Pediheart: Pediatric Cardiology Today

Latest Episodes:

Pediheart Podcast #184: Assessing The Coronary Microvasculature Of HLHS Patients Through CMR Nov 05, 2021

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This week we review a recent important work from Germany about the coronary perfusion in patients with HLHS and possible relations between this flow and clinical outcomes. What factors are associated with abnormalities in microvascular coronary flow in the HLHS patient? What anatomical substrate is more concerning for these sorts of problems? Are there factors that might be modifiable that could possibly improve outcomes due to coronary microvascular flow problems in the HLHS patient? How practically easy are CMR studies to assess microvascular coronary flow in the HLHS patient? These are amongst the questions posed this week to Professor Carsten Rickers of University Heart and Vascular Center at the University Hospital Hamburg-Eppendorf. DOI: 10.1161/CIRCIMAGING.121.012468

Pediheart Podcast #77 Replay: Risk for Cancer Amongst Those With Congenital Heart Disease Oct 29, 2021

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This week we replay an episode reviewing a large administrative database study from Sweden on risk for cancer amongst patients with CHD. Why are cancer rates different in the CHD patient? What are the most important factors? What actions should be taken by cardiologists caring for ACHD patients in order to properly screen for cancer? We discuss these issues with Assistant Professor of Pediatrics, Harvard Medical School, Dr. Michelle Gurvitz. doi:10.1001/jamanetworkopen.2019.6782

Pediheart Podcast #183: Feasibility of Real Time Myocardial Contrast Echo To Assess Pediatric Cardiac Allograft Vasculopathy Oct 22, 2021

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This week we delve into the world of heart transplantation and echocardiography to review a recent work on non-invasive assessment of the pediatric heart transplant patient. Can stress echo and real time myocardial contrast echo identify coronary vasculopathy in this patient group? How do the results compare to coronary angiography? How difficult is this form of imaging and can it be done by pediatric echo techs and staff physicians? Professor Jonathan N. Johnson of the Mayo Clinic shares his insights this week. DOI: 10.1016/j.echo.2020.12.009

Pediheart Podcast #182: Contemporary Outcomes Of Aortic Arch Reconstruction Oct 15, 2021

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This week we delve into the world of cardiovascular surgery to review a recent work on outcomes of arch reconstruction in the newborn and small child. We speak with Dr. Ramana Dhannapuneni, lead cardiac surgeon of Alder Hey Children's Hospital in Liverpool, UK. How often in the present era is re-operation or reintervention required? How common is the recurrent laryngeal nerve or phrenic nerve injured or affected by surgery? Dr. Dhannapuneni provides us with the surgical perspective to this complex surgery this week. doi: 10.1017/S1047951121003747

Pediheart Podcast #181: Delirium In The Pediatric Postoperative Cardiac Patient Oct 08, 2021

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This week we enter the world of cardiac critical care to discuss delirium in the postoperative pediatric cardiac patient. We speak with nursing scientist, Professor Sandra Staveski of UCSF about a recent large multicenter study she conducted on this topic. How prevalent is this problem and why is it an important morbidity to tackle and reduce? How can nursing interventions reduce this problem and how can the ICU team working together identify and manage this problem? Dr. Staveski shares her deep nursing and critical care knowledge with us this week. DOI: 10.1097/PCC.0000000000002591

Pediheart Podcast #180: Fetal and Neonatal Findings Associated With Neonatal Permanent Pacing In Antibody-Mediated CCHB Oct 01, 2021

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This week we review a recent report from the team at Children's Hospital of Los Angeles about prenatal and neonatal factors that might help predict the need for newborn permanent pacing in the setting of antibody-associated CCHB. We speak with Assistant Professor of Pediatrics at Mount Sinai, Dr. Justin Pick about this work. How important is third trimester fetal heart rate in predicting possible need for early pacing? Dr. Pick provides many insights this week. doi: 10.1007/s00246-021-02723

Pediheart Podcast #179: Bivalirudin Use For Pediatric Ventricular Assist Devices Sep 24, 2021

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This week we review a recent 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 #81 Repeat: A Standardized Protocol To Improve Junior Cardiology Fellow Echo Function Assessment Sep 17, 2021

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This week we enter the worlds of fellow education and echocardiography to review a recent report of a QI project performed at Children's Hospital of Philadelphia regarding the performance of echocardiograms by first year fellows in cardiology. Can the implementation of a checklist protocol improve the consistency of echocardiograms performed by fellows? What was the impact of this protocol? What areas were particularly well served by this approach? Dr. Brian White, senior cardiology fellow at CHOP provides important insights into this project that he co-authored. doi: 10.1111/echo.14441

Pediheart Podcast #178: Outcomes Of Pregnancy For the DTGA/Arterial Switch Patient Sep 10, 2021

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This week we delve into the world of ACHD when we review a recent large data evaluation from the team at Erasmus University in the Netherlands regarding outcomes of DTGA/Arterial Switch patients who have gone through pregnancy. How do these patients fare in general? What sort of pre-pregnancy evaluation should these patients have? Where should their offspring be delivered? Is a maternal fetal medicine expert required for all? Do all DTGA/Switch patients require tertiary care centers? Dr. Karishma Ramlakhan, PhD candidate at Erasmus University shares her deep insights this week. doi: 10.1161/JAHA.120.018176

Pediheart Podcast #177: Clinical Outcome Disparities Among Black Children With Kawasaki Disease Sep 03, 2021

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This week we review a recent work from the team at University of Alabama in Birmingham about clinical outcome disparities amongst Black children with Kawasaki disease. What differences exist in outcomes between these groups and are these differences social or biological in origin? We speak with one of the authors of this work, Assistant Professor of Pediatrics Leslie Collins about this important work. doi: 10.1016/j.jpeds.2020.09.052

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