Download PEDIATRIC CARDIOLOgy - Children`s Hospital of Pittsburgh

division of
Pediatric Cardiology
Mission
The mission of the Division of Pediatric Cardiology is:
•To provide comprehensive clinical services from the fetus to children and
adults with congenital heart disease as well as to children with acquired
heart disease
221
•To train the next generation of clinical pediatric cardiologists and physicianscientists through a comprehensive fellowship program of superior quality
•To perform high-quality clinical and basic research in the fields of heart
disease and development
•To teach the fundamentals of pediatric cardiology to medical students,
pediatric residents, and pediatric and adult cardiology fellows.
DEPARTMENT OF PEDIATRICS 2012 ANNUAL REPORT
division of Pediatric Cardiology
division of Pediatric Cardiology
faculty and staff
Vivek Allada, MD
Evonne Krushansky, DO
Jamie Bloch, BSN, MSN, CRNP
Professor of Pediatrics
Interim Chief, Division
of Pediatric Cardiology
Clinical Director,
Pediatric Cardiology
Codirector, Heart Institute
Assistant Professor of Pediatrics
Cardiac Catheterization Laboratories
Elisa Marcuccio, MD
Janet Kulka, MS, PA-C
Assistant Professor of Pediatrics
Inpatient Services
Francis M. McCaffrey, MD
Beth Kus, MPAS, PA-C
Cardiac Transplant Program
Gaurav Arora, MD
Associate Professor of Pediatrics
Director, Exercise Laboratory
Assistant Professor of Pediatrics
Associate Director, Electrophysiology
Susan A. Miller, MD
Concetta Lombardo, BSN,
MPAS, PA-C
Assistant Professor of Pediatrics
Outpatient Services
Sara Trucco, MD
Assistant Professor of Pediatrics
Elena Flores-Noel, DNP, FNP,
CRNP-BC
Linda M. Russo, MD
Outpatient Services,
Exercise Stress Lab
Lee B. Beerman, MD
222
Professor of Pediatrics
Director, Electrophysiology
Constantinos Chrysostomou, MD
Assistant Professor of Pediatrics
and Critical Care Medicine
Stephen C. Cook, MD
Visiting Associate Professor of
Pediatrics and Internal Medicine
Director, Adolescent and Young Adult
Congenital Heart Disease Center
Mark DeBrunner, MD
Assistant Professor of Pediatrics
Director, Pediatric Cardiology
Fellowship Program
Stacey Drant, MD
Associate Professor of Pediatrics
Director, Noninvasive Imaging
Johanna L. Drickman, MD
Assistant Professor of Pediatrics
Brian D. Feingold, MD, MS
Assistant Professor of Pediatrics
Director, Heart and
Heart-lung Transplantation
Lizabeth Lanford, MD
Clinical Assistant Professor
of Pediatrics
Jacqueline Kreutzer, MD
Associate Professor of Pediatrics
Director, Cardiac Catheterization
DEPARTMENT OF PEDIATRICS 2012 ANNUAL REPORT
T
OVERVIEW OF DIVISION
Assistant Professor of Pediatrics
Frederick S. Sherman, MD, MBA
Professor of Pediatrics,
Obstetrics, Gynecology,
and Reproductive Sciences
Director, Perinatal Cardiology
he Division of Pediatric Cardiology forms an integral part of the Heart Institute service line at Children’s Hospital
of Pittsburgh of UPMC and is the leading provider of comprehensive pediatric cardiovascular services in Western
Pennsylvania and the tristate area. It is an internationally recognized center of excellence in pediatric heart failure,
cardiomyopathy, mechanical circulatory support, and heart and lung transplantation. The Heart Institute integrates
the various divisions and programs necessary to provide state-of-the-art cardiovascular services to children and young
adults with congenital heart disease and to children with acquired heart disease. The components of the Heart Institute
include the Division of Pediatric Cardiology (Interim Chief Vivek Allada), the Division of Cardiothoracic Surgery
(Chief Victor Morell), the Cardiac Intensive Care Unit (CICU) (Chief Ricardo Munoz), and Cardiac Anesthesia
(Chief Steven Lichtenstein). The CICU is a 12-bed unit and is the only dedicated pediatric CICU in the tristate area.
