Claim OwnershipPediheart: Pediatric Cardiology Today
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© Copyright Robert Pass
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A review of the latest literature and thought leaders in pediatric cardiovascular care.
405 Episodes
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This week we review a recent multicenter, randomized trial pitting 2 different immunosuppressive therapeutic approaches against each other. How did a novel approach of everolimus + low dose tacrolimus compare to more standard MMF + standard, higher dose tacrolimus in avoidance of major adverse transplant events or complications? How did this first ever prospective trial in the pediatric heart transplantation world start and how difficult was it to perform in the absence of corporate or NIH support? Why can these data help inform FDA labelling for this novel approach and why is this important? Dr. Kevin Daly of Boston Children's Hospital shares his deep insights into this work this week!DOI: 10.1001/jama.2025.14338
This week we review a recent report of the use of phenoxybenzamine for the reduction of SVR in children undergoing congenital heart surgery in India. How does this agent work and what might be the advantage versus other agents like nitroprusside or milrinone which are more commonly used? How does the cost of this agent (or phentolamine) compare with newer agents? We speak with Dr. Rohit Loomba of Lurie Children's Hospital. For those interested, in addition to working as a critical care cardiologist, Dr. Loomba is also a noted cardiac morphologist and his wonderful videos can be seen at the following web address:https://www.youtube.com/@Talking_HeartsToday's paper:DOI: 10.4103/jpbs.jpbs_868_25
This week we replay an episode from 2 years ago 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
This week we review a recent report from the Boston Children's team on their 39 year experience managing and caring for children with myocardial infarction following Kawasaki disease (KD). What were the clinical features of KD patients that were most associated with this rare complication? What signs or symptoms should be concerning for the caregiver of patients with KD? What are the more common approaches to the management of MI in this fragile and young patient population? Dr. Sunil Ghelani of Boston Children's Hospital offers the answers this week. DOI: 10.1016/j.jpeds.2025.114638
This week we review a landmark paper that came out this month on the topic of ACHD. How common is neurocognitive dysfunction amongst the ACHD patient population? What factors are associated with worse or better such outcomes? What interventions should be considered to mitigate these issues? What is the relationship between mental illness and neurocognitive dysfunction? Dr. Scott Cohen of The Medical College of Wisconsin and Dr. Ali Zaidi of The Icahn School of Medicine at Mount Sinai share their insights into their recent multicenter study. doi: 10.1016/j.jacc.2025.06.051Also featured after the article is a brief description of the upcoming Mount Sinai ACHD Conference called: Kawasaki Disease Across The Ages: From Childhood Onset To Adult Outcomes - The 4th Mount SInai ACHD Symposium. We speak with Dr. Nadine Choueiter who is the Course Director of this conference about the goals and objectives of the conference. Dr. Zaidi is the course co-director. For those interested in signing up, please go to this webpage:https://physicians.mountsinai.org/news/register-today-for-the-fourth-annual-mount-sinai-adult-congenital-heart-disease-symposium
This year is the 50th anniversary of the first transcatheter ASD closure in a human. To celebrate this achievement, this week we air a live interview from PICS 2025 in Chicago (conducted 8/26/25) with living interventional cardiology legend Dr. Terry King speaking about the events surrounding his landmark intervention as the first person to ever perform a transcatheter ASD closure with his partner, surgeon Dr. Noel Mills. In this one on one interview, Dr. King discusses how he came up with this idea with Dr. Mills and how he found a patient in which to proceed. He reviews what 'informed consent' was in 1975 and also how he and Dr. Mills accurately estimated ASD size in an era that preceded 2D echocardiography. Dr. King speaks about the role of family in his life and offers advice to the next generation. Finally, he shares with us what he is up to today and why he does not believe in retirement. Prepare to be excited and inspired by this wonderful figure in our field.
