This week we explore a provocative paper on the use of a femoral vein homograft for Sano shunt for Stage I palliation for HLHS. Does the incorporation of this form of shunt improve outcomes? How does the valve in this graft function over time? Are there demonstrable improvements in RV function or PA growth when using this approach? We speak with Dr. TK Susheel Kumar who is Associate Professor of Surgery at NYU Medical Center. Dr. Kumar shares his thoughts and insights into this novel approach. https://doi.org/10.1016/j.jtcvs.2019.03.123
This week we have a replay of an episode from 9 months ago on T wave inversions in athletes and why their presence may represent possible disease in the athlete. We speak with Professor Sanjay Sharma of the UK who is a world authority on this topic. This is an important episode worth hearing once more. Coming this week in the middle of the week is our 75th episode with Professor Sylvia Griffiths! Keep a look out for Professor Griffith's episode coming later this week!
This week we review the topic of transposition of the great arteries and the most common late long term complication of the arterial switch operation - supravalvar pulmonary distortion or stenosis. How effective were interventions for this problem and what complications were encountered? Does balloon dilation alone ever work to help this problem? Are there risk factors for possible catheterization related complications when working on the pulmonary arteries? We discuss these and more questions with the first author of a recent report on this topic - Dr Jesse Lee who is Assistant Professor of Pediatrics at Baylor College of Medicine. Dr. Lee reviews this large series from his former group at Rady Children's Hospital. doi: 10.1111/chd.12726
This week we jump back into the world of ACHD and review a recent registry study assessing outcomes in adults with ASD and elevated PVR who underwent ASD closure. Who was a good candidate for this approach? What were the long term outcomes of this form of therapy? Did ASD closure in this setting confer a survival benefit? We review these and many other questions in a 'virtual roundtable' discussion with Drs. Elisa Bradley of Ohio State and Ali Zaidi of Mount Sinai - NYC. Both are world authorities on ACHD and it is a great treat to have such 2 experts both on the show to discuss the subtleties of this complex topic. doi: 10.1016/j.ijcard.2019.03.056
This week we enter the worlds of cardiovascular surgery and interventional catheterization to review a recent STS dataset analysis of postoperative transcatheter interventions. Who needed these sorts of catheterizations more commonly after surgery and what was the relation between needing such an intervention and overall outcomes? How much variability existed between centers in their use of interventional cath following congenital heart surgery? We speak with Associate Professor of Pediatrics, Kevin Hill of Duke University about his recent study on this subject. doi: 10.1161/CIRCINTERVENTIONS.119.007853
In this special episode # 71 co-presented with the SADS Foundation (SADS.ORG) we speak with the president of the foundation, Professor Michael Ackerman of The Mayo Clinic about a recent work he co-authored on a novel approach to assessing patients with possible CPVT. How should the phenotype help to inform genotype results? Can a novel CPVT scorecard help to improve our understanding of genetic test results? How are genes determined to be 'benign', 'likely disease causing' or a variant of uncertain significance (VUS)? We discuss these issues and more with Dr. Ackerman who provides great insights into this fascinating topic that affects all cardiologists who use genetic testing as part of their practice. doi: 10.1161/CIRCGEN.119.002510
This week we review the role that complications have on outcomes in the ACHD patient undergoing cardiac surgery. How commonly do complications occur and if they do occur, what impact do these have on ultimate outcomes? Are there strategies that can be employed to reduce complications amongst this fragile patient population? We discuss these issues and more with the senior author of this work, Dr. Oscar Benavidez who is the Director of Congenital Cardiology at Massachusetts General Hospital in Boston, MA. doi: 10.1007/s00246-019-02103-5.
This week we speak with Professor Yoav Dori of Children's Hospital of Philadelphia about a recent paper he co-authored on the topic of lymphatic abnormalities in children with Noonan's syndrome. What are the typical findings in severely affected children and who is a candidate for intervention? Are there patients who are good candidates for 'thoracic duct ligation' or pleurodesis? Is there anyone in whom this would be considered appropriate therapy? We discuss these questions and more with the master of the lymphatic system, Dr. Dori. doi: 10.1007/s00247-018-04337-6.
This week we explore a recent CMR study in Fontan patients assessing the impact of pulmonary blood flow maldistribution and exercise capacity. How closely associated are these differences in relative pulmonary blood flow to functional status and overall outcomes? How aggressively should we intervene for these sorts of problems? We discuss these issues and more with Dr. Rahul Rathod who is the senior author of this work and also Assistant Professor of Pediatrics, Harvard Medical School. doi: 10.1186/s12968-018-0505-4
This week we review a fascinating paper that assesses the direct myocardial effects of IV antiarrhythmic agents upon cardiac muscle function performed by the group at Boston Children's Hospital - Harvard University. We speak with one of the principle authors of this work, Dr. Elizabeth DeWitt, who is an attending electrophysiologist at that large institution about this important work. Which agents were substantial negative inotropes and which had no effects? The answers may be surprising. Dr. DeWitt shares the general approach of the team in Boston when treating arrhythmias that require rapid IV therapies. doi: 10.1177/1074248418810811