The Heart Center

Standardizing Training in Pediatric Cardiac Critical Care
Standardizing Training in Pediatric Cardiac Critical Care 150 150 Mary Bates, PhD

In a new report, a taskforce of experts presented their recommendations to standardize training in pediatric cardiac critical care. The authors hope the report is a first step toward more oversight of training and certification in the field. The field of pediatric cardiac critical care is relatively young but growing quickly. Currently, there are 120…

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Stent Implantations Are an Option for Small Patients
Stent Implantations Are an Option for Small Patients 1024 670 Mary Bates, PhD

Stents that can be dilated to adult size are safe and effective for the treatment of coarctation of the aorta in young patients. Studies have demonstrated stent implantation is more effective and safer than balloon angioplasty for the treatment of coarctation of the aorta in adult and older pediatric patients. In smaller patients, however, particularly…

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Cylinder Mitral Valve Construct is a Safe and Durable Alternative for Young Patients
Cylinder Mitral Valve Construct is a Safe and Durable Alternative for Young Patients 1024 752 Mary Bates, PhD
Top-down view of heart valves

The new technique could potentially reduce the number of lifetime surgeries required by these patients, researchers say. In a new study, researchers from Nationwide Children’s Hospital report that pediatric patients who underwent cylinder mitral valve construct, a new technique for replacing the mitral valve, had improved left ventricular function over time. In addition, there were…

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Occurrence and Cost of Infections After Heart Transplant
Occurrence and Cost of Infections After Heart Transplant 150 150 Mary Bates, PhD

Researchers identify risk factors, long-term outcomes of vaccine-preventable infections following heart transplantation in pediatric patients. Recently, a study using the Pediatric Health Information System (PHIS) database found that one in six pediatric solid organ transplant recipients were hospitalized with respiratory syncytial virus (RSV) or vaccine-preventable illness in the first five years after transplant. Within this…

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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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Novel Nitric Oxide-Mediated Mechanism Facilitates Calcific Aortic Valve Disease
Novel Nitric Oxide-Mediated Mechanism Facilitates Calcific Aortic Valve Disease 1024 752 Lauren Dembeck
Top-down view of heart valves

The novel pathway could be targeted to prevent or reverse aortic valve calcification in humans. Researchers have recently described a novel nitric oxide-mediated mechanism in calcific aortic valve disease that involves the ubiqutin-proteasome pathway, and its modulation in animal models was shown to cause aortic valve calcification. The pathway could potentially be modulated to prevent…

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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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Transplant-Free Survival Among Children With Hypoplastic Left Heart Syndrome Undergoing Hybrid Palliation
Transplant-Free Survival Among Children With Hypoplastic Left Heart Syndrome Undergoing Hybrid Palliation 1024 683 Katie Brind'Amour, PhD, MS, CHES
Young child

The first long-term evaluation of kids with hypoplastic left heart syndrome undergoing hybrid palliation procedures finds transplant-free survival similar to that of the standard treatment at age 15 years. As one of the few teams in the world almost exclusively performing hybrid palliation surgery for babies with hypoplastic left heart syndrome (HLHS) and related congenital…

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Findings Show TEVG Stenosis Spontaneously Resolves
Findings Show TEVG Stenosis Spontaneously Resolves 600 400 Katie Brind'Amour, PhD, MS, CHES
Tissue engineered vascular graft

The complication that halted a clinical trial for tissue-engineered vascular grafts for children with congenital heart disease may reverse spontaneously without clinical complications. Based on promising laboratory and animal modeling of a biodegradable scaffold seeded with a patient’s own cells, a clinician-scientist research team now based at Nationwide Children’s Hospital initiated a pediatric tissue engineered…

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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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From Expectant Parents to Advocates: One Family’s Journey With Hypoplastic Left Heart Syndrome
From Expectant Parents to Advocates: One Family’s Journey With Hypoplastic Left Heart Syndrome 1024 575 Abbie Roth

