Claim OwnershipPediheart: Pediatric Cardiology Today
Subscribed: 412Played: 14,539
Subscribe
© Copyright Robert Pass
Description
A review of the latest literature and thought leaders in pediatric cardiovascular care.
421 Episodes
Reverse
This week we replay an important episode from 2 years ago in which we delved into the world of antibiotic prophylaxis for dental procedures. What are the data to support its use in the congenital heart patient? Why has this been such a difficult topic to study? What do we now know about this topic and what still remains unanswered? Given the low prevalence but dire consequences of this disease, how can investigators consider studying this topic in the future? Is there adequate equipoise to proceed with a randomized controlled trial? We speak with Advanced Imaging Fellow at Boston Children's Hospital, Dr. Francesca Sperotto of Harvard University about her recent multicenter meta-analysis of 30 studies including over one million cases of endocarditis. DOI: 10.1001/jamacardio.2024.0873
This week we review a follow-up work from the team at USC and Children's LA led by Dr. Yaniv Bar-Cohen on a novel micropacemaker. How has the device changed and improved over the past 3-5 years since his last visit to Pediheart? What are some of the difficulties of designing a device that is both stable on the epicardium but not inclined to develop inflammation? Why did the team move from a screw in eletrode model to a different design? What applications could this device have both for infants but also adults? Dr. Bar-Cohen shares his deep knowledge of both electrophysiology and device design this week.DOI: 10.1016/j.hrthm.2025.01.036For those interested in stepping back in time to hear Dr. Bar-Cohen's first description of an earlier version of this novel pacemaker, here is the link from 2018:https://podcasts.apple.com/us/podcast/pediheart-podcast-26-novel-means-of-epicardial/id1341472214?i=1000498801107
This week we review a recent large scale PHIS database study on pericardial effusion following congenital heart surgery. Which operations other than ASD are most highly associated with the development of an effusion? What might be some approaches both surgically and medically to reduce the chances of these developing or requiring intervention? What are the implications of a pericardial effusion after surgery? How many require readmission for this complication? Dr. Mario O'Connor, who is a congenital heart surgical research fellow at UT Austin, shares his insights into his recent publication. DOI: 10.1177/21501351251322876
This week we review a recent report on LV strain following the Ross operation. Can this sort of functional analysis help predict remodeling after aortic valve replacement? How can the type of Ross potentially affect heart function after the operation? Why might some parameters of LV strain improve but others not following surgery? Can preoperative strain measurements predict perioperative course? How does the addition of a Konno to a Ross change the outcomes of function? We speak with Chief of Cardiovascular Surgery at Primary Children's Hospital in Utah, Dr. S. Adil Husain and 3rd year integrated cardiac surgical resident Michal Schaffer of the University of Utah about these and other topics related to LV function following the Ross operation in children. · DOI: 10.1007/s00246-025-04124-9
This week we end 2025 with a Pediheart tradition - an episode on personal finance for medical professionals with noted authority on index investing and personal finance, Mr. Paul Merriman. Paul is a retired investment advisor who now has a popular podcast "Sound Investing" and website in which he offers advice on investing for 'do it yourself' investors. In this week's episode, the 5th of his visits to Pediheart, Mr. Merriman discusses 'factor investing' via index-like ETF's and funds. He also reviews who he believes might benefit from a financial advisor, what sort of advisor most should seek out and why he believes that many do not need one if they can 'stay the course'. Resources mentioned in today's podcast are below. Wishing all a happy and healthy new year in 2026. Paul's website:https://www.paulmerriman.com/#gsc.tab=0'Best In Class' ETF's:https://www.paulmerriman.com/Best-in-Class-ETF-Recommendations2025#gsc.tab=0Sound Investing 'Quilt Charts':https://irp.cdn-website.com/6b78c197/files/uploaded/(K)_Quilt_Charts_(1928-2024)_-_2024_Returns_(1).pdfDFA 'Turn Out The Noise':https://www.dimensional.com/filmAs a reminder, all of the information provided in this week's episode should be considered entertainment and all financial decisions should be vetted with professionals or knowledgeable and trusted friends/family.
