Pediheart: Pediatric Cardiology Today

This week we delve into the world of cardiovascular surgery to review a recent work on outcomes of arch reconstruction in the newborn and small child. We speak with Dr. Ramana Dhannapuneni, lead cardiac surgeon of Alder Hey Children's Hospital in Liverpool, UK. How often in the present era is re-operation or reintervention required? How common is the recurrent laryngeal nerve or phrenic nerve inju...

This week we enter the world of cardiac critical care to discuss delirium in the postoperative pediatric cardiac patient. We speak with nursing scientist, Professor Sandra Staveski of UCSF about a recent large multicenter study she conducted on this topic. How prevalent is this problem and why is it an important morbidity to tackle and reduce? How can nursing interventions reduce this problem and...

This week we review a recent report from the team at Children's Hospital of Los Angeles about prenatal and neonatal factors that might help predict the need for newborn permanent pacing in the setting of antibody-associated CCHB. We speak with Assistant Professor of Pediatrics at Mount Sinai, Dr. Justin Pick about this work. How important is third trimester fetal heart rate in predicting possible...

This week we review a recent work on the use of bivalirudin on outcomes of pediatric VAD patients. We speak with Dr. Caroline Carly Heyrend of Primary Children's Hospital in Utah about a recent work she co-authored on time in therapeutic range for this agent in children with VAD's. How does bivalirudin work differently than heparin and what are the theoretical benefits or disadvantages of this age...

This week we enter the worlds of fellow education and echocardiography to review a recent report of a QI project performed at Children's Hospital of Philadelphia regarding the performance of echocardiograms by first year fellows in cardiology. Can the implementation of a checklist protocol improve the consistency of echocardiograms performed by fellows? What was the impact of this protocol? What a...

This week we delve into the world of ACHD when we review a recent large data evaluation from the team at Erasmus University in the Netherlands regarding outcomes of DTGA/Arterial Switch patients who have gone through pregnancy. How do these patients fare in general? What sort of pre-pregnancy evaluation should these patients have? Where should their offspring be delivered? Is a maternal fetal medi...

This week we review a recent work from the team at University of Alabama in Birmingham about clinical outcome disparities amongst Black children with Kawasaki disease. What differences exist in outcomes between these groups and are these differences social or biological in origin? We speak with one of the authors of this work, Assistant Professor of Pediatrics Leslie Collins about this important w...

From August 2020 - This week we delve into the topic of fellow wellness and review a recent work from the Boston Children's group on fellow fears and stressors when beginning their training. Are there patterns amongst the fellow concerns that can be identified and used to inform interventions to help allay these fears and reduce the stress? We speak with Dr. David Brown, Associate Professor of Ped...

This week we spend the entire episode speaking with Professor Peter Lang of Harvard University about his rich and long career in pediatric cardiology during one of the most exciting times of the field. Dr. Lang's story includes a virtual who's who of important cardiologists and cardiac surgeons for the past 50 years including Dr. Connie Hayes, Dr. Roberta Williams, Dr. Alexander Nadas, Dr. Richard...

This week we review a recent work assessing changes in Fontan conduit cross sectional area over time. What accounts for these changes and how do these affect exercise capacity? What does the future hold for the Fontan procedure? Is there an optimal conduit size for patients? We speak with Assistant Professor of Pediatrics at USC, Dr. Neil Patel this week! doi: 10.1016/j.jtcvs.2020.09.140

This week we enter the world of pulmonary hypertension (PH) and review a large multicenter registry study assessing outcomes of the Potts shunt for the management of severe PH. Who is a good or bad candidate for this therapy? Is there an advantage to placement of a valve in the shunt? Does this form of palliation affect lung transplant eligibility? We speak with the first author of this week's pap...

This week we enter the world of CT surgery to review a recent STS database study on outcomes of diaphragm paralysis following congenital heart surgery. How common is a diaphragm paralyzed following surgery and what are the main risk factors for this complication? How commonly are these plicated and how do those who are plicated fare in comparison to those managed more conservatively? Professor Nar...