Mila’s parents wanted her to have the best chance at surviving her high-risk comprehensive stage 2 surgery – their journey led them to The Heart Center at Nationwide Children’s. Mid-way into their pregnancy, Jacob and Kayla went in for their 20-week ultrasound. “We were very excited to get into things like paint colors for our…

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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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Percutaneous Occlusion Linked to Respiratory Improvements in Low-Weight Infants with PDA
Percutaneous Occlusion Linked to Respiratory Improvements in Low-Weight Infants with PDA 1024 575 Abbie Roth
Nurse caring for infant in Neonatal Intensive Care Unit (NICU)

Percutaneous occlusion for patent ductus arteriosus (PDA) in infants weighing less than 6 kg is associated with potential longer term improvements in respiratory health, research by investigators at Nationwide Children’s Hospital shows. “A new device for PDA closure recently approved by the FDA has potential to reduce the incidence of device-related complications. This important work…

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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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Using Computer Models to Predict How Tissue Engineered Vascular Grafts Will Work
Using Computer Models to Predict How Tissue Engineered Vascular Grafts Will Work 150 150 Kevin Mayhood

Model and experimental data strongly suggest testing TEVGs until scaffold has biodegraded Identical tissue engineered vascular grafts (TEVGs) being tested in small-diameter veins and arteries of a mouse model performed well for 12 weeks. At 14 weeks, all TEVGs in the veins continued performing well, but all in the arteries suddenly failed. During their effort to understand…

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Optimal Use of an FDA-Approved Device for PDA Closure in Infants
Optimal Use of an FDA-Approved Device for PDA Closure in Infants 150 150 Mary Bates, PhD

Randomized, controlled clinical trials are needed to answer questions regarding when and with whom to use the device. In January 2019, the US Food and Drug Administration approved a novel device for patent ductus arteriosus (PDA) closure in infants. The Amplatzer Piccolo Occluder is indicated for catheter-based closure of PDA in infants weighing more than…

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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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Fetal Balloon Aortic Valvuloplasty for Critical Aortic Stenosis
Fetal Balloon Aortic Valvuloplasty for Critical Aortic Stenosis 1024 575 Abbie Roth
Fetus in utero receiving valvuloplasty

Some heart defects, such as aortic stenosis can be detected on fetal ultrasound. For some fetuses, an intervention can be beneficial before birth. Aimee Armstrong, MD, director of Cardiac Catheterization and Interventional Therapies at Nationwide Children’s Hospital, performs fetal balloon aortic valvuloplasty among other fetal heart catheterization procedures as part of the Congenital Heart Collaborative, a…

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Keeping Young Patients With Congenital Heart Disease Connected to Care
Keeping Young Patients With Congenital Heart Disease Connected to Care 150 150 Mary Bates, PhD

Race, type of insurance and severity of disease affect likelihood of experiencing a lapse in care for CHD patients younger than 5 years. Lapse in care is prevalent among congenital heart disease survivors by age five, with nonwhites demonstrating elevated risk, according to a new study from Nationwide Children’s Hospital researchers. Medicaid patients and those…

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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
Opening the Door to Adult Medicine
Opening the Door to Adult Medicine 1024 575 Katie Brind'Amour, PhD, MS, CHES

Care transition plans aren’t just for kids with congenital conditions anymore. Could your practice benefit from a proactive transition plan for all patients? In the shift from pediatric to adult care, young patients have the responsibility to adjust to a new life of self-management. But health care providers also play an important role in this…

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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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From What-if to Widely Available – A Proposed Path for Tissue Engineered Vascular Grafts
From What-if to Widely Available – A Proposed Path for Tissue Engineered Vascular Grafts 150 150 Abbie Roth

What if you could utilize tissue engineering, imaging and 3D printing technologies to bring the benefits of a tissue engineered vascular graft to every child who needs one? Children born with a single ventricle heart defect undergo a series of surgeries and procedures to reroute the blood flow through their heart. The Fontan operation is…

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The PDA Conundrum
The PDA Conundrum 150 150 Jeb Phillips