This week we go back in time 2 years to review a recent paper from 2023 about outcomes of cardiac transplantation in the adult congenital heart patient (ACHD). Little has been written on this topic until this very robust and large scale report. How do single ventricle ACHD patients fair at transplant and how do they compare to non-ACHD heart transplant recipients? Why might 1 and 3 year outcomes not be a 'fair' method of assessing outcomes in this very high risk patient group? How do HLHS patient outcomes compare with other single ventricles? Are there better ways to measure risk in this patient group and how might the data in this work inform risk stratification and management of failing Fontan patients in whom transplantation is being considered? These are amongst the questions posed this week to the week's expert, Dr Daphne Hsu who is Professor of Pediatrics at the Albert Einstein College of Medicine at The Children's Hospital at Montefiore.https://doi.org/10.1016/j.jacc.2023.06.037For those interested in learning more about Dr. Hsu, take a listen to episode #166 from June, 2021:https://www.spreaker.com/episode/pediheart-podcast-166-a-conversation-with-professor-daphne-hsu--45144274
This week we speak with noted congenital cardiologist Professor Krishna Kumar of the Amrita Institute in Cochin, India and discuss his recent work on inequities in congenital heart care in the world. Over 90% of patients with CHD do not have access to care in the globe today. What is the path forward to improve this sobering statistic? How can a World Health Assembly resolution practically help improve care in LMIC countries worldwide? Dr. Kumar shares his deep insights.This week we also briefly note the passing of the wonderful and caring pediatric cardiologist Dr. Sangeetha Viswanathan of Chennai, India who tragically died suddenly this week while attending the World Congress events in Hong Kong. Dr. Kumar's words regarding his friend, former fellow and colleague are read in remembrance of this wonderful and giving cardiologist whose loss will be deeply felt by her patients, family and friends. DOI: 10.1016/j.jacc.2025.07.070
ECMO is the topic of this week’s episode of Pediheart. We speak with Assistant Professor of Pediatrics and cardiac critical care specialist at Northwell Health, Dr. Ivana Capin about a recent ELSO database study she conducted to assess outcomes in single ventricle patients who were treated with ECMO prior to single ventricle palliation. What factors were associated with worse overall outcomes? Can this therapy be used to stabilize the HLHS patient with an intact atrial septum? Why have outcomes for this high risk patient group not appreciably improved in the recent decade? How can these data improve prognostic clarity when speaking with families in this difficult situation.Also joining us briefly is Associate Professor of Pediatrics at the Icahn School of Medicine at Mount Sinai, Dr. Scott Aydin to discuss his co-author and mentor, Dr. George Ofori-Amanfo as we approach the 4th anniversary of his untimely and tragic passing. DOI: 10.1017/S1047951125001386
This week we go back in time to 2020 to delve into the topic of fellow wellness and review a work from the Boston Children's group on fellow fears and stressors when beginning their training. Are there patterns amongst the fellow concerns that can be identified and used to inform interventions to help allay these fears and reduce the stress? We speak with Dr. David Brown, Associate Professor of Pediatrics, Harvard Medical School and also Dr. Tony Pastor who was then the ACHD Fellow at Boston Children's Hospital/Brigham and Women's Hospital about their thoughts on fellow fears and stressors as well as fellow (and doctor) wellness. doi: 10.1007/s00246-019-02276-z.
