Podcasts about adult congenital heart disease

Commentary by Dr. Candice Silversides and Dr. Lorna Swan

Joining us on Well Said is Dr. Catherine Weinberg. Dr. Director of Adult Congenital Heart Disease at Northwell Health, Director of High-Risk Cardiovascular Obstetrics at Lenox Hill Hospital, and Assistant Professor of Cardiology at Donald and Barbara Zucker School of Medicine to educate us on adults living with congenital heart disease. As techniques for evaluating and treating heart disease in children have improved, it has allowed more and more affected individuals to survive (and thrive) into adulthood. The result has been a growing number of adults with conditions previously only seen in kids.

As cardiology advances, cardiology fellowship education must evolve with it. On MedAxiom HeartTalk, host Melanie Lawson speaks with Ami Bhatt, MD, FACC, the chief innovation officer of the American College of Cardiology and associate professor of medicine at Harvard Medical School, Doreen DeFaria Yeh, MD, FACC, adult congenital heart disease cardiologist at Massachusetts General Hospital, and Ana Mercurio-Pinto, VP of Care Transformation at MedAxiom. Together, they explore how cardiology fellows are the future and discuss opportunities for enhancing education during cardiology fellowship.Guest Bios:Ami B. Bhatt, MD, FACC:Dr. Ami Bhatt is the Chief Innovation Officer (CIO) of the American College of Cardiology. As CIO, Bhatt provides leadership and expertise in healthcare innovation and continues to grow the College's comprehensive Innovation Program in support of the ACC's Mission to transform cardiovascular care and improve heart health.A graduate of Harvard College and the Yale School of Medicine, Bhatt completed her medicine and pediatrics residency at Harvard, her adult cardiology fellowship at Brigham and Women's Hospital and her adult congenital heart disease and pulmonary hypertension fellowship at the Boston Children's Hospital. She was the Inaugural Richard Liberthson Endowed Scholar in Adult Congenital Heart Disease and Director of the ACHD program for over a decade. She most recently served as the Director of Outpatient and Telecardiology at the Massachusetts General Hospital (MGH) Corrigan-Minehan Heart Center. Dr. Bhatt continues as a Harvard College premedical mentor and associate professor at Harvard Medical School.As an active clinical cardiologist, investigator, and educator Bhatt brings nearly ten years of experience in telemedicine and digital health to her new role. She founded her first program in virtual care in 2013 and continues to work on creating culturally relevant personalized virtual cardiovascular care delivery models. Her research has centered on identifying and implementing solutions to overcoming access barriers to cardiovascular and telemedicine care.Dr. Bhatt's interest in digital health strategy and the digital transformation of the cardiovascular field stems from her belief that state-of-the-art, personalized care can be delivered to individuals in the community, empowering patients and creating stronger clinician-patient partnerships for sustainable health outcomes. The ACC Innovation Program has a robust platform to transform digital patient care and advance technologies that are reshaping medicine and is focused on furthering these strategies.Doreen DeFaria Yeh, MD, FACC:Dr. Doreen DeFaria Yeh completed Internal Medicine Residency at Massachusetts General Hospital and Cardiology and Echocardiography fellowships at the University of California at San Francisco. She completed advanced training in Adult Congenital Heart Disease and Cardio-Obstetrics at the University of San Francisco California, and currently serves as the Associate Director of the MGH Adult Congenital Heart Disease (ACHD) Program and Co-Director of the MGH Cardiovascular Disease and Pregnancy Program. She is board certified in Internal Medicine, Adult Cardiovascular Disease and Adult Echocardiography. The has received Certification from the National Board of Echocardiography for Adult Comprehensive Echocardiography.Dr. DeFaria was selected as one of the American College of Cardiology 2012 Emerging Faculty and received the Brian McGovern Memorial Award from the Department of Medicine in 2012 and 2016 for Excellence in Clinical Teaching in cardiology. She also received the MGH, Department of Medicine Fellowship as part of the Eleanor and Miles Shore Scholars in Medicine from Harvard Medical School. In 2013 she was awarded the Clinician Teacher Development Award, a four-year grant supported by the Massachusetts General Hospital Physicians Organization and Center for Diversity and Inclusion, a project titled: Redefine ACHD Education. She currently serves as the Director of the MGH Cardiovascular Disease Fellowship Program and Chair of Internship Selection for the Department of Medicine.Her clinical focus is ACHD, Pregnancy & Cardiovascular Disease, particularly high-risk cardiac conditions in pregnancy as well as Echocardiography with expertise in ACHD Echocardiography. Dr. DeFaria speaks regionally and nationally on these topics.Ana A. Mercurio-Pinto, MM:Ana is energized by the possibilities. She has extensive professional experience running large, multi-specialized cardiovascular medicine divisions and has had the privilege of working and partnering with some of the industry's leading thought leaders: master clinicians, practice changing trialists and groundbreaking research scientists. She is dedicated to developing nimble and adaptive organizations that combine the best of traditional practice with the spirit of continuous modernization in the face of evolving and changing times.As vice president of care transformation at MedAxiom, Ana applies her wide-ranging experience in budgeting, forecasting, physician/practice P&Ls, clinical and federal/non-federal research operations, new program development, service-line integration, and dyad and other matrixed leadership structures to help cardiovascular organizations transform care. Ana has a keen interest in hospital/physician organization integration, faculty transitions, staffing optimization, administrative and research operations, and startup ventures.Ana has a bachelor's degree in business administration from Boston University Questrom School of Management and a master's in management with a concentration in Healthcare Management. Additionally, Ana has pursued certificates in Launching New Ventures and Research Administration.

