Pediheart: Pediatric Cardiology Today

Latest Episodes:

Pediheart Podcast #277: Can Anti-Coagulation Be Continued For Children Undergoing Cardiac Catheterization? Dec 08, 2023

Show notes

In this week's episode we delve into the world of cardiac catheterization and speak with Assistant Professor of Pediatrics at USC, Dr. Neil Patel about a recent work he co-authored at Children's LA about continuation of anti-coagulation during catheterization. Does AC have to be stopped to safely perform a catheterization? Are there certain cases or patients in whom the risk may be especially high? What about NOACs or DOACs? When should closure devices be considered? These are amongst the questions posed to Dr. Patel this week.

DOI: 10.1007/s00246-023-03097-x

Pediheart Podcast #276: Postoperative Ectopic Atrial Tachycardia Following Congenital Heart Surgery Dec 01, 2023

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This week we review a recent work on postoperative ectopic atrial tachycardia (EAT) following congenital heart surgery in children. Are there risk factors for this arrhythmia and are any modifiable? What is the 'go to' therapy used by the electrophysiologists at Children's LA for the acute and chronic treatment of this arrhythmia in the postoperative period? Is the presence of EAT in a postoperative congenital heart patient a marker for a worse outcome? These are amongst the questions posed to Children's of Los Angeles pediatric electrophysiologist, Dr. Jonathan Uniat.

DOI: 10.1007/s00246-022-03068-8

Pediheart Podcast #275: Single Ventricle Reconstruction Trial At 12 Years: Long Term Follow-Up Nov 24, 2023

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This week we review the results of the latest update of the Single Ventricle Reconstruction trial, specifically SVR III. How are HLHS patients are faring post Norwood at age 12? What is the overall transplant-free survival rate in this group? Are there differences in survival seen at 12 years between BTTT shunt patients and RV-PA conduit shunt patients? How do they compare in exercise capabilities? What about rates of PLE or arrhythmias seen? Are there interventions that may improve outcomes going forward? These are amongst the questions reviewed this week with the first author, Dr. Caren Goldberg who is Professor of Pediatrics at the University of Michigan.
DOI: https://doi.org/10.1161/circulationaha.123.065192

Pediheart Podcast #274: Bringing Humanity To Healthcare With NYT Author and CHD Parent James G. Robinson Nov 17, 2023

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This week's special episode of Pediheart is a conversation with NYT author James G. Robinson. Mr. Robinson recently released his memoir More Than We Expected: Five Years With A Remarkable Child (Post Hill Press) which reviews the life and times of the Robinson family and their son Nadav who was born with complex single ventricle disease in the setting of heterotaxy syndrome. Nadav lost his life at age 5 but was a blessing to his family and those who knew him. What were some of the characteristics of the better medical communicators that the Robinson's observed? How can parents better advocate for their children during times of critical illness? How can we all bring the 'simple power of human kindness' to our care of children with congenital heart disease? Why is the opinion of the parent so important in delivering optimal care to a child with serious disease? These are amongst the many lessons we take away from Mr. Robinson's book and our conversation this week.
More Than We Expected: Five Years With A Remarkable Child is available on Amazon:
www.amazon.com/More-Than-We-Expected-Remarkable/dp/1637588224
For those interested in learning more about the book, please visit the book's website:
http://morethanamemoir.com/
Finally, for those interested in communicating with Mr. Robinson, he can be reached at:
https://morethanamemoir.com/contact/

Pediheart Podcast #273: Can Nasal Intubation Of Newborns Undergoing CHD Surgery Improve Postoperative Oral Feeding? Nov 10, 2023

Show notes

This week we delve into the worlds of cardiac critical care and congenital heart surgery when we review a recent report of a randomized controlled trial assessing the impact of nasal intubation on rates of NG or G tube feeds at discharge following neonatal congenital heart surgery. Do nasally intubated patients eat by mouth faster and have shorter lengths of stay? What would be the theoretical reasons that this might be useful? What is an 'ICU Liberation bundle' and how did its application to all postop newborns improve outcomes? Can the route of tracheal intubation truly be viewed as a possible 'modifiable risk factor'? These are amongst the questions posed to cardiology fellow at the Cleveland Clinic, Dr. Melissa Yildirim who conducted this study at the University of Virginia during pediatric critical care fellowship.
doi: 10.1007/s00246-023-03322-7

