Congenital Heart Conditions, Diagnostics & Treatments

Heart disease symptoms are frequently present early in life, but it is possible for some congenital heart problems to go undetected throughout life. With the advances in prenatal imaging, heart conditions are being detected while still in utero. Some children may not exhibit any signs while others may exhibit shortness of breath, cyanosis, syncope, heart murmur, under-developing limbs and muscles, poor feeding or growth or respiratory infections. Congenital heart defects cause abnormal heart structure that produces certain sounds called heart murmur. These can sometimes be detected; however, not all heart murmurs are caused by congenital heart defects.

Conditions

Adult congenital heart disease
Cardiomyopathy
- Dilated
- Hypertrophic
Connective tissue disorders
Cyanotic
- Complex congenital heart disease
- Ebstein's anomaly
- Hypoplastic left heart
- Pulmonary atresia
- Pulmonary stenosis
- Single ventricle anatomy and physiology
- Tetralogy of Fallot
- Transposition of the great vessels
- Tricuspid atresia
- Truncus arteriosus
Fetal cardiovascular diagnosis and management
Genetic conditions with increased risk for heart defects
- DiGeorge syndrome
- Down syndrome
- Heterotaxy
- Marfan syndrome
- Noonan syndrome
- Trisomy 13 and 18
- Turner syndrome
- Williams syndrome
Noncyanotic
- Aortic stenosis
- Atrial septal defect (ASD)
- Atrioventricular canal (endocardial cushion) defect
- Coarctation of the aorta
- Congenital coronary anomalies including coronary fistula
- Congenitally corrected transposition of the great arteries
- Hypoplastic aorta
- Patent ductus arteriosus
- Pulmonic stenosis
- Ventricular septal defect
Pediatric arrhythmias
Pregnancy in congenital heart disease

Diagnostics

Cardiac catheterization
Cardiac CT
Cardiac MRI
Cardiogenetics
Cardiopulmonary exercise testing
Chest X-ray
Complex congenital cardiac imaging (transthoracic echocardiography, transesophageal echocardiography, intracardiac echocardiography, congenital cardiac MRI, congenital cardiac CT, 3D rotational angiography)
Echocardiogram
Electrocardiogram (EKG)
Electrophysiology (adult congenital heart disease >14 years)
Fetal cardiac diagnosis and counseling and cardiac genetic evaluation and counseling
Fetal echocardiography
Invasive echocardiography (transesophageal and intracardiac)
Stress testing: medical and exercise
Three-dimensional rotational angiography

Treatments

Interventional catheter therapies
- Angioplasty/stent
  - Aorta
  - Central veins
  - Patent ductus arteriosus
  - Pulmonary arteries
- Septal defect closure
  - Atrial septal defect
  - Patent ductus arteriosus
  - Premature patent ductus arteriosus closure (>500gm)
  - Valvular septal defect
- Valve repair
  - Mitral (Adult congenital heart disease)
  - Tricuspid (Adult congenital heart disease)
- Valve replacement
  - Aortic (Adult congenital heart disease)
  - Pulmonary
- Vascular occlusion treatment
Surgical procedures
- Complex repairs
  - Arterial switch
  - Double switch procedure
  - Fontan procedure
  - Norwood procedure
  - Repair pulmonary atresia
  - Ross operation
  - Tetralogy repair
- Septal defect closure
  - Atrial septal defect
  - AV (Atrioventricular) canal
  - Patent ductus arteriosus
  - Valvular septal defect
- Valve repairs/replacements
  - Aorta
  - Mitral
  - Pulmonary
  - Tricuspid
- Vascular
  - Aorta coarctation
  - Complex aortic repairs

Surgical Care of Neonates Through Adulthood

Hybrid procedures
- Hybrid Stage 1 for HLHS
- Periventricular approach to RVOT and Melody valve
Ross procedure
Valve sparing aortic root replacement
Ebstein’s valve repair

Dedicated Congenital Heart Perfusion

Extracorporeal membrane oxygenation (ECMO), transport ECMO
Ventricular assist devices
Dedicated perfusionist
Blood conservation program
- Jehovah's Witnesses program

Services and Technology

Fetal cardiac diagnosis and counseling and cardiac genetic evaluation and counseling
Neonatal heart surgery, as well as pediatric, adolescent and adult congenital heart surgery
Dedicated pediatric and adult cardiac intensive care units with extracorporeal membrane oxygenation support
Transcatheter valve therapy/replacement (pulmonic, aortic, mitral, tricuspid)
Transcatheter ASD, VSD, PFO, PDA closure
Transcatheter treatment of complex vascular stenosis (angioplasty/stent pulmonary arteries, angioplasty/stent aorta, angioplasty/stent venous stenoses, stent PDA)
Complex congenital cardiac imaging (transthoracic echocardiography, transesophageal echocardiography, intracardiac echocardiography, congenital cardiac MRI, congenital cardiac CT, 3D rotational angiography)

Highlights

Infrastructure to care for congenital heart patients and their families from fetal diagnosis through senescence by a single highly specialized multidisciplinary team
Multidisciplinary team composed of pediatric and adult congenital heart disease cardiologists and surgeons, neonatologists, dedicated cardiac anesthesiologists, congenital cardiac intensivists, pediatric and adult subspecialists, and advanced pediatric cardiac nurse practitioners
One of only a few U.S. centers with access to both Melody and Sapien valves for pulmonic valve replacement
Novel hybrid techniques aimed at minimizing morbidity and mortality
Clinical trials site affording patients access to the latest therapeutic advances in congenital heart disease