This week we review a recent work addressing the growing mismatch between the numbers of ACHD patients and the numbers of well trained ACHD providers. What are the most important factors influencing trainees' decisions regarding the pursuit of a career in ACHD? How can more young people be influenced to pursue this fascinating and growing field? We speak with Dr. Katia Bravo-Jaimes of The Mayo Clinic in Jacksonville, FLA about a recent survey study she conducted on the factors that influenced these important decisions. Dr. Bravo-Jaimes shares her thoughts on solutions to increase the ACHD workforce.https://doi.org/10.1161/jaha.125.041276
In this week's replay episode from 3 years ago, we delve into the world of pediatric heart transplantation and the impact that race or insurance status may have on outcomes. What are the factors that explain worse outcomes for black children waiting for a heart transplant? How is the PHTS Racial Disparity Taskforce working to reduce inequities in this field? What role does insurance status have on these outcomes? We speak with noted heart failure and transplantation expert, Dr. Neha Bansal who is Associate Professor of Pediatrics at The Icahn School of Medicine at Mount Sinai about this recent PHTS multicenter study.DOI: 10.1016/j.healun.2022.12.002
This week we lost one of the true 'nice people' in pediatric cardiology - Dr. Richard J. Golinko who died at the age of 95. Dr. Golinko led the Mount Sinai Pediatric Cardiology Program for many years. He established many of the programs at Sinai that are now fundamental to the program and the care of children with congenital heart disease in the tri-state region. To honor Dr. Golinko's memory, we stretch back over 40 years to review a paper he co-wrote with Dr. Rubin Cooper on balloon angioplasty of aortic coarctation. We speak with Dr. Cooper, the work's first author about the work as well as his remembrances of the man, Dr. Golinko. Also joining us this week is Dr. Anthony Rossi of Nicklaus Children's Hospital and Dr. Rica Arnon of Mount Sinai to share their individual remembrances of this wonderful and warm leader. doi: 10.1161/01.cir.70.5.903
Professor Ziyad Hijazi of SIdra Medical joins Pediheart this week to celebrate Pediheart's 350th milestone and discuss his life and times from his early days in Jordan to the absolute heights of interventional cardiology. How did he meet Dr. Kurt Amplatz and become involved in the development of Amplatzer devices? Who were some of his mentors and what does he think about being a mentor? How did he come up with the idea for the PICS interventional course and how has he managed to do this consistently for over 20 years? What does he believe is important when thinking about a work/life balance? This is a rare opportunity to learn from someone who has seen and done it all in every corner of the world in pediatric cardiology. For those interested, this is the link to the PICS course in late August, 2025 in Chicago:https://www.picsymposium.com/home.html
This week we go back in time to 2022 to re-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's for these patients? PhD candidate and physician Dr. Puck Peltenburg and CPVT world authority, Dr. Christian van der Werf (both of University of Amsterdam) share their deep insights this week. doi: 10.1161/CIRCULATIONAHA.121.056018. Epub 2021 Dec 7
This week we review a recent important longitudinal follow up study of patients who have undergone palliation for the treatment of HLHS at The Children's Hospital of Philadelphia over the past 35+ years. What are the 'transplant-free' survival numbers at 35 years follow up following newborn palliation? Are there differences between hybrid and traditional "Norwood/Stage I" palliation? What factors explain the group of HLHS patients who do are 'super-Fontan's'? What accounts for the marked variability in outcomes of these complex patients? Dr. J. William Gaynor shares his deep insights both from his large scale paper and long-term experience caring for patients with HLHS.doi: 10.1016/j.jacc.2025.04.028
This week we review a recent surgical paper on the 'off-label' use of the Melody valve for replacement of the AV valve in small infants and children. How effective and safe was this procedure? What factors were associated with the need for reintervention and what sorts of reinterventions were most common? Why was catheter based reintervention rarely employed? What sort of anti-coagulation protocol seems best to protect these valves? Assistant Professor of Pediatrics at the University of Nebraska, Dr. Samantha Gilg shares the insights from her work this week. DOI: 10.1007/s00246-024-03538-1
This week Dr. Nadine Choueiter of Mount Sinai hosts a special episode of Pediheart: Pediatric Cardiology Today in which we speak with emeritus Professor of Pediatrics at the University of Toronto, Dr. Brian McCrindle about his career and life. How did he develop a love of pediatric cardiology? Who were some of his early mentors? How did he develop the international Kawasaki Disease Registry and how has he cultivated it despite minimal funding? How did he develop an interest in preventive cardiology? How can a young person make their clinical work also their academic work? Dr. McCrindle also shares some insights into navigating a successful life as well as retirement. This is a rare opportunity to be inspired by one of the great pediatric cardovascular researchers of the past 3 decades.
