April 22, 2014


Dr. Henri Justino, director of the C.E. Mullins Cardiac Catheterization Laboratory, is something of a magician when it comes to repairing a child’s heart in the least invasive way possible. He and his colleagues in the cath lab can remove a blockage, close a hole in the heart, and replace a defective heart valve using thin, flexible catheters and some deft flicks of the wrist, leaving no trace of their efforts other than a tiny incision near the patient’s hip.

One thing that has consistently bothered him, however, is the lack of available options for children with defective heart valves.

“Compared to the adult market, the pediatric market is simply too small for companies to invest in,” Justino said. “Seventy-five percent of children who need a valve replacement need a pulmonary valve, but there’s only one kind available today that can be delivered by a catheter approach and is approved for use in the pulmonary position. It’s expensive and hard to come by. We need another option.”

Justino and his partners – Daniel Harrington, Ph.D., at Rice University, and Kwonsoo Chun, Ph.D., at Baylor College of Medicine – are on a mission to create an artificial pediatric pulmonary valve that can be delivered by a catheter-based approach into the heart.

“Right now, we are working on getting the mechanics right,” Justino said. “We need a solid valve that works well, opens and closes well with every heartbeat, and is designed to last.”

Getting the valve’s mechanics right is no small feat. It must be small, thin and flexible enough to snake through a young child’s veins and through the chambers of the heart. Once it’s in the right place, it needs to expand to full size, anchor in place with no sutures or adhesive, and be durable enough to last many millions of cycles in a child’s heart, which beats up to twice as fast as an adult’s. They’re also trying to design the valve so that it can grow with a child over time.

“We’ve definitely got some challenges,” said Justino, who compares catheterization to a mechanic trying to fix the motor on a car while it’s still running. “We’re doing all sorts of procedures on the heart without ever having to stop the heart or put the patient on a heart-lung machine.”

And that’s the point – to fix the heart with as little disruption as possible.

“Open heart surgery does work very well, and it is a very good option if it’s your only option,” Justino said. “If you can get the very same result without having the chest opened, without a long scar, without using an artificial machine to circulate blood through your brain, and if you can go home the very same day instead of staying in the hospital for several days – even go to school the next day – why would you not want that?”

After three years of development, Justino, Harrington and Chun have a working prototype and are very close to completing their first milestone, which is to prove that it works in the lab setting and meets the criteria the FDA requires of valves. The next phase is animal testing: How does this device perform when it’s placed in a living organism, in contact with organs, tissue and blood? The final step, human testing, may be several years away depending on funding and how well the first two stages go.

“Our long-range goal, after all of this is complete, is to see if we can coat the valve with living tissues and various kinds of cells to make the device more biocompatible with the patient, similar to what Dr. Jacot and his team are doing,” Justino said. “But that’s a long way away. For now, our main goal is to get the best performance we can from this valve and then get it on the market – helping children – as quickly as possible.”

Cutline: Drs. Henri Justino, Daniel Harrington and Kwonsoo Chun examine the prototype valve in a high-cycle tester.


Hospital photographers place first and fourth in national competition

Texas Children’s Hospital is hosting the 2013-2014 Children’s Hospital Association (CHA) Photo Exhibit, a biennial competition that celebrates its 20th anniversary this year. The national exhibit, which is on display on the fourth floor of Texas Children’s Pavilion for Women during the month of April, features photographs by Texas Children’s Hospital photographers Paul Kuntz and Allen Kramer. Visit childrenshospitals.net/photoexhibit to view the images.

Kuntz and Kramer received special recognition as their photos were selected as “top 5” photos, chosen from more than 250 photographs submitted by 56 children’s hospitals across the country and internationally. Kuntz placed first in this competition, the second time he has won this honor, and Kramer placed fourth and fifth. This marks the third competition in a row that Kuntz and Kramer have both placed in the top five. Additionally, there are four other images from the duo in the exhibit.

The CHA Photo Exhibit is comprised of 50 poignant and powerful images that portray the everyday heroes in children’s hospitals – brave patients, supportive families and compassionate health care providers.

Additionally, the exhibit’s presence at the hospital coincides with an international Arts & Health conference hosted by Texas Children’s, the Global Alliance for Arts & Health’s 2014 Annual International Conference, Enhancing Lives Through Arts & Health: 25th Anniversary Conference & Celebration. This exhibit truly embraces the goal of the conference which aims to bring much needed attention to the transformative impact the arts have on the healing process.

The CHA photo exhibition has been traveling around the country since last year and will be on display June 23-24 on Capitol Hill in Washington in conjunction with the Association’s Speak Now For Kids Family Advocacy Day event.