The Heart Institute actively participates in numerous National Institutes of Health (NIH)-, foundation-, and industrysponsored clinical and basic research programs. The program has an active pediatric cardiology fellowship program
accredited by the Accreditation Council for Graduate Medical Education (ACGME). The CICU also offers postgraduate training in pediatric cardiac intensive care to fellows who have completed training in pediatric cardiology
or pediatric intensive care. Achievements for the past year include continued expansion of cardiology services (regional,
national, and international; see below), expanded NIH funding to perform multicenter trials in pediatric heart transplantation, continued development of novel mechanical circulatory support devices for use in children, and expansion of
the fellowship program. Strong research collaborations exist with Pitt’s Swanson School of Engineering Department
of Biomedical Engineering, Thomas E. Starzl Transplantation Institute (STI), and the cardiac genetics research program
of Pitt’s School of Medicine’s Department of Developmental Biology under the chairmanship of Cecilia Lo, PhD.
223
T
Clinical activities
he Division of Pediatric Cardiology provides comprehensive clinical services to children and adults with congenital
heart disease as well as to children with acquired heart disease. This clinical program includes ambulatory diagnostic
services at 15 locations: the Children’s Hospital of Pittsburgh of UPMC campus in Pittsburgh’s Lawrenceville
neighborhood; the three satellite facilities in Wexford, Monroeville, and Bethel Park; Magee-Womens Hospital of UPMC;
UPMC Presbyterian; and nine other outreach locations throughout western and central Pennsylvania and the panhandle
of West Virginia. With this extensive outreach program, cardiology is taking its services out into the community and has
the most extensive outreach services of any program within Children’s Hospital. This year, office visits exceeded 13,000,
and half of the patients were seen at locations other than the Lawrenceville campus. The division reached a milestone:
more than 2,000 patients were seen in remote outreach locations beyond the metropolitan Pittsburgh area. This model
is now being pursued by other divisions. Ambulatory services include diagnostic outpatient office visits, noninvasive imaging
including echocardiography (surpassing 16,000 studies for the first time), arrhythmia detection including electrocardiography,
24-hour Holter and 30-day event recorder monitoring, cardiopulmonary exercise testing, and preventive cardiology services.
The program supports a comprehensive Perinatal Cardiology Program in collaboration with the obstetrics team at Magee.
This program has three facets: neonatal cardiology, fetal cardiology, and maternal cardiology. It is a unique program, and
the fetal clinical program is now one of the busiest in North America, eclipsing 2,000 fetal echocardiograms for the first
time in its history. The program now performs fetal interventions, notably in utero dilation of the aortic valve to prevent
progression of critical aortic stenosis to hypoplastic left heart syndrome. Pediatric Cardiology also provides inpatient and
same-day services at Children’s Hospital, and these services include diagnostic and state-of-the-art interventional cardiac
catheterization; diagnostic and therapeutic arrhythmia management, including arrhythmia ablation using radiofrequency
or cryoablation; and medical management of cardiac dysrhythmias, inflammatory diseases of the heart, and heart failure.
The cardiology faculty also follows all children receiving surgical management of congenital or acquired cardiovascular
malformations. The pediatric CICU is dedicated to the medical and surgical management of critically ill patients with
congenital and acquired cardiovascular disease. This is the only such unit in our region. The improved medical and surgical
outcomes of children with congenital heart disease have led to a growing number of survivors flourishing in the community.
It is now estimated that there are more adults living with congenital heart disease than children, and adult congenital
heart disease comprises approximately 10%–15% of the work of the Heart Institute at this time and continues to grow.
The pediatric cardiology division has a formal Adolescent and Young Adult Congenital Heart Disease Service under
DEPARTMENT OF PEDIATRICS 2012 ANNUAL REPORT
division of Pediatric Cardiology
division of Pediatric Cardiology
the direction of Stephen Cook. This program serves to improve and expand the care offered to the growing population
of adults with congenital heart disease. As part of a comprehensive program, Cook also directs a Congenital Heart Disease
Cardiac Magnetic Resonance Imaging Program at UPMC Presbyterian. The interventional catheterization team continues
to perform transcatheter replacement of the pulmonary valve, thus avoiding open heart surgery for selected patients.
