December 22, 2015

122315PCICS640Intensivists, cardiologists, cardiovascular surgeons, nurses, and outcomes and quality experts from Texas Children’s Heart Center and Baylor College of Medicine served as presenters and moderators during the Pediatric Cardiac Intensive Care Society (PCICS) 11th International Meeting held December 9 through 11 in Houston.

Nearly 300 cardiovascular experts from 13 countries met during the two-day multidisciplinary, interactive conference, which includes cutting-edge research presentations and panel discussions. PCICS is an international professional forum for promoting excellence in pediatric cardiac critical care medicine. Through programs, meetings and educational curriculums, the society has a large role in vital research and training that will improve the level of care of pediatric patients with congenital heart disease and acquired cardiovascular disease.

“I’m thrilled so many of our leading Heart Center experts presented and moderated at this year’s conference in front of an international audience,” said Dr. Paul Checchia, medical director of the Cardiovascular Intensive Care Unit (CVICU) at Texas Children’s and president of the PCICS.

Checchia, who also serves as a professor of pediatrics-critical care and cardiology at Baylor, and Dr. Lara Shekerdemian, chief of critical care medicine at Texas Children’s and professor of pediatrics-critical care and cardiology at Baylor, were program directors of the meeting. The 11 Texas Children’s Heart Center experts who presented or moderated throughout the meeting include:

  • Dr. Patricia Bastero, pediatric intensive care physician at Texas Children’s and associate professor of pediatrics-critical care at Baylor, presented: Lessons Learned from Simulation: How to Keep a Safe Environment for Real Life Event Debriefings.
  • Kathleen Carberry, director of the Texas Children’s Hospital Outcomes and Impact Service, moderated: Wave the Magic Wand: What do Bedside Nurses Need to Create a Safer Culture?
  • Dr. Charles D. Fraser Jr., surgeon-in-chief and chief of congenital heart surgery at Texas Children’s and professor of surgery and chief of the division of congenital heart surgery at Baylor, moderated: The Risks We Used to Take: Panel of Innovators.
  • Trudy Leidich, director of quality and safety at Texas Children’s, presented: Reassurance vs. Criminal Charges, How Do We Handle/Talk About Errors?
  • Dr. Carlos Mery, congenital heart surgeon at Texas Children’s and assistant professor of surgery-congenital heart surgery at Baylor, presented: Congenital Heart Disease in Mexico: Building Programs and Changing Paradigms.
  • Dr. Jack Price, pediatric cardiologist at Texas Children’s and associate professor of pediatrics-cardiology at Baylor, presented: Candidate Selection: Different Views from Across the Spectrum – Medical.
  • Dr. Craig Rusin, cardiology research core, physiological signal processing and algorithm development at Texas Children’s and assistant professor of pediatrics-cardiology at Baylor, presented: Capturing Data in CVICU: When is Enough, Enough?
  • Kerry Sembera, CVICU nurse at Texas Children’s, served on the panel: Wave the Magic Wand: What do Bedside Nurses Need to Create a Safer Culture? and presented: Improving Patient Outcomes: Just in Time!
  • Shekerdemian moderated: The Future is Now: Updates on Trials and Research and present: PHN/NIH Update.
  • Dr. James Thomas, pediatric intensive care physician at Texas Children’s and professor of pediatrics-critical care at Baylor, presented: Ethics in ECMO: How to Handle Difficult Cases.
  • Dr. Eric Williams, medical director of quality at Texas Children’s and associate professor of pediatrics-critical care at Baylor, presented: Being Resilient: The Cardiac ICU as a Complex Socio-Technical System.
December 15, 2015

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Falon Wiesner-Jones was just a baby when she had her first visit to the Texas Children’s Heart Center diagnosed with a congenital heart disease that has been a fabric of her life ever since. Now 33, she’s still a patient at the heart center. Today, she sees specialists in the Adult Congenital Heart Disease Program, part of the transitional medicine program that allows pediatric patients to continue their care here at Texas Children’s Hospital into their adult years.