The BP MS 150 is a two-day bicycle ride from Houston to Austin organized by the National MS Society: Lone Star Chapter to raise funds to fight against the devastating neurological disorder multiple sclerosis. Since 2006, Texas Children’s Hospital has sponsored its own team of riders who have helped raise more than $1.53 million to date for the cause.

In 2014, Team Texas Children’s consisted of 218 registered riders, with 183 actually completing the ride on April 12-13. The 2014 team will raise more than $220,000 this year. In addition to the riders, approximately 100 employees and community volunteers gave their time to hand out snacks, haul luggage, blow up air mattresses, set up the overnight tent in La Grange and provide other much-needed and much-appreciated support.

Did you know?

  • The BP MS 150 is the largest event of its kind in North America.
  • The first MS 150 Houston to Austin bike tour was held in 1985, with 237 cyclists raising just over $100,000.
  • Since 2007, the wildly popular event has been capped at 13,000 riders.
  • Since surpassing the $15 million mark for the first time in 2008, the BP MS 150 has raised an average of $16 million per year.
  • This year’s ride is expected to raise around $18.5 million for MS.
  • A “fashion show” of sorts, teams compete to have the most creative, colorful and distinctive jersey designs.
  • Team Texas Children’s is among the most popular and most recognizable, winning multiple competitions for Best Jersey in recent years.
  • In 2014, four of the top 300 fundraisers rode on Team Texas Children’s.
  • In 2014, Team Texas Children’s riders ranged in age from 12-74 years old, with seven children under the age of 18 participating.


Texas Children’s patients recently had the chance to learn more about hospital procedures during the annual Teddy Bear Clinic on The Auxiliary Bridge during Child Life Week.


You know when all the magazines, books and all your friends begin to tell you that the second trimester of your pregnancy will be this euphoric honeymoon filled with bunnies and sunshine? You’ll gain all your energy back, you’ll glow with perfect skin and shiny hair, you’ll basically be able to take on the world and find the solution for world peace… You know what I think? I think they have all conspired against me (and the rest of the pregnant population) and are partially lying.

Yes, I gained some energy back – but instead of reorganizing furniture, cleaning my gutters, hand washing my car in the front drive or crocheting a blanket – I took all those 4 extra minutes of energy and spent them eating everything in my kitchen. Literally, everything. You know you’ve hit a low in your adult life when your husband catches you eating a grilled cheese in the bathtub late at night. I was caught, like a deer in headlights, enjoying the ooey-gooey-cheesy goodness (in PEACE!) when he “thought something was wrong” and busted in the bathroom like Hercules. No, nothing was wrong. It’s just me, your wife, sitting in the bubble-less tub, eating a golden crispy grilled cheese at 9:20 p.m. I figured I would rather get crumbs in the drainable tub and multi-task (I am becoming a mom right?) than waste any more precious time by having tub time pre or post grilled cheese. Men – then just don’t get it.

So besides eating everything in sight (HEB is still in business because of me) and also thinking about going over to the neighbor’s house to eat their food, since they have a teenage boy and I can assume their pantry is well stocked, one lovely pregnancy symptom decided to rear its annoying little head, headaches. I’m not prone to headaches, and now I can say with true humbleness – those who are headache sufferers, I don’t know how you manage. Anything I did gave me a headache! Reading, driving, cooking, thinking, feeding the dogs. I succumbed to my ailment and decided to pull one of the limited “Can you do this for me” cards I have during my pregnancy – and handed over my domestic duties to my husband. I literally would lie in bed for hours just thinking about what I could do, to make the ache behind my eyeballs go away. I am not a girl who enjoys taking medicine (crazy I work at TCH and all the doctors reading this are putting me on their black list), but my philosophy is: if you are vomiting or bleeding to death – then it’s OK to pop an Advil. I waddled over to our measly medicine cabinet, took out a Tylenol and a steak knife, and proceeded to cut the pill in half. My husband walked in, took one look at me with a steak knife and pill bottle, and briskly walked right out. When this brilliant idea didn’t do jack for my headache – I finally sent a message via the TCH-MyChart App to my OB nurse at the Pavilion, who is on Dr. Ivey’s team. She immediately called me and said “Wait Kelli, you actually cut the Tylenol pill in half? (I think I heard her and the rest of the third floor Pavilion laughing) “That’s really not going to do anything.” I was defeated by her giggles and the Tylenol bottle that was staring and mocking me. Finally, under her direction, I took a whole two Tylenol pills and whaa-laa, headache gone. Doctors are miracle workers! I secretly continued to say I was achy, so my sweet and doting husband would feed the dogs, and clean up the bathroom since there were grilled cheese crumbs pretty much everywhere. The moral of this story: headaches are terrible, food is awesome, but the TCH – Pavilion OB Staff is incredible and the MyChart App is a lifesaver! If you don’t have it, download it! My nurse replied to my cries for help, within minutes.

