September 30, 2019

Texas Children’s Hospital has announced the two new leaders of the Adult Congenital Heart Disease (ACHD) Program at Texas Children’s Heart Center® – esteemed cardiologist, Dr. Peter Ermis, as medical director and Dr. Edward Hickey, a recognized cardiovascular surgeon, as surgical director. Beginning on October 1, they will together guide the largest ACHD program in the state.

Texas Children’s is ranked No. 1 in the nation for pediatric cardiology and heart surgery by U.S. News & World Report, but for years the hospital has also offered expert care for adults with congenital heart disease. Texas Children’s ACHD Program allows patients with congenital heart disease to receive seamless continuity of care from birth throughout adulthood. As pediatric patients with congenital heart defects transition into adulthood, the program’s multidisciplinary team of experienced congenital heart disease specialists advises them on health and lifestyle choices for their adult needs, including physical challenges, exercise options and family planning. The program offers comprehensive medical and surgical care in collaboration with colleagues at Texas Children’s Pavilion for Women® and Texas Children’s Fetal Center®. The hospital’s ACHD Program is accredited by the Adult Congenital Heart Association (ACHA) and is one of only three accredited programs in Texas.

Ermis, a native Houstonian and dedicated member of Texas Children’s ACHD Program team since 2014, also serves as assistant professor at Baylor College of Medicine, Texas Children’s academic partner.

“I’m honored to take on a leadership role in the program where I began my cardiology career,” said Ermis. “As this population of patients grows, it is even more important they are cared for by congenital heart disease specialists who recognize their specific needs as they transition to and live through adulthood. Our team is revolutionizing the way we care for these patients, and I look forward to continuing to do so in partnership with Dr. Hickey.”

Ermis received his undergraduate degree at Rice University. He earned his medical degree from the University of Texas Health Science Center at San Antonio, and went on to complete his residency and pediatric and adult cardiology fellowship at Baylor. He is board certified in pediatric cardiology, adult cardiology and adult congenital heart disease. Ermis is a fellow in the American College of Cardiology and a member of the American Academy of Pediatrics, Texas Heart Institute Cardiac Society and the International Society on Adult Congenital Heart Disease.

Hickey, a proven leader in cardiovascular surgery, most recently served as associate professor of cardiac surgery at the University of Toronto and cardiac surgeon and chief of the ACHD program at The Hospital for Sick Children. In addition to his leadership role, he will also perform congenital heart surgeries and serve as associate professor of surgery at Baylor.

“I’m thrilled to join Texas Children’s and lead the ACHD Program alongside Dr. Ermis,” said Hickey. “Treating these unique patients requires dedication from an entire team, and it is evident Texas Children’s is paving the way in this field. I’m looking forward to joining this innovative and collaborative group as we continue to develop tailored approaches for our patients.”

Hickey received a Bachelor of Medicine degree from the University of Southampton in the U.K., where he also completed his general surgery residency. He went on to complete higher surgical training in cardiothoracic surgery and simultaneously earned his Doctorate of Medicine research thesis from Oregon Health & Science University and the University of Southampton, respectively. Later, he received the John Kirklin Fellowship from the Congenital Heart Surgeons’ Society, University of Toronto and spent two years at The Hospital for Sick Children in Toronto. He then pursued residency training in Cardiovascular Surgery at the University of Toronto, followed by a clinical fellowship in congenital heart surgery.

Learn more about Texas Children’s ACHD Program.

September 23, 2019

Just a few months after being named the No. 1 destination in the country for pediatric cardiology and cardiac surgery for the third straight year, Texas Children’s Heart Center® is celebrating another milestone.

One year ago, on September 25, the Heart Center made the historic move into its new home in Lester and Sue Smith Legacy Tower.

Watch the video of move day.

The entire day was a carefully orchestrated ballet of coordination.

“The move to the Heart Center was the culmination of two years of preparation and was a momentous day for us all,” said Chief of Critical Care Dr. Lara Shekerdemian. “There were lots of moving parts all working together in concert, which was incredible. The entire day was a testament to collaboration and great planning.”

Six specially trained teams made up of more than 200 members transported 64 heart patients, some critically ill, safely to their new, state-of-the-art rooms. The patients ranged in age from 3 days to 22 years. As units in the new tower prepared for patients’ arrival, team members in a command center were monitoring patients’ conditions, making sure facilities were ready, and stationing support teams along the travel routes in case of emergency.

