Pediheart: Pediatric Cardiology Today

This week we will hear 2 lectures from the World Congress on ablation in children from two world authorities. In the first, Professor Jeff Kim of Texas Children's Hospital speaks about unusual accessory pathway connections and offers some insights into how to ablate them. Following Dr. Kim, Professor John Papagiannis, chief of cardiology at the Onassis Center in Greece offers us some insights into...

This week we go back in time 2 years ago and 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 William...

This week we review a recent large scale assessment of survival amongst patients with CHD who were born between 1980 and 1997 in the US. What percentage of those born with CHD actually survived to age 35? What were the factors associated with improved or worse outcomes? How did those with HLHS fair in this time period? What was the impact of genetic syndromes or non-cardiac abnormalities on outcom...

This week we review a recent work from the UK on the causes of death in adolescents who die suddenly. The novelty of this week's work is that all the individuals in this very large study had specialized cardiac pathologists perform careful assessments of the hearts of these subjects. What is the most common cardiac cause of SCD in the adolescent and how do the findings of this work compare with pr...

This week we travel back in time 2 years to re-review a work from the team at Boston Children's Hospital on the long term outcomes of truncal valves in the setting of truncus arteriosus. Who amongst truncus patients is at risk for the development of truncal regurgitation or a need for reintervention? Are there predictors that might help forecast patients who should be more closely monitored? How d...

This week we review a recent fascinating work from the team in Toronto on a novel large mammalian model of HLHS (in fetal lambs). How did the team develop this model and what insights into the development of HLHS has it afforded? How does reduction in inflow to the developing LV result in changes in cellular proliferation in the LV of the fetal lamb? Which is more important in the development of H...

This week's episode is a replay from 2019 of a 'co-branded' episode with the SADS Foundation (SADS.ORG) and we speak with the founder and director of Crediblemeds.org , Professor of Medicine Ray Woosley of the University of Arizona. Dr. Woosley speaks with us about how he started the first website dedicated to assessing the evidence for drugs' impact on the QT interval establishing a reliable and...

This week we delve into the world of ACHD when we review a recent important work from the multicenter INDICATOR study group assessing the impact on overall outcomes in TOF patients who have their pulmonary valve replaced. Are survival rates improved by replacement of the pulmonary valve in the TOF patient? What about the effect on ventricular tachycardia? What are the proposed mechanisms by which...

This week we delve into the world of cardiovascular surgery when we check in with the group from Nationwide Children's Hospital and review a novel approach to managing the dreaded LPA stenosis or hypoplasia in the HLHS patient. Why does the LPA seem to be small or stenosed in this condition and how does a preemptive stent address this? Why can't standard PA plasty be used for this particular indic...

This week we delve into the world of electrophysiology and also single ventricle physiology when we review a recent work from the Stanford group on outcomes after the development of ventricular arrhythmias in the single ventricle Fontan patient. Just how worried should the clinician be when these are recorded on ambulatory ECG monitors? What associations exist between these arrhythmias and the use...

In this week's episode, we delve into the world of pediatric heart transplantation and the impact that race or insurance status may have on outcomes. What are the factors that explain worse outcomes for black children waiting for a heart transplant? How is the PHTS Racial Disparity Taskforce working to reduce inequities in this field? What role does insurance status have on these outcomes? We spea...

In this week's first of 2 Pediheart podcast releases, we review the nursing and critical care tracks of the upcoming 8th World Congress of Pediatric Cardiology and Cardiac Surgery coming in late August, 2023. In this collaborative podcast between the Pediheart and PCICS podcasts , hosts Robert Pass, Sadie Rodriguez and Deanna Tzanetos speak with Dr. Amir Ashrafi of CHOC, Bruna Cury of Sao Jose do...

In this week's episode we speak with Assistant Professor of Pediatrics at Mount Sinai, Dr. Jennifer Cohen about a recent large scale Fetal Heart Society project she conducted on the topic of fetal ccTGA and outcomes. What observations in fetal life are associated with worse clinical outcomes? Why is it valuable to perform serial fetal echocardiograms in this patient group? How common are genetic o...

