Cardiology

How Important is Fasting for Pediatric Routine Cholesterol Screening?
How Important is Fasting for Pediatric Routine Cholesterol Screening? 1024 575 Andrew Tran, MD

A nonfasting lipid panel is a great first-line screening tool to use. While it is ideal to have a fasting lipid panel, this can be difficult to obtain in practice. For the purposes of screening, I think that it is much more important to go ahead and get the nonfasting lipid panel while the patient…

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Incidence and Impact of Acute Kidney Injury in Patients With Hypoplastic Left Heart Syndrome
Incidence and Impact of Acute Kidney Injury in Patients With Hypoplastic Left Heart Syndrome 150 150 Abbie Roth

While incidence of severe kidney injury after surgery for hypoplastic left heart syndrome is low, it may be linked to increased 30-day mortality. Acute kidney injury – the abrupt decline of renal function – following pediatric heart surgery leads to worse outcomes, including increased mortality. The overall incidence of acute kidney injury (AKI) after pediatric…

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COVID-19 and the Heart: SARS-CoV-2-Associated Myocardial Infection
COVID-19 and the Heart: SARS-CoV-2-Associated Myocardial Infection 150 150 Simon Lee

Myocardial infection following COVID-19 illness has made headlines. Simon Lee, MD, tackles some commonly asked questions about MIS-C and isolated myocarditis after COVID-19 recovery.

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Risk Stratification in Infants With Primary Pulmonary Vein Stenosis
Risk Stratification in Infants With Primary Pulmonary Vein Stenosis 1024 681 Mary Bates, PhD
sleeping infant

Categorizing infants with pulmonary vein stenosis into stable and progressive groups could help inform treatment. Primary pulmonary vein stenosis is a rare, often lethal, cardiac disease. It is challenging to treat, as the disease can be progressive in some patients but not others. In a new study, researchers from Nationwide Children’s describe outcomes among preterm infants…

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A Collaborative Approach to Preventive Cardiology
A Collaborative Approach to Preventive Cardiology 1024 575 Andrew Tran, MD

Many of us have friends or family members who have had an early heart attack. The event is sudden, unexpected and sobering. Those who recover often make drastic changes to their diet and lifestyle, along with taking medications, and endeavor to delay and undo years of accumulated toll. However, these efforts can only go so…

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Cardiomyopathy in Mothers of Boys With Muscular Dystrophy
Cardiomyopathy in Mothers of Boys With Muscular Dystrophy 1024 670 Mary Bates, PhD

Female carriers of the genetic defect that causes muscular dystrophy in boys show evidence of cardiac fibrosis. An interdisciplinary team from Nationwide Children’s Hospital reports about half of women who carry the genetic defect responsible for muscular dystrophy show evidence of cardiac fibrosis. The study, published in the International Journal of Cardiology, suggests that cardiac muscle,…

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CMS Approves New Code for Adult Congenital Heart Disease Subspecialty
CMS Approves New Code for Adult Congenital Heart Disease Subspecialty 1024 683 Katie Brind'Amour, PhD, MS, CHES

The official billing code will enable growth of the subspecialty and is expected to result in improved patient care. In March, the Centers for Medicare and Medicaid Services (CMS) approved a unique code for subspecialists in adult congenital heart disease (ACHD). The code will allow board-certified ACHD specialists to bill as such, rather than as…

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COVID-19 in Children With Congenital Heart Disease
COVID-19 in Children With Congenital Heart Disease 1024 683 Mary Bates, PhD

Data are still emerging, but COVID-19 – and the subsequent inflammatory syndrome sometimes seen in children – could have serious cardiac impacts. In a recent review article, researchers from institutions including Nationwide Children’s Hospital outlined the impact of COVID-19 in pediatric patients with heart disease. The review, published in the Journal of the American Heart Association,…

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Technical Aspects of Fetal Aortic Valvuloplasty Predict Success of the Procedure
Technical Aspects of Fetal Aortic Valvuloplasty Predict Success of the Procedure 1024 575 Mary Bates, PhD
Fetus in utero receiving valvuloplasty

The procedure is often successful but comes with significant risks to fetal health and life. Fetal aortic valvuloplasty (FAV) is a procedure performed mid-gestation in a subset of fetuses with aortic stenosis who would likely develop hypoplastic left heart syndrome with no intervention. Although often successful, it is a high-risk procedure that is associated with…

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Study Supports Expanded Use of Ventricular Assist Devices in Children With Complex Congenital Heart Disease
Study Supports Expanded Use of Ventricular Assist Devices in Children With Complex Congenital Heart Disease 150 150 JoAnna Pendergrass, DVM