In fact, Children’s Hospital was the first center to implant such a device in the United States after the Melody Valve was
approved for use by the U.S. Food and Drug Administration. Finally, a new initiative in pediatric cardiology this year
is a state-of-the art telemedicine echocardiography service that supports the reading of fetal and pediatric transthoracic
echocardiograms throughout western Pennsylvania and West Virginia.
Cardiology at the Children’s Hospital has always been recognized for its excellence in clinical care, service delivery,
and communication with referring physicians. The division has continued to focus on these areas throughout the course
of the year. Cardiology faculty routinely receives the highest levels of patient satisfaction from both Children’s Hospital
and national surveys.
224
The clinical activities of the division continue to grow, as demonstrated by the spectacular seven-year trends shown
in the table below.
KEY INDICATORS
FY 05
FY 06
FY 07
FY 08
FY 09
FY 10
Outpatient Visits (Total) Outreach outpatient visits Echocardiograms (Total)
FY 11
FY 12
% CHANGE
2005–12
8,439 9,43110,95011,76012,27012,75913,00113,629
776
891
908
1,409
1,867
1,947
1,951
2,104
62%
171%
9,69811,12312,89813,27413,96714,74715,22716,425
69%
Echocardiograms (postnatal)7,990 9,45211,19411,43512,12612,95813,34714,342
79%
Fetal/neonatal echo at
Magee-Womens Hospital
Vivek Allada, MD
RESEARCH
Vivek Allada led a study characterizing physician productivity at academic pediatric cardiology echocardiography
laboratories. This survey, the first of its kind in this group,
aims to understand the practice patterns and manpower
needs in pediatric cardiology.
Noninvasive assessment of ventricular function, including following heart transplantation: Use the Myocardial
Performance Index Derived by Echocardiography to
Identify Rejection in Patients after Heart Transplant
ADVISORY COMMITTEE MEMBERSHIPS
• Cochair, Committee on Echocardiography Lab
Organization and Productivity, American Society
of Echocardiography
Editorships
• Guest editorial reviewer, American Journal of Cardiology
• Guest editorial reviewer, Congenital Heart Disease
• Guest editorial reviewer, Pediatric Research
1,7081,6711,7041,8391,8411,7891,880 2083 22%
Holter monitors
493 378 7821,4871,2771,2071,335 1769 259%
Exercise stress tests
217295298333358638684763
252%
Cardiac catheterization 52252463564164870070874342%
Electrophysiology ablations 296066
10886918899
241%
Gaurav Arora, MD
Research
Gaurav Arora’s research interests include management
of arrhythmias.
T
RESEARCH AND OTHER SCHOLARLY ACTIVITIES
he Division of Pediatric Cardiology and Heart Center faculty lead multiple active clinical, translational, and basic
research programs in cardiovascular disease. The clinical research program is multifaceted, with clinical studies
and trials in all aspects of pediatric cardiology, cardiac intensive care, and congenital heart surgery. Particular
strengths include the research programs focusing on optimizing outcomes following pediatric heart and lung transplantation and the multidisciplinary program developing novel mechanical circulatory support devices for children with failing
hearts. Cardiac genetics research is being carried out in collaboration with Cecilia Lo, PhD, chair of the Department
of Developmental Biology within the University of Pittsburgh School of Medicine. Lo is an internationally recognized
expert on the genetics of congenital cardiovascular malformations, working with mouse models and human subjects.
Finally, the research arm of the cardiology division has completed development of a comprehensive cardiology database,
based on a long-standing database carrying patients from the 1960s to the present and incorporating all programs within
the Heart Institute. This powerful tool has been and will continue to enable research studies aimed at improving the lives
of children and adults with congenital heart disease.
DEPARTMENT OF PEDIATRICS 2012 ANNUAL REPORT
Risk Stratification in Wolff-Parkinson-White (WPW)
Syndrome: The Correlation between Invasive and Noninvasive
Testing. This project aims to review a large body of patients
with WPW syndrome, correlating results of invasive
electrophysiology testing with noninvasive (Holter, exercise, electrocardiography) testing to identify whether any
noninvasive markers adequately predict high-risk accessory
pathway conduction.
