Pediheart: Pediatric Cardiology Today

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 as well as motherhood. This is an inspirational story by an inspirational figure from whom we all can learn much.

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 reliable? We have 2 noted experts on this topic - Professor Michael Silka of USC and Professor Steven Fishberger of Spokane, Washington and U. Miami. This is a rare opportunity to hear 2 'gurus' on pediatric electrophysiology 'riff' on a topic about which they each have encyclopedic knowledge. https://doi.org/10.1017/s1047951121000056

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 Professor Pedro DelNido of Harvard University. This is a rare opportunity to speak with one of the finest congenital heart surgeons in the world today and a noted expert on the cone repair. doi: 10.1016/j.jtcvs.2020.10.124

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 for these dilations? Professor Chaturvedi provides all the answers and more this week! doi: 10.1161/CIRCINTERVENTIONS.120.008938

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 patients are candidates for this novel approach? This is a rare opportunity to have the author present their own data followed by questions from Dr. Pass and Dr. Aimee Armstrong of Nationwide Children's Hospital. https://doi.org/10.1016/j.jacc.2019.12.070

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 life? How did Dr. Mullins design the 'Mullins sheath'? These are amongst the many topics we touch upon in this 'slice of life' conversation that was recorded today from the 2021 Scientific Sessions of SCAI which continues through May 1, 2021!

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 the OR versus the ICU? These are amongst the questions we address with Professor Jane Newburger of Harvard University - Boston Children's Hospital this week! doi: 10.1161/CIRCULATIONAHA.118.037495

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 patients such as sickle cell disease or cystic fibrosis? Were all ACHD patients affected similarly from the advent of the ACA? We speak with U. of Michigan ACHD fellow Dr. Katherine Salciccioli about this important work from the group at Texas Children's Hospital. doi: 10.1002/bdr2.1878

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 than the general population? What are the challenges to their implantation and what is coming down the pipeline in terms of innovation with these devices? Dr. von Alvensleben shares his insights this week. doi: 10.1016/j.jacep.2020.07.010

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 Heart Center to share with us information about the upcoming Mount Sinai Hot Topics In Fetal Cardiology Conference on May 1. Information can be found at: https://mssm.cloud-cme.com/course/courseoverview?P=3000&EID=4460

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 recent work and also briefly discuss the PICS Society for pediatric and adult interventional cardiologists with Dr. Hijazi and Dr. Damien Kenny. doi: 10.1007/s00246-020-02418-8

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 knowledge in a roundtable discussion this week. DOI: 10.1016/j.amjcard.2020.07.012

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? What training is needed to do this and how does the neonatal team collaborate with cardiology to provide optimal neonatal physiological support and care? We speak with 2 experts to get the perspective of the neonatologist and cardiologist. Senior author and neonatologist Professor Patrick McNamara of University of Iowa and noted cardiac imaging expert, Professor Leo Lopez of Stanford University share their deep insights this week. doi: 10.1016/j.echo.2020.11.005

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 ways to make the use of warfarin more safe? What about novel anticoagulants - what is their possible role and what evidence exists for their use in this setting? Dr. Attard provides many key 'takeaways' this week! doi: 10.1016/j.jtcvs.2020.12.102

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 publication. doi: 10.1016/j.jtcvs.2020.10.149