October 27th, Minutes of the Canadian Pediatric Cardiology Association Business Meeting. Location: Edmonton, Alberta

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October 27th, 2009 Minutes of the Canadian Pediatric Cardiology Association Business Meeting. Chair: Dr. Reeni Soni Recorder: Dr. Andrew Mackie Location: Edmonton, Alberta In attendance: 32 members of the CPCA and one invited guest, Dr. Erwin Oechslin, President of the Canadian Adult Congenital Heart Network. The meeting was called to order at 12:40 pm Old Business: One revision to the 2008 business meeting minutes was made. Specifically the CPCA account balance at the time of the 2008 meeting was $9142.42, not $5104.00 as had been reported. The minutes of the 2008 meeting were accepted by Dr. Lori West and seconded by Dr. Martin Hosking. New items for Discussion: 1. CCS and CPCA business items: a. Secretariat agreement: CPCA has an agreement with the CCS by which the CCS provides a variety of services for an annual fee of $1000.00. Services include development and maintenance of the CPCA website, membership dues collection, membership database and directory, and membership communication, as well as organizational support for the CCC. This agreement requires annual renewal; by hand-raise, the majority of the members in attendance agreed to renew this agreement for the next 12 months. b. CPCA website: This is a work in progress. The plan is to go live in the next few months. It will include a link to membership application with the CPCA. There is the potential for expansion to more than 5 static pages. There is a need to discontinue the old website which is under a different domain name. Dr. Marie Béland tried to close the old website previously, but she was unable to do so as this website had been created by a private company in Quebec City. Action item: Dr. Jean-Marc Coté agreed to explore how to close the existing (old) website. The new CPCA website will include a directory of existing Pediatric Cardiology programs and training programs across the country, posting relevant announcements and links to relevant websites.

c. CPCA/CCS membership: Membership with the CPCA is important for our status relative to the Canadian Cardiovascular Society. The CPCA has affiliate status at this time. There are currently 58 paying members. A motion was passed and agreed upon by a majority of hand vote to send out formal invitations to new recruits and reminders to those who haven t renewed. d. CCC venues: Currently the plan is to restrict venues to Montreal, Vancouver, and Toronto affective 2010. These cities will simply rotate hosting the CCC every three years. The cost of the Sunday night social event for the CPCA is estimated at approximately $5000 per year based on input from Marie Béland and Anne Dipchand. It was suggested that the CPCA contribute ~$1000-$2000 each year towards this event, and that each Division across the county also contribute a few hundred dollars to cover the cost. This was accepted by a majority hand raise. e. CCS Council Report/CCS Consensus Statement Committee: Dr. Brian McCrindle noted that the CPCA is an official CCS affiliate which provides us with some important status within the CCS. Most CPCA members are also CCS members. This led to a discussion of the CCS Consensus Statement Committee. Unfortunately scientific guidelines published by the CCS have little to no pediatric input. The need for formal pediatric representation at the level of the CCS Consensus Statement Committee was raised. For example, recent lipid guidelines did not have any pediatric input. Cardiovascular risk guidelines, which are coming out, will need pediatric involvement. Dr. Andrew Warren proposed that Dr. McCrindle be the pediatric representative on the CCS Consensus Statement Committee and this was accepted by majority hand vote. Dr. Marc Paquet indicated that this had been a very long standing issue going back more than a decade. f. CPCA financial summary: This was provided by Andrew Mackie. The CPCA earned $1.49 in deposits over the past 12 months, a reflection of the economic times. Debits were $500 to the Richard Rowe Award in October 2008, and $613.91 for travel for Dr. Andrew Warren to the CCS Advisory Committee Meeting in December 2008. The current balance is $8030.00. However, Dr. Mackie learned only yesterday that the CCS has a trust account for the CPCA. This account holds membership dues for 2008 and 2009, minus the annual $1000 fee for services based on the secretariat agreement and minus expenses related to the 2008 CCC. Andrew Mackie has been in contact with Linda Palmer at the CCS in order to find out the balance within that trust account. It was pointed out that having two separate accounts was inefficient and likely to cause confusion. It was moved that the account with the Bank of Montreal in Edmonton held by the CPCA be closed and that the balance be moved into the trust account held by the CCS. This motion was accepted by majority hand raise. 2