Natural History of WPW in a Pediatric Cohort. This study
reviews the outcomes of WPW in a large pediatric cohort,
spanning more than 30 years of data. Gaurav Arora’s team
has reviewed the natural history of these patients with
regard to symptoms, documented arrhythmias, and cardiac
events (syncope, resuscitated sudden death, sudden death).
This study will be the first comprehensive and contemporary investigation of WPW in North America.
Major
Lectureships
and Seminars
• Course director,
Master Class in
Congenital Cardiac
Morphology,
Children’s Hospital,
Robert H.
Anderson, October
2011
• “Super Sized
Kids: Cholesterol
Vivek Allada, MD
and Obesity in
Interim Division Chief,
Pediatric Cardiology
Children,” invited
speaker, pediatric
grand rounds, St. Vincent Medical Center, Erie, Pa.,
October 2011
225
Professional Affiliations/Society Memberships
• American Academy of Pediatrics
• American College of Cardiology
• American Society of Echocardiography
• Section on Cardiology and Cardiothoracic Surgery,
American Academy of Pediatrics
• Adult Congenital Heart Association
WPW Syndrome: Adenosine Response and Correlation with
Invasive Electrophysiology Study. This project aims to review
the response of pediatric patients with WPW to adenosine
and to attempt to correlate with invasive electrophysiology
testing results, specifically the risk of rapid antegrade conduction. This project has been submitted for publication.
Natural History of Ventricular Ectopy in Pediatric Patients.
This study reviews the outcomes of previously healthy
children who presented with ventricular ectopy, both
isolated premature ventricular complexes (PVCs) and
ventricular tachycardia. We reviewed the Children’s
Hospital database to create the largest natural history
study in a pediatric cohort.
Impact of Three-dimensional (3D) Mapping System on
Fluoroscopy Time of Atrioventricular Node Reentry Tachycardia
(AVNRT) in Pediatric Patients. This study evaluates the
impact of a 3D mapping system on fluoroscopy times for
ablation of AVNRT in a pediatric cohort. Radiation exposure
during ablation has long been the gold standard, but novel
imaging systems, like 3D catheter mapping systems, have
DEPARTMENT OF PEDIATRICS 2012 ANNUAL REPORT
division of Pediatric Cardiology
allowed for reduction of fluoroscopy time in centers using
the system for the expressed goal of decreasing fluoroscopy.
At Children’s Hospital, the system has been used for five
years. In this study, the impact of 3D mapping on fluoroscopy
time and efficacy is explored.
Double-blind, Randomized, Historical Control Study of the
Safety and Efficacy of Eslicarbazepine Acetate Monotherapy in
Subjects with Partial Epilepsy Not Well-controlled by Current
Antiepileptic Drugs (Sonovian 045). Multicenter study;
contributing author; project ongoing
226
A Multicenter, Open-label Study to Investigate the Safety,
Tolerability, and Pharmacokinetics of Lacosamide Oral Solution
(Syrup) as Adjunctive Therapy in Children with Partial-onset
Seizures (Lacosamide 847). Multicenter study
Albuterol and Diastolic Hypotension. Contributing author
Dexmedetomidine Versus Adenosine: Electrophysiologic Effects
and Therapeutic Use for Terminating Supraventricular
Tachycardia. Coinvestigator
Major Lectureships and Seminars
• “Cost-effective Analysis of ICDs in Pediatric Dilated
Cardiomyopathy,” invited talk, Heart Rhythm Society
Meeting, May 2012
division of Pediatric Cardiology
Professional Affiliations/Society Memberships
Advisory Committee Memberships
Professional Affiliations/Society Memberships
• Heart Rhythm Society
• Pediatric and Congenital Electrophysiology Society
• Pittsburgh Electrophysiology Society
• Rheumatic Fever, Endocarditis, and Kawasaki Disease
Committee, Council on Cardiovascular Disease in the
Young, American Heart Association
• Writing groups, Guidelines for the Diagnosis of
Rheumatic Fever Using the Jones Criteria, Update
in the Era of Echocardiography, and Update on
Management of Bacterial Endocarditis in Pediatric
Population, American Heart Association
• President and executive committee, Children’s Hospital
Alumni Association
• President-elect, Children’s Hospital Medical Staff,
2011–12
• American Academy of Pediatrics
• American College of Cardiology
• American Heart Association
• Society of Critical Care Medicine
• Pediatric Cardiac Intensive Care Society
• World Society of Pediatric and Congenital Heart Surgery
Lee B. Beerman, MD
Research
Risk Stratification in WPW Syndrome: The Correlation
between Invasive and Noninvasive Testing. This project aims
to review a large body of patients with WPW syndrome,
correlating results of the invasive electrophysiology
testing with noninvasive (Holter, exercise, electrocardiography) testing to identify whether any noninvasive
markers adequately predict high-risk accessory pathway
conduction.