New multicenter study shows that the HeartMate3 ventricular assist device is associated with low morbidity and adverse events in pediatric patients with complex CHD. Ventricular assist devices (VADs), such as the HeartMate3 (HM3) continuous-flow VAD, provide critical heart function support in patients with advanced heart failure. Although design improvements in VADs have reduced complication rates…

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New Application of Nuclear Imaging in the Legs May Enable Early Detection of Cardiovascular Problems
New Application of Nuclear Imaging in the Legs May Enable Early Detection of Cardiovascular Problems 150 150 Katie Brind'Amour, PhD, MS, CHES

Researchers have used a non-invasive imaging modality to quantify perfusion reserve in specific muscles of the extremities — a novel approach with numerous potential clinical applications Researchers have shown for the first time that SPECT/CT imaging can be used to quantify perfusion reserve of specific muscle groups in the lower limbs, which they directly related…

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For Some Fetuses With HLHS, One Follow-up Echocardiogram May Be Enough
For Some Fetuses With HLHS, One Follow-up Echocardiogram May Be Enough 1024 575 Kevin Mayhood

“Not every patient with hypoplastic left heart syndrome, also known as HLHS, is the same: there appears to be a high-risk group that has significant atrioventricular valve regurgitation, atrial septal restriction or other concerns; and a low-risk group that, on their first scan, has none of these comorbidities of the heart,” says Bernadette Richards, FASE,…

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Targeting Cardiac-Related Strokes in Infants
Targeting Cardiac-Related Strokes in Infants 150 150 Mary Bates, PhD

New study describes risk factors for stroke in children with cardiac disease. Advances in surgical techniques and intensive care management have led to an increase in the number of infants surviving with cardiac disease. Unfortunately, children with cardiac disease are at higher risk for experiencing an arterial ischemic stroke. Now, a new study points to…

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When is Palliative Care Right for Families of Children With Single Ventricle Congenital Heart Defects?
When is Palliative Care Right for Families of Children With Single Ventricle Congenital Heart Defects? 150 150 Kevin Mayhood

Practitioners suggest involving a palliative care team early after diagnosis Single ventricle congenital heart defects (SV) disrupt critical blood flow and require a series of complex operations in order for a child to survive. As few as 80% of children born with SV live to age 1, 70% to age 20. Because of the high…

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Regular Physical Activities Tied to Improved Quality of Life in Adults With Fontan Circulation
Regular Physical Activities Tied to Improved Quality of Life in Adults With Fontan Circulation 150 150 Kevin Mayhood

Starting regular exercise in childhood can help lay the groundwork for greater health and quality of life, pediatric cardiologists suggest. Children and adults with Fontan circulation are at risk of a sedentary lifestyle. This is due in part to physicians who advise patients restrict exercise out of concern vigorous physical activity may contribute to venous…

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Cheaper, Generic Drug Just as Effective in Preserving Heart Function in Duchenne Muscular Dystrophy
Cheaper, Generic Drug Just as Effective in Preserving Heart Function in Duchenne Muscular Dystrophy 150 150 Mary Bates, PhD

A new clinical trial found a cheaper generic drug is effective in protecting the heart in boys with Duchenne muscular dystrophy. A recent clinical trial conducted found a cost-effective generic medication works just as well as a more expensive drug in preserving heart function in boys with Duchenne muscular dystrophy. Published in the Journal of the…

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New Model Provides Novel View of Congenital Heart Disease
New Model Provides Novel View of Congenital Heart Disease 150 150 Lauren Dembeck

The small animal model helps researchers to interpret genomic findings. Researchers at Nationwide Children’s Hospital have developed the first mouse model of congenital heart valve disease using a human gene carrying a disease-causing mutation. Using this model, they were able to follow the human valve disease phenotype from birth to adulthood and identify developmental deficits…

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Variation in Functional Measurements of the Left Ventricle
Variation in Functional Measurements of the Left Ventricle 150 150 Mary Bates, PhD

Data from The Pediatric Heart Network Normal Echocardiogram Database show interobserver variability, especially in younger and smaller patients. Echocardiography is the primary tool clinicians have to assess ventricular size and function. Accurate evaluation of the left ventricle is critical in the treatment of patients with congenital and acquired heart disease, as well as other conditions…

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Use of Cardiac MRI to Monitor Medical Treatment of Rhabdomyoma
Use of Cardiac MRI to Monitor Medical Treatment of Rhabdomyoma 150 150 Mary Bates, PhD

