February 11, 2019

 

It’s Heart Month, which is always a special time at Texas Children’s as we celebrate our patients and families, the care we provide at our No. 1-ranked Heart Center and our many milestones. This year, we’re kicking off Heart Month celebrating yet another momentous first.

A team of experts at Texas Children’s Heart Center®, led by congenital heart surgeon Dr. Iki Adachi, became the first in the United States – and only the second in the world – to implant the Jarvik 2015 ventricular assist device (VAD), a groundbreaking new technology Adachi helped develop.

“Dr. Adachi is truly a pioneer and a world-renowned authority on mechanical heart support,” said Dr. Christopher Caldarone, Texas Children’s chief of Congenital Heart Surgery. “His work in the development of the Jarvik 2015 VAD has been tremendous and is a great example of the power of Texas Children’s in bringing new technologies to benefit our patients.”

Bridge to transplant

For patients with heart failure, a VAD can buy valuable time until they match an organ. In some rare cases, a VAD can be used as a permanent therapy for heart failure or can even improve heart function to such a degree that it makes a transplant unnecessary. VADs can either simulate heart function with pulsing action or allow a continuous stream of blood to flow through the heart. Continuous-flow VADs tend to be smaller and quieter but also more durable, and in recent years have yielded improved results in adult heart failure patients.

The Jarvik 2015 is the first and only implantable continuous-flow VAD designed specifically for small children. Development took more than a decade and was not without setbacks. After the previous prototype failed to gain FDA approval, the team of engineers enlisted Adachi to assist with crucial design modifications to the VAD’s pump while keeping the size of the device small – about the size of a AA battery. Following extensive testing in the Texas Medical Center, the FDA approved the Jarvik 2015 for clinical trial.

A chance at life

One of the most significant benefits of this new technology is that it allows the patient to become stronger, making them a better candidate for transplant. Such was the case with Katlyen Hickman.

You would never know by looking at Katlyen today that the smiling, energetic four-year-old needed multiple surgeries to save her life only a few months ago. She was born with complex congenital heart disease, including ventricular septal defects and small left heart structures, and despite numerous procedures and surgeries during her first years of life, her condition was rapidly deteriorating this past fall.

“It was clear she was moving in the direction of needing heart transplantation,” Adachi said. “She was admitted to the ICU and her heart was just getting worse and worse.”

Though the Jarvik 2015 had been cleared for clinical trials, it hadn’t been approved for commercialization. But because Katlyen’s case was so dire, and because she was too small to receive an adult-size VAD, Adachi and Texas Children’s were able to obtain expanded access from the FDA to implant the device. The fact that the team was already very familiar with the Jarvik 2015, following their extensive laboratory testing, helped facilitate the process with the FDA.

The results couldn’t have been better. Not only did the device keep Katlyen alive, but it also improved her blood flow, which helped her organs recover. This success paved the way for the next critical step in her journey – a heart transplant, which she received on November 23, 2018. It was the day after Thanksgiving. Only a month later she was discharged and spent Christmas at home with her family.

Adachi anticipates the Jarvik 2015 will do well in the upcoming multi-institutional clinical trial and hopes its availability may further accelerate the trend toward the use continuous-flow devices in children.

“Pediatric VAD support will continue to evolve as the pediatric mechanical circulatory support area matures,” he said. “The popularization of continuous-flow devices could be a landmark event that represents a paradigm shift in the field. And Texas Children continues to lead that shift.”

Learn more about Texas Children’s Heart Center and the Jarvik 2015 VAD clinical trial.

January 22, 2019

A group of more than 30 Texas Children’s pediatric cardiac intensive care medicine experts – including intensivists, nurse practitioners, cardiologists, cardiovascular surgeons and nurses – recently attended the 14th International Meeting of the Pediatric Cardiac Intensive Care Society (PCICS) in Miami, Florida. It was the largest conference in the society’s history, with more than 700 participants from across the nation and around the world.

