Congenital Heart Program
The University of Maryland Children’s Heart Program provides a continuum of care for patients with congenital heart disease from birth through adulthood. This unique approach allows patients to be seen by a team of physicians in the same facility, providing exceptional care to infants, adolescents and adults. Highly respected for its medical and surgical techniques, the Congenital Heart Program strives for excellent outcomes, reduced mortality and enhanced quality of life for its patients. The program’s cutting-edge technology and the vast expertise of its physicians — all of whom are University of Maryland School of Medicine faculty members — make it a distinguished leader in congenital heart disease care. Stacy Fisher, M.D., exemplifies the high level of expertise among Congenital Heart Program physicians. She is an assistant professor of medicine, specializing in women’s heart health, as well as adolescent and adult heart patients. Dr. Fisher’s clinical specialties include echocardiology, adult congenital heart disease, heart disease during pregnancy and pulmonary hypertension.
“The collaborative and expanding nature of the program, including pediatrics, cardiology, adult cardiology and cardiac surgery, sets the Congenital Heart Program apart from other programs,” says Dr. Fisher. “I’m proud of our multidisciplinary approach that provides better outcomes for our patients.”
Enhanced screening and interventional care
There are many genetic causes of congenital heart disease, including Marfan syndrome, arrhythmia, hypertrophic cardiomyopathy and aneurysm. The Cardiogenetics Clinic allows increased diagnostic accuracy for possible patients and can thoughtfully guide genetic testing and screening for first-degree relatives of patients to detect potential problems. Using EKG, echocardiology, arrhythmia monitoring, cardiac CT or MRI, and/or genetic testing when appropriate, physicians look for associated problems in family members in an effort to reduce associated sudden death.
“Our multidisciplinary approach includes interventional catheter based care, arrhythmia management, electrical physiology assessment and care, imaging and genetics,” says Dr. Fisher. “We’re also proactive in screening and managing our pregnant patients who have known structural heart disease, arrhythmias or underlying clotting problems so we can anticipate problems before they occur.” The Congenital Heart Program also offers congenital heart surgery from neonatal patients to adults. Surgical procedures range from correcting heart physiology to heart transplantation. “By correcting heart physiology, we can reduce the consequences and suffering from complications of congenital heart disease,” says pediatric cardiothoracic surgeon, Sunjay Kaushal, M.D., associate professor of surgery. “In the past 15 years we’ve moved into a new phase in caring for congenital heart disease patients by looking at long-term and quality of life outcomes.”
Dr. Kaushal, the only pediatric cardiac surgeon who is board certified in congenital heart surgery in Maryland, believes enhancing patients’ quality of life and ability to contribute to society is a huge change. This has been made possible, in part, by altering surgical methods and manipulating the cardiopulmonary bypass machine to improve clinical outcomes including the impact on intelligence and behavior issues.
Promising stem cell therapies
Hypoplastic left heart syndrome is a rare congenital heart defect in which the left ventricle is severely underdeveloped, and the right ventricle serves as the pumping chamber for systemic circulation. Stem cells from the patient’s own heart can be used to improve right heart function in these patients.
Dr. Kaushal has been exploring novel therapies to treat underdeveloped cardiac chamber disease using resident cardiac stem cells to help patients regrow heart tissue. Early studies have shown the safety, feasibility and efficacy of this potentially breakthrough therapy. Application of these stem cells hasn’t been explored in pediatric patients who exhibit different causes including myocardial ischemia and cardiomyopathy. “I hope to obtain IRB and FDA approval to conduct Phase I clinical trials within three months,” says Dr. Kaushal. “We would be the first in the world to do this type of surgery, and it will make the University of Maryland very unique in the world for treating heart failure in children.
The Children’s Heart Program at University of Maryland Children’s Hospital was designed with an emphasis on treating the entire range of cardiac disorders from the most common to the most severe conditions. The Children’s Heart Program offers a comprehensive spectrum of services, including clinics oriented to treat children with blood lipid abnormalities and hypertension, and a hybrid catheterization suite that allows complex treatments that can’t be performed in other institutions.
“We’ve recruited experts ranging from congenital heart surgeons to pediatric and interventional cardiologists who can work together to address the most complex needs of congenital heart patients,” says Geoffrey Rosenthal, M.D., professor of pediatrics and director of the Children’s Heart Program at the University of Maryland Children’s Hospital. “Our staff can perform the most cutting-edge surgical and catheter approaches in a hybrid surgical suite to achieve results that can’t be realized with one approach alone.”
According to Dr. Rosenthal, approximately 3% of the 4 million infants born in the United States each year have a birth defect. Congenital heart disease is the most common of these, occurring in about 1 in 110 births, affecting nearly 40,000 infants annually in the United States.
Approximately 75% of all serious congenital heart disease is identified before birth. Following a screening test, pregnant mothers are referred to the University of Maryland Medical Center’s Center for Advanced Fetal Care and/or the Children’s Hospital for diagnostic work to address structural heart abnormalities.
“I’m very proud of the way people at all levels of our institution and community have come together to meet the needs of these children,” says Dr. Rosenthal. “We’ve achieved outstanding outcomes caring for children with the highest risk of complications and mortality. University of Maryland Children’s Hospital is operating at a level that far exceeds the national average.”
To learn more, call Physician OneCall at 1-800-373-4111 or visit www.umm.edu