Psychotherapist Tracy Livecchi, LCSW, joins Paul Cardall to discuss healing hearts and minds of people born with an illness that requires a life time of medical care. Both Tracy and Paul were born with complex congenital heart defects. Although congenital heart disease or CHD is the least funded of all major illnesses, CHD remains the leading cause of infant related deaths. However, because of advancements in medicine and technology millions of people have survived and adapt to what would be considered a normal life, although their lives have required a life-time of medical care and surgical procedures. They swap stories and go into detail about the miracle of life and how Tracy's parents were instrumental in working with doctors to secure her survival. Because of the lack of information for lifelong patients, Tracy and her colleague Liza Morton, PhD have written "Healing Hearts and Minds: A Holistic Approach to Coping Well With Congenital Heart Disease." ABOUT TRACY LIVECCHI, LCSWTracy writes on her website: In terms of my training, I received my Masters Degree in Social Work from Rutgers University. I have worked in a variety of settings as a private therapist, a clinical director, as well as a consultant for long-term care and hospital settings. I have been working as a psychotherapist in private practice since 1998, and currently provide psychotherapy to individual adults, adolescents, and couples in my Westport practice. I work from an eclectic theoretical orientation and provide supportive counseling while also utilizing cognitive, behavioral, psychodynamic and trauma informed, mindfulness approaches, when appropriate. I am the Mental Health Consultant for the Adult Congenital Heart Association's Peer Mentorship Program and speak nationwide on the importance of addressing the psychosocial effects of heart disease. I am passionate about mental health access for all and have a special interest in working with individuals and their families dealing with serious and chronic illness. I live in CT with my husband and two daughters. Website: https://tracylivecchi.com/GET THE BOOK: Healing Hearts & MindsACHA or ADULT CONGENITAL HEART DISEASE ASSOCIATION  ABOUT THE HOST PAUL CARDALLhttp://www.paulcardall.comhttp://www.facebook.com/paulcardallmusichttp://www.youtube.com/cardallhttp://www.instagram.com/paulcardall LISTEN TO HIS MUSICAPPLE MUSIC - https://music.apple.com/us/artist/paul-cardall/4312819SPOTIFY - https://open.spotify.com/artist/7FQRbf8gbKw8KZQZAJWxH2AMAZON - Ask Alexa to play Peaceful Piano by Paul Cardall Paul Cardall is an artist who has given a new meaning to the phrase, a change of heart and how he used this radical change to take his music to an unexpected place.  Despite being born with a potentially life-threatening heart defect Paul Cardall has become a world recognized pianist. He is even endorsed by Steinway & Sons as one of the finest pianist of our time. A Dove award winner for his Christmas album, Paul's recordings have debuted on 11 No. 1 Billboard charts along with 46 other chart debuts. His music has 25 million monthly listeners with more than 3 billion lifetime streams and is often categorized as Classical, Christian, and Holiday. Although most of albums are instrumental, Paul has songs that feature Grammy winning gospel legend CeCe Winans, Matt Hammitt (Sanctus Real), Kristin Chenoweth, Country duo Thompson Square, David Archuleta, Tyler Glenn (Neon Trees), Audrey Assad, Steven Sharp Nelson (The Piano Guys), and more.    Paul has performed for audiences worldwide including the White House. Forbes, American Songwriter, Jesus Calling, Lifestyles Television, Mix Magazine, and countless other media outlets have share his remarkable journey of receiving a life changing heart transplant and using music as a tool to help God heal spiritual, mental, and emotional hearts.

Dr. Zachary Steinberg, MD, is a board-certified Interventional Cardiologist and Adult Congenital Heart Disease specialist with the UW Medicine's Heart Institute. Dr. Steinberg specializes in the care of adults born with heart defects and performs transcatheter intervention on this complex patient population.  He has a wide array of interventional expertise including complex coronary artery revascularization, transcatheter valve implantation, septal defect closure, and balloon pulmonary angioplasty for patients with chronic thromboembolic pulmonary hypertension (CTEPH).00:55 - Dr. Specialization13:00 - "A Profession of Lifelong Learning"15:10 - Intervention Cardiology First19:45 - A Day in the Life - Chronic thromboembolic pulmonary hypertension28.25 - Learning Chronic Pulmonary Angioplasty36:45 - Approaching Orphan Diseases37:30 - Our Interventional Team39:50 - Repairing Congenital Defectsuwheart@uw.edu