This week's episode is a collaborative episode between the Pediheart and PICS Podcast s and we have 4 guests. Joining us this week are Dr. Carissa Baker-Smith of Nemours Medical Center in Delaware, Dr. Martina Bruekner of Yale University, Dr. Shelby Kutty of Johns Hopkins University and Dr. Jacqueline Sanz of Children's National Hospital. In this week's episode we learn about the general cardiolog...

This week we re-review a 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 work on this to...

In this week's episode from SCAI 2023 , we speak with Professor Kritvikrom Durongpisitikul of Mahidol University, Siriraj Hospital in Bangkok, Thailand about their experience in transcatheter and surgical pulmonary valve replacement (PVR). Who is a candidate for each in the present era? Why was surgery associated with higher mortality rates in this work? Should the criteria for transcatheter PVR d...

In this week's episode from SCAI 2023, Dr. Aimee Armstrong of Nationwide Children's Hospital joins Dr. Pass in a live session from the annual scientific sessions of SCAI . Professor of Pediatrics at UC Davis, Dr. Frank Ing, reviews his experience with recanalization of central veins in a large pediatric cohort. Who is a candidate for this intervention? When are stents preferred vs. angioplasty alo...

In this week’s episode we delve into the evidence for digoxin reducing mortality in the interstage period following Norwood palliation for HLHS. We speak with Assistant Professor of Pediatrics at the University of Pennsylvania, Dr. Michael O’Byrne about a recent analysis of the PHIS database using the relatively novel “preference based instrumental variable” approach to analysis of an observationa...

In this week's episode we review the important topic of troponin levels in children. What is an abnormal high sensitivity troponin level in children and do the levels vary based upon the assay? What are the differences between high sensitivity troponin I and T levels? Are there differences between boys and girls? Why would using the 97.5%ile upper reference limit result in a more reliable 'line in...

This week we delve into a critically important topic which is the mental health of our patients with chronic disease. How common are mental health issues amongst patients with sickle cell disease, cystic fibrosis and congenital heart disease? What accounts for differences in diagnosis or treatment of things like anxiety, depression or ADHD in these different chronic disease state patients? What is...

This week we delve into the world of adult congenital heart disease when we review a recent work from the ACHD team at UCSF that assesses the impact of BMI on clinical outcomes in the single ventricle adult Fontan patient. What is the cause of elevation in BMI in some Fontan patients? Is obesity the only explanation? Is BMI a modifiable risk factor for our Fontan patients and should exercise be 'p...

This week in a replay of a previous co-branded episode with the SADS Foundation (SADS.ORG) from 2.5 years ago, we speak with Professor Peter Schwartz of University of Pavia about a recent work he authored on the topic of changes in repolarization amongst well trained athletes. Can athletic training masquerade as LQTS causing prolongation and/or abnormalities in the QT interval? How can these patie...

In this episode we speak with Professor of Surgery at the University of Pennsylvania, Dr. Stephanie Fuller about a recent work she co-authored on the impressions of CT surgical trainees and attitudes towards the field of congenital heart surgery. What factors were important amongst those surgeons who chose to pursue the field? What are the obstacles that may make it less appealing to the CT surgic...

This week we sit down and speak with living legend of pediatric and congenital cardiology, Dr. Welton Gersony who is Professor Emeritus of Pediatrics at Columbia University. Dr. Gersony was the chief of cardiology for 4 decades at NY Presbyterian Hospital and is the winner of innumerable awards in our field. Today we speak with him about his life, choices and what he loved most about medicine and...

This week we review a recent report that focuses on the question of whether the direct thrombin inhibitor, bivalirudin is superior to heparin for the small patient with a paracorporeal device both from a medical and financial perspective. Bivalirudin is 40x the cost of heparin but does that capture all of the costs and how does overall cost differ between patients treated with one versus the other...