“Fortunately, we had experience since we had moved the pediatric and the transitional intensive care units over to the new building in the months prior to the Heart Center move,” said Maria Happe, Texas Children’s nurse practitioner and clinical project manager for Lester and Sue Smith Legacy Tower. “There was a lot of excitement and tons of activity in each unit as we were getting patients, parents and teams ready to move.”

Settling in

The new Heart Center was designed from top to bottom with families in mind. One of the most important difference-makers that Heart Center staff and employees are quick to point out is the ability for families to stay together while a child receives care.

“Being able to have parents in the rooms with their children, for them to be able to comfortably stay in the space, has been a huge improvement, said Carmen Watrin, director of nursing for inpatient units. “It’s also made families essentially a part of the care team, which has been phenomenal. The families are so grateful.”

The new space also increased desperately needed care capacity. During one especially difficult period in 2013, spatial constraints rendered Texas Children’s incapable of accepting additional transports of critically ill children. We were simply too full. This prompted the historical expansion of critical, surgical and emergency care capacity that included the construction of Lester and Sue Smith Legacy Tower.

“We never want to be in a position where we say no to a family or to a child,” said Chief of Cardiovascular Anesthesiology Dr. Emad Mossad. “This new setting has given us the privilege, and the space and resources, to be able to serve as many patients as come our way. It’s been a great thing to move to a new space, a new place, a fresh start, and to have the capacity to be able to say yes to families who are seeking our help.”

In addition to new space, the Heart Center has been on a mission to ensure that it has the staff needed to deliver the highest possible level of care. One example has been the onboarding of over one hundred new nurses to ensure that nurse-to-patient ratios are always at the optimum level. There’s also no substitution for experience, especially in health care, which is why in the months leading up to the Heart Center move, cardiac intensive care unit (CICU) leadership worked not only to recruit the best nurses, but also to retain them. As a result, the number of CICU nurses with greater than two years’ experience has increased over the past year, which helps improve the overall quality of the team.

Eyes on the future

With a year now in the books, the No. 1 heart center in the country is focused on continuing to deliver the best care, but also to improving wherever possible and to growing as a team.

“I’m looking forward to further consolidating the concept of a heart center as something that we all are part of,” said Chief of Congenital Heart Surgery Dr. Christopher Caldarone. “We all have allegiances to many things – to our community, to our families, to our homes, to the hospital, to our academic department. Over the next year, we want to continue creating a culture here in the Heart Center where people feel like they are truly a part of this big team.”

Additionally, the Heart Center is looking forward to growing care capabilities, including an expansion of the Adult Congenital Heart Disease (ACHD) program. Over the course of the next year, the Heart Center will develop a dedicated center for adults with congenital heart disease, where they will be treated by specialists who recognize and understand their unique needs.

“This expansion will be a huge statement by Texas Children’s Hospital,” said Chief of Pediatric Cardiology Dr. Daniel Penny. “There should never be an expiry date on the care of children with congenital heart disease as they transition to adulthood. Our ACHD team already provides amazing care, but with this expansion, all aspects of care for adults with congenital heart disease will be available on one dedicated unit. It’s an exciting time at Texas Children’s Heart Center.”

Learn more about the world-class care and services provided at Texas Children’s Heart Center.

August 26, 2019

A group of 25 Texas Children’s ventricular assist device (VAD) patients of all ages and more than 100 other guests, including families, caregivers and guest speakers, recently attended the second annual VAD celebration – “A Night with VAD Superstars.”

There was plenty of food, a visit from Child Life Specialist Adair Galanski with Bailey – the dedicated therapy dog for Lester and Sue Smith Legacy Tower – and games and activities provided by Physical Therapy, Occupational Therapy and Child Life.

The evening was emceed by Barbara Elias, VAD coordinator and the event’s founder, who started the celebration as a way to honor patients currently on heart pump or circulatory support, or those patients who have previously been on support but have had their pump removed or received a transplant. The VAD celebration also honors families and caregivers and has quickly become an outlet for information exchange and networking.

“Device patients are a special group that lead challenging lives, and their families and caregivers are with them every step of the way for what is sometimes a very long journey,” said Elias. “This event serves many purposes: It provides a forum for families to meet one another, share their experiences and build a community. It allows parents of children with VADs to meet other children or adults who have lived through the experience and persevered. And it gives caregivers – especially those from the ICU, who have seen these patients at their worst – an opportunity to see these patients living their lives and doing well.”

