ACC.23 Wrap Up: An ACPC Perspective

ACC.23 was a big success in the Big Easy and great learning was to be had in the Adult Congenital and Pediatric Cardiology (ACPC) sessions: "real solutions for real problems by real people". As we emerge from a global pandemic, ACC Virtual in 2021, and the first "hybrid" meeting in 2022, ACC.23 had a good in-person showing of ACPC members. It was truly heart-warming to encounter friendly faces in real life and not virtually. Many opportunities for networking and relationship building would not have been possible with an all virtual format.

Community Day

The ACPC pre-meeting Community Day was off to an exciting start with a special virtual guest, William E. Flanary, MD, (aka "Dr. Glaucomflecken" of YouTube fame) with his amusing observations regarding our field of specialty. This was followed by an inspiring keynote by William L. Border, MD, who discussed a multi-pronged approach to enhancing physician and staff wellness. Lively discussions during break-out sessions touched on clinician well-being, obviating the "leaky pipeline" of physician and staff retention, as well as career guidance for fellows-in-training (FITs). Kudos to the ACPC section leadership for putting together this timely agenda!

Scientific Sessions

This year's sessions focused on a plethora of topics. The kick-off scientific event, "My Way or the Highway: Surgical and Cath Controversies in Congenital Heart Disease" (Session 603) included lively banter on the "right" path to take for a borderline left ventricle (LV) previously slated for single ventricle palliation. Innovative surgical approaches for circulatory re-routing and "ventricular recruitment" as a staged strategy to encourage LV growth in hypoplastic left heart that may result in potential biventricular (BiV) repair are encouraging. In the end, it was evident that there is truly no data to support a particular pathway applicable to all children in all centers, and that bad decisions may close the door to transplant eligibility. Patient selection is key and for the appropriate patient, BiV outcomes are better, as the term "Good Fontan" may be a misnomer.

Diversity, inclusion and equity in healthcare and the work environment were the over-arching themes of ACC.23, and we heard about social determinants of health and adverse experiences affecting congenital heart disease (CHD) outcomes, disparities in the delivery of fetal, pediatric, and adult congenital cardiology care, and what we can do about them. The history of pioneer women leaders who paved the way for us and the stories of contemporary luminary women in our field as they forged their own winding paths and bravely share their career and life lessons were highlighted. The Women in Cardiology Member Section hosted practical sessions discussing pregnancy and parental leave during training, thriving as a parent and a cardiologist, women's healthcare access, and other relevant issues. It is indeed time for gender equity!

Posters and moderated poster events discussed a wide range of topics across the lifespan, from in utero parameters that might predict the need for balloon atrial septostomy, to bedside transcatheter procedures to close ductus arteriosi in the extremely low birth weight neonate, to novel arrhythmia management in adults with CHD, and other creative ways of dealing with conundrums in our field.

The Future is Close

There were sessions that included presentations on right ventricle (RV) recovery with lessons on optimizing RV function and performance to make the previously deemed inoperable patient a decent surgical candidate by manipulating pre-load and pulmonary vascular resistance and optimizing coronary perfusion. Transcatheter therapies to relieve acute RV outflow tract obstruction in the setting of acute endocarditis or in patients deemed to have a high surgical mortality or chronic thromboembolic pulmonary hypertension were discussed. The sessions on artificial intelligence, myocardial regeneration, innovations in Fontan assist devices and 4D phase contrast magnetic resonance imaging proved they are truly not just sci-fi anymore. Advancements in telecommunications that have made borderless learning and sharing experiences as a "World University," to address the global burden of CHD, are now reality. Inequity is indeed a global problem, and care for every child born with CHD is the future universal goal.

Entertaining, while still being truly educational, were the game style debates: Stump the Chump, Play or Stay, and March Match-up Family Feud!

These are just a few highlights of this year's sessions. Kudos to all the presenters and to C. Huie Lin, MD, PhD, FACC and Elisa A. Bradley, MD, FACC for this innovative lineup!

The Year in Review and The McNamara Lecture

In her "Year in Review" presentation, Candice K. Silversides, MD, FACC gave an excellent summary of CHD in 2022, emphasizing multi-disciplinary advances to move our field forward. The papers she featured were truly trailblazing.

Daniel J. Murphy Jr., MD, FACC, gave an inspiring Dan G. McNamara Keynote underscoring the importance of a culture of wellness and self-compassion, including actions programs and individuals can implement for improved work-life balance such as building individual and team relationships, promoting effectiveness of clinical practice, and celebrating successes. These measures are key to building professional fulfillment and meaningful work lives. Dr. Murphy noted that the great Dr. McNamara himself would likely be surprised that wellness is an issue today, as we are all resilient.

ACPC Section Meeting

Also well attended was the ACPC Member Section meeting which celebrated the past year's achievements of the section work groups: Cardiology Chiefs, Fellowship Training Directors, Education, Advocacy, Artificial Intelligence, Quality, Women in Cardiology, and Publication/Communications. We thank Arwa Saidi, MB BCh, FACC for her selfless dedication as ACPC Section Chair and we welcome Ritu Sachdeva, MBBS, FACC in her new role as the incoming Section Chair. The ACPC Member Section aims to be your professional ACC home, and there truly are multiple ways to be involved.

We look forward to ACC.24, under the leadership of Dr. Elisa Bradley, with more member engagement and involvement, and increased submissions and presentations spotlighting the myriad perspectives of care for all our patients. See you in Atlanta in 2024!

P.S. Do not forget to claim your ABP MOC Part 2 credit for the sessions you attended!

Clinical Topics: Arrhythmias and Clinical EP, Congenital Heart Disease and Pediatric Cardiology, Implantable Devices, SCD/Ventricular Arrhythmias, Atrial Fibrillation/Supraventricular Arrhythmias, Congenital Heart Disease, CHD and Pediatrics and Arrhythmias

Keywords: ACC Annual Scientific Session, ACC23, Heart Ventricles, Cardiologists, Leadership, Gender Equity, Artificial Intelligence, Pandemics, Goals, Parental Leave, Heart Defects, Congenital, Hypoplastic Left Heart Syndrome, Univentricular Heart, Perfusion, Regeneration, Endocarditis, Arrhythmias, Cardiac

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