Partial anomalous pulmonary venous return refers to anomalies in which one or more (but not all) of the pulmonary veins connects to a location other than the left atrium. This causes left to right shunting which may have hemodynamic and therefore clinical significance, warranting repair in some patients. Join CardioNerds to learn about partial anomalous pulmonary venous return! Dr. Dan Ambinder (CardioNerds co-founder), Dr. Josh Saef (ACHD FIT at the University of Pennsylvania and ACHD Series co-chair), and Dr. Tripti Gupta (ACHD FIT at Vanderbilt University and episode lead) learn from Dr. Ian Harris (Director of the Adult Congenital Heart Disease program at University of California, San Francisco). Audio editing by CardioNerds Academy Intern, student doctor Shivani Reddy. The CardioNerds Adult Congenital Heart Disease (ACHD) series provides a comprehensive curriculum to dive deep into the labyrinthine world of congenital heart disease with the aim of empowering every CardioNerd to help improve the lives of people living with congenital heart disease. This series is multi-institutional collaborative project made possible by contributions of stellar fellow leads and expert faculty from several programs, led by series co-chairs, Dr. Josh Saef, Dr. Agnes Koczo, and Dr. Dan Clark. The CardioNerds Adult Congenital Heart Disease Series is developed in collaboration with the Adult Congenital Heart Association, The CHiP Network, and Heart University. See more Disclosures: None Pearls • Notes • References • Guest Profiles • Production Team CardioNerds Adult Congenital Heart Disease PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Pearls - Partial Anomalous Pulmonary Venous Return (PAPVR) What is partial anomalous pulmonary venous return (PAPVR)? PAPVR refers to anomalies in which one or more (but not all) of the pulmonary veins connects to a location other than the left atrium. Often, this means one or more pulmonary veins empty into the right atrium or a systemic vein such as the superior vena cava or inferior vena cava. Physiologically, this produces a left-to-right shunt, allowing for already-oxygenated blood to recirculate into the lungs and result in excessive pulmonary blood flow.  What are the clinical features of PAPVR?Diagnosis is usually incidental on a cross sectional imaging such as CTA or CMR.The most common associated lesion is an atrial-level defect.It is unusual for a single anomalous pulmonary venous connection of only 1 pulmonary lobe to result in significant shunting. Patients with a significant degree of left to right shunting may have right heart dilatation or symptoms of dyspnea on exertion. When are some strategies for managing patients with PAPVR?A surgical correction is recommended for patients with PAPVR when functional capacity is impaired and RV enlargement is present, there is a net left-to-right shunt sufficiently large to cause physiological sequelae (aka: ratio of pulmonary flow (Qp) to systemic flow (Qs) is > 1.5:1), PA systolic pressure is less than 50% systemic pressure and pulmonary venous resistance is less than one third of systemic venous resistance.Surgical repair involves intracaval baffling of the left atrium (Warden procedure) or direct reimplantation of the anomalous pulmonary vein into the left atrium.Pregnancy is well tolerated in patients with repaired PAPVR. In patients with unrepaired lesion who may have right sided heart dilatation and/or pulmonary hypertension, preconception evaluation and counseling should address how pregnancy may affect mother's and fetus's health. Antibiotic prophylaxis for infective endocarditis is typically not needed unless patients are less than 6 months from recent surgery, have residual defect at the patch margin or prior history of infective endocarditi...

Yonatan Buber, MD earned his M.D. from Ben Gurion University in Israel.   Dr. Buber specializes in all forms of congenital heart disease, pregnancy in women with heart disease, pulmonary hypertension and exercise physiology.0:40 - Dr. Buber's Journey from Israel3:05 - A week that inspired an Adult Congenital Heart Disease career5:00 - Differences in ACHD Care Israel vs. US7:40 - Recruiting persistence of Drs. Krieger and Stout10:05 - Cardiopulmonary Exercise Testing, Cardio-Obstetrics, Aortopathy Clinic14:30 - Cardio-Obstetrics22:15 - Global Health Collaborations26:30 - Regional ACHD Care30:20 - Defusing Bombs in Israel 36:30 - Advice for future cardiologistsEmail: bubery@uw.edu

CardioNerds (Daniel Ambinder) and ACHD series co-chair Dr. Dan Clark discuss advanced heart failure therapies including mechanical circulatory support (MCS) and heart transplantation (HT) in patients with adult congenital heart disease (ACHD) with Dr. Rafael Alonso-Gonzalez, cardiologist and director of Adult Congenital Heart Disease program at the University of Toronto and ACHD fellow Dr. Andy Pistner (University of Washington). They cover epidemiology of heart failure in ACHD, outcomes after HT, unique challenges of HT in this population, impact of allocation policies on access to transplantation, and regionalization of advanced heart failure care. They also discuss a practical approach to advanced heart failure therapy evaluation in ACHD. Audio editing by CardioNerds Academy Intern, student doctor Adriana Mares. The CardioNerds Adult Congenital Heart Disease (ACHD) series provides a comprehensive curriculum to dive deep into the labyrinthine world of congenital heart disease with the aim of empowering every CardioNerd to help improve the lives of people living with congenital heart disease. This series is multi-institutional collaborative project made possible by contributions of stellar fellow leads and expert faculty from several programs, led by series co-chairs, Dr. Josh Saef, Dr. Agnes Koczo, and Dr. Dan Clark. The CardioNerds Adult Congenital Heart Disease Series is developed in collaboration with the Adult Congenital Heart Association, The CHiP Network, and Heart University. See more Disclosures: None Pearls • Notes • References • Guest Profiles • Production Team CardioNerds Adult Congenital Heart Disease PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Pearls - Advanced Heart Failure Therapies (MCS/HT) Among ACHD Patients Heart failure is a major comorbidity and the leading cause of death in adults with congenital heart disease.Identification of advanced heart failure in ACHD is challenging. ACHD patients do not always self-identify exercise limitations or exertional dyspnea. Cardiopulmonary exercise testing is a useful tool in evaluating these patients.Patients with ACHD awaiting heart transplantation are less likely than non-ACHD patients to receive a heart transplant, and ACHD patients have an increased risk of death or delisting while awaiting heart transplantation.Evaluation of transplant candidacy and potential need for multi-organ transplantation in complex congenital heart disease (i.e., Fontan palliation) requires a multidisciplinary approach.Regionalization of care improves outcomes for ACHD patients with advanced heart failure. High volume transplant centers have better early survival for ACHD patients after heart transplant, and the highest volume ACHD transplant centers in each UNOS region have better early survival. Show notes - Advanced Heart Failure Therapies (MCS/HT) Among ACHD Patients 1. How many ACHD patients have heart failure? Patients with ACHD are a large and heterogeneous group. The signs and symptoms of heart failure vary widely depending on the underlying congenital heart disease. Patients with D-transposition of the great arteries repaired with an arterial switch operation have low rates of heart failure (~3%)1 compared to those patients Fontan palliation for single ventricle physiology (40%)2. Heart failure is the leading cause of death in patients with ACHD3,4. 2. How many patients with ACHD end up receiving a heart transplant or mechanical circulatory support? Heart transplantation for congenital heart disease in adults has been increasing in frequency since the late 1980s. Between 2010 and 2012, this accounted for 4% of all adult heart transplants in the United States5. This represents a small fraction compared to the number of adults who die due to complications of heart failure ...