“I’ve been here from day one and I’ll continue my care here,” said Wiesner-Jones who now drives to Houston from Dallas to see her doctors. “The doctors are well-versed in my history and it makes it easier to come to one place and receive all of the care I need.”

Wiesner is part of a growing population of adults with congenital heart disease. The Centers for Disease Control and Prevention (CDC) estimates that about 40,000 babies are born each year with a congenital heart disease. It is the most common birth defect.

“The data shows that people who were born in the 1940s and 50s, before the era of advanced surgical and interventional repairs had only about a 15 percent chance of survival past their first birthday,” said Dr. Wayne Franklin, director of the Adult Congenital Heart Disease Program at Texas Children’s Hospital. “In the modern area, we’ve reversed that and now 85 to 90 percent survive into adulthood so there is a real need for the right care for these adults who have had heart disease throughout their lives.”

That care now includes women’s care for Wiesner who just delivered her second child at Texas Children’s Pavilion for Women. When she told her physician, Dr. Wayne Franklin, director of the Adult Congenital Heart Disease Program at Texas Children’s Heart Center, she was pregnant again, he was thrilled to know her care coordination would take place in the ob-cardiac clinic at The Pavilion where both her cardiology doctors and her obstetrician meet in one place to see her during her monthly appointments.

“Women’s health and cardiology were an underserved area in medicine,” said Franklin. “With the Pavilion, we’re able to offer that to her and all of our other patients. We offer multidisciplinary care that is most crucial to these patients during pregnancy.”

Because the heart has to work harder during pregnancy, patients with heart disease are watched closely by an interdisciplinary team, meeting often in the ob-cardiac clinic for appointments.

“It’s reassuring to know all the resources we need are in one spot, all here to help me deliver safely,” Wiesner-Jones said.

Texas Children’s Hospital offers several programs for adults outside of women’s care including heart disease programs, cystic fibrosis programs as well as a program for survivors of pediatric cancer.

“Texas Children’s is now in the arena of adult medicine,” Franklin said.

November 17, 2015

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Each year, Texas Children’s Heart Center honors its founder, Dr. Dan McNamara, with a grand rounds dedicated to pediatric cardiology. This year’s speaker was Dr. Chris Feudtner from Children’s Hospital of Philadelphia Department of Medical Ethics and the Pediatric Advanced Care Team. Feudtner spoke to a standing-room only audience of physicians at McNamara Grand Rounds in the Texas Children’s Hospital Auditorium. The subject of his talk, compassionate confrontations: integrating hopes, emotions and duties when confronting serious illness, was a message of giving care to families coping with difficult decisions and grim prognoses.

“Even though I am one of you and I like living and working at the hospital, no parents likes hospitals and we have to remember that,” Feudtner said. “When communicating with parents, we need to remember we’re all feeling beings who have thoughts.”

Feudtner gave several examples of relaying difficult news to patient families. He encouraged providers to ask parents their hopes for their child. Acknowledging that hope as well as the hopes that can be achieved.

“Don’t argue with someone’s hope. Respect and honor patient family’s hopes and allow them to share other hopes that can then help you with the course of action you take with their child’s care,” Feudtner said.

Feudtner suggested to thank parents for sharing their first hopes, which will almost always be false hope characterized by Feudtner as “duty-based hope” that allows parents to remain wishful that the prognosis will improve against all odds. His suggestion, acknowledge the importance of this hope and how as a caregiver, you too wish this were possible, but ask for other hopes which opens the door for dialogue.

“The parents then may say they hope their child is not in a lot of pain,” Feudtner said. “When the second and third hopes are shared, it’s easier for you to say ‘I can help with that.’”

Feudtner ended the conversation by encouraging the health care providers to be in partnering relationships with patients to move forward in care.