The evening’s speakers included Dr. William Dreyer, Texas Children’s medical director of Heart Failure, Cardiomyopathy and Cardiac Transplant; Dr. Lara Shekerdemian, chief of Critical Care; and Texas Children’s heart surgeon Dr. Iki Adachi. Attendees also heard from special guest speaker Dr. Richard Wampler, the inventor of Medtronic’s HeartWare® HVAD pump, a device frequently used in Texas Children’s patients. In turn, the event gave Wampler an opportunity to see firsthand how his invention has positively affected the lives of so many children at Texas Children’s.

“This event was testimony to what our VAD program has accomplished over the last decade,” said Adachi. “There is no doubt that VAD support has provided our patients with a chance for life. It was a pleasure seeing and sharing the happiness generated by such life-saving therapies with patients, families and medical colleagues.”

The VAD program’s expertise was on display in the evening’s two special patient honorees, Eugene Carrette and Jameson Finney. Eugene, who is from Belgium, was the smallest and youngest patient to receive a VAD since the beginning of the program. Thanks to the expert care he received at Texas Children’s, he has been able to travel with his family to Europe recently, a phenomenal feat for a young VAD patient. Jameson Finney earned the nickname “Daredevil” for living life to the fullest while on a device, running, golfing and riding bikes until receiving a heart transplant in 2018. Both the VAD implantation and the transplant were performed by Adachi. Jameson has been doing well since his transplant and continues to lead an active life.

The event concluded with a special moment of sharing and reflection. During this emotional and cathartic time of testimony, patients, families and caregivers who wished had the opportunity to share their stories and to speak frankly about living with a VAD. Many also thanked the experts at Texas Children’s for the care they received and how it has empowered them to live their lives.

“The event was extremely well received and was powerful for everyone in attendance,” said Elias. “I would like to thank Dr. Adachi, Dr. Hari Tunuguntla, my partner, VAD coordinator Jason McMullen, RN, the Heart Center Social Committee, and therapies including Physical and Occupational Therapy and Child Life, whose efforts allowed the event to occur.”

Texas Children’s Heart Center® was recently named the No. 1 pediatric heart center in the country for a third straight year by U.S. News & World Report. The VAD program is part of the Heart Failure Program and is one of the busiest pediatric programs in the country. There are currently 15 VAD patients in the program. Seven of those are full-time students.

Learn more about the Heart Center and its recent U.S. News ranking.

August 6, 2019

Early on the morning of June 18, Texas Children’s Heart Center staff filed into Taussig auditorium on the 16th floor of Lester and Sue Smith Legacy Tower. Details about the meeting’s purpose had been scarce. Little did everyone know that they’d been called in for a big reveal.

Texas Children’s Heart Center had once again been named the best place in the country for pediatric cardiology and heart surgery in the U.S. News and World Report 2019-2020 Best Children’s Hospitals rankings – the center’s third straight year at No. 1.

“It’s thrilling for our team to be recognized for the care we provide to our patients every day,” said Chief of Pediatric Cardiology Dr. Daniel Penny. “Even though we received the top honor, we know there is always room for improvement. We are continuing to evolve as a true multidisciplinary team that is dedicated to setting a new standard for the treatment of children and adults with congenital heart disease.”

The U.S. News rankings use a well-accepted framework for evaluating quality of health care, which factors in patient outcomes, such as mortality and infection rates; available clinical resources, such as specialized clinics and programs and external accreditations; and compliance with best practices. Improved rankings demonstrate a health care organization’s commitment to not only providing high-quality care, but also to identifying gaps where improvements are needed.

But where do you go when you’re No. 1?

“Our goal is to be so far ahead that no one can catch us,” said Dr. Christopher Caldarone, Texas Children’s chief of Congenital Heart Surgery. “Being No. 1 is a state of mind, where commitment to excellence is inherent in everything a program does. Our team has a No. 1 mindset. We work hard, we constantly measure our performance, and we drive ourselves to improve in every aspect of providing care.”

Big wins for patients and families

This past year, the Heart Center built on the successes of previously existing programs and also implemented new initiatives to increase transparency, reduce risk of infection and improve the quality of care.

  • Participated in STS National Database public reporting
    The Society of Thoracic Surgeons (STS) is a national leader in health care transparency and accountability. Participation in STS public reporting demonstrates a commitment to quality improvement in health care delivery and helps provide patients and families with access to information that can help them make more informed health care decisions.

Texas Children’s holds a three-star rating in the STS Congenital Heart Surgery Database (CHSD), which is calculated based on overall risk-adjusted operative mortality for all patients undergoing pediatric and/or congenital heart surgery. The rating is the highest category of quality and places Texas Children’s among the elite congenital heart surgery programs in the U.S. and Canada. Additionally, STS recognized Texas Children’s for having operative and adjusted operative mortality rates that were consistently below expected rates over a 4-year period.