Tamanna Singh, MD and Adriano Tonelli, MD discuss non-invasive and invasive cardiopulmonary exercise testing.

Commentary by Dr. Candice Silversides

Dr. Laith Alshawabkeh to learn all about adult congenital heart disease. We discuss patient population, day-to-day life, training pathway, and more! Join us!

Clinicians often have questions about referring patients to Cleveland Clinic for adult congenital heart disease. Dr. Margaret Fuchs answers questions.

With the growing number of pediatric congenital heart patients growing up thanks to ever improving medical care, Dr. Scott Pilgrim takes us inside one of the few programs in the nation that bridges the gap to adult care without missing a beat. Meet the speaker Meet Dr. Pilgrim Related information Cook Children's Adult Congenital Heart Disease Program Adult Congenital Heart Disease Conditions Cook Children's Heart Center Specialty Programs Cook Children’s Heart Center Coming home: nurse returns to Cook Children’s for open heart surgery Diving heart first Heart-to-heart. Mother and daughter share the same cardiologist Transcript 00:00:02 Host Hello and welcome to Cook Children's Doc Talk. Today we're talking with Dr. Scott Pilgrim, who is the medical director of the Adult Congenital Heart Disease program here at Cook Children's. Dr. Pilgrim is board-certified in pediatrics, internal medicine, pediatric cardiology and adult congenital cardiology. Prior to coming to Cook Children's, Dr. Pilgrim founded the adult congenital heart disease program at the Steven and Alexandra Cohen Children's Medical Center in Long Island. Today, under his leadership, the Adult Congenital Heart Disease program at Cook Children's Medical Center has shown tremendous growth with over 500 adult visits every year. Welcome Dr. Pilgrim. 00:00:42 Dr. Pilgrim Thank you. 00:00:43 Host So growing up with a sister who had heart surgery as a child had a major influence in your life, and ultimately led you to your role here at Cook Children's as medical director of the ACHD program, compared to many other cardiac specialties, adult congenital as a specialty is relatively new, can you give us a little history. 00:01:03 Dr. Pilgrim So, as you mentioned, my sister was born with a congenital heart disease. And so growing up with this in my family, it became of interest to me at a very young age. But as a field, congenital heart disease is something that has been around obviously, for several decades, this field of adult congenital heart disease has grown primarily because of the success stories that we've had in pediatric cardiology, namely, the surgical outcomes and the longevity of patients related to improved surgical care, improved surgical technique, you know, recognizing disease, early on fetal diagnosis, and so on and so forth. And so the incidence of congenital heart disease really hasn't changed. But the lifespan of individuals growing up with congenital heart disease has tremendously improved. And so when we think about the growth of adult congenital heart disease in the country, it really has grown out of necessity, because these kids are now growing up and becoming adults. In fact, the number of adults with congenital heart disease now far outweighs the number of children with congenital heart disease in th

Dr. Eric Roselli and Dr. Joanna Ghobrial discuss the importance of collaboration, and the adult congenital heart disease - pulmonary hypertension combined clinic.

Congenital Heart Disease or CHD is the number one leading cause of infant related death and it wasn't that long ago when the cardiovascular community didn't have enough “congenital heart disease” specialists working with adult survivors of CHD. Today, with help from the Adult Congenital Heart Disease Association (ACHA) the cardiovascular community has helped educate cardiologists on these abnormalities of the human heart and build a network of specialists throughout the world. I spoke with ACHA accreditation manager Misty Sharpe, also a CHD patient and nurse at Vanderbilt, about what ACHA is doing to connect adult patients, encourage and educate families, as well as work closely with the medical community to ensure families are aware of CHD specialists in their area or where the closest clinic is to their coordinates. As a survivor of CHD, Misty and I discuss the challenges we experienced when we became adults and had outgrown the children's hospital's age limit. Discover what happened and how we resolved that problem.ABOUT MISTY SHARPE"As the Accreditation Program Manager for the Adult Congenital Heart Association (ACHA), I manage all aspects of the organization's national Accreditation Program for adult congenital heart disease (ACHD) centers. With a focus on patient-centered care, my role assists and guides programs through the process to ensure each meet a rigorous set of standards comprised of one hundred individual criteria across twenty categories related to staffing, policies and ancillary services. In 2020, the ability to adapt and pivot was critical for non-profit organizations and as ACHA's flagship program, it was necessary that the ACHD Accreditation Program do the same. I transitioned all site visits from an in-person format to completely virtual using the Zoom platform and successfully continued to move over ten programs through the process. During my career with ACHA, I have also participated in and led several initiatives related to volunteer recruitment, support programming improvement, community outreach and fundraising. I have collaborated on a variety of projects across various departments and currently serve on the Diversity, Equity and Inclusion Standing Committee. My background and education in both nursing and communications has been beneficial in providing opportunities to lend my knowledge and experience to meaningful discussions, projects and initiatives throughout the organization." -Misty Sharpe  (Reference: https://www.linkedin.com/in/mistyksharpe/)All Heart with Paul Cardall is sponsored by doTERRA, whose products are designed to offer hope and healing. For more information on Paul Cardall, please visit https://paulcardall.com/ or find him on Facebook, Instagram, Twitter, and YouTube.Episode artwork Episode transcript Socials (insert links for all social handles)Website - www.paulcardall.com/podcastFacebook - @paulcardallmusicIG - @paulcardallIG - @allheartwithpaulcardallTwitter - @paulcardallYoutube - @cardall  

