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Expanding Expertise in Congenital Heart Disease

Expanding Expertise in Congenital Heart Disease

A new collaborative center representing disciplines of pediatric cardiology, cardiac surgery, and anesthesiology and critical care medicine offers lifelong care for patients born with CHD.

In November 1944, Johns Hopkins sur­geons performed the first landmark op­eration on an infant whose heart is unable to pump blood to the lungs to provide enough oxygen to the body. A surgical team led by Alfred Blalock, with his longtime technician Vivien Thomas guiding him, implanted a shunt to in­crease blood flow to the lungs. Pediatric cardiologist Helen Taussig worked with Blalock to develop the shunt. The procedure is credited with saving the lives of thousands of children and launching the field of modern cardiac surgery.

In 2020, Johns Hopkins Medicine brought multiple specialists in pediat­ric and congenital heart disease (CHD) into the new Blalock-Taussig-Thomas Pediatric and Congenital Heart Center. A collaboration among the divisions of pediatric cardiology, pediatric cardiac surgery, and pediatric anesthesiology and critical care medicine, the center offers lifelong care for patients born with CHD.

“Johns Hopkins was the birthplace for congenital heart disease interven­tions in surgery,” says Jamie McElrath Schwartz, co-director of the new center and division chief of pediatric critical care medicine. “We picked the name specifi­cally to include these three pioneers, as we are building on that past and creating a new future.”

Although experts from different dis­ciplines who care for CHD patients collaborated in the past, Schwartz says this reorganization establishes a fully in­tegrated, multidisciplinary approach at Johns Hopkins Medicine.

“We have the ability to create dedicated services like operative teams, pediatric perfusion teams, a cardiac intensive care unit and nursing,” she says. “That’s excit­ing, because these are people who want to narrow their practice to CHD, to work with these families long term and provide them excellent care.”

Center co-director Shelby Kutty, who also serves as director of pediatric and congenital cardiology, says the cen­ter’s structure maximizes the available expertise at Johns Hopkins Medicine, benefits patients’ families and gives the in­stitution a competitive edge for recruiting top experts and garnering research dollars. CHD patients are very complex, he adds, often requiring a spectrum of services: “It’s a very outcomes-driven specialty, and the key to having good outcomes is a dedicated team and teamwork.”

Bret Mettler, director of pediatric cardiac surgery, is also a co-director of the center. He recently came to Johns Hopkins Medicine from Vanderbilt

University Medical Center, where he was director of pediatric cardiac transplanta­tion and mechanical support. Pediatric and congenital cardiac surgeon Dani­elle Gottlieb-Sen, with expertise in the genetics and prenatal diagnosis of CHD, will have a clinical practice while directing pediatric cardiac research for the heart center.

“Our goal is to provide a service line of care, where patients and their families can call one phone number and have access to outpatient care, surgeries, postoperative care and research studies,” Mettler ex­plains. “We do plan to develop the heart center at Johns Hopkins into an elite destination.”

With Johns Hopkins experts in mater­nal-fetal medicine and obstetrics close at hand, the new heart center will help ex­tend full-service care for mothers and their babies. The new center also incorpo­rates an adult CHD program, directed by cardiologist Ari Cedars, to manage teens and young adults’ CHD needs as well as any adult-onset heart conditions such as coronary artery disease and ar­rhythmias. Also, because congenital heart disease affects a relatively small patient population, Mettler hopes to form clini­cal and research partnerships with other CHD programs.

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