July 14, 2015

Texas Children’s is spotlighted in an hour-long documentary about Knatalye Hope and Adeline Faith Mata, who were born conjoined on April 11, 2014 at Texas Children’s Pavilion for Women. An elite surgical team at Texas Children’s Hospital successfully separated the twins 10 months later. Both girls are doing well and are with their family in Little Field, which is just outside of Lubbock.

Produced by Lincoln Square Productions, an ABC News Production Company, the documentary will air at 8 p.m. Thursday, July 16 on the Discovery Life Channel. Called “Conjoined Twins: Miracle Separation,” the documentary follows the twins’ extensive journey from birth through separation. It also includes the first interview with the Mata family since they made it home.

“We are truly honored to be able to share the Mata family’s remarkable story,” said Jane Latman, general manager of Discovery Life Channel. “Our belief is that their story will offer hope and inspiration to other families going through difficult situations.”

A large portion of the documentary focuses on the 26-hour separation surgery the girls went through at just 10 months old. Cameras inside the operating room captured the complex choreography between the surgeons, anesthesiologist and surgical nurses who worked tirelessly to separate the conjoined twins, who were fused from the chest to the pelvis.

“This surgery was not without its challenges with the girls sharing several organ systems,” said Dr. Darrell Cass, lead surgeon and co-director of Texas Children’s Fetal Center. “This is the first time a separation surgery for thoraco-omphalo-ischiopagus twins with this particular configuration has been successful.”

In addition to seeing what the twins went through during surgery, viewers of the documentary also will follow Knatalye and Adeline through every phase of the arduous process leading up to and following their separation. At only 8 months old, the twins underwent a tissue expansion surgery to prepare their skin for separation. The girls continue to receive a rigorous regime of physical, occupational and speech therapy.

Elysse and Eric Mata, the twins’ parents, share their feelings on the documentary about the entire ordeal and what they had to go through as a family to make it all happen. Elysee talks about how she lived out of a temporary home near the hospital for a year while her girls were at Texas Children’s Hosptial. Eric, meanwhile, maintained his job at their permanent residence nearly eight hours away, commuting to hospital as much as possible.

“They have only been a part of our lives for nine months, but they have done so much for me as a mom,” Elysse said a month before Knatalye and Adeline were separated. “I just can’t imagine not having them.”

71515Matainside640The encore of the documentary is scheduled for July 20 and October 9 on Discovery Life. Find out what channel Discovery Life is on in your area and with your provider here. The documentary also will air July 20 on TLC. Check the network’s website for showtimes.

71515SurgeryReview640Since Dr. Charles D. Fraser Jr. was made surgeon in chief five years ago, he has taken a morning each year to formally talk about the successes, challenges and goals of the Department of Surgery. This year’s talk happened July 10 in the packed Texas Children’s Hospital auditorium and focused on how far the department has come during the past five years.

“You are a tremendous department,” Fraser said to the group before delivering his presentation. “The work you are doing is extraordinary.”

Representing 600 employees and at least 9 different subspecialties, the Department of Surgery is dedicated to caring for and improving the health of children through patient care, education and research.

The department’s more than 80-member surgical team treats children in and around the greater Houston area via our five Health Centers and two, soon to be three, hospitals. The team also sees patients at other hospitals around the country and the globe.

Annually, Texas Children’s surgeons perform 25,000 operative cases and 115,000 clinic visits, including 90 fetal procedures and about 20 neurological laser ablations.

Fraser said his goal for the department has been and will continue to be three fold:

  • Deliver the best possible pediatric surgical care.
  • Be preeminent in pediatric surgical research.
  • Be the epicenter in educating tomorrow’s leaders in pediatric academic surgery.

In all areas, Fraser said, the department has improved. In terms of delivering the best possible pediatric surgical care, the Department of Surgery offers an expanded pallet of services, has fostered relationships with various other entities both inside and outside the hospital, and has created an organized effort to improve the quality of care provided at Texas Children’s Hospital.

The result of such efforts can be seen in the number of people visiting the Department of Surgery each year. The number of surgical outpatient visits last year was up 70 percent compared with 2009. That number was up 14 percent compared with 2013. The number of surgical cases, operating room hours and Texas Children’s Pediatric referrals also has gone up every year for the past five years.

“Our outcomes have garnered us a lot of attention,” Fraser said, highlighting the separation of conjoined twins Knatalye Hope and Adeline Faith Mata as well as Baby Audrina, who was born with her heart outside of her chest. “Your tireless effort to get the job done has paid off.”

As for research, the Department of Surgery still has room to grow. However, conducting pediatric surgical research has become an important part of the department’s portfolio, bringing in National Institutes of Health funding, seed grants and significant publications.

71515Surgeryinside640A product of the department’s dedication to such research is the Edmond T. Gonzales Jr., Surgical Research Day, which provides a forum for researchers to unveil their work highlighting remarkable advancements in the field of pediatric surgery. This year, almost 300 clinicians attended the event.

“We will continue to invest in research and we will continue to be good stewards of the money we receive,” Fraser said.