Natural History of WPW in a Pediatric Cohort. This study
reviews the outcomes of WPW in a large pediatric cohort,
spanning more than 30 years of data. We have reviewed
the natural history of these patients with regards to
symptoms, documented arrhythmias, and cardiac events
(syncope, resuscitated sudden death, sudden death). This
study will be the first comprehensive and contemporary
investigation of WPW in North America.
Professional Affiliations/Society Memberships
• American Heart Association
• Heart Rhythm Society
• Pediatric and Congenital Electrophysiology Society
• Pittsburgh Electrophysiology Society
• Adult Congenital Heart Disease Association
Honors
• 2012 Peter J. Safar Pulse of Pittsburgh Award, a lifetime
achievement award, sponsored by the American Heart
Association, 2011
Constantinos Chrysostomou, MD
Research
Constantinos Chrysostomou has led the introduction of
dexmedetomidine in the pediatric population and particularly in children with cardiac disease. Ongoing studies led
by Chrysostomou include the following:
• A Phase II, Open-label, Multicenter, Escalating
Dose Study to Determine Pharmacokinetic and
Pharmacodynamic Profile of Dexmedetomidine
in Neonates Ages ≥ 28 Weeks to ≤ 44 Weeks Post
Gestational Age
• Phase III Multicenter Clinical Trial: Dexmedetomidine
Safety and Efficacy in the Pediatric Population
• Evaluation of Electrocardiographic Effects of Dexmedetomidine in Children with Congenital Heart Disease
• Assessment of Pulmonary Artery Pressure and
Left Ventricular Function after Administration
of Dexmedetomidine
• Effect of Dexmedetomidine on Inflammatory Response
after Cardiopulmonary Bypass in Children
DEPARTMENT OF PEDIATRICS 2012 ANNUAL REPORT
Stephen C. Cook, MD, FACC
Research
Development of a New Adult Congenital Heart Disease
Program: Health Care Appraisal and Needs upon Embarkment.
This is a quality-improvement study to obtain an improved
understanding of the needs of the adult congenital
community in a newly established program and identify
problematic areas that may require attention in a tertiary
care center.
227
Assessment of the Coronaries and Cerebral Circulation in Adults
with Repaired Coarctation. The goal of this study is to assess
the prevalence of atherosclerosis and cerebral aneurysms
noninvasively in young adults who have undergone prior
surgical repair of coarctation of the aorta.
Shock, Sexual Function, and Implantable Cardiac Defibrillators
(ICDs): An Evaluation of the Adult Congenital Community.
This study evaluates sexual function in adults with
congenital heart disease without ICDs compared to those
with ICDs.
Advisory Committee Memberships
• Cochair, Research Committee, Adult Congenital Heart
Association
• Pediatric and Adolescent CTA Committee, Society of
Cardiovascular Computed Tomography
• Alliance for Adult Research in Congenital Cardiology
Major Lectureships and Seminars
• “Adults with Congenital Heart Disease,” Department
of Pediatrics grand rounds, Children’s Hospital,
October 2011
Professional Affiliations/Society Memberships
• International Society for Adult Congenital
Cardiac Disease
• Society for Cardiovascular Magnetic Resonance
• Society of Cardiovascular Computed Tomography
• American Medical Association
• American Academy of Pediatrics
• American College of Cardiology
DEPARTMENT OF PEDIATRICS 2012 ANNUAL REPORT
division of Pediatric Cardiology
Mark DeBrunner, MD
Johanna L. Drickman, MD
Research
Professional Affiliations/Society Memberships
Noninvasive assessment of ventricular function, including
following heart transplantation
• American Academy of Pediatrics
• American College of Cardiology
• American Physicians Fellowship
Major Lectureships and Seminars
• “Master Class in Congenital Cardiac Morphology,”
course director, Children’s Hospital, Robert H.