October 6, 2015

bench-and-beside-Header2Bench and Bedside is a digest of the previous month’s stories about the clinical and academic activities of our physicians and scientists. We welcome your submissions and feedback.

10615PaintingGroup300September 2

Pulmonary hypertension team hosts the painting party, proceeds benefit PHA

Physicians and staff with Texas Children’s Pulmonary Hypertension Program hosted a tile painting party on August 22 where patients transformed ceramic tiles into colorful pieces of art. The event benefited the Pulmonary Hypertension Association. Read more

September 9

Texas Children’s Hospital West Campus expands urology services

Urology services at Texas Children’s Hospital West Campus have been extended to meet the needs of patients in Houston and its surrounding area. Read more

September 9

Dormans sets sights high for future of Orthopedics Department

Chief of Orthopedics Dr. John Dormans joined Texas Children’s three months ago and has already developed a plan to make the Texas Children’s Orthopedics Department one of the top programs in the world. His plan focuses on three main areas – recruitment, operations and facilities, and reputation and expertise. Read more

10615drhairaward300September 9

Hair receives 2015 Clinical Faculty of the Year Award

Dr. Amy Hair, a neonatologist and director of neonatal nutrition at Texas Children’s, recently received the Baylor College of Medicine’s 2015 Clinical Faculty of the Year Award for demonstrating “exemplary performance of activities that are above and beyond the scope of assigned responsibilities.” Read more

September 9

New program offers emotional healing for parents of special-needs children

Texas Children’s Geneticist Dr. Christian Schaaf and his colleagues developed a support program that helps parents cope with the emotional challenges of caring for children with developmental disabilities by learning to let go of things they cannot control. Read more

September 15

Clinical Research Center/Research Resources Office presents research award to Dr. Wenderfer

The Clinical Research Center/Research Resources Office presented the Clinical Research Award for Third Quarter 2015 to Dr. Scott Wenderfer, Department of Pediatrics-Renal, Baylor College of Medicine. Wenderfer’s research activities focus on Inflammatory Kidney Diseases and Lupus Nephritis. Read more

10615summercamps300September 15

Texas Children’s patients, staff create shared memories at Camp Spike N Wave, Camp Periwinkle

Every summer, Texas Children’s staff and their patients make the 90-mile trek to Camp for All, a 100-acre, barrier-free recreational facility where children with complex medical conditions experience the thrill of camping just like other kids their age. More than 185 children with epilepsy attend Camp Spike N Wave and roughly 185 patients from Texas Children’s Cancer Center go to Camp Periwinkle. Read more

September 29

Dormans presides over 50th annual meeting of SRS

Dr. John Dormans, chief of Orthopedics at Texas Children’s Hospital, completed his year as president of the Scoliosis Research Society (SRS) at the 50th anniversary meeting in Minneapolis September 30 to October 3 and presented one of six special lectures titled, “Neural Complications in Spinal Deformity: Detection and Avoidance.” Read more

September 29

Dr. Swathi Bataji joins Pediatric Surgery

Dr. Swathi Balaji has joined the Pediatric Surgery Research Laboratory at Texas Children’s Hospital. Balaji also has been appointed assistant professor in the Department of Surgery at Baylor College of Medicine. Read more

September 29

ICD-10 debut: New coding system launchess at Texas Children’s October 1

On October 1, Texas Children’s and other hospitals around the world switched to the ICD-10 coding system that will allow greater detail and precision in reporting patients’ diagnoses and procedures. For more than a year, Texas Children’s ICD-10 preparedness teams worked diligently to ensure all employees were prepared for the mandatory October 1 conversion. Read more

10615PICS300September 29

Heart Center physicians perform two cases broadcasted to live audience

Heart Center physicians performed two pediatric interventional cardiac care cases for the Pediatric and Adult Interventional Cardiac Symposium. The cases, which were performed at the Main Campus, were transmitted live to the conference in Las Vegas, Nevada via satellite. Read more

September 29, 2015

Physicians from around the world attending the Pediatric and Adult Interventional Cardiac Symposium in Las Vegas, Nevada were invited to watch two live cardiac catheterization cases performed by the Texas Children’s Heart Center team. The cases, which were performed at the Main Campus, were transmitted live to the conference via satellite. The purpose of these cases is to showcase the surgical techniques of the different hospitals and encourage greater collaboration. Texas Children’s was among nine hospitals from around the world chosen to participate in these live cases.

