Pediheart: Pediatric Cardiology Today

This week we explore both fetal cardiology and cardiovascular surgery. The first work reviews a fascinating case report of fetal treatment of cardiac rhabdomyomas in the setting of hydrops fetalis. The second reviews a recent report on LV retraining prior to attempted double-switch operations in LTGA and DTGA. Can one accurately predict 'retrainability' of the LV? Can life threatening rhabdomyomas...

This week we explore the notion of pulmonary valve function preservation at the time of TOF/PS repair with Dr. Ram Emani, Associate Professor of Surgery at Harvard Medical School/Boston Children's Hospital. Dr. Emani shares his insights from recent work he and colleagues have performed using a novel intraoperative balloon dilation approach. Can TOF/PS repair be performed without creating significa...

This week we discuss 2 papers on different areas of congenital cardiology. The first is a recent Brazilian report on Zika Virus Syndrome and associations with congenital heart disease. The second is a recent report by the team at Children's Hospital of Philadelphia on exposure to plastic neurotoxicants found in many common medical devices. Do these plastic substances have an impact on neurodevelop...

This week we review a very recent work on long term (14 years!) outcomes of children with hypertrophic cardiomyopathy in Australia and speak with its author, Professor Robert Weintraub of Royal Children's Hospital in Melbourne. Dr. Weintraub explains the data in his work for us and what he considers to be important risk factors for poor outcomes. He also shares some thoughts on how he thinks about...

This week we explore 2 unrelated but possibly 'game changing' papers. First we delve into a very recent report on a novel intranasal therapy for acute termination of SVT. Then we review a recent report from the Boston Adult Congenital Heart Program (BACH) on a potential role for inflammation as a possible cause for poor outcomes in ACHD patients. Can inflammatory markers predict poor outcomes in A...

This week we delve into the world of novel means for epicardial pacing and defibrillation in small children or those with congenital heart disease. Dr. Bradley Clark of The Children's Hospital at Montefiore and Dr. Yaniv Bar-Cohen of Children's Hospital of LA discuss their recent works on developing minimally invasive epicardial pacing and defibrillation in infants and those with congenital heart...

This week we replay the 2nd podcast in the series. Dr. George Ofori of Montefiore reviews a recent paper on a project in Angola to provide outstanding congenital cardiovascular care in that nation and the challenges associated with these sorts of projects and we also review an extraordinary report of non-invasive ablation of severe ventricular arrhythmias using radiation. Can arrhythmias be ablate...

In this landmark 25th episode of the podcast we delve into the world of echocardiography with one of the masters of this field, Dr. Shubhika Srivastava of Mt. Sinai Medical Center in NYC to discuss a recent paper by her team on 'twisting' and 'untwisting' abnormalities in repaired tetralogy patients. Who is at risk for these problems? What do these findings mean? Can they help inform decisions reg...

This week we explore the role of transcatheter closure of the PDA in the infant, particularly those < 2 kg and even < 1 kg. We review data from the IMPACT trial on closure of the PDA in small infants and also discuss an important paper by Dr. Evan Zahn on transcatheter closure of PDA's in the premature or very small infant. What are the outcomes when closing the PDA in a small infant? What are the...

This week we review a recent paper on follow-up of the novel approach of percutaneous carotid artery vascular access in infants requiring neonatal or early infancy catheterizations with Dr. Christopher Petit of Children's Healthcare Atlanta - Emory University. Dr. Petit reviews how the team in Baylor and Atlanta came to use this type of vascular approach and also some important 'pearls' of perform...

This week we explore fetal cardiology with 2 fetal cardiology experts - Mary Donofrio, MD from Children's National Medical Center and Maciej Slodki of Polish Memorial Mother's Research Institute. Both authors/experts discuss the notion of predicting the initial minutes and hours after birth with complex congenital heart disease. Are there new ways to predict the need for atrial septal intervention...

This week we delve into the world of postoperative CICU management of complex congenital heart surgical patients with one of the pioneers of this field, Dr. Anthony Rossi of Nicklaus Children's Hospital. Dr. Rossi has been at the forefront of research into the optimal management of children following complex congenital heart surgery. Are there ways to predict problems before they become problems i...