As for leading in educating tomorrow’s leaders in pediatric academic surgery, the Department of Surgery has made great strides, hosting several educational conferences, recognizing excellence and fostering achievement. In addition, Fraser said the department has created a distinct sense of community, participating in Texas Children’s events together, working collaboratively on setting priorities, and promoting and celebrating their own successes.

“We are one team and we are focused on the relentless pursuit of excellence,” he said at the end of his Friday talk. “Dream big, work hard and keep the faith.”

71515HealthCenterTours640With the opening of the outpatient and subspecialty building at Texas Children’s Hospital The Woodlands just 15 months away, steps are being taken to ensure the transition for staff, patients and their families is seamless.

One such step was taken June 25 and 26 when staff and leaders at the Woodlands Health Center and staff and leaders at the West Campus Outpatient and Subspecialty Building met and discussed what it’s like to go from working at a small community health center to a community hospital.

The 60-member staff at the Woodlands Health Center will move into the Woodlands Outpatient and Subspecialty Building in October 2016. The building will be adjacent to Texas Children’s Hospital The Woodlands, which will open its doors in the fall of 2017. A similar situation occurred five years ago when West Campus Outpatient and Subspecialty Building started seeing patients. The nearby West Houston Health Center closed and its staff moved to the outpatient and subspecialty building.

“The staff at West Campus has been through this and has a lot of good advice to offer,” said Julie Barrett, who recently was named director of outpatient and clinical support services for Texas Children’s Hospital The Woodlands. “During the recent field trip, they alleviated a lot of our anxiety about the move and got us really excited about working in a community hospital setting.”

Some of the topics covered at the meeting included differences between a hospital setting and a health center, lessons learned from West Campus’ transition, operational challenges, and relationship with Main Campus. In addition to the panel discussion, health center staff also had the opportunity to tour West Campus.

“The overall experience was extremely beneficial to our health center employees, many of whom have never worked in a larger hospital setting,” said Diane Scardino, vice president of medical subspecialty practices and Health Centers at Texas Children’s. “They needed to see and hear what their new setting will be like from people who have been in their shoes.”

Scardino and President of Texas Children’s Hospital The Woodlands Michelle Riley-Brown will continue to work together to provide additional training that will help staff understand and navigate the differences between working at a stand-alone health center versus one that is part of a community hospital.

Once completed, the Woodlands facility will be a 560,000-square-foot complex and will offer inpatient and outpatient specialty pediatric care. Facilities will include 22 emergency center rooms, 85 outpatient rooms, five radiology rooms, four operating rooms and 32 acute-care and 12 PICU beds with future expansion plans for up to 200 beds.

Along with serving families throughout The Woodlands Area, Texas Children’s anticipates serving families in counties throughout Greater North Houston, including Montgomery, Walker, Grimes, Liberty, Harris, Polk, San Jacinto and Hardin.

In November, Riley-Brown was named president of the hospital and Dr. Charles Hankins was named chief medical officer of the institution. Riley-Brown and Hankins assumed their positions as the Woodlands leadership team in January.

“We are working hard every day to prepare for the opening of Texas Children’s Hospital the Woodlands,” Riley-Brown said. “These site visits to the West Campus were important to host for the Woodlands Health Center staff, as it allowed them to get a glimpse into the similar capabilities of the future Woodlands hospital and outpatient services.”

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.

July 7, 2015

7815RADIOLOGYREADING640It’s 9 a.m. and outside the new radiology reading room a group has gathered to talk through the day’s challenges and prepare for the day ahead. Yesterday, several patients cancelled appointments due to heavy rainfall, and today there will be more appointments than expected to make up for it. With a team there to talk through the situation and challenges, the problems are quickly resolved. Dr. Lane Donnelly, associate radiologist-in-chief, asks if the right amount of staff are here to take care of this higher demand. Next, he talks about any other concerns. One MRI machine is down, which may slow down the process, but an alternative plan has been put in place to move patients through the system as seamlessly as possible.

The morning huddle operation was brought to Texas Children’s by way of Donnelly who had devised similar processes in his previous roles at other institutions.

“It improves our coordination and ability to identify and track issues,” Donnelly said. “It builds in support by bringing everyone together to resolve issues efficiently.”

The daily readiness process takes place every morning within the Radiology Department to ensure that the hospital’s imaging services are ready for patients. Present for this meeting are radiologists, radiology nurses and techs, other support services staff, such as representatives from information services and biomed, along with leaders within the department. Each day the team discusses safety, methods, equipment, supplies and work staff adequacy. This process is made to ensure that every machine and every staff member is properly equipped and ready to handle various cases throughout the day in our diverse imaging facilities throughout the hospital and our community locations.

The huddle is also a communication vehicle to share lessons-learned and best practices.

“I think the sense of our team changes because of this new process,” Donnelly said. “The informal huddle allows for better collaboration.”

The huddles are held just outside a new ballroom style reading room built to bring together radiologists who were previously spread throughout the organization at various locations on Main Campus. Radiologist-in-Chief Dr. George Bisset said this new process is just one of the many ways this new expansion and the concentration of the radiology services have helped the team and its partners.