The conference, held in Las Vegas, focuses on opportunities for greater integration between congenital heart and adult structural heart disease specialists. Texas Children’s Heart Center is ranked #2 nationally in cardiology and heart surgery by U.S. News & World Report.

Led by interventional cardiologist Dr. Henri Justino, The Charles E. Mullins Cardiac Catheterization Laboratories at Texas Children’s Hospital include three dedicated labs and a team of five dedicated interventional cardiologists. In 2014, the team performed more than 1,150 cardiac catheterization procedures and more than 98 percent of cases occurred without complication.

“We are thrilled to showcase Texas Children’s specialized pediatric interventional cardiac care on an international level,” Justino said. “Our team performed two procedures on patients with extremely complex cardiovascular malformations which will further highlight the depth and breadth of minimally invasive transcatheter treatments we provide to our patients every day.”

Justino was joined by Dr. Athar Qureshi, associate director of the Mullins Catheterization Laboratories at Texas Children’s along with the team. The first case involved a patient with Abernethy malformation with portopulmonary hypertension. The team plans a percutaneous splenic vein puncture, splenoportography and possible placement of an additional device in the large congenital portosystemic shunt. The second case features a patient who has pulmonary vein stenosis due to Cri-du-Chat syndrome, a chromosomal condition that results when a piece of chromosome 5 is missing. The team plans balloon dilation and/or stenting of the right pulmonary vein stents with possible intentional stent fracture.

July 28, 2015

72915fraser640Thanks to the vision of legendary heart surgeon Dr. Denton H. Cooley and the leadership of Texas Children’s Hospital Surgeon-in-Chief Dr. Charles D. Fraser Jr., the Texas Children’s Hospital Heart Center is one of the most active pediatric heart programs in the United States, setting a record with 32 heart transplants in 2014 and consistently treating the most complex heart issues every day.

Since its inception 60 years ago, surgeons with the program have performed more than 27,000 cardiac operations, many of which have pushed the boundaries of a field pioneered by Cooley at Texas Children’s Hospital. The center has continued to push such boundaries under the leadership of Fraser, who joined Texas Children’s in 1995 and has helped focused the center on increasingly complex repair work, particularly in newborns and premature infants.

“I think Cooley would say that some of the contributions we’ve made in the past 20 years he didn’t dream could possibly be happening,” Fraser said. “We will continue to reach for a high bar and not coast on what Cooley and others got started here.”

The Heart Center began shortly after Texas Children’s opened its doors in 1954, a time when the idea of specializing in cardiology or heart surgery was a new concept on adults, much less children and infants. But, Cooley, a masterful surgeon ready to implement the advancements he had seen in medical school, was determined to make Texas Children’s the birthplace of pediatric cardiac care.

One of the program’s first major advances came when Cooley and his colleagues were able to open up the heart and operate inside it. The development of the heart-lung machine, which diverted blood from the heart and lungs, allowed this to happen and drove other doctors to Texas Children’s to observe what was unfolding.

Another milestone that garnered the Heart Center a lot of attention came in 1984 when Cooley performed the first pediatric heart transplant on 6-month-old Sara Remmington. The procedure was unlike anything that had been done, even in adults.

“That really was an exciting occurrence that attracted a lot of attention to the Texas Children’s surgical program,” Cooley said.

