Pediheart: Pediatric Cardiology Today

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...

This week we delve into the world machine learning and decision tree analysis modeling as it is applied to postoperative heart block decisions. Traditional thinking suggests that all congenital heart surgical patients with postoperative heart block should be observed for 7-10 days to allow for possible resolution of conduction block. However, is 7 days truly required in all cases? Are there patien...

This week's episode of the podcast is supported by the SADS Foundation (SADS.ORG) and is on the topic of the overdiagnosis of LQTS. What sorts of conditions can lengthen the QT interval without true congenital LQTS syndrome? What are the most common errors of ECG interpretation that account for misdiagnosis of this condition and are there leads of the ECG that might help or hurt when attempting to...

In this replay episode from 2021, 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 revie...

This week we review a recent report of a new technique to implant SAPIEN valves for transcatheter pulmonary valve replacement in which 1-3 stents are implanted simultaneously with the SAPIEN valve. What are the potential benefits or disadvantages of this approach and who might be a better candidate for this method? Why is a stent needed outside of the relatively strong SAPIEN prosthesis and how do...

This week we delve into the world of adult congenital heart disease when we review a recent research letter from the team at the Harvard Congenital Heart Program about venous insufficiency in the Fontan patient. Why do patients with Fontan circulation develop chronic venous insufficiency and what are the implications of this problem in the Fontan patient? What sort of evaluation should be performe...

In this week's special episode that is a combination of the Pediheart Podcast and PCICS Podcast, we speak for the entire episode with Professor of Pediatrics Dr. Gil Wernovsky of Children's National. Dr. Wernovsky is the Co-Chair of the upcoming World Congress of Pediatric Cardiology and Cardiac Surgery and shares with us all of the exciting plans for this 'meeting of meetings' that will be staged...

This week we delve into the world of electrophysiology when we review a recent multicenter work on the rare topic of atrial standstill. What is atrial standstill and how does it differ from SA node dysfunction? What risks are associated with this condition and how can they be mitigated? Are there factors in an atrial standstill patient that might prompt implantation of a primary prevention ICD? We...

This week we delve into the world of neonatal congenital heart surgery and review a recent work on changes in the incidence of brain injury following congenital heart surgery. How common is it to see brain injury on the MRI's in this patient group? How have incidences changed over time and what is the likely reason for this? Can the types of inotropic agents used in the postoperative period potent...

This week we delve into the world of ACHD when we review a recent work on outcomes of non-cardiac surgery in the ACHD patient. How do ACHD patients fare in comparison to their non-ACHD cohort undergoing non-cardiac surgery? What can be done to improve outcomes in this patient group? We speak with the senior author of this work, Dr. Peyman Benharash, who is Associate Professor of Surgery at UCLA. D...

This week we replay a 2020 episode in which we reviewed a then recent PCCC study assessing outcomes of single ventricle patients who have undergone replacement of the AV or semilunar valve. We speak with Professor Geetha Raghuveer of University of Missouri-Kansas City about this work she co-authored. Outcomes are generally poor in this patient group but are there lessons that can be gleaned from t...

This week we return to the topic of congenital heart surgery when we speak with Dr. John Iguidbashian who is a resident in surgery at U. Colorado. Dr. Iguidbashian reviews a recent paper he co-authored on the topic of the relation of duration of open chest following heart surgery to the development of surgical site infections (SSI). How long is 'too long' when it comes to an open chest and the ris...

This week we delve into the world of partial heart transplantation when we review a recent paper that discusses the rationale for its potential use in children, particularly in infants. We speak with the work's senior author, Dr. T. Konrad Rajab of the Medical University of South Carolina about the potential benefits of this approach. Who might be a candidate for this approach? What are the theore...