This week we review the topic of mitral annular disjunction ("MAD") and the possible association with ventricular arrhythmia or sudden death in the connective tissue disease patient. Is there a 'cut off' distance above which patients deserve more significant arrhythmia surveillance? What is the best way to measure the MAD distance? Can patients with low MAD distances have lower degrees or even no arrhythmic surveillance? How often should this distance be measured on CMR and can an echo measurement provide similar data? Dr. Daniel Castellanos, the first author of this work and Assistant Professor of Pediatrics at Harvard Medical School shares his deep insights this week.DOI: 10.1016/j.jocmr.2025.101954
This week we review a recent retrospective review from Phoenix Children’s Hospital about coronary artery fistulae. How common are they and who needed intervention? How should the cardiologist think about the small fistula? Should they all be ‘followed’ or can they be discharged from cardiology follow-up? How small is ‘small enough’? We speak with Dr. Marie Chevenon who is a fetal cardiologist at Phoenix Children’s Hospital about her recent study on the Phoenix experience with coronary artery fistulae. https://doi.org/10.1007/s00246-024-03600-y
This week we speak with Ohio State ACHD fellow Andrew Freddo MD, PhD about a recent large single center study he conducted assessing the cardiovascular drugs that adult Fontan patients are taking and whether they might offer us insights into general well-being. Are there agents that are associated with worse outcomes? If so, is this a situation of the agent causing harm or is it a possible marker of illness? Are there agents associated with improved outcomes? These are amongst the questions reviewed with Dr. Freddo this week. DOI: 10.1016/j.jacadv.2025.102070
This week we review the results of the new pivotal trial of the 'Minima' stent by Renata Medical. What is special about this new device that makes it particularly desirable for use in small children? How strong is cobalt chromium and what evidence exists that it can be expanded repeatedly over 1-2 decades? Can this technology supplant surgery for certain diseases such as native coarctation? What are the limitations of this device? We speak with the first author of the pivotal trial, Dr. Patrick Sullivan of CHLA who is Associate Professor of Pediatrics at Keck Medicine at USC. DOI: 10.1161/CIRCINTERVENTIONS.125.015618
This week we review a recent survey study assessing the beliefs of fetal cardiologists and how these may influence the content and conduct of their counseling. Do most fetal cardiologists review all options including intervention, comfort care and pregnancy termination? Should there be a mandate that all do? Is it realistic or appropriate to ask a fetal cardiologist to suggest an option when they do not believe it to be a reasonable or correct choice? We speak with two of the authors of this work and they are Dr. Joanne Chiu of Harvard University and Dr. Caitlin Haxel of The University of Vermont. DOI: 10.1002/pd.6706
This week we review an episode from 3 years back and delve into the world of adult congenital heart disease when we review a recent work from the ACHD team at UCSF that assesses the impact of BMI on clinical outcomes in the single ventricle adult Fontan patient. What is the cause of elevation in BMI in some Fontan patients? Is obesity the only explanation? Is BMI a modifiable risk factor for our Fontan patients and should exercise be 'prescribed' for these patients? If so prescribed, what type of exercise is best for the Fontan patient? This week's work's senior author, Dr. Anushree Agarwal, Assistant Professor of Medicine at UCSF, shares her insights into this important topic. DOI: 10.1161/JAHA.122.026732Also mentioned in today's episode is episode #222 with Dr. Dan Halpern of NYU medical center (https://www.stitcher.com/show/pediheartpediatric-cardiology-today/episode/pediheart-podcast-222-impact-of-cardiac-rehab-on-exercise-tolerance-in-the-achd-patient-206781483)
This week we review a recent work from the "Women In Pediatric Cardiology" group which is a 4 year old initiative to help lift up women pediatric cardiologists through the fostering of connections and also via mentorship programs. Why did this program develop and what are the most pressing issues affecting female pediatric cardiologists? What are the best solutions to help address gender inequities in our field? We speak with two co-authors of this week's work, Drs. Sarah Ford of Brown University and Kristin Laraja of University of Massachussetts. For those interested in participating in their work, feel free to email Pediheart@gmail.com and your information will be passed along to the authors. DOI: 10.1007/s00246-024-03576-9
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
Comments
Download from Google Play
Download from App Store
United States