This week's 20th episode tackles the topic of pulmonary hypertension both in the newborn premature infant and the adult with primary pulmonary hypertension. We have 2 experts this week - Dr. Nicole Sutton of Albert Einstein College of Medicine and Erika Berman Rosenzweig of Columbia University College of Physicians and Surgeons speak about managing pulmonary hypertension in infants with BPD and hi...

This week we delve into the topic of pregnancy in the single ventricle Fontan patient with 2 experts in this area - Dr. Melinda Davis of University of Michigan and Dr. Mark Johnson of Imperial College - London, England - to discuss who is a good Fontan candidate for pregnancy and what are the risks. We review the latest data on this area and also the many aspects of this topic that remain unknown...

In this week's episode we learn about the latest data on pulmonary vein stenosis outcomes from a large meta-analysis of prior works on this topic and then review recent provocative data from the group in Boston on the use of adjunctive biological inhibition agents in concert with interventional approaches to combat multi vessel intraluminal pulmonary vein stenosis. The work's first author, Dr. Rya...

In this episode we review 2 wonderful recent works. The first reviews the use of perioperative EP studies to predict postoperative VT and SCD amongst TOF patients undergoing PVR. The second is an intriguing study on the relatively new concept of HIS BUNDLE pacing. Joining us this week is Dr. Edward Walsh from Boston Children's Hospital to discuss his thoughts on ventricular arrhythmias in the sett...

This week we learn about the exciting field of 3D printing in congenital heart disease. We discuss an interesting article on this topic that was recently published with one of the true world authorities on this topic, Dr. Kanwal Farooqi who is Assistant Professor of Pediatrics at Columbia University. Dr. Farooqi will take us through the basics of this rapidly evolving field and explain to us how t...

This week we delve into the exciting world of congenital interventional cardiology with 2 very different types of interventional cardiology research. In the first highly technical work from the group at Children's Hospital of Michigan in Detroit, we review an innovative approach to transcatheter management of pulmonary regurgitation in tetralogy when the RVOT is just too large for a valved stent....

This week we review 2 works on the topic of aortic coarctation. The first reviews outcomes of arch repair in the setting of a bovine arch and the second reviews the possible long term impact of having mild transverse arch hypoplasia after repair - a common problem afflicting many patients who have undergone coarctation repairs. Dr. Emile Bacha, Professor of Surgery at Columbia University and Dr. A...

This week we review 2 works on pediatric ventricular assist devices and the most common adverse event associated with their use - specifically, infections. Dr. Scott Auerbach, medical director of the ventricular assist device program at Denver Children's Hospital and Associate Professor of Pediatrics at The University of Colorado will discuss the findings of the PEDIMACS registry data as well as s...

This week we explore the topic of Artificial Intelligence with a true expert in the field, Dr. Anthony Chang who is chief intelligence and innovation officer at Children's Hospital of Orange County. Dr. Chang recently earned a master’s degree in Biomedical Data Science and Artificial Intelligence from Stanford University and he reviews with us what AI is, what the potential value of this technolog...

This week’s episode explores the sedative and anxiolytic agent dexmedetomidine and its use in the pediatric cardiac ICU. This agent, which was initially introduced for short term sedation, is increasingly used in our postoperative cardiac patients and we explore issues related to its use with particular attention to the issue of withdrawal. Dr. Michael Ushay, Director of Pediatric Critical Care at...

This week we devote the episode to congenital cardiac electrophysiology. We review 2 works - the first on outcomes of ablation for the treatment of atrial arrhythmias in Ebstein's anomaly and the second focuses on the ablation of posteroseptal accessory pathways in children, risks for coronary injury and strategies to avoid this potential serious complication. We are joined by Dr. Christopher McLe...

This week we review the most recent report of the SVR trial study group. The great economic cognitive and mathematical psychologist Amos Tversky once said "The world is not kind to collaboration." However, the SVR trial may just be the exception to prove Professor Tversky's rule. This month the group reports on how patients are doing 6 years after Stage I Palliation (Norwood) for HLHS -> RV-PA shu...

This week we review 2 important aspects of pediatric cardiovascular surgery - postoperative evaluation of pulmonary vein repair and management of the anomalous coronary artery for the prevention of sudden cardiac death. Dr. Carlos Mery of Texas Children's Hospital joins us to discuss the findings of a recent project he published on a large series of operations for these disorders.