g. Scientific Committee Report: This was provided by Dr. Andrew Warren. Sixty-eight abstracts were submitted to this year s program, of which 58 were accepted, an 84% response rate. The cut off score (range 1-10) was a 6.8 for acceptance. The CPCA has a defined number of abstract spots that can be accepted for each meeting. Dr. Warren made a request for nominations for the John Keith lecture for 2010, ideally a speaker from North America. He also reminded us of the importance of checking off the box for the CPCA when submitting abstracts to the annual meeting. He also made a request that instead of submitting workshop proposals to the CCS that instead we contact Dr. Warren directly, before February 2010, with workshop proposals. The problem with submitting workshop proposals directly to the CCS, and not through Dr. Warren, is that the CCS will stick them at a time that is likely to be inconvenient for CPCA members. 2. Royal College of Physicians and Surgeons Report: This is provided by Dr. Jean-Luc Bigras. He noted that on the examination held September 30th and October 1st, 2009 the examinees performed well in the OSCE, did reasonably well on the short answer questions, and did quite poorly on the graphic questions. The same has been noted amongst the Adult Cardiology Examinees. More time will be allowed for the graphic station at next year s examination. In addition, Dr. Bigras noted that pathology specimens will no longer be part of the examination beginning in 2011. Rather the pathologic aspects of the examination will be performed within the individual institution. Dr. Martin Hosking noted that this may require some time to be approved through the Cardiology Committee within the Royal College. Dr. Bigras was to confirm what steps would be required for Royal College approval of this change. 3. Trainee Review Program Update: This was provided by Dr. Jennifer Russell. She noted that attendance was a problem last year due to other commitments of trainees. Trainees may attend on more than one year (may attend as many years as they like). The program may be lost if attendance does not approve. An OSCE was done this year at the Hospital for Sick Children which went well. Rather than having this event at an airport hotel, there will be an effort to stay in the downtown core next year. This event is funded by the Canadian Cardiovascular Academy and members were encouraged to contribute to that. There will be no exclusion to Canadian trainees who are training outside of Canada. 4. Division Heads Update: This was provided by Dr. Soni. There are 15 Canadian Pediatric Cardiology Programs, eight of which are surgical and seven non-surgical. An annual Division Heads meeting was held this year on October 25th. There was representation from 12 of the 15 centers. It will be the responsibility of the CPCA to continue to organize a Division Heads meeting on an annual basis. 5. New Business: a. CPCA Executive issues: The Executive consists of the President, Secretary Treasurer, and Scientific Director. Discussion was held as to whether these terms should be renewable. It was felt that the President should remain in that position for only three years, so that this 3

b. SBE registry: The annual cost of the SBE registry is $20,000 a year for two years. The Canadian Pediatric Society has agreed to have SBE included in the Canadian Pediatric Surveillance Program, but is not providing the $40,000 required. An attempt to obtain external funding from the CIHR was unsuccessful. It was suggested that there could be cheaper ways of determining the annual incidence of endocarditis in Canada, including having a registered nurse contact each of us on a monthly basis, either by email or telephone. It was also suggested that funds could be potentially found within Canadian Pediatric Cardiology Programs, particularly those Divisions who have representation on the SBE Registry Committee. A deadline was set and agreed upon of January 1st, 2010 to find funds within these programs, and if that was not successful then to look at alternative sources of funding. It was generally agreed upon that determining the incidence of endocarditis in Canada remains a research priority. c. Sub-Committee Updates: i. The National Cardiology Grand Rounds was discussed briefly. This is at a difficult time of day for many people, but given the number of times zones involved it is difficult to change. Dr. Soni was to contact Dr. John Finley in Halifax regarding possibly conducting a survey about how these rounds were meeting member s needs and what could be done, if anything, to improve the format and/or time of these rounds. ii. The existence of several clinical working groups was noted, particularly the Pulmonary Hypertension Task Force, and the newly developed Children s Heart Failure Network. The Pulmonary Hypertension Task Force is funded by Actelion and meets annually during the CCC. The Children s Heart Failure Network meet for the first time in 2009 and that was spearheaded by Dr. Paul Kantor from Toronto. The purpose of these groups is to foster research collaboration and a more uniform approach to the management of these rare but challenging conditions. iii. A report was received from the Nomenclature Working Group stating that there is a need for incorporation of the six digit IPCCC code into clinical databases and echo, cath, and MRI reports. Dr. Rodney Franklin in England will be incorporating the IPCCC code into the ICD-11 codes. Snowmed has also chosen to go with the IPCCC codes. Members are encouraged to check www.ipccc.net. This report was provided by Dr. Marie Béland. d. Pan-Canadian Research Initiatives: The potential roll of the CPCA in assisting with cross country research initiatives was emphasized, helping to establish collaborations. It was noted that the Canadian Adult Congenital Heart Network has been quite successful within 4

their organization at pan-canadian research. Members were encouraged to submit research proposals to Dr. Soni which then would be disseminated for review across the country. e. Pediatric Echocardiography Standards: A request was received from the CCS to create formal standards for performance of pediatric echocardiography in Canada. This stems from the problems that have occurred with echocardiograms performed outside of academic centers. It was suggested that the CPCA come up with standards from within the organization. It was acknowledged that we cannot create standards that are binding or that prohibit non-academic centers from performing pediatric echocardiography, but that the existence of standards nonetheless would set a benchmark. Dr. Béland pointed out the challenges related to the increasing availability of machines in neonatal intensive care units, emergency rooms, and so on, where sometimes quick echos are being performed. Adult training standards do exist. Canadian pediatric guidelines for echocardiography were published in 1996 and it was generally felt that these needed to be updated. Nominations for an individual to head up this initiative should be sent to Dr. Soni. f. Adult Congenital Issues: The Canadian Adult Congenital Heart Network president Dr. Erwin Oechslin was introduced. He spoke to the importance of a partnership between the CACH network and the CPCA. There was a proposal put forward to have cross representation on each board. Dr. Oechslin will be joining the CPCA membership himself. The CACH network will be undergoing a constitutional review over the next six months. g. The Canadian Cardiovascular Congress in 2010 will be held in Montreal. The meeting was adjourned at 12:55 pm. This motion was accepted by Dr. Andrew Warren and seconded by Dr. Myriam Brassard. 5