Pediheart: Pediatric Cardiology Today

Latest Episodes:

Pediheart Podcast # 56: Balloon Angioplasty And Stenting for Unilateral PA Stenosis - Impact On Formal Exercise Testing Results Feb 22, 2019

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This week we discuss the rationale for intervening for unilateral proximal PA stenosis with a stent or angioplasty. In the setting of normal RV function or pressure, are there exercise data to support intervening and if so, at what degree of maldistribution should such an intervention be considered? How should this decision be made? Is this safe? We review these and other questions with the first author of this work, Gurumurthy Hiremath MD who is the director of the pediatric catheterization laboratory at the University of Minnesota. doi: 10.1016/j.jcin.2018.11.042

Pediheart Podcast #55: Extended Ambulatory ECG Monitoring In The ACHD Patient Feb 15, 2019

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This week we review a recent paper on the topic of extended ambulatory ECG monitoring in the ACHD patient. Does this form of monitoring provide benefit versus a more traditional 24 or 48 hour "Holter" monitor? How commonly were arrhythmias in ACHD patients found after 48 hours and how commonly were changes made to management based upon these findings? We discuss these issues and more with the senior author of this work, Dr. Scott R. Ceresnak, Associate Professor of Pediatrics - Stanford University. doi: 10.1111/chd.12736

Pediheart Podcast #54: Sildenafil Use In Children With Pulmonary Hypertension Feb 08, 2019

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This week we review the topic of pulmonary hypertension and specifically the use of sildenafil for treatment of this difficult problem. Is this agent safe in children? How commonly does it need to be discontinued for side effects? Is it effective? Do patients ever improve to a degree that it can be discontinued? We review all of these questions and more with Dr. Jennifer Cohen who wrote this work while a general cardiology fellow at Columbia University but is now the Advanced Non-Invasive Imaging Fellow at The Icahn School of Medicine at Mount Sinai - NYC. doi: 10.1016/j.jpeds.2018.09.067

Pediheart Podcast #53: Psychological Interventions For Patients with Childhood-Onset Cardiovascular Disease Feb 01, 2019

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This week we speak with Associate Professor of Medical Psychology at UNSW, Nadine Kasparian about a recent publication regarding evidence for efficacy for various forms of psychological therapy in the setting of childhood-onset heart disease. What do we know about the efficacy of interventions for this fragile population of congenital heart disease patients? How prevalent are psychological problems amongst patients and patient families with childhood onset heart disease? What approaches work best? Dr. Kasparian points to the future in regards to what is needed going forward to advance our knowledge of this critically important problem affecting pediatric and adult congenital heart disease patients. doi: 10.1037/hea0000704

Pediheart Podcast # 52: Artificial Intelligence - Cardiologist-Level Interpretation of ECG Rhythm Jan 25, 2019

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This week we go back to the world of artificial intelligence and review a recent work from Stanford University on the use of deep neural networks to interpret ECG rhythms. How good did a novel algorithm do in comparison to cardiologists in characterization of rhythm abnormalities? What are some novel uses of AI in medicine today and how can AI potentially identify signs of disease that even human scientists are unable to discern? We discuss these interesting questions and many others with Pranav Rajpurkar who is a PhD candidate in computer science at Stanford University and a co-author of this week's important work that we review. doi: 10.1038/s41591-018-0268-3.

Pediheart Podcast # 51: CINE Magnetic Resonance Imaging to Visualize Fetal Congenital Heart Disease Jan 18, 2019

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This week we delve into the world of fetal cardiology to review a recent work comparing fetal MRI to fetal echo. How did this relatively new technology application fair in comparison to more traditional echocardiography? What role might this technology have in the assessment of congenital heart disease in the fetus? We explore these questions and others with fetal cardiology expert, Professor Lisa Hornberger of the University of Alberta - Stollery Children's Hospital. Dr. Hornberger also discusses how she personally uses CMR in her own fetal practice. doi: 10.1161/CIRCIMAGING.118.007745

Pediheart Podcast #50: Contrast Induced Acute Kidney Injury In The ACHD Patient Jan 11, 2019

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This week we review a recent work on contrast induced acute kidney injury in the ACHD patient undergoing catheterization. Are there data to suggest what a safe volume of dye might be in this population of patients? Does the renal response to contrast suggest something about the general health of the patient? How does the team in Boston plan catheterizations in the adult congenital population to minimize contrast usage? We review these questions and others with the first author of this work, Dr. Laura Gellis, who is a senior clinical fellow in cardiology in the Department of Cardiology, Boston Children's Hospital - Harvard Medical School. doi: 10.1002/ccd.27798.

Pediheart Podcast 49: Surveillance of the Fontan Patient + Novel Ventilation Approaches for the Fontan Patient Jan 04, 2019

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This week we review the Fontan and long term issues of surveillance and Fontan failure with 2 articles. The first is a large survey study reviewing practice patterns amongst large Fontan clinics in the US. We review this interesting topic of optimal assessment of the Fontan with Dr. Mike DiMaria who is first author of this recent work and also Associate Professor University of Colorado. We then review a case report on biphasic curaiss ventilation for the treatment of Fontan associated PLE and plastic bronchitis with first author Professor Seigo Okada from Kyushu Hospital in Japan and also with Dr. Pradeep Charla who is the director of the adult congenital heart program at University Hospitals and Rainbow Babies Hospital. Both Dr. Okada and Dr. Charla have extensive experience with this form of 'iron lung' therapy in the setting of a Fontan and share this experience with us all. doi: 10.1007/s00246-018-1966-9 and doi: 10.1536/ihj.17-292.

Pediheart Podcast # 48: Individualized Family-Centered Care for Infants in the CICU Dec 28, 2018

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This week we turn to the world of cardiovascular nursing and review the notion of individualized family centered care for infants in the CICU. What is meant by the term "Individualized Family-Centered Developmental Care" and what are its components? What is the evidence that use of this approach can result in improved neuro-developmental outcomes? We review these important concepts with the first author of this work, Amy Jo Lisanti PhD, RN who is a clinical nursing specialist and researcher at The Children's Hospital of Philadelphia. Dr. Lisanti explains this novel multidisciplinary approach to care in the CICU and why she believes it may hold hope in improving outcomes following complex neonatal surgery. doi: 10.1097/JCN.0000000000000546

Pediheart Podcast # 47: ICD's In Young Athletes Dec 21, 2018

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This week we review the notion of sports participation in athletes who have ICD's. Is this a safe approach? How do the athletes fare? How do the devices stand up to sport? What are the subtleties of discussing this important topic with a family and how does shared decision making work in this process? We review this serious and complex topic with Dr. Rachel Lampert, Professor of Medicine at Yale University and Dr. Elizabeth Saarel, Professor of Pediatrics - The Cleveland Clinic. Both experts have much to share about their experience in this important work on how to potentially improve the quality of life for our ICD patients. doi: 10.1161/CIRCEP.118.006305

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