  • Implemented a program to routinely track and submit IMPACT data
    In partnership with clinical and physician leadership, the Heart Center’s Cardiac Catheterization Labs implemented processes to submit metrics on all catheterization procedures included in the American College of Cardiology’s IMPACT Registry®. This national register collects quality-focused data on the management and outcomes of pediatric and adult congenital heart disease (ACHD) patients who undergo diagnostic and interventional cardiac catheterization procedures. The registry also allows Heart Center leadership to compare performance against a national aggregate for quality improvement initiatives.
  • Increased the number of cardiac intensive care unit (CICU) RNs with greater than 2 years’ experience
    CICU care requires a multidisciplinary team effort. Success is due, in part, to the team’s being able to rely on experience. In the months leading up to the Heart Center’s move into Lester and Sue Smith Legacy Tower, CICU leadership worked tirelessly to not only recruit the very best nurses, but also to retain them. This enables the nurses to gain valuable experience and mature as caregivers, and also helps improve the overall quality of the CICU team. The response has been extremely positive, with low turnover.
  • Implemented a universal methicillin-resistant Staphylococcus aureus (MRSA) decolonization treatment protocol
    To reduce the risk of infection faced by all surgical patients during the perioperative period, the Congenital Heart Surgery team partnered with experts from Infectious Disease to implement a universal decolonization protocol for MRSA, which causes infections that are more difficult to treat than methicillin-susceptible staph. The protocol, which involves five days of antibiotic ointment in the nose and five days of special wipes, has the added benefit of decreasing MRSA wound infections, and incidence of methicillin-susceptible staph ventilated-associated pneumonia and central line infections.

Learn more about the Heart Center, its services, and volume and outcomes.

June 18, 2019

The results of the 2019 U.S. News & World Report survey of Best Children’s Hospitals are in, and Texas Children’s Hospital is again among the best in the nation!

This year, Texas Children’s tied for third place among all children’s hospitals nationally, a ranking no other pediatric hospital in the state has ever achieved.

In addition, for the first time, Texas Children’s is ranked in the top 10 in each of the U.S. News & World Report-recognized pediatric sub-specialties. Six of our sub-specialties were ranked in the top 3 – two are ranked #1, two are ranked #2, and another two are ranked #3.

“We should all be very proud of this remarkable accomplishment,” said Texas Children’s President and CEO Mark Wallace. “It is because of our One Amazing Team and each team member’s steadfast commitment to quality and excellence that we were able to reach this achievement. Thank you for your dedication to Texas Children’s Hospital and to the patients and families we serve.”

Some highlights of the 13th annual Best Children’s Hospitals rankings for Texas Children’s include:

  • Cardiology and Congenital Heart Surgery is again ranked #1 in the nation, due in part to our increasing the number of RNs in the PICU with more than two years of experience, and exceeding thresholds in four-year combined risk-adjusted operative mortality.
  • Pulmonology, which first debuted in the top spot in the 2016 rankings, is again ranked #1 in the nation. We decreased the percentage of patients readmitted to the hospital to address asthma-related symptoms, and exceeded thresholds in structure metrics, such as mean LOS for asthma patients.
  • Nephrology moved up a spot and is now ranked #2 in the nation, with a significant decrease in hemodialysis catheter associated BSI and an improvement in children younger than 5 years of age receiving hemodialysis.
  • Gastroenterology & GI surgery rose to #2 in the nation from #4, achieving successful Kasai procedures in biliary atresia patients and improving the percentage of patients experiencing prednisone-free admission.
  • Cancer is #3 in the nation, up from #6. We increased the five-year survival of patients with neuroblastoma and increased the percentage of patients who received intravenous treatment antibiotics within an hour of triage.
  • Neurology and Neurosurgery remained at #3 in the nation, showing a significant improvement in 30-day unplanned return to the operating room for craniotomy and a decrease in readmission within 30 days of surgery for Chiari decompression patients.

Our entire list of rankings includes:

#1 Cardiology and Congenital Heart Surgery
#1 Pulmonology
#2 Gastroenterology and GI surgery
#2 Nephrology
#3 Neurology and Neurosurgery
#3 Cancer
#6 Urology
#7 (tie) Neonatology
#8 Diabetes and Endocrinology
#10 Orthopedics

Overall, Texas Children’s exceeded nursing intensity thresholds, made significant improvement in ICU CLABSI rates and exceeded thresholds for hospital acquired pressure injuries.