Texas Children’s presence was felt throughout the event. Not only were we an institutional sponsor, but our cardiac critical care expertise was on display, with our specialists leading or participating in 40 programs, meetings, research presentations and pro/con debates, which covered a variety of clinical topics, including:

  • Simulation and quality improvement
  • Managing cardiac arrest
  • Bedside rounds
  • Ethics and social media
  • Approaches to single ventricle neonate management
  • Effective communication and counseling
  • CICU monitoring
  • VAD management
  • Healthy work environments
  • Global perspectives on CICU education

“As an educational opportunity, this event is extremely important for our people, as it highlights important new research, training initiatives and innovations for patients,” said Dr. Paul Checchia, Texas Children’s associate chief of Critical Care Medicine and immediate past president of PCICS. “But it also allows Texas Children’s faculty and staff, who are recognized leaders in this field on an international level, to showcase their thought leadership and to educate others.”

PCICS is an international forum with more than 1,000 members worldwide that promotes excellence in pediatric cardiac intensive care medicine. The annual meeting – the only one of its kind dedicated exclusively to pediatric to pediatric cardiac critical care – plays a large role in the advancement of research and training that has the ability to improve the care of pediatric patients with congenital heart diseases and acquired cardiovascular diseases.

“PCICS is the premier scientific meeting of our field, and Texas Children’s ‘swept the board’ at this year’s meeting,” said Chief of Critical Care Dr. Lara Shekerdemian. “I am particularly proud that all of our clinician groups that included nursing were so strongly represented. This reflects our belief in the importance of collaboration at every level – from clinical care to academic productivity.”

This year’s PCICS conference held additional significance for Texas Children’s as Checchia was honored with the Anthony Chang Lectureship, the only named lecture in the field of pediatric cardiac intensive care medicine. The award is named in honor of Dr. Anthony Chang, who founded PCICS 20 years ago. The Anthony C. Chang Award for Excellence in Pediatric Cardiac Intensive Care recognizes an attending physician who has made exemplary contributions to the field of pediatric cardiac intensive care and to PCICS, and who is making a positive difference in the lives of colleagues, patients and families, as well as in the communities where they live.

About Texas Children’s Cardiac ICU

Texas Children’s 48-bed CICU is one of the largest and most active units in the nation, and a vital part of the complete continuum of care offered by Texas Children’s Heart Center® – No. 1 in Pediatric Cardiology and Congenital Heart Surgery in the country, according to U.S. News & World Report.

Every year, we admit more than 1,000 children with heart disease, the majority of whom have undergone heart surgery. And we provide comprehensive, specialized care for each child’s individual cardiac condition.

Our multidisciplinary team includes cardiac intensivists, cardiologists, cardiac surgeons, cardiac anesthesiologists, perfusionists, advanced practice providers, nurses and respiratory therapists, all working collaboratively to provide the best care and outcomes for patients. State-of-the-art facilities coupled with dynamic decision-making in the CICU allow our team to carefully analyze each child’s case and deliver a customized care experience. Additionally, we are a recognized leader in cardiac critical care education and are dedicated to training the next generation of specialists and nurses on caring for a patient population with complex needs and interventions.

Learn more about Texas Children’s CICU.

December 18, 2018

Experts from across the country recently convened for the fourth Symposium on Coronary Artery Anomalies, hosted by Texas Children’s Heart Center®.

The event was founded by leaders of Texas Children’s groundbreaking Coronary Anomalies Program – the first of its kind in the nation – as a way for caregivers, researchers and others to gather and discuss the diagnosis and management of patients with coronary artery anomalies, such as anomalous aortic origin of coronary artery (AAOCA), which can lead to the phenomenon known as sudden cardiac death (SCD), which usually occurs in young athletes.

“Before we began to really focus on these conditions, there was very little data about the potential risks or causes, which in turn led to controversy surrounding the proper ways to evaluate, treat and monitor children with these conditions,” said Texas Children’s cardiologist Dr. Silvana Molossi. “This event provides an open, dedicated forum for discussion and information sharing, and has become a valuable resource for experts nationwide who are involved in the diagnosis and care of patients with these rare conditions.”

The event featured comprehensive presentations by members of Texas Children’s Coronary Anomalies Program, as well as 11 visiting faculty from some of the country’s preeminent pediatric health care institutions, including Boston Children’s, CHOP, Stanford University, Columbia University, UT Southwestern, and the Heart & Vascular Institute at Hartford Hospital in Connecticut. Major topics included AAOCA, Kawasaki disease and myocardial bridges.

An addition to this year’s conference was a special Patients & Families Symposium.

“We were astounded by the response to the family symposium before it even started,” said Molossi. “We expected between 25 and 30 people to register – we ended up having nearly 80 in attendance.”

