Pediheart: Pediatric Cardiology Today

This week we explore both fetal cardiology and cardiovascular surgery. The first work reviews a fascinating case report of fetal treatment of cardiac rhabdomyomas in the setting of hydrops fetalis. The second reviews a recent report on LV retraining prior to attempted double-switch operations in LTGA and DTGA. Can one accurately predict 'retrainability' of the LV? Can life threatening rhabdomyomas be treated in fetal life? These are amongst the questions answered this week. Articles: DOI: 10.1056/NEJMc1800352; DOI: 10.1016/j.athoracsur.2017.11.047

This week we explore both fetal cardiology and cardiovascular surgery. The first work reviews a fascinating case report of fetal treatment of cardiac rhabdomyomas in the setting of hydrops fetalis. The second reviews a recent report on LV retraining prior to attempted double-switch operations in LTGA and DTGA. Can one accurately predict 'retrainability' of the LV? Can life threatening rhabdomyomas be treated in fetal life? These are amongst the questions answered this week. Articles: DOI: 10.1056/NEJMc1800352; DOI: 10.1016/j.athoracsur.2017.11.047

This week we explore the notion of pulmonary valve function preservation at the time of TOF/PS repair with Dr. Ram Emani, Associate Professor of Surgery at Harvard Medical School/Boston Children's Hospital. Dr. Emani shares his insights from recent work he and colleagues have performed using a novel intraoperative balloon dilation approach. Can TOF/PS repair be performed without creating significant degrees of pulmonary valve regurgitation? We learn the answers this week.

This week we explore the notion of pulmonary valve function preservation at the time of TOF/PS repair with Dr. Ram Emani, Associate Professor of Surgery at Harvard Medical School/Boston Children's Hospital. Dr. Emani shares his insights from recent work he and colleagues have performed using a novel intraoperative balloon dilation approach. Can TOF/PS repair be performed without creating significant degrees of pulmonary valve regurgitation? We learn the answers this week.

This week we discuss 2 papers on different areas of congenital cardiology. The first is a recent Brazilian report on Zika Virus Syndrome and associations with congenital heart disease. The second is a recent report by the team at Children's Hospital of Philadelphia on exposure to plastic neurotoxicants found in many common medical devices. Do these plastic substances have an impact on neurodevelopmental outcomes? Dr. William Gaynor of CHOP speaks with us about this very important and somewhat troubling work.

This week we discuss 2 papers on different areas of congenital cardiology. The first is a recent Brazilian report on Zika Virus Syndrome and associations with congenital heart disease. The second is a recent report by the team at Children's Hospital of Philadelphia on exposure to plastic neurotoxicants found in many common medical devices. Do these plastic substances have an impact on neurodevelopmental outcomes? Dr. William Gaynor of CHOP speaks with us about this very important and somewhat troubling work.

This week we review a very recent work on long term (14 years!) outcomes of children with hypertrophic cardiomyopathy in Australia and speak with its author, Professor Robert Weintraub of Royal Children's Hospital in Melbourne. Dr. Weintraub explains the data in his work for us and what he considers to be important risk factors for poor outcomes. He also shares some thoughts on how he thinks about who might be a candidate for primary ICD prophylaxis in the young HCM population.

This week we review a very recent work on long term (14 years!) outcomes of children with hypertrophic cardiomyopathy in Australia and speak with its author, Professor Robert Weintraub of Royal Children's Hospital in Melbourne. Dr. Weintraub explains the data in his work for us and what he considers to be important risk factors for poor outcomes. He also shares some thoughts on how he thinks about who might be a candidate for primary ICD prophylaxis in the young HCM population.

This week we explore 2 unrelated but possibly 'game changing' papers. First we delve into a very recent report on a novel intranasal therapy for acute termination of SVT. Then we review a recent report from the Boston Adult Congenital Heart Program (BACH) on a potential role for inflammation as a possible cause for poor outcomes in ACHD patients. Can inflammatory markers predict poor outcomes in ACHD patients as they do in non ACHD adult patients? Dr. Alexander Opotowsky, Associate Professor of Pediatrics at Harvard Medical School shares his insights into this very unusual and novel concept in the world of ACHD.

This week we explore 2 unrelated but possibly 'game changing' papers. First we delve into a very recent report on a novel intranasal therapy for acute termination of SVT. Then we review a recent report from the Boston Adult Congenital Heart Program (BACH) on a potential role for inflammation as a possible cause for poor outcomes in ACHD patients. Can inflammatory markers predict poor outcomes in ACHD patients as they do in non ACHD adult patients? Dr. Alexander Opotowsky, Associate Professor of Pediatrics at Harvard Medical School shares his insights into this very unusual and novel concept in the world of ACHD.

This week we delve into the world of novel means for epicardial pacing and defibrillation in small children or those with congenital heart disease. Dr. Bradley Clark of The Children's Hospital at Montefiore and Dr. Yaniv Bar-Cohen of Children's Hospital of LA discuss their recent works on developing minimally invasive epicardial pacing and defibrillation in infants and those with congenital heart disease. The ability to provide epicardial pacing or defibrillation without the need for a surgical incision is exciting and both experts speak of the challenges and future of this important work.

This week we delve into the world of novel means for epicardial pacing and defibrillation in small children or those with congenital heart disease. Dr. Bradley Clark of The Children's Hospital at Montefiore and Dr. Yaniv Bar-Cohen of Children's Hospital of LA discuss their recent works on developing minimally invasive epicardial pacing and defibrillation in infants and those with congenital heart disease. The ability to provide epicardial pacing or defibrillation without the need for a surgical incision is exciting and both experts speak of the challenges and future of this important work.

This week we replay the 2nd podcast in the series. Dr. George Ofori of Montefiore reviews a recent paper on a project in Angola to provide outstanding congenital cardiovascular care in that nation and the challenges associated with these sorts of projects and we also review an extraordinary report of non-invasive ablation of severe ventricular arrhythmias using radiation. Can arrhythmias be ablated successfully without even placing a catheter in the heart? This recent article from The New England Journal suggests that this may be an exciting paradigm shift in electrophysiology. We will be back with a new podcast next week!

This week we replay the 2nd podcast in the series. Dr. George Ofori of Montefiore reviews a recent paper on a project in Angola to provide outstanding congenital cardiovascular care in that nation and the challenges associated with these sorts of projects and we also review an extraordinary report of non-invasive ablation of severe ventricular arrhythmias using radiation. Can arrhythmias be ablated successfully without even placing a catheter in the heart? This recent article from The New England Journal suggests that this may be an exciting paradigm shift in electrophysiology. We will be back with a new podcast next week!

In this landmark 25th episode of the podcast we delve into the world of echocardiography with one of the masters of this field, Dr. Shubhika Srivastava of Mt. Sinai Medical Center in NYC to discuss a recent paper by her team on 'twisting' and 'untwisting' abnormalities in repaired tetralogy patients. Who is at risk for these problems? What do these findings mean? Can they help inform decisions regarding surgery or follow-up? Dr. Srivastava helps us understand this somewhat complex topic on the podcast this week!