Pediheart: Pediatric Cardiology Today

Pediheart: Pediatric Cardiology Today

A review of the latest literature and thought leaders in pediatric cardiovascular care.

Episodes

February 3, 2023 37 min
This week we delve into the world of neonatal congenital heart surgery and review a recent work on changes in the incidence of brain injury following congenital heart surgery. How common is it to see brain injury on the MRI's in this patient group? How have incidences changed over time and what is the likely reason for this? Can the types of inotropic agents used in the postoperative period potentially explain some of the impro...
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This week we delve into the world of ACHD when we review a recent work on outcomes of non-cardiac surgery in the ACHD patient. How do ACHD patients fare in comparison to their non-ACHD cohort undergoing non-cardiac surgery? What can be done to improve outcomes in this patient group? We speak with the senior author of this work, Dr. Peyman Benharash, who is Associate Professor of Surgery at UCLA. DOI: 10.1136/heartjnl-2022-321512

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This week we replay a 2020 episode in which we reviewed a then recent PCCC study assessing outcomes of single ventricle patients who have undergone replacement of the AV or semilunar valve. We speak with Professor Geetha Raghuveer of University of Missouri-Kansas City about this work she co-authored. Outcomes are generally poor in this patient group but are there lessons that can be gleaned from the data regarding optimal timing fo...
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This week we return to the topic of congenital heart surgery when we speak with Dr. John Iguidbashian who is a resident in surgery at U. Colorado. Dr. Iguidbashian reviews a recent paper he co-authored on the topic of the relation of duration of open chest following heart surgery to the development of surgical site infections (SSI). How long is 'too long' when it comes to an open chest and the risk for infection? Is the dur...
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This week we delve into the world of partial heart transplantation when we review a recent paper that discusses the rationale for its potential use in children, particularly in infants. We speak with the work's senior author, Dr. T. Konrad Rajab of the Medical University of South Carolina about the potential benefits of this approach. Who might be a candidate for this approach? What are the theoretical benefits of this approach...
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This week, to end 2022, we delve into the world of personal finance for the final episode of 2022 when we speak with Mr. Paul Merriman of paulmerriman.com. Mr. Merriman is a world-renowned expert in personal finance and investing who reviews how we might go about funding a newborn child's retirement (in 65 years!) through the magic of index investing, low costs and compounding interest. There are many lessions for all types of ...
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This week we enter the world of cardiogenetics and electrophysiology when we review the topic of catecholaminergic polymorphic ventricular tachycardia (CPVT). Is there a 'best' beta blocker for the treatment of this condition? Why is one better than others? How should one manage the patient who is intolerant of beta blockade but needs it for prevention of arrhythmia? What is the role of flecainide, sympathectomy or even ICD...
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This week we review a recent important work on outcomes of pregnancy in patients with bioprosthetic valves. What percentage of women entering pregnancy have a dysfunctional bioprosthetic valve? Is there a particular position of valve where the risk of dysfunction is greater for cardiac or fetal events? We speak with noted cardio-obstetrical expert, Dr. Barbara Wichert-Schmitt of Johannes Kepler University in Linz, Austria about her...
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This week we review a recent report from the team at Children's National Hospital in Washington, DC on their experience with the hybrid approach to high risk infants with ductal-dependent systemic circulation. Some patients get ductal stents and others not. How is this decision made? How difficult was it to change the approach of a center that had a reputation for excellence with a more 'traditional/Norwood/Stage I palliati...
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This week's episode focuses on gender disparities in salary in the field of congenital electrophysiology. To what degree are female electrophysiologists paid less than their male counterparts despite similar levels of education, work effort and seniority? What interventions could be enacted to help 'mind the gap' and level the playing field in this regard? We speak with the chief of pediatric electrophysiology at The Ch...
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This week we review a recent work from the Precision Medicine For Cardiomyopathy (PRIMaCY) study group on the role of stress testing in the pediatric HCM patient. Does stress testing help identify patients at risk for possible SCD or progression to heart transplantation? Should all pediatric HCM patients undergo this form of testing? What risks are associated with its use and how should these studies be performed? We speak with the...
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In this week's replay of a most special 'fellow takeover episode', Dr. Sarah Pradhan, sometime co-host of Pediheart and interventional cardiology fellow at Toronto Sick Children's Hospital, speaks with Professor Roberta Williams of USC about her long and illustrious career as a pioneer in both echocardiography as well as pediatric cardiac critical care. Prepare for a lot of wisdom about career and life from this gia...
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This week we review a recent report from China on transcatheter closure of peri-membranous VSD's with the Amplatzer ADO II device. Reported results are outstanding and this week's report is one of several from China demonstrating efficacy and safety to this approach. Despite this, this procedure is rarely performed in the west. Why might that be? Do we need 'local data' to adopt an approach or can we proceed based u...
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This week we delve into the world of cardiac critical care when we review a recent report on an attempt to use a multidisciplinary group of hospital professionals plus parents to design an optimal family meeting structure. How should teams prepare for these meetings? What roles should different care providers play in the team meeting? Is there evidence that a better planned meeting can be more effective in transmitting information ...
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This week we review a recent cardiac MRI report on Fontan geometry and hemodynamics as measured by computational fluid dynamic analysis. How do factors like Fontan geometry or 'power loss' relate to quality of life for the Fontan young adult patient? How do these data inform imaging in the operating room during these palliations? We speak with the first author of this work, Associate Professor of Pediatrics at U. Penn, Dr. ...
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This week we review a recent international review on the topic of life threatening events occurring during electronic gaming. What risks do video games pose for the typical child or child with an arrhythmia condition? What precautions, if any, should be considered? Are there some sorts of games that are potentially more dangerous than others? We speak with the first and senior authors of this international survey - Dr. Claire M. La...
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This week we speak with noted cardiovascular surgeon Dr. John J. Lamberti who is presently Associate Professor of Surgery at Stanford University. Dr. Lamberti's career has spanned from the time of Dr. Robert Gross in the 1960's to present day with Dr. Frank Hanley and the team in Stanford. His career perfectly mirrors the transition from the 'old days' of cardiac surgery up until the present modern age and he shares...
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This week we review a recent report on the differences between pulse oximeter Sp02 and arterial Sa02. Are there patient specific factors that may result in inaccuracies of measurement? What single ventricular factors may also result in more significant inaccuracies and how should these data be used at the bedside when assessing a child who is cyanosed? We speak with Dr. Cara Pritchett, critical care fellow at Lurie Children's H...
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This week we review a recent work from the team at Stanford University on post-traumatic stress disorder amongst pediatric patients with ICD's as well as their parents. How common is this diagnosis seen amongst these patients and their parents and what are some of the reasons for this? How should patients receiving devices be properly screened for this and why is identification of PTSD so important? Associate Professor of Psych...
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This week's episode is a replay of a co-branded 2020 episode with SADS.ORG and is on the topic of pre-participation screening. Can the ECG offer important benefits vs. the standard 14 point AHA H&P approach? Which approach was more effective in 'real life'? We speak with Professor Robert Campbell of Emory University this week to delve into this contentious and important topic. DOI: 10.1016/j.hrthm.2020.04.032
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