This post was authored by Amit V. Khera, MD, fellow-in-training member of the ACC, Massachusetts General Hospital, Boston, MA.

More than 250 cardiologists, cardiothoracic surgeons, and other health care providers attended a highly successful Cardiovascular Conference at Snowmass, directed by Carole Warnes, MD, FACC, from Jan. 17-21. The participants, the majority of whom were repeat attendees, enjoyed world-class didactics and workshops surrounding beautiful days on the slopes of Snowmass Mountain.

Dr. Warnes and the planning committee conducted a careful needs assessment based on previous audience post-tests, questions most often missed on the cardiology boards, and real-time feedback to craft the five-day agenda. The first day began with ACC President Patrick T. O’Gara, MD, FACC, discussing the role of disruptive technology and novel care models in serving the College’s dual mission of population health and individualized medicine. Dr. O’Gara then joined Rick Nishimura, MD, MACC, in an interactive review of Maintenance of Certification Sessions.

Day two began with a session on the management of stable ischemic heart disease, including a nuanced discussion of the management of nonculprit lesions in patients suffering from a myocardial infarction and the optimal surgical management of ischemic mitral regurgitation.  A subsequent update on valvular disease provided insight into the future of cutting-edge devices for percutaneous mitral valve intervention and the treatment of the oft-forgotten tricuspid valve in patients undergoing surgery.

The following day delivered both a dusting of fresh powder for the skiing enthusiasts as well as insightful discussion on the management heart failure subphenotypes ranging from hypertrophic cardiomyopathy to those with isolated right heart failure. The electophysiologists in the group tuned in for a subsequent arrhythmia series discussing patient selection for atrial fibrillation ablation as well as a simplified review of how to assess wide complex tachycardias.

The next day brought a practical conversation on controversial new guidelines for the management of hypertension and cholesterol, including a talk on the future of renal denervation and the association between pregnancy-related complications and future cardiovascular health. The final sessions involve case-based workshops of particularly challenging patient scenarios across a wide range of general cardiology fields. Day five, the final day of the conference, concluded with a series of presentations illustrating common mistakes in topics ranging from EKG interpretation to the management of adult congenital heart disease.

As a fellow-in-training, the conference was amongst the most rewarding experiences of my fellowship training, consolidating an incredible amount of learning and knowledge consolidation into five short days.  In discussion with fellow attendees, we departed Snowmass with take-home points that included the following:

1. The art of medicine is alive and well. Despite an increased emphasis on homogenizing cardiovascular care and increasing guideline adherence, the conference made clear the role of the careful clinician judgment in the absence of certainty.  For example, interventionalist David R. Holmes, Jr., MD, MACC, discussed his use of ventricular septal defect closure devices in treating a large coronary sinus to right atrial fistula that developed after high-risk calcific mitral valve surgery.
2. It takes a village (or at least a Heart Team…) Rapid increases in the complexity of management will increasingly require multidisciplinary discussions with patients and their families to arrive at decisions. Vinod Thourani, MD, FACC, impressed the audiences with videos from hybrid approaches to coronary revascularization involving strategic use of both bypass grafts and percutaneous interventions.
3. Outstanding clinician-educators should never be taken for granted. The commitment to excellence in adult learning espoused by Dr. Warnes and colleagues is rare and often insufficiently valued in academic centers.  Every cardiovascular provider should have the privilege of seeing Dr. Nishimura deconstruct cases of constriction vs. restriction or Samuel Asirvatham, MBBS, FACC, debate the meaning of an early repolarization pattern on the EKG of a patient with syncope. The ACC, via its Emerging Faculty program, and other didactic sessions demonstrates a clear commitment to replenishing the pipeline of individuals dedicated to educating future generations of providers.

Participants leaving the conference left reinvigorated and with a renewed appreciation for the opportunity to practice modern cardiovascular medicine.

See you in January 2016 at the 47th Annual ACC Cardiovascular Conference at Snowmass!

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