During this day-long event, parents and children attended talks that addressed topics such as the impact of coronary anomalies on families and the importance of counseling and shared decision-making when determining a plan of care. And in a session titled, “This is My Story: Patients and Families Living with AAOCA,” visitors had an opportunity to hear from Texas Children’s patients and families who have had similar experiences of unknowingly living with these life-threatening conditions, receiving crucial diagnoses and making the tough decisions that follow, undergoing open-heart surgery, and living a normal life in the aftermath. This emotional and powerful session was followed by discussions about the importance of networking and building a sense of community and collective support for people affected by coronary anomalies.

About the Coronary Anomalies Program at Texas Children’s

Seeing the need for more complete data and a more specialized approach to care, experts at Texas Children’s formed the Coronary Anomalies Program. The multidisciplinary core team of cardiologists, congenital heart surgeons, radiologists and researchers works together to provide the best treatment for patients with congenital coronary anomalies, study outcomes, and educate health care providers and the public about these conditions.

A cornerstone of this team’s approach is the development and use of a clinical algorithm to facilitate the diagnosis and management of these patients. The team presents cases in monthly multidisciplinary meetings to determine the best course of action for each patient, and then tracks the patients’ outcomes over time.

November 13, 2018

On November 10, Texas Children’s Chief of Pediatric Cardiology Dr. Daniel Penny was named the American Heart Association’s (AHA) 2018 Helen B. Taussig Memorial Lecturer. The prestigious honor was awarded at the AHA’s Scientific Sessions in Chicago, Illinois, following Penny’s presentation “Working Together towards New Levels of Excellence in the Care of Children with Heart Disease.”

“I am truly grateful to receive this distinguished award from the AHA,” said Penny. “As a pediatric cardiologist, I believe it is my responsibility to carry on the incredible legacy of innovators such as Dr. Taussig, and it is a privilege to do so at Texas Children’s. Every day, my goal is to enhance the level of cardiology care we provide to our patients.”

Penny’s receipt of this historic award forges yet another link between Texas Children’s Hospital and the remarkable legacy of Dr. Helen B. Taussig, the pioneering pediatric cardiologist. Taussig was best known for her work with children born with serious heart defects – most notably blue baby syndrome – as well as for her co-development of the Blalock-Thomas-Taussig shunt, the first surgical procedure for children with pulmonary stenosis.

The list of past Taussig lecture awardees features the names of some of the most renowned innovators in the field of pediatric heart disease, including Dr. Dan G. McNamara – Texas Children’s first director of cardiology. McNamara, who was a student of Taussig’s while at Johns Hopkins Hospital, was responsible for the design and integration of Texas Children’s first cardiac catheterization lab, which significantly advanced the diagnosis of heart ailments in children.

“Dr. Penny exemplifies the best of pediatric cardiology,” said Physician-in-Chief Dr. Mark W. Kline. “Drs. Taussig and McNamara would be proud of the work he and his team are doing to further advance the specialty.”

Penny, originally from Cork Ireland, completed his medical degree at University College Cork, The National University of Ireland. Before coming to Texas Children’s in 2010, he trained and practiced at some of the world’s top pediatric institutions, including the famed Great Ormond Street Hospital in London and The Royal Children’s Hospital in Melbourne. Today, he serves as co-director of Texas Children’s Heart Center®, ranked the No. 1 pediatric heart center in the nation for the past two years by U.S. News & World Report.

“This well-deserved honor is another shining example of Dr. Penny’s dedication to our patients and their families,” said President and CEO Mark Wallace. “He is a visionary leader in his field, and continues to guide our team as they pave the way in the treatment of children with congenital heart disease.”

Texas Children’s Heart Center provides the highest-quality cardiac care possible, combining cutting-edge technology with a compassionate, family-centered approach. Now located at its new home in Lester and Sue Smith Legacy Tower, the Heart Center occupies eight floors and features four cardiac catheterization labs including integrated MRI scanner, four cardiovascular operating rooms, three cardiovascular ICU floors with 48 private rooms, two cardiac acute care floors with 42 private patient rooms, and dedicated space for families.

Learn more about the Heart Center.

