The IX t h Makassed Medical Congress - American University of Beirut

T h e I X t h M a k a s e d M e d i c a l C o n g r e s s
ADVANCES IN MANAGEMENT OF CONGENITAL CARDIAC DISEASES AND
CHANGING OUTCOMES
Zohair Al Halees, MD
Congenital heart surgery is special. It is a profession that combines art and science, skill and
decisiveness. Though it is considered a young specialty, great advances have been made over
the last 50 years. Almost all congenital cardiac defects are now manageable one way or another.
Fetal diagnosis helped in better planning intervention.
In the presentation, we go through the milestones of cardiac surgery and talk about the advances
that have occurred over the years through the pioneering efforts of many innovative and visionary
surgeons. Advances were also related to critical reviews of outcomes and adopting changes
that prove beneficial. Pediatric Cardiology became a subspecialty of its own which helped in
better defining management pathways of patients with congenital cardiac defects. Cardiac
morphology improved the understanding of the structural changes associated with congenital
cardiac defects and allowed both cardiologists and surgeons to better plan repairs and avoid
complications. A good example of this is the delineation of the conduction system within the
heart and avoidance of heart block postoperatively. Improved technology particularly imaging
technology [echocardiography, CT scanning, MRI] together with advances in anesthesia, critical
care, and surgical techniques all made an impact in improving outcomes of these patients.
This also led towards operating on patient at an earlier age with a strong trend towards early
corrective surgery. Palliation became less and mostly have become a part of planned strategy
towards full repair.
HEART FAILURE UNIT: IS IT ESSENTIAL TO ESTABLISH?
Hadi Skouri MD
Heart failure is a leading cause of hospitalization and death and its prevalence continues to
increase. The clinical care of patients with HF encompasses a continuum from acute settings to
chronic management. Chronic management in the outpatient setting provides an opportunity to
improve patient care and health outcomes through early identification of symptom progression,
utilization of evidence-based medication, quality-of-life evaluation, and patient education to
increase adherence. HF is a leading cause of ambulatory visits and outpatient care accounts
for a significant proportion of total heart failure expenditures. Observational studies have shown
improved outcome if patients are being treated and followed up by specially trained providers.
So “HF clinic” has become a vital element in comprehensive care of the patients with HF. It
reached the level of national and international HF Guidelines.
BEDSIDE ASSESSMENT AND MANAGEMENT IN ACUTE HEART FAILURE
SYNDROME
Hadi Skouri MD
Acute Heart Failure Syndrome (AHFS) includes patient with reduced and preserved LV function.
In acute settings they have similar clinical presentation. Immediate therapy to optimize
hemodynamics and improve symptoms is similar or overlapping. There are some clinical and
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