Pediheart: Pediatric Cardiology Today

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...

In this replay of episode 80 from 2019, we review a study from The University of Toronto on the impact of timing of the arterial switch operation for DTGA on brain growth and neurodevelopmental outcomes. Can the timing of this surgery impact these outcomes? What is the reason for this? Is it rational to perform this surgery early to improve neurological outcomes? How important is the conduct in th...

This week we delve into the world of healthcare disparities and ACHD when we review a recent 'big data' study on levels of insurance coverage amongst ACHD patients and the impact of the affordable care act ("Obamacare") on this metric. To what extent did the enactment of this program increase insurance coverage for ACHD patients? How do their levels of coverage compare with other chronic illness p...

This week in a co-branded episodes with the SADS Foundation (SADS.org) we speak with Professor Johannes von Alvensleben of U. Colorado about a recent PACES study on the outcomes of S-ICD's in children and ACHD patients. What are the challenges to their use and who is a good candidate? What is involved in screening patients for an S-ICD and why do children and ACHD patient seem to 'screen out' more...

This week we delve into the world of fetal cardiology to review a recent work on accuracy of fetal echo in the diagnosis of congenital heart disease. We speak with Dr. Namrita Mozumdar of Pediatric Cardiology Of Long Island about her work. What factors are associated with diagnostic discrepancies? DOI: 10.1016/j.echo.2020.06.017 Also joining us is Professor Kenan Stern of Mount Sinai Children's He...

This week we review a recent survey study on the topic of aortopulmonary collaterals in single ventricle patients. How often are these occluded in the single ventricle patient and when this is performed, how do interventionalists decide? How should they be occluded? Are there guidelines regarding this? We speak with Professor Ziyad Hijazi of Sidra Cardiovascular Center in Doha, Qatar about this re...

In this week's replay episode 133, we delve into the world of electrophysiology and ACHD when we review a very recent work on TOF and factors associated with possible risk for sudden death. Can a novel algorithm identify high or low risk patients in this cohort? We speak with Professor Joseph Atallah of The University of Alberta and Dr. Edward Walsh of Harvard University. Both share their deep kno...

This week we explore a recent work assessing the degree of anatomical concordance between neonatologist-performed echocardiograms and those by pediatric cardiology. What is the role of a hemodynamic consultation team in the management of the transitional physiology of the newborn? How do neonatologists use echocardiography in real time to help manage complex physiological problems of the newborn?...

This week we review the important topic of anticoagulation of the Fontan patient. We speak with hematology researcher, Dr. Chantal Attard of The Murdoch Children's Research Institute of The University of Melbourne about a recent cross-sectional study comparing multiple factors in patients with Fontan circulation on aspirin vs. warfarin. What were the demonstrable differences in outcome? Are there...

This week's work reviews a recent STS database study on airway anomalies and the impact they have on cardiovascular surgical outcomes for congenital heart disease. To what degree does the presence of a concomitant airway surgery impact the morbidity and mortality of congenital heart surgery? Dr. Kyle Riggs, a PGY4 resident in thoracic surgery at Northwell Health shares his insights from his recent...

This week we delve into the world of general cardiology and echocardiography to evaluate the role of the echo in the evaluation of a palpitation patient. Which pediatric palpitation patients should undergo an echo? What is the yield of this test in this patient group? What is the appropriate evaluation of a palpitation patient and what testing should such a patient undergo? We speak with Dr. Salon...

This week we review a recent work from the large ACHD team in Sydney, Australia regarding outcomes of ACHD patients at age 50. How are these patients progressing from both a medical and psychosocial perspective? What resources are needed to address this rapidly growing population of middle aged ACHD patients? We speak with Professor Rachael Cordina of the University of Sydney about her recent work...

This week we delve back into the world of the Fontan to discuss the fate of the liver in the Fontan patient. We speak with hepatologist, Professor Dellys Soler Rodriguez of Emory University about a recent work she published on the fate of the liver in patients following heart-only transplantation who were Fontan patients. How should these patients be monitored? How should all Fontan patients be mo...