October 16, 2018

Sweeping views of the Houston skyline from high atop the Lester and Sue Smith Legacy Tower were the backdrop for a special ceremony to formally dedicate the 23rd floor as the Direct Energy Patient Floor. The floor will serve as the new home of the Heart Center’s Cardiac Patient Care Unit.

Texas Children’s and Direct Energy executives, as well as physicians, staff and volunteers celebrated the milestone alongside U.S. Representatives Sheila Jackson Lee and Al Green, and State Representative Sarah Davis. A bright orange ribbon cutting ceremony followed remarks from Texas Children’s President and CEO Mark Wallace, Manu Asthana, president of Direct Energy Home, and Chief of Pediatric Cardiology Dr. Daniel Penny.

“This facility, with all its new technologies, is something that we’ve all accomplished together,” Penny said. “But the point of all this technology is to shorten these children’s hospital stays, to reduce the number of operations they need, and to give them back their childhood. Direct Energy has been with us from the start and has helped us see it through. And we owe them a heartfelt thank you.”

Following the ribbon cutting, the festivities continued as Direct Energy volunteers visited patient rooms with the Direct Energy Fun Cart, which is full of toys and activities for patients and their families to enjoy during their hospital stay.

In 2015, Direct Energy committed $5 million to Promise: The Campaign for Texas Children’s Hospital to support the expansion of the Heart Center. It is the largest corporate gift ever made to a Texas Children’s campaign priority. With Direct Energy’s generous support, Texas Children’s is able to provide highly specialized care to even more children who come to the hospital for help – and particularly to those who are the most critically ill and have the most complex cardiac conditions.

To learn more about the Heart Center visit texaschildrens.org/heart.

October 2, 2018

Last week was monumental for Texas Children’s with the move of our No. 1 ranked Heart Center into the new state-of-the-art Legacy Tower. The milestone came just months after the historic May 22 move of our pediatric intensive care and progressive care units into the spacious, high-tech tower adjacent to the Texas Children’s Pavilion for Women and across the street from Mark Wallace Tower.

“What a great day it’s been for everyone at Texas Children’s as we’ve moved into the upper floors of Legacy Tower,” said Texas Children’s President and CEO Mark Wallace. “We’ve transferred a lot of patients today and everything has gone flawlessly. This remarkable new space will make a world of difference for the critically ill patients and families we serve.”

View photos below from the move and the events that followed.

The Move
Over the course of about eight hours on September 25, six specially-trained clinical teams comprised of more than 200 members transported 64 heart patients, some critically ill, safely to their new, state-of-the-art rooms in Legacy Tower. The patients ranged in age from 3 days to 22 years.

The following day, on September 26, 11-year-old Colin Rankin of Dallas, became the first patient to undergo a cardiac catheterization procedure and an intra-cath MRI in Legacy Tower at the Heart Center’s new Charles E. Mullins, M.D. Cardiac Catheterization Laboratories.

Moments before Colin’s procedure, performed by Dr. Athar Qureshi, a ribbon cutting ceremony was held to commemorate the opening of our four new catheterization labs and integrated MRI. Dr. Charles E. Mullins, the pioneering Texas Children’s physician and father of modern interventional pediatric cardiology for whom the suite of labs are named, was present at the ceremony and cut the ribbon along with Dr. Henri Justino, director of the Mullins Cardiac Catheterization Labs.

On September 27, Associate Chief of Congenital Heart Surgery Dr. Jeff Heinle cut the ribbon to officially open the Heart Center’s new cardiovascular operating rooms, and to usher in a new era of cardiac surgery at Texas Children’s. Later that morning, 4-year-old Rizan Merchant underwent the first surgical intervention in the expansive new space – a Fontan procedure, performed by Heinle.

And on October 1, patients received treatment for the first time in the new Legacy Tower Therapy Gym. The gym is a powerful resource to help children and parents learn and focus on what they can do, rather than what they can’t. Features include machines for building core strength and balance, exercise bikes, and a bathtub and set of stairs for parents to practice everyday tasks at home with their children.

A week before the move, patients and families entered the doors of the Heart Center’s new outpatient clinic for the first time. Situated on the 21st and 22nd floors of Legacy Tower, the clinic is designed top to bottom with Texas Children’s families in mind. The bright, welcoming space was specially configured to offer a more personal approach to care, and to handle high clinical volume. During the first afternoon clinic session, 25 patients were seen, and 18 outpatient echocardiograms and 18 outpatient ECGs were performed. To read more about the new Outpatient Clinic, click here.