Patients who are born with a congenital heart condition have many questions about heart care over the years.

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It's been a busy month on the blog with plenty for Iain and Simon to talk about. The Manchester Arena bombing, new guidelines for Anaphylaxis management, Adult Congenital Heart Disease, Calcium in Major Haemorrhage and Spontaneous Coronary Artery Dissection all get a mention alongside the usual witterings of two middle aged emergency physicians. 

This is the second in a two part podcast series discussing Adult Congenital Heart Disease (ACHD) and how these patients may present to the Emergency Department (ED). Dr Sam Fitzsimmons, our guest on the podcast, is a Consultant in Adult Congenital Heart Disease at University Hospital Southampton. There is more information in this blog post. In this episode we discuss Eisenmenger Syndrome, Transposition of the Great Arteries and Coarctation of the Aorta. 

This is the first in a two part podcast series discussing Adult Congenital Heart Disease (ACHD) and how these patients may present to the Emergency Department (ED). Dr Sam Fitzsimmons, our guest on the podcast, is a Consultant in Adult Congenital Heart Disease at University Hospital Southampton. There is more information in this blog post. Look out for Part 2, which will be released next week, where we discuss Eisenmenger Syndrome, Transposition of the Great Arteries and Coarctation of the Aorta.  Background With advances in paediatric cardiac surgery, more and more patients with complex congenital heart disease are surviving to adulthood: in the 1950s you might expect a survival rate of about 10%, whereas now this is more like 85%. In fact, there are more patients in the adult congenital heart disease population than there are in the paediatric one (with 2.3 million adults vs 1.9 million children in Europe). Many patients with Adult Congenital Heart Disease are young and able to live a relatively normal life. This means that they can travel and take part in just the same sort of activities as those without ACHD. They may well turn up in your Emergency Department one day, regardless of whether you are a tertiary centre or a district general hospital (DGH). They are experts, and know their disease well, but this does not abstain you from a responsibility to know about them too! When these patients become unwell, they can go downhill very fast and you may not have the chance to discuss with them their exact lesion and its management. The anatomy and physiology of these patients is abnormal, so they may present in atypical ways, and may not respond to usual medical interventions: in fact, some of our usual treatments may even be harmful. However, starting with our usual 'ABC' approach is by far the best way to go, whilst gathering more information and contacting their specialist centre. Many patients will have their last clinic letter and ECG with them (which will also have the direct dial number of their specialist). And if they, or their relative, say there is something wrong you must believe them and do all you can to make sure they are fully investigated.     The presence of scars may give you some clues as to the patient's underlying condition and previous surgical repairs. (BMJ 2016; 354: i3905)   A General Approach Do your usual ABC assessment. Pay particular attention to the respiratory rate - this should be normal. Give oxygen if they look unwell. They should have a 'normal' blood pressure - any hypotension should be taken as abnormal and investigated. The Fontan Circulation This is not a condition in itself, but in fact the resulting circulation after a series of operations that could've been performed due to a number of different underlying conditions:   Tricuspid Atresia Double Inlet Left Ventricle Atrio-ventricular Septal Defect – unbalanced Pulmonary Atresia Hypoplastic Left Heart Syndrome In essence these patients are born with a single functioning ventricle, that has to be utilised to supply the systemic side of the circulation, whilst the Fontan acts as a passive means of returning blood to the pulmonary circulation.   It was first devised in the early 1970s by Dr Francis Fontan, so the majority of patients with this are in their mid thirties and younger. Potential reasons for admission to the ED - Fontan circulation 1, Arrythmia As the patient is entirely dependent on their systemic ventricle to work optimally, any disturbance of the delivery into it is very poorly tolerated. Thus, any arrhythmia is life threatening, even a mild atrial tachycardia. These patients need to be returned to sinus rhythm as quickly as possible and the recommended method for this is DC cardioversion in expert hands. Fontan patients have an incredibly fragile circulation and any change in their respiratory physiology can be life threatening, especially if it increases their pulmonary pressures (and thus prevents the passive flow within the Fontan circulation). These patients are not candidates for sedation in the ED and should have an experienced anaesthetist to manage them during the procedure. Beware if the patient comes in and tells you they are fasted! This means they have been in this situation before and needed DC cardioversion. 2, Haemoptysis Over time the patient develops venous hypertension within the Fontan connection. This causes the formation of collateral vessels, that may link into the bronchial arterial tree. If the patient presents in shock treat them as you would any other patient with emergency blood transfusion. Any haemoptysis, however small, may herald the beginning of a massive bleed. These patients need further investigation, probably a CT chest with contrast. These vessels may then be coiled by interventional radiology. 3, Cyanosis If the patient has a non fenestrated Fontan they should have normal oxygen saturations. However, if there is a fenestration there will be shunting and therefore a reduction in oxygenation. For patients this is trade of between being pink or blue, each of which have complications. Dr Sam Fitzsimmons Dr Sam Fitzsimmons is a Consultant Cardiologist in Adult Congenital Heart Disease (ACHD) at the University Hospital Southampton, UK. Sam also subspecialises in pulmonary hypertension and maternal cardiology. Working within a tertiary surgical ACHD centre, Sam delivers an ACHD on call service for emergency admissions, inpatient care, routine outpatient follow-up, intra-operative imaging and post-surgical care, as well as specialist clinics in Pulmonary Hypertension and Maternal Cardiology. Sam holds a Honorary Senior Clinical Lecturer post with the University of Southampton as she is passionate about teaching and in particular, she is enthusiastic about helping demystify congenital heart disease for many non-specialist to improve patient care. Sam is well published in peer review journals, cardiology textbooks and specialist guidelines.    