This week we speak with congenital heart surgeon T. Konrad Rajab of Arkansas Children's Hospital about a recent report he co-authored on piglet experiments on partial heart transplantation. How did transplanted heart valves grow in comparison to standard homografts and how did the valvular function differ with time? Is there a minimum dose of immunosuppresion that can protect these valves and can this dose be lower than full heart transplantation immunosuppresion therapy? Is partial heart transplantation considered a potential life-long approach to valve replacement or mostly something used to allow for growth of valves during childhood? What do we know about the world's limited experience in humans of this approach? Dr. Rajab shares the answers this week in an exciting 'sci-fi' episode. The future is now.https://doi.org/10.1016/j.jacbts.2024.10.015
This week we speak with Professor Vladimiro Vida of U. Padua about a recent ECHSA large scale study assessing surgical outcomes of newborn cardiac surgery in Europe. What trends have become apparent in the past 10 years and why are outcomes generally better overall in this complex patient group? Why have outcomes for single ventricle surgery not improved as much as other newborn surgeries? Is there a relationship between center volume and outcomes? What interventions might result in improvements in outcomes of Norwood palliation? Dr. Vida provides his insights this week. https://doi.org/10.1016/j.athoracsur.2024.07.023
This week we speak with Assistant Professor of Pediatrics at Harvard Medical School, Dr. Audrey Dionne about a recent work she co-authored on the topic of outcomes of ablation in the early postoperative period following congenital heart surgery. Who is a candidate for this intervention and what were the outcomes? How commonly were serious complications encountered and how successful were these procedures? Dr. Dionne reviews these and other aspects of this novel review this week. https://doi.org/10.1016/j.hrthm.2024.08.061
This week we venture back in time to 2023 to review the results of the 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
This week we speak with Professor Robert Hamilton of the University of Toronto about a recent case-control study in which his team identified a novel auto-antibody targeting a fetal cardiac protein that proved to have excellent sensitivity and specificity for the identification of fetuses that would develop heart block in fetal life in the offspring of women with maternal connective tissue disorders. How did the team in Toronto choose these particular target proteins? How well did this test perform in predicting heart block in pregnancies where there had been a prior pregnancy affected by block? Does this test possibly mean that fewer fetuses of mothers with connective tissue will need surveillance? Dr. Hamilton shares the details of this fascinating study this week. https://doi.org/10.1016/s2665-9913(25)00092-xWe also speak with Drs. David Ezon and Kenan Stern about the upcoming 16th Annual Mount Sinai Imaging Symposium - Conversations in Care: Cardiac Conundrums & 3D Echo Workshop which will be taking place at Mount Sinai on 5/31/25. Details are available at the following website:https://mssm.cloud-cme.com/course/courseoverview?P=5&EID=46043
This week we move into the arena of preventive cardiology when we review a recent report from the team at Northwestern and Princeton on the impact of early childhood food insecurity on cardiovascular health of people in young adulthood. How does food insecurity in young childhood impact the cardiac health of adults? Why is most of the impact seen on BMI but not other measures of cardiovascular health. How can food programs that support improved food and nutrition security work to improve long term cardiovascular health of children and adults? Do the benefits of such programs outweight their costs? Dr. Nilay Shah of Northwestern University shares his deep insights into his work and these questions this week.DOI: 10.1001/jamacardio.2025.1062
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