Throughout the entire move and for days afterward, the Legacy Tower Go Live Support Center was set up on the fourth floor of the Pavilion for Women and comprised of hundreds of individuals from across the hospital system who focused on patient move tracking from West Tower to Legacy Tower. The team included support staff from Supply Chain, Security, BioMedical Engineering, Facilities Operations, Information Services, Pharmacy and Respiratory Care.

“We all are incredibly blessed by this space, but this move isn’t just about the building. It’s the people as well,” said Vice President Judy Swanson. “We have such a committed, amazing team, all of whom worked so hard to make this move happen and to make it special for our patients and families.”

The Purpose
Texas Children’s started planning for Legacy Tower more than five years ago as an effort to reinvest in the programs our most critically ill patients need. Demand for these services continues to grow – here in our community and far beyond Houston. And prior to Legacy Tower, our core areas – Critical Care, Emergency Center and ORS/PACU – were often at capacity.

As an organization, we needed to make changes that advance quality, service, safety and strategic growth. We needed to broaden our expertise and better coordinate care to improve the experiences of our patients and their families. And we needed to expand our access to make certain we do not have to turn children away when they need us most.

Legacy Tower is helping Texas Children’s accomplish all of this and more. The 640,000-square-feet of new space includes:
– 8 floors for Texas Children’s Heart Center
– 7 floors of intensive care patient rooms
– 1 radiology suite
– 6 high-intensity surgical operating rooms
– 4 cardiovascular operating rooms
– 2 intraprocedural MRIs
– 4 cardiac catheterization labs.

A helistop atop Legacy Tower is scheduled to open in November.

“The building of Legacy Tower has been a long journey and has really shown Texas Children’s at its best,” said Executive Vice President Mark Mullarkey. “This effort is and has always been focused around our patients and families.”

The Future
For our clinical staff, Legacy Tower will give them a better place to do what they do best – treat some of our most critically ill patients. It also will position them to continue to provide some of the best pediatric care in the world.

“Everything we would ever want as a specialty is here,” said new Chief of Congenital Heart Surgery Dr. Christopher Caldarone. “We have new and innovative centers like the exercise center, the gym where we can show patients what they’re capable of doing rather than telling them what they can’t do.”

All of this sets Texas Children’s apart, Caldarone said, adding that the only way to stay ahead of everyone else is make sure we bring all the expertise available to bear to every decision for every baby in a timely manner.

“That’s no small feat,” he said. “I think that’s where we’re going to be able to set ourselves apart.”

Chief of Pediatric Cardiology Dr. Daniel Penny said everything about the new Heart Center is about reducing the impact of heart disease on children and on their families.

“Whether it’s the amazing new clinical technologies that we’ve built, our new magnet in the Cardiac Catheter Lab, right down to the tiny design features,” Penny said. “They were all done with one thing in mind and that is what was best for parents and their children.”

Dr. Lara Shekerdemian, service chief of Critical Care Services, said everyone is extremely excited about Legacy Tower, the additional capacity it provides and the overall better environment it has made available to patients, families and staff. Patient rooms, Shekerdemian noted, are twice the size of the old rooms in West Towers. Dedicated family space has been incorporated into the design of the building and each inpatient room has its own bathroom.

“It’s a bright, beautiful, spacious, quiet and peaceful environment,” she said. “It’s a huge change from what we had previously.”

September 25, 2018

For months, teams have been preparing for the opening of the new Texas Children’s Heart Center® in Legacy Tower. The outpatient clinic went live on September 18. And this week, Move Day into our inpatient space has finally arrived.

Before the flurry of activity, we had the opportunity to sit down with new Chief of Congenital Heart Surgery Dr. Christopher Caldarone, who shared a little about his background and his vision for the No. 1 heart center in the nation.

Tell us a little about yourself. Where’d you grow up?

“I was born in Boston and grew up in Upstate New York and New Jersey. We still have a lot of family in Boston and spend time there in the summer.”

Were you always interested in medicine as a career?

“I had a predisposition toward engineering and science as a kid. I ruptured my spleen in a high school wrestling match and spent a few months in hospitals. I was fascinated by the environment and I think that’s when it really started for me. I went to college at Johns Hopkins for bioengineering but found the subject matter to be too dry. I realized I really liked the medical part of my studies, so I switched over to pre-med.”