This week we replay an episode that reviews a critically important neurodevelopmental issue affecting infants who have single ventricle palliation - namely hearing loss. How common is hearing loss seen and what role does IV furosemide play in this finding amongst single ventricle patients? Are there techniques to avoid this complication and yet still use this commonly used diuretic agent? We discu...

This week we delve into the world of myocarditis and cardiogenetics when we review a recent work on deleterious cardiomyopathic genes and a possible role for these in patients who have unfavorable myocarditis outcomes. Are cardiomyopathy genes seen more commonly in pediatric patients with myocarditis who die? Is there a role for genetic testing in the myocarditis patient? How might deleterious gen...

This week we delve into the heart failure and transplantation realm when we review a recent large scale PHIS database study assessing the associations of tracheostomy and outcomes of pediatric heart transplantation. Are tracheostomies associated with worse outcomes or mediastinitis? Who is a good candidate for this therapy? How difficult is it to discuss this option with families and why? These ar...

This week in our 2nd 'fellow takeover' episode we speak with the inspiring figure, Dr. Elisabeth Martin, who is Assistant Professor of Surgery at Stanford University and one of the cardiovascular surgeons at Lucile Packard Children's Hospital. How did this young surgeon choose to become a cardiac surgeon and what trials and tribulations have accompanied her journey to the highest levels of congeni...

This week we review a recent very large scale project from Denmark on the impact of CHD on preterm labor and birth. We speak with Assistant Professor of Pediatrics at Indiana University, Neonatologist Paulomi Chaudhry about the work and her thoughts on what factors may be modifiable in the care of the preterm infant with CHD. What sorts of studies are needed going forward to improve the outcomes o...

This week, in a co-branded episode with SADS.ORG, we speak with Professor Michael Ackerman of The Mayo Clinic about a recent work he published with his team on a novel AI model to assess the ECG for the diagnosis of LQTS. How accurately can this technology identify a patient with LQTS? Can it identify the genetic diagnosis from the ECG alone? What are the implications of this sort of technology in...

This week we delve into the world of noninvasive imaging and review a very novel approach from the team at Stanford University about tele-visits and the use of remote parentally acquired, focused echocardiograms for monitoring of Marfan's patients. Can any parent be trained to perform a focused echocardiogram in their homes? What is the cost associated with this approach? Can this technique be app...

This week's episode is co-hosted by Dr. Sarah Pradhan in our first 'fellow takeover' of the podcast! Dr. Pradhan speaks with Professor Daphne Hsu of Albert Einstein College of Medicine about her career, how she became a heart failure and transplantation authority, how she thinks about mentoring the next generation and also how she balanced a very full life including the highest levels of medicine...

This week we review a recent work from the team at Children's LA about an unusual form of pre-excitation and use this as a place to launch a discussion about pre-excitation. What sorts of pathways cause pre-excitation? Should all pre-excited patients undergo formal testing? Should all pathways be ablated? How can we invasively or non-invasively assess these patients and are these approaches reliab...

This week we review a recent work on CMR outcomes pre and post cone reconstruction of the tricuspid valve in Ebstein's anomaly. How durable of a repair is this operation? Is there evidence for ventricular remodeling? Is there an optimal age to perform this surgical procedure? How should arrhythmia risk be assessed prior to surgery? These are amongst the many questions reviewed by and posed to Prof...

This week we play a live podcast session from SCAI 2021 (April 30, 2021) on the topic of balloon angioplasty for native aortic coarctation in infants aged 3-12 months. We speak with the senior author of this recent work from Toronto Sick Children's Hospital - Professor Rajiv Chaturvedi. How often were complications encountered? How do results compare with surgical repair? Is high pressure required...

This week we speak with Professor Eric Rosenthal of Evelina Children's Hospital in London, England from a session at SCAI 2021. Who is a candidate for closure of a superior sinus venosus ASD in the cath lab and how is this determined? If there is a residual shunt, how much is too much? How did Professor Rosenthal embark on this approach and what have been the results? What percentage of these pati...

This week we have a special treat in playing a session from the SCAI meeting from today, April 29, 2021! We speak with Professor Julie Vincent of Columbia University and Professor Chuck Mullins of Baylor College of Medicine. Both speak about their early lives, how they chose to become physicians and how life in retirement is treating them. What role did teamwork play in each doctors' professional...