Mary speaks with Lindsay, a  fellow Adult Congenital Heart Disease survivor, about the importance advocacy, mental health, relocation with a chronic illness, and so much more.  Lindsay has never let CHD define her and is passionate about  patient advocacy and using her own life experiences to help CHD patients and their families get the right care. 

Host/Editor: Raj Sahulee, DO Producer: David Werho, MD. Allie Rippe, NP and Alexandra Lamari-Fisher, PhD from the Texas Center for Pediatric and Congenital Heart Disease at Dell Children's Medical Center in Austin, TX discuss the multidisciplinary and creative teamwork it took to address the organic and inorganic pain in an adult patient with single ventricle heart disease.

This week is about empowering women. First, we begin talking to Jan Langbein, CEO of Genesis Women's Shelter in North Texas. This is a very important resource for any woman who may find herself in a domestic violence situation. Genesis offers a "way out," including an Emergency Shelter, Transitional Housing, Counseling Services and Legal Services. Services, including schooling, are also provided for children of domestic violence situations. For more information, visit their website at: https://www.genesisshelter.org/Next, Cathy Glenn joins us from Texas Health Presbyterian Dallas. She is the Injury Prevention Trauma Outreach Coordinator there and works directly with domestic violence patients coming to the Emergency Room. One of the services offered through many of our North Texas Hospitals to rape victims is the SANE (Sexual Assault Nurse Examiners) program. Cathy explains how this program works, and how it benefits women (and men) who have been sexually assaulted document and build forensic evidence, whether or not law enforcement becomes involved. We pivot in the second half of the show to focus on Women in Healthcare. Vivian Dimas, M.D., joins us to discuss the future of women in this dynamic field, especially from her perspective as a pediatric and adult heart surgeon. Dr. Dimas is Director of Interventional Cardiology at Children's Health℠ and serves as an associate professor of pediatrics at UT Southwestern Medical Center. She specializes in minimally invasive treatments of heart failure and other complex heart conditions. Dr. Dimas is also board certified in Adult Congenital Heart Disease.The future for women is very bright in healthcare, and finding a mentor who has blazed the trail ahead of you is key to success, as Dr. Dimas explains. See acast.com/privacy for privacy and opt-out information.

Congenital - Adult Congenital Heart Disease: Failing Fontan (Benjamin Smood and Stephanie Fuller) by TSRA

In Episode #82, we met Jeremy Keck as a patient born with L-TGA and DILV treated with Fontan procedure. Now, in this very special episode, we meet Jeremy Keck beyond his heart disease through the eyes of his loving wife Ana Keck. His legacy underscores the importance of seeing our patients as people beyond their illness, in the context of their lives, values, and loved ones. We learn to appreciate the full life one can live with complex adult congenital heart disease but also of the work that remains to be done. This powerful discussion is led by Dr. Evelyn Song (internal medicine resident at Johns Hopkins Hospital), Dr. Pablo Sanchez (cardiology fellow at Stanford University), and Dr. Michael Landzberg (cardiovascular and palliative care faculty and former director of ACHD at Brigham and Women’s Hospital). ​ Jeremy's gofundme pageJeremy's case discussion - episode 82Jeremy's obituary page CardioNerds Case Reports PageCardioNerds Episode PageSubscribe to our newsletter- The HeartbeatSupport our educational mission by becoming a Patron! In Loving Memory of Jeremy Keck Jeremy Keck was a giant within the construction industry and accomplished so much in his 37 years of life. However, his greatest point of pride was his family. He is survived by his wife Ana, two young daughters, Emilee and Kaylee, his parents, Jeff and Terri Keck, brother Kevinn (Deana) Keck, nephews Jeremy and Payne, and nieces Taylore and Payge. Jeremy also had a heart for philanthropy. He was an active supporter of the Heart Center at Phoenix Children's Hospital. In an interview with The Arizona Republic in 2015, Jeremy said he wouldn’t change his experience even if he had the chance. “I have a perspective on life that you can't teach anybody," he said. “You can't even explain it to people. The small things that happen that might not go your way seem pretty minor.” Jeremy had such a positive impact on those around him, inspiring everyone to live life to the fullest. He will be deeply missed. Visit Jeremy's gofundme page for more information. Music AcknowledgementsEternal Hope by Kevin MacLeod is licensed under a Creative Commons Attribution 4.0 license. https://creativecommons.org/licenses/by/4.0/ Source: http://incompetech.com/music/royalty-free/index.html?isrc=USUAN1100238. Artist: http://incompetech.com/