Pediheart Podcast #272: Safety Of MRI In Pediatric And ACHD CIED Patients Nov 03, 2023

Show notes

This week's episode is co-branded with SADS.ORG and is a review of a recent multicenter PACES study on the general outcomes of patients with congenital heart disease who have undergone MRI's. Just how worried should the practitioner be to send a pacemaker or ICD patient for an MRI of any body part? Is there a period of time after implantation when it is safer to proceed with an MRI? What is meant by an MRI conditional device or lead? Does the part of the body imaged matter in regards to risk to CIED's? These are just some of the questions posed to the senior author of this week's work, Dr. Thomas Pilcher of Primary Children's Hospital in Salt Lake City, Utah.
doi: 10.1016/j.hrthm.2023.08.034
For those interested to learn more about the SADS Foundation, please visit their website:
SADS.ORG

Pediheart Podcast #271: A Conversation With Dr. Jane Newburger Oct 27, 2023

Show notes

In this week's episode we sit down with Professor Jane Newburger of Harvard University to learn a little bit about her life and times. Where did she grow up and who was her inspiration for becoming a doctor and cardiologist? Who were some of the mentors in her professional life? What was it like to work with Dr. Ami Rosenthal or Dr. Alexander Nadas? After such a rich and impactful career and life, what does Dr. Newburger count as her most satisfying and important accomplishments? These are amongst the many questions posed to Dr. Newburger during a live interview from the New England Congenital Cardiology Association (NECCA) in Rockport, Maine that took place on 10.21.23. Also joining the podcast to discuss the organization and its goals and accomplishments is its immediate past president, pediatric cardiac electrophysiologist, Dr. Michael Epstein.
For those interested to learn more about NECCA, please go to their website:
https://necca.wildapricot.org

Pediheart Podcast Replay of #179: Bivalirudin Use For Pediatric Ventricular Assist Devices Oct 20, 2023

Show notes

In this replay episode of 2021, week we review a work on the use of bivalirudin on outcomes of pediatric VAD patients. We speak with Dr. Caroline Carly Heyrend of Primary Children's Hospital in Utah about a recent work she co-authored on time in therapeutic range for this agent in children with VAD's. How does bivalirudin work differently than heparin and what are the theoretical benefits or disadvantages of this agent in comparison with unfractionated heparin? Why are thrombotic complications still common amongst those with pediatric VAD's even when anticoagulation is maintained appropriately? What are the factors at work that make safe anticoagulation so difficult in this complex and fragile group of patients? Dr. Heyrend provides the pharmacist's perspective this week.
DOI: 10.1097/MAT.0000000000001261

Pediheart Podcast #270: Hybrid Palliation For Critical Left Heart Obstructive Disease - Outcomes Oct 13, 2023

Show notes

This week we delve into cardiovascular surgery when we review a recent report from the Congenital Surgeons' Society on the outcomes of the hybrid approach of pulmonary artery bands for treatment of infants with critical left heart obstructive disease. What risk factors are associated with worse outcomes? Does this approach confer an advantage in comparison to the traditional 'stage I/Norwood' approach to this problem? Does the presence of multiple risk factors worsen outcomes and if so, to what degree? How does the heterogeneity of indications for this approach to obstructive left heart lesions stymie efforts to study this intervention?

DOI: 10.1016/j.jacc.2023.07.020

Editorial Comment :

DOI: 10.1016/j.jacc.2023.08.023

Pediheart Podcast #269: Role Of The Stress Echo In The Monitoring Of The Kawasaki Disease Patient Oct 06, 2023

Show notes

This week we discuss the role of the stress echo in the evaluation and follow-up of the patient with Kawasaki disease. What are the present recommendations on the role of this form of imaging in this patient group? What are its benefits and limitations? Can this form of testing provide actionable data beyond imaging such as CT angiography? What is the possible role of CMR in the management and follow-up of the KD patient? Dr. Kirstin Dummer of Rady Children's Hospital shares her deep insights into this endlessly fascinating topic.

DOI: 10.1007/s00246-022-03037-1

The AHA Scientific Statement On KD:

DOI: 10.1161/CIR.0000000000000484

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