How did that lead to your interest in surgery?

“Sometimes people find that they just fit in a field. You just feel like there are places in life where you belong and others you don’t, and I always felt like I belonged in surgery.”

How does it feel to be a part of the team at Texas Children’s?

“It feels amazing. I think that for those of us who’ve been at other institutions, it’s easy to appreciate how special this place is. It’s a spectacular environment.”

What was it about Texas Children’s that attracted you?

“It was all about fit and impact. I spent fifteen years in Toronto with a great team. But from the very first call from Texas Children’s, I felt that we shared a common vision and I felt that I was a good fit for what they were looking for in a very genuine way. That was very compelling. Secondly, the potential here to make a difference is vast. There is an opportunity to take what I learned in my previous role as surgeon-in-chief and refocus on congenital heart disease, which is the area that interests me the most.”

Why is multidisciplinary collaboration so important?

“Being part of a team and functioning as a team is my preferred environment. I just enjoy it more. But that isn’t the reason why it’s important. It’s important because the congenital heart program at Texas Children’s is already competing at the Olympic level. The gradations between the best pediatric hospitals are so fine that to compete at this level, you have to optimize every aspect of the entire program. People can’t work harder and there are no better people to hire. The only option we have is to create an organizational structure that functions more efficiently than other programs, if we want to improve faster than they’re improving. That’s why a multidisciplinary team approach is important. It’s literally the only way to compete at this level.”

How does the layout of the new Heart Center help facilitate improved interaction?

“Architecture influences culture. It can enhance or detract from it. Locating cardiology, cardiac surgery, anesthesia, perfusion, the advanced practice providers and our administrative staff in one environment helps make magic. Having everyone in close proximity on the same floors is enormously beneficial for our patients and our care providers.”

You have an active translational research background. Will you continue to build on that?

“I want to continue my own research, but my main objective here is to support other clinician’s translational science efforts throughout the Heart Center. I’ve found that if you get a team together, find resources and focus on a target, you can produce powerful results. My role is to support an environment where multidisciplinary teams routinely get together, target specific areas and create impact. I think of it as translational science ‘one step removed’. I think that’s one of the reasons I’m here.”

What’s something you want people reading this to know about the leadership team’s vision for the Heart Center?

“I want people to know that the Heart Center leadership is dedicated to creating a shared stewardship model, through which we work together to identify specific targets, pool our resources and act upon those targets as a unified group. The model makes collaboration the expectation rather than the occasional nice outcome. In most other institutions, collaboration can happen; there’s nothing to restrict it. But if it doesn’t happen, it’s a silent failure and a missed opportunity.

“Here, we have a group of leaders that is accountable to see that our resources are deployed in a meaningful way that drives change. This creates the dynamic that is necessary to provide that Olympic level of care. If the patient is truly our focus, then every little thing we do here has to be better. Everything has to keep improving. And every single person in the Heart Center has a role and the potential to influence how we extend our lead and, more importantly, how we can improve care for our patients.”

Time for rapid fire: What’s your favorite film?

“The Year of Living Dangerously.”

Favorite sport?

“I don’t really have a favorite. I appreciate a good contest, regardless of the sport.”

Favorite place you’ve traveled?

“Thailand.”

What are you listening to right now on the way to work?

“NPR.”

Beatles or Rolling Stones?

“Tough one! It’s a toss-up. Depends on my mood.”

Caldarone is an internationally recognized leader in congenital heart surgery and most recently served as surgeon-in-chief at The Hospital for Sick Children in Toronto. He received his undergraduate degree from Johns Hopkins University and his medical degree from Columbia University, and he completed his general surgery and cardiothoracic surgery residencies at Beth Israel Deaconess Medical Center/Harvard Medical School. He also completed a fellowship in congenital heart surgery at The Hospital for Sick Children. Caldarone is a member of the American Association for Thoracic Surgery, the Society of Thoracic Surgeons and the Congenital Heart Surgeons’ Society. His specific research interests include the role of apoptosis related mitochondrial dysfunction and remote ischemic preconditioning as mediators of reperfusion injury. Most recently, Caldarone has focused on pulmonary vein stenosis and tissue engineering of pulmonary valves.