A patent ductus arteriosus is associated with increased morbidity and mortality, but common treatments are associated with poor outcomes as well. What is a neonatologist to do? Until the mid-2000s, most neonatologists were pretty sure they knew how to handle a patent ductus arteriosus (PDA) in an infant born preterm – it needed to be…

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The National Mortality Rate for the Comprehensive Stage 2 Procedure
The National Mortality Rate for the Comprehensive Stage 2 Procedure 1024 575 Jeb Phillips

A substantial overall U.S. rate, in contrast to the low rates reported by a few single centers such as Nationwide Children’s, shows room for improvement in handling the hybrid approach for left ventricular physiology. Most published outcomes data on the pediatric Comprehensive Stage 2 procedure come from the few institutions routinely using the “hybrid approach”…

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A Key to Preventing Stenosis in Tissue-Engineered Vascular Grafts
A Key to Preventing Stenosis in Tissue-Engineered Vascular Grafts 600 400 Kevin Mayhood
Tissue engineered vascular graft

Seeding a high number of bone marrow mononuclear cells on graft appears to prevent narrowing. Tissue-engineered vascular grafts hold promise for children with congenital heart disease because the grafts, which carry a patient’s own cells, have the potential to grow and regenerate just as the child’s blood vessels do. But over time, some grafts develop…

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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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How Genes and Environment Interact to Raise Risk of Congenital Heart Defects
How Genes and Environment Interact to Raise Risk of Congenital Heart Defects 150 150 Mary Bates, PhD

Genetic susceptibility plus maternal hyperglycemia interact to contribute to heart defects during fetal development. Infants of mothers with diabetes have a three- to five-fold increased risk of congenital heart defects. Such developmental defects are likely caused by a combination of genetic and environmental factors. However, the molecular mechanisms by which maternal diabetes disrupts normal heart…

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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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A Narrow Focus: Perfecting Tissue Engineered Vascular Grafts
A Narrow Focus: Perfecting Tissue Engineered Vascular Grafts 1024 575 Abbie Roth
image of heart with fontan conduit highlighted

A pair of surgeon-researchers is perfecting tissue engineered vascular grafts through bench, clinical and computational modeling studies.

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ANH Preserves Platelet Count and Function Regardless of Storage Method and Time
ANH Preserves Platelet Count and Function Regardless of Storage Method and Time 150 150 Kevin Mayhood

Length of storage during cardiac surgeries appears to have no detrimental effects on blood. Across the United States, transfusions are standard in cardiac operating rooms, but at Nationwide Children’s Hospital, a practice geared toward limiting blood transfusion has been established and finely honed. According to a recent study from The Heart Center at Nationwide Children’s, more than…

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How a QI Project Dramatically Increased Pediatric Survival After Cardiopulmonary Arrest
How a QI Project Dramatically Increased Pediatric Survival After Cardiopulmonary Arrest 150 150 Jeb Phillips

A survival rate of 37-48 percent among young heart surgery patients who experience code events is the norm. A multidisciplinary review process helped achieve an 81 percent rate at Nationwide Children’s Hospital. Survival rates have remained stubbornly low for young heart surgery patients who experience cardiopulmonary arrest; critical care literature reports that fewer than 50…

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Understanding Stress Experienced by Survivors of Congenital Heart Disease
Understanding Stress Experienced by Survivors of Congenital Heart Disease 150 150 Tiasha Letostak, PhD

For adolescent and adult survivors of congenital heart disease, how they perceive disease-related stress has a key connection to how they report health outcomes, such as quality of life and emotional well-being. Researchers at Nationwide Children’s Hospital are the first to systematically identify different types of disease-related stress experienced by survivors of congenital heart disease,…

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A New Use for Kangaroo Care
A New Use for Kangaroo Care 150 150 Kevin Mayhood

A parent’s touch reduces agitation, allows infants and toddlers to remain extubated after heart surgery. A small percentage of babies and young children who have undergone congenital cardiac surgery and early tracheal extubation are treated with a calming parent’s touch at Nationwide Children’s Hospital – a strategy that physicians have found works better in some…

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