Case study shows success for medical therapy and MRI monitoring of a cardiac rhabdomyoma. In a new case study, researchers from Nationwide Children’s Hospital report treating cardiac rhabdomyoma in a newborn with an mTOR inhibitor called everolimus. They monitored the tumor’s regression using cardiac MRI. Cardiac rhabdomyoma is a common type of heart tumor in…

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How do Babies With Single Ventricles Fare Between Stage 1 and 2 Hybrid Palliation?
How do Babies With Single Ventricles Fare Between Stage 1 and 2 Hybrid Palliation? 150 150 Katie Brind'Amour, PhD, MS, CHES
Influences of Maternal Diabetes on Fetal Heart Development
Influences of Maternal Diabetes on Fetal Heart Development 150 150 Abbie Roth
Are We Turning Away Too Many Pediatric Donor Hearts?
Are We Turning Away Too Many Pediatric Donor Hearts? 150 150 Katie Brind'Amour, PhD, MS, CHES

More than half of all pediatric donor hearts are declined for use each year, despite the fact that many children die waiting for a heart. But why? And what can be done about it?   As many as one in every four infants on the heart transplant list dies awaiting an organ. For older children,…

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Bridging the Gap Between the Genomics Lab and the Cardiology Clinic: CardioGX for Phenotype-Driven Variant Analysis
Bridging the Gap Between the Genomics Lab and the Cardiology Clinic: CardioGX for Phenotype-Driven Variant Analysis 150 150 Abbie Roth

The cloud-based platform is a free tool that empowers clinicians and fosters collaboration to find new genetic mutations that cause heart disease. Finding ways to support clinicians and researchers in accessing and utilizing genomic data is paramount to incorporating genomics into clinical care. CardioGX (CardioGenomics eXchange commons) is an interactive web application designed to help clinicians and…

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Room for Improvement: Heart Catheterization Risks in Young Patients With Pulmonary Hypertension
Room for Improvement: Heart Catheterization Risks in Young Patients With Pulmonary Hypertension 1024 575 Katie Brind'Amour, PhD, MS, CHES
Illustration of heart, CAVD

Identifying risk factors for cardiac catheterization complications offers physicians a way to improve pulmonary hypertension care. Up until a few years ago, cardiac catheterization in patients with pulmonary hypertension was considered a low-risk procedure for children and young adults. Some of the country’s best physicians had published studies showing very few complications among hundreds of…

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Building Heart Valves From Extracellular Matrix
Building Heart Valves From Extracellular Matrix 150 150 Abbie Roth

Physicians at Nationwide Children’s Hospital describe the use of an extracellular matrix cylindar valve in the mitral position. At The Heart Center at Nationwide Children’s, Patrick McConnell, MD, a pediatric cardiothoracic surgeon, is using an alternative to the traditional cadaveric, mechanical or biological replacement valve. In a recent case report published in Echocardiography, Dr. McConnell and his colleagues describe the…

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Dopamine: A Rescue Therapy for Fontan Patients With Protein-Losing Enteropathy?
Dopamine: A Rescue Therapy for Fontan Patients With Protein-Losing Enteropathy? 150 150 Jeb Phillips

Patients with quickly worsening PLE saw serum albumin levels stabilize after dopamine treatment. Patients who have undergone the Fontan procedure for single ventricle congenital heart disease do not often develop protein-losing enteropathy (PLE) – but those who do are at substantial risk of mortality and morbidity. Only heart transplant has been shown to alleviate PLE…

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Family Focus Restructures Single Ventricle Care
Family Focus Restructures Single Ventricle Care 150 150 Brianne Moore

Standardize, connected care in a multidisciplinary team environment aims to improve outcomes and quality of life for patients born with single ventricle heart anatomy. Children with single ventricle anatomy, one of the most harrowing of congenital heart defects, face unique challenges that require multiple procedures and hospital admissions to treat. In most institutions, each admittance…

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Taking Innovation to Heart: Next Gen Interventions in Heart Valve Disease
Taking Innovation to Heart: Next Gen Interventions in Heart Valve Disease 1024 575 Abbie Roth

From bioengineers to interventional cardiologists, molecular biologists to cardiothoracic surgeons, experts with diverse backgrounds are focusing on the problem of heart valve disease in children. Heart valve disease affects more than 5 million Americans. And while acquired disease in the adult population certainly accounts for much of this, children with heart valve disease face multiple…

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Using Whole Exome Sequencing to Find Genetic Cause of Congenital Heart Disease in At-Risk Patients
Using Whole Exome Sequencing to Find Genetic Cause of Congenital Heart Disease in At-Risk Patients 150 150 Brianne Moore