Fraser, who recently celebrated his 20th anniversary with Texas Children’s Hospital, is no stranger to monumental surgeries. During his career with the organization, he has performed the smallest arterial switch operation ever reported on a baby girl weighing less than two pounds. He also led a surgery on then 5-week-old Audrina Cardenas, who was born with her heart outside her chest. Fraser and a group of multidisciplinary surgeons saved Audrina’s life during a miraculous six hour open-heart surgery where they reconstructed her chest cavity to make space for the one-third of her heart that was outside of her body.

“We have a tremendous breadth of expertise in pediatrics at Texas Children’s,” Fraser said. “The Heart Center couldn’t be successful with a small baby without this whole focused interest on the children.”

Looking forward, Fraser said his team will continue to refine their techniques and focus on smaller and smaller children. Also, he said his team will work toward providing children with heart problems a life similar to that of a person with a normal, healthy heart.

“The pediatric cardiovascular field has had great success in obtaining survival and meaningful life for people with heart problems,” Fraser said. “Giving such patients a completely normal life, however has not yet been attained and is a goal we want to work toward.”

An important part of the Heart Center’s path forward is its continued relationship with the Texas Heart Institute, which Cooley started in 1962. For more than four decades, the two institutions have worked closely as they achieved numerous successes and Fraser said as long as he’s with Texas Children’s that relationship will continue.

“We’re enormously respectful and grateful for that mutually beneficial partnership,” Fraser said. “We can do so much more together moving forward.”

July 14, 2015

71515HeartFAILUREICU640Texas Children’s Heart Center and the section of Critical Care Medicine cut the ribbon July 6 on a new, first-of-its-kind pediatric Heart Failure Intensive Care Unit. This highly-specialized 12-bed unit focuses on the treatment of children with heart failure, as well as those requiring intensive care before and after heart transplant.

“We are thrilled to be the first in the nation to offer this highly-specialized level of pediatric critical care,” said Dr. Paul Checchia, medical director of the Cardiovascular Intensive Care Unit at Texas Children’s Hospital. “Patient outcomes will only continue to improve as we treat their unique needs in this new setting.”

Checchia and Dr. Lara Shekerdemian, chief of critical care medicine at Texas Children’s Hospital, oversee the unit. Drs. Antonio Cabrera and Jack Price, associate professors of pediatrics-cardiology and critical care at Baylor, serve as associate medical directors of the unit. Shekerdemian had the honor of leading the recent ribbon cutting, which was attended by attended by the CVICU team, Heart Center leadership, Physician-in-Chief Dr. Mark W. Kline, Surgeon-in-Chief Dr. Charles D. Fraser Jr., Chief of Pediatric Cardiology Dr. Daniel Penny, and other Texas Children’s leaders.

“We are excited about our additional capacity and space to care for our critically ill cardiovascular patients in a less congested and more family supportive setting, said Kerry Sembera, a heart center clinical liaison.

Sembera and Gail Parazynski, assistant vice president of Critical Care, worked in collaboration with physician leadership to execute a successful intensive care room design as well as plan for safe transition of patients to this new environment. Patient Care Manager Amanada Wollam in partnership with the CVICU nursing team, were enthusiastic champions of the unit leading to a seamless transition.

The heart failure and cardiac transplantation programs at Texas Children’s Heart Center are among the largest and most successful programs in the world. More than 650 cardiomyopathy patients are cared for each year by a team of physicians, nurse coordinators and administrative personnel. When a transplant is not immediately available, a variety of circulatory support devices are used as a bridge to transplantation. Currently, Texas Children’s Heart Center is able to offer a wide range of mechanical circulatory support devices, as well as extracorporeal membrane oxygenation (ECMO), to children whose hearts are failing: Maquet Rotaflow, Cardiac Assist Tandem Heart, Thoratec Paracorporeal VAD (ventricular assist device), Thoratec HeartMate II, Berlin Heart EXCOR, Heartware LVAD and Syncardia Total Artificial Heart.