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Meet Karen Texter, MD, Director of Fetal Echocardiography at Nationwide Children’s

Meet Karen Texter, MD, Director of Fetal Echocardiography at Nationwide Children’s 1024 691 Abbie Miller

Karen Texter, MD, is a pediatric cardiologist and director of Fetal Echocardiography at Nationwide Children’s. Her clinical and research interests include echocardiography in congenital and acquired heart disease and fetal cardiology.

What inspired you to pursue a career in pediatric cardiology? How did you get into fetal cardiology, specifically?

My interest in pediatric cardiology really started back in medical school. I was fascinated with the mechanics of the heart and all the tissues, cells and pathways at a cellular level that must work together for the heart to function. When I began clinical work, I was amazed at the world of congenital heart disease. I am really drawn to figuring out the how and why CHD develops. This brings in the study of how the heart develops and embryology. From there, you can see how I landed in fetal. Working in fetal cardiology, you really get to dig into how the heart forms during development.

Additionally, I was fortunate to train with pioneers in the field of fetal medicine and fetal cardiology during my time in Texas. I learned so much and was really inspired by that team.

What do you find rewarding or motivating about your work with expectant parents and newborns with CHD?

In the Fetal Cardiology clinic, all our patients come in having been identified with risk factors for congenital heart disease. They’re here for additional screening and looking for answers. This is stressful for families, even if they get the good news that the screen is clear. When the screen results in a diagnosis of CHD, the family’s world is turned upside down.

I feel so privileged to be present with these families in these moments, whether they are times of celebration or crisis. For families that are experiencing the crisis, my goal is to do everything I can to make the experience a little less horrible. This is my niche – connecting with families, meeting them where they are, and supporting them through the next steps.

I also love that in these moments, the families aren’t just supported by me. We have a tremendous team in the Fetal Center, and being part of that team is so rewarding.

What brought you to your current role at Nationwide Children’s?

I joined Columbus Children’s in 2008 as a new grad. We weren’t Nationwide Children’s yet, but we knew it was coming. It has been an exciting time to be at the organization with lots of opportunities for growth and expansion. The sprit of innovation and collaboration that I felt when I first started has just continued to grow. This means more options for my patients, and I am so appreciative of that.

Here at Nationwide Children’s, I’ve been given the encouragement and opportunity to become my best professional self, try new things, work across teams and departments and join with my talented coworkers to break down barriers to care. In The Heart Center, our single ventricle team is different from single ventricle teams in other institutions – and this helps us try new things and move the field forward.

This spirit of innovation and teamwork carries into the Fetal Center. We want to do something unique, and our focus is on filling a need that goes unmet for too many families. We do this through partnerships with different roles, different departments, and even different organizations.

What excites you about the future of fetal cardiology?

Everyone asks what’s new in fetal, and there’s a lot to be excited about. One of the things I’m most excited about is the impact of genomic medicine. Families, doctors, we all want to know what causes congenital heart disease to happen. I’m really optimistic that genomics will help us unpack the causes of CHD. Then, we really have the opportunity to affect the incidence. Now, we’re focused on treatment. Once we better understand the causes, we can focus on prevention.

What are the challenges the field faces and how do you think you and your colleagues should be addressing them?

Biggest challenge facing fetal cardiology and congenital heart disease is the suboptimal prenatal diagnosis rate. Only 60% of critical CHD is diagnosed before birth. We’d be limited in our thinking if we thought we could move the field forward with only about half the patient being diagnosed before birth.

To address this challenge, we need to acknowledge and break down barriers to diagnosis, which for many includes getting beyond a level one screening. If the primary provider doesn’t see an abnormality on standard imaging and if they family doesn’t have any known risk factors, secondary screening or testing for CHD doesn’t happen.

Currently more than 90% of babies with critical CHD don’t have any known risk factors. We hope that genomics research will help us identify more risk factors as we better understand the causes of CHD, but there’s opportunity to look at biomarkers to identify risk.

A recent study looking at a promising prenatal biomarker for CHD was recently published in Circulation Research. It resulted from a collaboration with The Heart Center, Fetal Medicine and the Center for Cardiovascular Research, and identified elevated cell-free miRNAs in the blood of people carrying a fetus that has single ventricle heart disease. These cell-free miRNAs could eventually be developed as noninvasive biomarkers to detect single ventricle heart diseases sooner prenatally.

This type of work is exemplary of how teamwork and innovation are essential to driving changes in outcomes for CHD. I’m excited for what the future holds as we work together to meet these challenges.

About the author

Abbie (Roth) Miller, MWC, is a passionate communicator of science. As the manager, medical and science content, at Nationwide Children’s Hospital, she shares stories about innovative research and discovery with audiences ranging from parents to preeminent researchers and leaders. Before coming to Nationwide Children’s, Abbie used her communication skills to engage audiences with a wide variety of science topics. She is a Medical Writer Certified®, credentialed by the American Medical Writers Association.

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