“The greatest thing that this new area provides is teamwork,” Bisset said. “It is also a positive move for our clinicians who can now visit our large reading room, which serves as a one-stop-shop to receive all information on imaging for their patients.”

Radiologists have better access to their leaders and to each other. Fellows and residents are given access to all areas of radiology and can be educated on rare cases when they arise, even if it’s not within the area of their current rotation.

June 30, 2015

7115smallanimal640We’ve all heard the saying, “Hard work pays off.”

That old adage certainly rings true for Dr. Susan Blaney, deputy director of Texas Children’s Cancer Center and executive vice chair of Research for Baylor College of Medicine Department of Pediatrics.

While advancing pediatric cancer research remains one of her top priorities, Blaney has worked passionately to ensure researchers have the tools to advance their scientific investigations – all in the hopes of putting more childhood diseases on the curable or preventable list.

Seven years ago, Blaney garnered the support of the hospital’s section chiefs and the Chair of Department of Pediatrics, the late Dr. Ralph D. Feigin, who approved her proposal to establish the Small Animal Imaging Facility (SAIF). Blaney credits the SAIF as an important contribution to the success of translational research efforts at Texas Children’s Hospital.

“Small animal models of disease, particularly genetically engineered mice and mouse models of human tumors, are powerful tools in medical research,” Blaney said. “New, non-invasive in vivo methods for imaging small animals have greatly enhanced our ability to explore the pathological processes of human disease at the molecular and genomic levels.”

As the primary users of the SAIF, Texas Children’s and Baylor researchers rely on the facility’s resources to obtain preliminary data for grant proposals, with the goal of publishing their groundbreaking research in premier scientific journals and ultimately to improve the outcome for disease of childhood.

While there are multiple animal imaging facilities throughout the Texas Medical Center, many outside researchers use our facility to launch their pilot projects in collaboration with Texas Children’s faculty. These include principal investigators from the Texas Heart Institute, Rice University, the University of Texas Medical School at Houston, MD Anderson Cancer Center, the University of Houston, Houston Methodist Hospital and the University of Tennessee.

Co-directed by Drs. Robia G. Pautler and M. Waleed Gaber under the guidance of Blaney and Dr. Jordan Orange, vice chair of Research for Baylor’s Department of Pediatrics, the SAIF provides a comprehensive suite of state-of-the-art, high-resolution imaging equipment including:

  • magnetic resonance imaging (MRI) and spectroscopy
  • ultrasound
  • optical imaging (including bioluminescence and fluorescence)
  • computed topography
  • positron emission tomography
  • bone densitometer
  • pathological imaging (Leica microscope)
  • digital autoradiography system
  • single photon emission computed tomography

“We can uncover all sorts of amazing findings in human disease processes using multiple in vivo imaging modalities,” Pautler said. “We can measure fibrosis in the heart, track cellular and genetic activity in real-time, create blood flow maps to understand tumor growth and trace neural pathways in live animal models to detect early signs of neurodegenerative disorders.”

To enhance the power of translational research, the SAIF also helps investigators conduct longitudinal studies in the same live animal to observe different stages of disease progression and analyze what happens when potential therapeutic or diagnostic interventions are introduced.

In May, the SAIF hosted its first imaging symposium highlighting compelling research findings that would not have been possible without the support of Texas Children’s small animal imaging technologies. With approximately 100 attendees, the symposium also provided a forum to create new research ideas and initiate new collaborations with other investigators that will lead to higher levels of innovative research.

7115smallanimalinsideR640Without question, Blaney’s hard work has certainly paid off. With her vision fulfilled for the SAIF, the research vision of others has been enabled.

For example, a Texas Children’s principal investigator – who used MRI data from the SAIF to help drive his National Institutes of Health R01 grant application – recently received a score that ranked in the top one percent. Additionally, a junior Texas Children’s principal investigator who used imaging data from the SAIF in a grant application was recently awarded his very first foundation grant that will help launch his career.

“Researchers are starting to really appreciate the outstanding services provided to them through the SAIF,” Blaney said. “We are making incredible advances in research that will undoubtedly lead to novel treatments for our patients.”

7115NRIswannlab640As world leaders in neuroscience research, scientists from the Jan and Dan Duncan Neurological Research Institute (NRI) and the Cain Foundation Labs at Texas Children’s continue to pioneer innovative treatments to improve the quality of life for children with devastating neurological diseases.

From unlocking the molecular mysteries of epileptic seizures to providing novel insights on how to repair brain injuries in newborns, NRI researchers are helping to revolutionize the care and treatment for our patients at Texas Children’s Neuroscience Center and patients around the world.

In her blog, Texas Children’s scientific research writer Dr. Rajalaxmi Natarajan highlights some of the 2015 groundbreaking discoveries from the NRI labs of Drs. Benjamin Deneen, Hugo Bellen, Mirjana Malatic-Savatic and Anne Anderson.