Whole exome sequencing has the ability to identify disease-causing mutations, contributing to the development of personalized medicine and bridging a crucial gap between scientific knowledge and clinical application. Congenital heart disease (CHD) is the most common type of birth defect, affecting approximately 40,000 births per year in the United States. While some types of CHD…

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For Infants Born Very Preterm, Transcatheter Device Closure of Patent Ductus Arteriosus is Feasible
For Infants Born Very Preterm, Transcatheter Device Closure of Patent Ductus Arteriosus is Feasible 150 150 Jeb Phillips

Optimal timing of procedures and reduction of adverse events are avenues for future study. Approximately half of babies born at less than 32 weeks of gestational age have persistent patent ductus arteriosus (PDA), a condition associated with higher odds of death and respiratory morbidity. When doctors choose to close the ductus, a percutaneous approach is…

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Signaling Pathway Changes May Flag CAVD, Offer Target for Therapies
Signaling Pathway Changes May Flag CAVD, Offer Target for Therapies 150 150 Kevin Mayhood

Loss of TgfB1 from the endothelium leads to a reduction in Sox9 expression and valve calcification. A team of researchers has identified a molecular signaling pathway that, when altered, can contribute to calcific aortic valve disease (CAVD). The finding may provide a method for early diagnosis — many patients don’t learn they have the disease until it’s in the final…

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Delayed Umbilical Cord Clamping May Benefit Some High-Risk Newborns
Delayed Umbilical Cord Clamping May Benefit Some High-Risk Newborns 150 150 Jeb Phillips

Recent studies show the practice can offer circulatory advantages for infants born extremely preterm or with critical congenital heart disease. The practice of immediate or early umbilical cord clamping after birth has been the norm since research in the 1950s and 1960s showed that most blood volume for full term babies was achieved “within the…

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InSight: A Window to the Heart
InSight: A Window to the Heart 720 530 Katie Brind'Amour, PhD, MS, CHES

Cardiac MRI for Hypoplastic Left Heart Syndrome Hypoplastic left heart syndrome (HLHS) is a potentially fatal congenital heart defect affecting blood flow. It requires multiple palliative surgeries, starting within the first week of life. Nationwide Children’s employs a hybrid surgical approach. Hybrid Stage I (not shown) Bilateral branch pulmonary bands are placed to restrict blood flow.…

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Cholesterol Screening: What’s the Right Approach?
Cholesterol Screening: What’s the Right Approach? 150 150 Dave Ghose

The jury is still out on whether universal testing of children is a good thing. To screen or not to screen? For pediatricians, that question is far from answered when it comes to universal cholesterol testing. Despite an endorsement of the practice from an expert panel at the end of 2011, controversy continues to shroud…

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Survivors of Congenital Heart Disease Report Poor Risk Knowledge and High-Fat Diets
Survivors of Congenital Heart Disease Report Poor Risk Knowledge and High-Fat Diets 150 150 Tiasha Letostak, PhD

A new study suggests that CHD survivors may lack knowledge about their disease and would benefit from education about future risks and health behaviors. Over 1 million adults with congenital heart disease (CHD) currently reside in the United States. These individuals are at heightened risk for numerous health concerns, including endocarditis, pregnancy complications and life-threatening…

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Adult Congenital Heart Disease: Let’s Finish What We Started
Adult Congenital Heart Disease: Let’s Finish What We Started 150 150 Curt Daniels, MD

Congenital heart disease is the most common birth defect, diagnosed in nearly 1 percent of all births in the United States. Traditionally, life expectancy in many infants with severe CHD was limited to months. However, advances in medical and surgical care have led to remarkable improvements in survival: the median age of those living with severe…

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The End of “Under 12″
The End of “Under 12″ 150 150 Kelli Whitlock Burton

UNOS board eliminates age classification for child lung transplant candidates and alters rules for pediatric heart transplants. Many in the pediatric field were surprised last year when a federal judge ordered that a 10-year-old Pennsylvania girl with cystic fibrosis be added to the national adult waiting list for a double-lung transplant. She had spent 18 months…

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By the Book: Anticoagulation for CHD
By the Book: Anticoagulation for CHD 150 150 Kelli Whitlock Burton

The American Heart Association (AHA) has released its first evidence-based guidelines on anticoagulation in congenital heart disease (CHD). Anticoagulation is a key element in managing patients with congenital heart disease. Despite the therapy’s widespread use, there are no established guidelines on anticoagulants in this patient population, which often leads to inconsistency and guesswork in how…

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