Why did the statuses for being listed for a heart transplant change in 2018? Why would someone born with a congenital heart defect need a transplant and how do they compare to adults born with healthy hearts who suddenly need a heart transplant regarding where they would fall on "the list"? What are some of the devices used as a bridge to transplant? How do those devices play into the new criteria for heart transplantation? Dr. Ali Zaidi answers these questions and more in this episode of "Heart to Heart with Anna."Dr. Ali N. Zaidi is an Adult Congenital Heart Disease Specialist. He is one of only a few selected cardiologists’ in the U.S. who is board certified in Pediatrics, Internal Medicine, Pediatric Cardiology, Adult Cardiovascular Disease, Adult Echocardiography, and Adult Congenital Heart Disease. Dr. Zaidi heads the Mount Sinai Adult Congenital Heart Disease Center in NYC. For more information about the change in status in 2018 and for answers to more questions regarding heart transplantation, use this link: https://optn.transplant.hrsa.gov/data/organ-datasource/heart/heart-allocation-questions-and-answers/Links to 'Heart to Heart with Anna' Social Media and Podcast Pages:Apple Podcasts (https://itunes.apple.com/us/podcast/heart-to-heart-with-anna/id1132261435?mt=2)Facebook (https://www.facebook.com/HearttoHeartwithAnna/)YouTube (https://www.youtube.com/channel/UCGPKwIU5M_YOxvtWepFR5Zw)Instagram (https://www.instagram.com/hugpodcastnetwork/)If you enjoy this program and would like to be a Patron, please check out our Patreon page (https://www.patreon.com/HeartToHeart)Support the show (https://www.patreon.com/HearttoHeart)

Adult Congenital Heart Disease - Advice For Patients by American Heart Association

Allie Rippe, NP and Alexandra Lamari-Fisher, PhD from the Texas Center for Pediatric and Congenital Heart Disease at Dell Children’s Medical Center in Austin, TX discuss the multidisciplinary and creative teamwork it took to address the organic and inorganic pain in an adult patient with single ventricle heart disease. Host/Editor: Raj Sahulee, DO. Producer: David Werho, MD.

Allie Rippe, NP and Alexandra Lamari-Fisher, PhD from the Texas Center for Pediatric and Congenital Heart Disease at Dell Children’s Medical Center in Austin, TX discuss the multidisciplinary and creative teamwork it took to address the organic and inorganic pain in an adult patient with single ventricle heart disease. Host/Editor: Saidie Rodriguez, MD. Producer: David Werho, MD.

Patients with congenital heart disease are living longer than ever, making adult congenital heart disease (ACHD) a growing specialty. This episode's interviews feature ACHD specialists Drs. Ari Cedars and Hani Najm. Dr. Cedars practices at UT Southwestern Medical Center in Dallas, Texas, and leads the ACHD research interest group for the National Patient Centered Outcomes Research Network. Dr. Najm chairs the Department of Pediatric and Congenital Heart Surgery at the Cleveland Clinic.Watch videos of Dr. Cedars' and Dr. Najm's Grand Rounds talks and these interviews on the DeBakey CV Education YouTube channel: :Durable Mechanical Circulatory Support in ACHD (Ari M. Cedars, MD)Grand Rounds Interview with Ari M. Cedars, MD (October 25, 2018)Adult Congenital Heart Surgery: Is There a Place for Innovation? (Hani Najm, MD)Grand Rounds Interview with Hani Najm, MD, (June 13, 2019)We'd love to hear your thoughts about ACHD specialization and teams. Post your comments on Twitter with #CVnow and tag @debakeyCVedu, and be sure to follow @debakeyCVedu on all your social media platforms!

Echocardiography (Adult Congenital Heart Disease) for the Internist-10 Dr RR Baliga's MUST KNOW FACTS PODCASTS for PHYSICIANS from chapter Echocardiography for the Internist in Baliga's Textbook of Internal Medicine with 1480 MCQs www.MasterMedFacts.com authored by Dennis A Tighe, MD, FACC, FACP, FASE Professor, University of Massachusetts Director, Cardiac Ambulatory Services, UMass Memorial Health Care & Martin St. John Sutton, MBBS, MD, FRCP Emeritus Professor, University of Pennsylvania Recipient of 2016 Lifetime Achievement Award from the American Society of Echocardiography   This podcast is not Medical Advice or Medical Opinion

Today on MedNet21, we're going to discuss Update on Adult Congenital Heart Disease.