U.S. News & World Report introduced the Best Children’s Hospitals rankings in 2007 to help families of children with rare or life-threatening illnesses find the best medical care available. The rankings are the most comprehensive source of quality-related information on U.S. pediatric hospitals.

The U.S. News Best Children’s Hospitals rankings rely on clinical data and on an annual survey of pediatric specialists. The rankings methodology factors in patient outcomes, such as mortality and infection rates, as well as available clinical resources and compliance with best practices.

“The results also reflect the efforts of our team and their unwavering focus on the U.S. News survey,” Wallace said. “Compiling and refining our data is a continuous process and, with the support of our medical staff, in-chiefs, service chiefs, as well as Mark Mullarkey, Trudy Leidich, Elizabeth Pham and the entire Quality team, we have made significant strides this past year.”

This year’s rankings will be published in U.S. News & World Report’s “Best Hospitals 2020” guidebook, available in stores mid-September or online at usnews.com/childrenshospitals. You can learn more about Texas Children’s rankings here.

May 28, 2019

The National Institute of Health awarded a team of Texas Children’s scientists a $2.2 million grant in 2018 to study and develop computer and tissue-engineered models to predict the recurrence of congenital heart diseases. The study aims to change the way heart diseases are managed to improve the quality of life of children. Learn more by visiting our 2018 virtual Annual Report.

April 9, 2019

Texas Children’s Heart Center was once again the site of a groundbreaking novel treatment that gives experts in our new catheterization laboratories yet another method at their disposal in the treatment of complex heart conditions.

Dr. Henri Justino, co-director of the center’s cardiac catheterization labs and director of cardiac innovation, recently developed and performed a first-of-its-kind procedure in which a young patient’s lung veins were reached directly through the chest wall.

Hope for Bronx

Three-year-old Bronx Delarosa was born with total anomalous pulmonary venous return, a critical heart defect that causes oxygen-rich blood returning from the lungs to be pumped into the right atrium instead of the left atrium, as it normally should. There, the oxygen-rich blood mixes with oxygen-poor blood, which means the body doesn’t get the oxygen it needs.

At just 8 days old, Bronx underwent a surgery to repair the defect that was initially thought to be a success. However, following a second surgery, doctors told his parents he’d developed a secondary condition – pulmonary vein stenosis, a condition that caused severe narrowing in his surgically repaired veins. The Delarosas were heartbroken when they learned there was nothing else that could be done for Bronx in their hometown.

To give their son a fighting chance, they turned to Texas Children’s Hospital.

Breaking new ground

Justino performed Bronx’s first catheterization procedure in February 2018, during which he placed a metal stent in the blocked upper vein in Bronx’s right lung. However, he was unable to relieve the blockage in the lower vein.

After a personal friend underwent a lung biopsy, where a tissue sample was taken directly through the chest wall, Justino wondered if a similar approach could be applied in cases like Bronx’s – entering the veins of the lungs through the chest.

After thorough research, Justino decided to move forward with the unique approach to relieve the blockage in Bronx’s right lung.

Bronx was taken to the catheterization lab where the team performed a CT scan to identify the exact location where the blocked vein was sufficiently far apart from artery, yet close enough to the chest wall, to allow a needle to enter the vein directly between the ribs. Justino and his team also generated a 3-D computerized model to pinpoint the exact location where the needle would enter Bronx’s chest. To ensure the utmost accuracy, a laser crosshair was beamed on his chest at the entry point.

Justino carefully made his way into Bronx’s lung and placed a tiny catheter, the thickness of a raw spaghetti noodle. He then used a special wire to deliver radiofrequency energy to get across the blocked vein and into the heart. From there, the wire was threaded down through Bronx’s leg. This allowed a stent to be placed in the blocked vein via a catheter in the leg.

Bronx recovered well and a follow-up echocardiogram proved the experimental approach was a success. The first-of-its-kind procedure, which lasted more than eight hours, was performed in one of the Heart Center’s new state-of-the-art, 1,000-square-foot cardiac catheterization labs, which Justino helped design with this type of procedure in mind.

“We are proud that Dr. Justino was able to develop this completely novel procedure for Bronx,” said Texas Children’s Chief of Pediatric Cardiology Dr. Daniel Penny. “Pulmonary vein stenosis in children is an extremely difficult problem to treat and tests the limits of our abilities to innovate. We see this new procedure as another advancement in the treatment of these children, which will be applied more widely in the future and help us improve the care we offer for complex cardiac conditions.”

Learn more about Texas Children’s Heart Center, ranked No. 1 in the nation by U.S. News & World Report.