Pediheart: Pediatric Cardiology Today

This week we replay one of the most listened to episodes of the early part of this podcast history - episode 21 with Dr. Anthony Rossi. Professor Rossi is the Director of Pediatric Cardiology at Nicklaus Children's Hospital in Miami, Florida and is one of the leaders and pioneers in the field of pediatric cardiac critical care. We sit down with Dr. Rossi to review his approach to the assessment and management of the single ventricle patient following stage I palliation. The clinical 'pearls' come fast and furiously from Dr. Rossi - this is one to have pen and paper available to take notes! An inspiring figure to usher out the month of May!

This week we replay one of the most listened to episodes of the early part of this podcast history - episode 21 with Dr. Anthony Rossi. Professor Rossi is the Director of Pediatric Cardiology at Nicklaus Children's Hospital in Miami, Florida and is one of the leaders and pioneers in the field of pediatric cardiac critical care. We sit down with Dr. Rossi to review his approach to the assessment and management of the single ventricle patient following stage I palliation. The clinical 'pearls' come fast and furiously from Dr. Rossi - this is one to have pen and paper available to take notes! An inspiring figure to usher out the month of May!

This week we enter the world of cardiovascular anesthesiology to review a recent work from Duke University on the results of the use of IV methadone during cardiac surgery in children. Does this agent result in reductions in postoperative opioid usage while affording similar analgesia? What are the advantages of this agent in this setting? How much should the cardiologist worry about the impact of methadone on the QT interval? We speak with the first author of this work, Assistant Professor of Anesthesiology at UNC, Dr. Annika Barnett. doi: 10.1111/pan.13903

This week we enter the world of cardiovascular anesthesiology to review a recent work from Duke University on the results of the use of IV methadone during cardiac surgery in children. Does this agent result in reductions in postoperative opioid usage while affording similar analgesia? What are the advantages of this agent in this setting? How much should the cardiologist worry about the impact of methadone on the QT interval? We speak with the first author of this work, Assistant Professor of Anesthesiology at UNC, Dr. Annika Barnett. doi: 10.1111/pan.13903

This week we enter into the worlds of fetal cardiology and preventative cardiology to review a recent work from Professor Paul Leeson of Oxford University on the topic of pregnancy induced hypertension and the impact this plays on the cardiovascular health of the offspring. How does this form of HTN affect the structure of the RV and LV in the offspring and why might this explain the increased rates of adult HTN in the offspring of women who were hypertensive during pregnancy? Dr. Leeson provides many interesting insights and context this week. doi: 10.1161/JAHA.119.014586

This week we enter into the worlds of fetal cardiology and preventative cardiology to review a recent work from Professor Paul Leeson of Oxford University on the topic of pregnancy induced hypertension and the impact this plays on the cardiovascular health of the offspring. How does this form of HTN affect the structure of the RV and LV in the offspring and why might this explain the increased rates of adult HTN in the offspring of women who were hypertensive during pregnancy? Dr. Leeson provides many interesting insights and context this week. doi: 10.1161/JAHA.119.014586

This week we review a recent work from the team at Mercy Children's on the variability of sheath outer diameter (OD) amongst various sheaths. Can novel 4Fr adult radial sheaths have similar OD to more standard 3.3Fr pediatric sheaths? What are the trade-offs in using a radial sheath for this indication in a newborn? Senior author Dr. Abhay Divekar of Rocky Mountain Pediatric Cardiology shares his insights this week. doi: 10.1002/ccd.28825

This week we review a recent work from the team at Mercy Children's on the variability of sheath outer diameter (OD) amongst various sheaths. Can novel 4Fr adult radial sheaths have similar OD to more standard 3.3Fr pediatric sheaths? What are the trade-offs in using a radial sheath for this indication in a newborn? Senior author Dr. Abhay Divekar of Rocky Mountain Pediatric Cardiology shares his insights this week. doi: 10.1002/ccd.28825