CICMxJellybean 6 Recorded at ASM 2018 Hobart The GUCH Jellybean with Intensivist and Cardiologist Susanna Price Dr Susanna Price,Clinical Lead in Critical Care, Royal Brompton Hospital, President Elect of the European Society of Cardiology, published everywhere and part of so many guidelines related to cardiology. Fresh off the flight from London Susanna stepped up and talked sense to the biggest crowd ever to attend a CICM ASM. The cardiology focussed meeting was a bit of a silo smasher. Perhaps no group of patients bridge across the divide between paediatric and adult intensive care more than the “Grown Up Congenital Heart Disease” (GUCH) patient. These are amazing people with amazing medical histories and they are around in greater and greater numbers. They may have started in a hyper-specialised surgical centres but they might end up in any emergency department anywhere. The catch is that these people will not always know all the details of their past interventions. They were, after all, children at the time. Even if you understand what their original pathology was you may not know what type of surgery was done, where, why, when, who and do we still do that? Don’t be afraid, be informed. Susanna Price opens a GUCH treasure chest to show us what is in there. The organisers of the CICM ASM in Hobart worked hard to shine a light on the areas of critical care cardiology that cross the borders between specialities and the borders between paediatric, adolescent and adult intensive care. Dr Price clinical practice crosses borders and she is a Dual Trained UK Cardiologist and Intensivist, which is a rather rare combination in Britain. (It would be good to have a Different Strokes picture but it seems that all available images are under copyright. There are some great Different Gooch clips here though: http://heliotricity.com/diffrentstrokes.html) https://www.dailymotion.com/video/x548zhx Sometimes doing one specialty is not enough. For some it's an intellectual journey, for others it might be a migration. For a few it is a way to make things happen. Important things. Like getting your patient to the cath lab or into theatre. So not satisfied with just being a good intensivist, Susanna Price also became a cardiologist. That helps when you are working at the Royal Brompton Hospital, the largest specialist heart and lung centre in the UK [http://www.rbht.nhs.uk/#]. Add to the mix that Susanna worked with Adult Congenital Heart Disease pioneer, Dr Jane Somerville [YouTube URL - https://youtu.be/QmrUOK2dhO0]. It turns out that adult intensivists still need to know about paediatric congenital heart diseases and their management, because having survived their childhood, with or without surgery, they turn up as adults in any hospital. This matters. It affects assessment, monitoring and therapies. They may not even know they have or “had” a congenital heart disease. But there is help. Susanna and her European Society of Cardiology [https://www.escardio.org/] colleagues have decided that this is so important, they built an educational platform and give access away for free: ESC Grown Up Congenital Heart Disease (GUCH) E-Learning - https://www.escardio.org/Education/E-Learning/Clinical-cases/grown-up-congenital-heart-disease-guch Here is Susanna's talk on ICN; https://intensivecarenetwork.com/guch-a-growing-problem/

Breast artery calcification, evident on every mammogram, may help refine coronary artery disease risk in women. Also this week, new guidelines reclassify adult congenital heart disease, advice to eat a variety of foods seems to have backfired, and how PCI can now safely tackle complex chronic total occlusions.

Dr. Mark S. Sklansky leads the UCLA Division of Pediatric Cardiology in providing comprehensive, collaborative, state-of-the-art and compassionate evaluation and management of fetal and pediatric patients with a wide range of congenital and acquired forms of heart disease. The UCLA Division of Pediatric Cardiology offers a full spectrum of clinical and academic programs, including fetal cardiology, general pediatric cardiology, state-of-the-art cardiovascular imaging/echocardiography, interventional catheterization and electrophysiology, cholesterol/lipid management, heart failure, state-of-the-art congenital cardiac surgery and pediatric cardiac transplant programs, and a formal transitional cardiology program for adolescents transitioning into UCLA’s world-class Adult Congenital Heart Disease program. In this episode, Dr. Sklansky discusses ways UCLA’s Children's Heart Center offers the best possible outcomes and how it does so in a compassionate way. Learn more about pulmonary hypertension at www.phaware365.global. Never miss an episode with the phaware® podcast app. Follow us @phaware on facebook, twitter, instagram, youtube & linkedin Engage for a cure: www.phaware.global/donate #phaware  #phawareMD

In the January 2018 edition of the BJA Education podcast, Cliff Shelton interviews Senior Specialty Trainee in Anaesthesia Luke Bishop from Leeds General Infirmary about his paper 'Adult Congenital Heart Disease and Pregnancy'. The discussion includes the indications for cesarean section, the strategy for establishing appropriate about analgesia, and the approach to obstetric patients with congenital heart disease in the DGH setting.

Dr. Ari Cedars is a cardiologist at Baylor University medical Center in Dallas, Texas. He is a physician and the director of the Center for Adults with Congenital Heart Disease (or ACHD). He trained in Adult Congenital Heart Disease at Washington University in Saint Louis. He is passionate about research in the realm of adults with congenital heart disease, especially since it is a growing population with increasingly complex needs. He believes that doctors and patients can work together to improve the quality of life of those living with congenital heart defects.Support the show (https://www.patreon.com/HearttoHeart)

Congenital heart disease (CHD) is a problem present at birth that involves the structure of the heart, its valves, or blood vessels. It is the most common type of birth defect, affecting about one in 100 babies. Thanks to medical advances, increasing numbers of children with CHD are surviving into adulthood. Common problems associated with ACHD include difficulty with exercise, heart rhythm problems (arrhythmia), endocarditis (infection of the heart’s inner lining, often in the heart’s valves), heart failure, sudden cardiac arrest, stroke, and premature death.As the only adult congenital heart disease program in Alabama and one of only a handful in the country, our expertise greatly increases the chances that symptoms will be identified early. This helps ensure that smaller problems are addressed before they develop into larger, more life-threatening issues such as heart failure, arrhythmia, residual congenital heart defects, endocarditis, and stroke.Listen in as Marc G. Cribbs, MD explains that thanks to medical advances, increasing numbers of children with CHD are surviving into adulthood. In fact, the number of adults with congenital heart disease (ACHD) now exceeds the number of children living with CHD.

Commentary by Dr. Valentin Fuster

Commentary by Dr. Valentin Fuster

Dr Curt Daniels joins Dr Mike in the PediaCast Studio for a discussion on Adult Congenital Heart Disease. As surgical and medical outcomes improve for children born with congenital heart defects, more and more of these patients survive into adulthood. We cover the unique problems of these patients, the importance of long-term follow-up, medical and surgical management, and the latest research topics. Be sure to join us!

Dr. Michael Lloyd. What is Electrophysiologist's Role in Adult Congenital Heart Disease?. Recorded 2012-01-23.