FFR evaluation of side branch stenoses. Assessment of side branch results post bifurcation stenting
10.55Neal UrenDiffuse disease, serial stenoses
Key points: Evaluation of multiple lesions in single vessels. Use of steady state hyperaemia. The role of pullbacks in decision making in serial stenoses. Impact of tandem lesions on individual FFR readings in diffuse disease
11.15Interactive Clinical case (serial stenoses, +/- bifurcation)
Key discussants/operators:Richard Levy/Bernard De Bruyne
Key points: Introduction of clinical case
Panel discussants: Neal Uren, Andreas Baumbach, Faz Fath-Ordoubadi
Lunch
Session C
Multi-vessel disease & FAME
1.15 Introduction Andreas Baumbach
Key points: overview. The role of PCI in multi vessel disease
Introduction to Keynote speaker
Bernard De Bruyne
1.20Keynote lecture: Beyond FAME
Key points: Background to FAME study
Importance of the study
Impact on clinical practice
Interactions with other major recent studies: SYNTAX and COURAGE
Future developments and investigations
1:45Interactive/ live clinical Case Multi-vessel disease
Key discussants/live operators
Saqib Chowdhary/Phil MacCarthy
Key points: Introduction and clinical background to clinical case
Panelists: Doug Fraser, Ganesh Manoharan, Bernard De Bruyne
Session D
Moving forward with FFR
Use of invasive physiological tools in special clinical settings
3:05Bernard De BruyneACS
Key points: The role of FFR evaluation in ACS. Is it useful? Is it meaningful?
3.15Andreas BaumbachSTEMI
Key points:
Theory of FFR in post MI patients
Changes in flow in acute vs. chronic MI
Time frame for meaningful results with FFR post MI
Implications of loss of muscle mass on FFR
3.25Neal UrenMicrocirculatory dysfunction
Key points:
Background concept of microcirculation
Microcirculatory dysfunction in cardiac disease
How to measure it (non-invasive, invasive)
Relevance to PCI
3.35Ganesh ManoharanNon-coronary arterial flow
Key points: Is the concept of flow useful outside the heart?
Do the same principles apply?
Models of non-coronary flow evaluation
Pressure wire evaluation in renal arteries
3:45 Wrap up and close
Jaydeep Sarma