On this episode we speak with Professor Edward Walsh of Harvard University about a recent work he co-authored on Ebstein's anomaly. Can review of pathological specimens offer some insights into why ablations in this patient group are so challenging? Is there an optimal age or size to perform an ablation in this patient group? Why are these ablations so difficult? Dr. Walsh, Director of the Arrhythmia Service at Boston Children's Hospital, shares his deep insights this week. doi: 10.1016/j.hrthm.2020.01.013

On this episode we speak with Professor Edward Walsh of Harvard University about a recent work he co-authored on Ebstein's anomaly. Can review of pathological specimens offer some insights into why ablations in this patient group are so challenging? Is there an optimal age or size to perform an ablation in this patient group? Why are these ablations so difficult? Dr. Walsh, Director of the Arrhythmia Service at Boston Children's Hospital, shares his deep insights this week. doi: 10.1016/j.hrthm.2020.01.013

This week we delve into the world of cardiomyopathy and also stress echo to review a recent work from the team at Boston Children's on stress echo and its role in the assessment of the pediatric HCM patient. We speak with Assistant Professor of Pediatrics Ming Hui Chen of Harvard University about a recent work she co-authored on this modality in children with HCM. Are changes in the LVOT gradient with exercise associated with differences in medium term outcome? Dr. Chen provides the answers this week. doi: 10.1016/j.echo.2020.01.020

This week we delve into the world of cardiomyopathy and also stress echo to review a recent work from the team at Boston Children's on stress echo and its role in the assessment of the pediatric HCM patient. We speak with Assistant Professor of Pediatrics Ming Hui Chen of Harvard University about a recent work she co-authored on this modality in children with HCM. Are changes in the LVOT gradient with exercise associated with differences in medium term outcome? Dr. Chen provides the answers this week. doi: 10.1016/j.echo.2020.01.020

This week's episode, co-branded with SADS.ORG, reviews a recent guideline paper by the Mayo Clinic on how to improve the safety of potential COVID-19 therapies such as azithromycin or hydroxychloroquine. These agents can both prolong the QT interval and enhance the risk for torsades making the development of a simple protocol to prevent possible life threatening cardiac side effects critical, particularly in an era before there is strong scientific evidence of efficacy of these agents when used for this indication. Dr. Ackerman shares with us his thoughts on a brief protocol he devised with his colleagues to identify 'at risk' individuals and shares his thoughts on how to thoughtfully consider the risks of these agents when considering their use for COVID-19 therapy. A timely episode with one of the world's greatest authorities on the QT interval in Professor Ackerman. Dr. Ackerman's algorithm is located at https://cdn.prod-carehubs.net/n1/802899ec472ea3d8/uploads/2020/03/2020-COVID-QTc-Algorithm-Internal-and-Media.pdf and the website he mentioned regarding a novel QT calculator for COVID patients is located at: https://www.covidqtc.com .

This week's episode, co-branded with SADS.ORG, reviews a recent guideline paper by the Mayo Clinic on how to improve the safety of potential COVID-19 therapies such as azithromycin or hydroxychloroquine. These agents can both prolong the QT interval and enhance the risk for torsades making the development of a simple protocol to prevent possible life threatening cardiac side effects critical, particularly in an era before there is strong scientific evidence of efficacy of these agents when used for this indication. Dr. Ackerman shares with us his thoughts on a brief protocol he devised with his colleagues to identify 'at risk' individuals and shares his thoughts on how to thoughtfully consider the risks of these agents when considering their use for COVID-19 therapy. A timely episode with one of the world's greatest authorities on the QT interval in Professor Ackerman. Dr. Ackerman's algorithm is located at https://cdn.prod-carehubs.net/n1/802899ec472ea3d8/uploads/2020/03/2020-COVID-QTc-Algorithm-Internal-and-Media.pdf and the website he mentioned regarding a novel QT calculator for COVID patients is located at: https://www.covidqtc.com .

This week we speak with Professor Candice Silversides of U. Toronto about a recent work she co-authored on the topic of serious cardiac events for women with heart disease. How common are serious cardiac events encountered and what percentage of these are preventable? What is the optimal team for the pregnant patient with heart disease? What are the components of a pre-pregnancy cardiac evaluation? Dr. Silversides provides many insights this week. doi: 10.1016/j.jacc.2020.01.039