Pediheart: Pediatric Cardiology Today

This week we explore the topic of Artificial Intelligence with a true expert in the field, Dr. Anthony Chang who is chief intelligence and innovation officer at Children's Hospital of Orange County. Dr. Chang recently earned a master’s degree in Biomedical Data Science and Artificial Intelligence from Stanford University and he reviews with us what AI is, what the potential value of this technology might be for medicine and discusses the obstacles that exist for full implementation and development for medical applications. Should we embrace or be fearful of this future? Dr. Chang will provide the answers….

This week’s episode explores the sedative and anxiolytic agent dexmedetomidine and its use in the pediatric cardiac ICU. This agent, which was initially introduced for short term sedation, is increasingly used in our postoperative cardiac patients and we explore issues related to its use with particular attention to the issue of withdrawal. Dr. Michael Ushay, Director of Pediatric Critical Care at The Children’s Hospital at Montefiore joins us to provide clinical insight and perspective.

This week we devote the episode to congenital cardiac electrophysiology. We review 2 works - the first on outcomes of ablation for the treatment of atrial arrhythmias in Ebstein's anomaly and the second focuses on the ablation of posteroseptal accessory pathways in children, risks for coronary injury and strategies to avoid this potential serious complication. We are joined by Dr. Christopher McLeod of the Mayo Clinic to speak about his work on ablation of atrial arrhythmias in Ebstein's. His large experience and insights provide good perspective on this very challenging group of patients.

This week we review the most recent report of the SVR trial study group. The great economic cognitive and mathematical psychologist Amos Tversky once said "The world is not kind to collaboration." However, the SVR trial may just be the exception to prove Professor Tversky's rule. This month the group reports on how patients are doing 6 years after Stage I Palliation (Norwood) for HLHS -> RV-PA shunt vs. modified BT shunt and we delve into these important results. Dr. Rick Ohye, director of pediatric cardiovascular surgery at CS Mott Children’s Hospital and the senior author of this work joins us to discuss this paper (from Circulation) and also his insights into the findings in this trial so far as well as delving into the challenges he faced when starting such a massive "collaboration".

This week we review 2 important aspects of pediatric cardiovascular surgery - postoperative evaluation of pulmonary vein repair and management of the anomalous coronary artery for the prevention of sudden cardiac death. Dr. Carlos Mery of Texas Children's Hospital joins us to discuss the findings of a recent project he published on a large series of operations for these disorders.

This week's podcast explores the adult Fontan patient and the substantial challenges these patients face. We review 2 very recent articles on adult Fontan patients and explore the topic further with Dr. Ali Zaidi, Director of The Adult Congenital Heart Program at Montefiore Medical Center. Dr. Zaidi has a number of insights into these papers based upon his extensive clinical experience. This episode is dedicated to the memory of Professor Francis Fontan who passed last month. His impact on the lives of our congenital heart patients is inestimable.

On this podcast we explore two very recent papers on the topic of cardiac catheterization. The first is a large study reviewing the impact of NaHC03 + /- acetylcysteine on prevention of contrast nephropathy and the second is a comparison of endocarditis rates in surgical versus transcatheter pulmonary valve replacement. Dr. Gentian Lluri, the first author of the PVR paper joins us to discuss this work from UCLA and the "take away" points. As last week, we end with a wonderful piece from an operatic legend. Please leave a review or comment in iTunes! See you next week and I hope you enjoy....

This episode is in memory to Dr. Arthur Moss. We have today Dr. David Auerbach who was a key recent collaborator to review his 2 new recent works with Dr. Moss on the effects of antiseizure and antidepressant medications on LQTS patients. The discussion is very interesting and Dr. Auerbach shares his warm feelings for Dr. Moss with the audience. Finally, we end the podcast with a brief piece of opera.

Today we have 2 wonderful guests - Dr. Kenan Stern of Mt. Sinai Medical Center in NY, NY and Dr. Nadine Choueiter speaking on 2 different papers/topics. The papers reviewed are:Utility of a standardized postcardiopulmonary bypass epicardial echocardiography protocol for stage I Norwood palliation and Environmental epidemiology of Kawasaki disease: Linking disease etiology, pathogenesis and global distributionDr. Choueiter also references: Diagnosis, Treatment, and Long-Term Management of Kawasaki Disease: A Scientific Statement for Health Professionals From the American Heart Association and the link for this important statement is:http://circ.ahajournals.org/content/early/2017/03/29/CIR.0000000000000484I hope you enjoy the podcast. Please leave comments and rate us on iTunes!

We review 2 articles today:Prevalence and risk factors associated with non-attendance in neurodevelopment follow-up clinic among infants with CHD - Cardiology in the Young 2018Psychiatric Disorders and Function in Adolescents with Tetralogy of Fallot - J Peds 2017Both wonderful works that analyze under appreciated areas of care for our patients with CHD. Please review our podcast on iTunes - your listening and reviews are very much appreciated!