One thing I will say about the second trimester that is AMAZING, is feeling the first little kick. I was sitting in the parking lot, otherwise known as 610 at San Felipe, when I felt this teeny tiny flick. I immediately stopped singing Foreigner at the top of my lungs, and waited in silence for more flicks. About two more flicks happened, then little Baby Calderwood decided it had enough exercise for one day. It was truly amazing. I called my husband at work and was screaming on the phone like a little girl who sees Cinderella’s castle for the very first time up close and personal. Again, I think he is keeping a list of all my crazies so he has evidence when I say “I’ve never acted like that.” Anyway, it was a blessing and a miracle to feel those teeny tiny flicks. Ever since that day, Baby Calderwood has made it a habit to give me at least a few good kicks during the day.

In the last week my mind has been preoccupied with flowers, dresses and bows. We recently found out that Baby Calderwood is a GIRL! Of course my husband and I would be SUPER excited with any baby the stork wanted to bring us – but I think having a girl is really special. WE GET ANOTHER ME! (Just what my husband has always wanted.) My husband looked at me in the gender appointment, like he had just been hit with a Taser and said, “But the money – jewelry and weddings…… and boys.” I laughed pretty hard (at him, not with him) and told him to relax; we had some time before all that happened. He quickly snapped back with, “You didn’t know me as a little boy – we start flirting with the ladies early”….. So while Rico Suave comes up with a master plan of how to keep our beautiful baby girl out of the prowling eyes of toddler boys – I’ll keep awaiting her August arrival (and buying her bows and dresses!) Seven more weeks till the third trimester – then it’s game time!

Lastly, we decided to name our sweet baby girl, Amelia Grace Calderwood.

To read the first trimester experiences again, click here. Comment below and tell us what most shocked you about pregnancy!


The Spring 2014 graduates of the Texas Children’s Hospital Lean Six Sigma Green Belt program received their certifications at a ceremony on March 31. Since February 2009, the Department of Business Process Transformation has trained more than 150 employees including physicians, directors, managers and other informal leaders including front line staff members on the Lean Six Sigma process improvement methodology. More than 80 percent of the candidates trained in the program went on to complete the requirements for certification, with more students approaching their project close dates this summer.

The Texas Children’s certification recognizes candidates who provide statistically significant evidence that their process improvement project resulted in positive outcomes in quality, cost or cycle time metrics. Certified Green Belts at Texas Children’s include representation from inpatient/outpatient areas, ancillary departments, Texas Children’s Health Plan (TCHP), Texas Children’s Pediatrics, Baylor and Texas Children’s Physician Service Organization (TCPSO). The certification ceremonies are held annually each spring.

The Department of Business Process Transformation offers Lean Belt Training (a prerequisite for Green Belt) now available for enrollment through the Learning Academy.

Dr. Huda Zoghbi, director of the Jan and Dan Duncan Neurological Research Institute (NRI), will receive the 2014 March of Dimes Prize in Developmental biology at a ceremony held in Vancouver on May 5. The award, given annually, honors investigators whose research has profoundly advanced the science that underlies the understanding of birth defects.

Zoghbi’s best known for her pioneering work on Rett syndrome, a cause she first became passionate about after encountering children with the disease during her residency. She’s since been tireless in her efforts to find the genetic cause of the syndrome. In 1999, she was successful in identifying the Rett gene, providing a definitive genetic diagnoses for the condition and allowing a biological understanding and search for treatment.

“Dr. Zoghbi’s contributions to our understanding of several entirely different neurological disorders, including her finding of the genetic basis of Rett syndrome, have opened new areas of research,” says Dr. Joe Leigh Simpson, senior vice president for Research and Global Programs at the March of Dimes. “Her work influences the entire field of autism and other neuropsychiatric disorders.”

Rett syndrome is a genetic neurological disease that affects young girls who are born with the disease and develop normally for one to two years until they show progressive loss of motor skills, speech and cognitive abilities. Males with the condition usually die in infancy.

Zoghbi will deliver the 19th annual March of Dimes Lecture titled “Rett Syndrome and MECP2 Disorders: From the Clinic to Genes and Neurobiology,” during the Pediatric Academy Societies annual meeting. She will receive the March of Dimes Prize in Developmental Biology in a special award ceremony held during the meeting. Given annually, the March of Dimes Foundation created the prize in 1995 as a tribute to Dr. Jonas Salk, a pioneer in the development of the polio vaccine.
The March of Dimes Foundation is the leading nonprofit organization for pregnancy and baby health.