Anderson, October 2011
Professional Affiliations/Society Memberships
• American College of Cardiology
Stacey Drant, MD
228
division of Pediatric Cardiology
Research
Aortic Stiffness in Aortic Root Dilatation. A subgroup of
patients with bicuspid aortic valve develop aortic dilatation
during childhood and are at increased risk for aortic
dissection during adulthood. Patients with other forms
of aortic dilatation have been found to have abnormal
aortic elastic qualities. Using echocardiography to measure
aortic distensibility and stiffness, Stacey Drant’s team
is evaluating normal pediatric patients and those with
bicuspid aortic valve in an attempt to identify patients
who will be at increased risk for future aortic dissection.
National Clinical Trial of Beta Blocker Therapy (Atenolol)
Versus Angiotension lI Receptor Blocker Therapy (Losartan) in
Individuals with Marfan Syndrome. The primary aim of the
Marfan trial is to compare the effect of atenolol therapy to
that of losartan therapy on the rate of aortic growth and
progression of aortic regurgitation.
Use of the Myocardial Performance Index Derived by
Echocardiography to Identify Rejection in Patients after Heart
Transplant. Standard, noninvasive imaging has not proven
to be very effective in identifying patients with rejection following heart transplantation. The Myocardial
Performance Index, derived through Doppler and tissue
Doppler measurements, has been used to measure subtle
forms of myocardial dysfunction. This retrospective study
utilizes a large transplant database and confirmed that the
Myocardial Performance Index calculated with spectral
Doppler predicts cardiac transplant rejection. Ongoing
studies will utilize tissue Doppler indices to measure
Myocardial Performance Index in a prospective fashion.
Professional Affiliations/Society Memberships
• American Society of Echocardiography
DEPARTMENT OF PEDIATRICS 2012 ANNUAL REPORT
Brian D. Feingold, MD, MS
Research
Listing Strategies for Allosensitized Pediatric Heart Transplant
Candidates. Brian Feingold was awarded an NIH KL2
grant in July 2010 to determine historical outcomes for
children listed for heart transplantation with a requirement
for prospective crossmatch. A comparison of two competing
listing strategies for highly allosensitized patients also will
be performed. Analyses will be performed with data from
the United Network for Organ Sharing and Pediatric
Heart Transplant Study databases.
Importance of Alloantibodies in Determining Pre- and
Post-transplant Outcomes in Pediatric Heart Transplantation.
This project has investigated the role of preformed and
de novo alloantibodies in determining outcomes before
and after pediatric heart transplantation. The prevalence
of preformed and de novo antibodies by various detection
methods has been established, and the impact of alloantibodies on graft and patient outcomes is currently being
defined. The impact of transplanting against a positive
donor-specific crossmatch is being evaluated in a prospective
cohort of candidates who are known to be presensitized
against donor human leukocyte antigens (HLAs). The
pilot data have been used to develop the protocol for
the Clinical Trials in Organ Transplantation in Children
(CTOT-C), for which Feingold is the Children’s Hospital
site principal investigator.
Use of Cell-bound Complement Activation Product Levels in
Detecting Antibody-mediated Rejection in Pediatric Heart
Transplantation. This project, supported by a Hillman
Innovation Development Transplantation Award, is
designed to determine whether cell-bound complement
activation products measured on whole blood of pediatric
heart transplant recipients can be used as a simple, noninvasive marker of antibody-mediated rejection. Feingold’s
research team hypothesizes that cell-bound complement
activation products and complement regulatory proteins
are useful biomarkers for antibody-mediated rejection
after pediatric cardiac transplantation. It is anticipated that
this research will allow for accurate diagnosis of antibodymediated rejection, with the potential to predict impending
acute antibody-mediated rejection prior to the onset of
graft dysfunction. This would enable tailoring of immunosuppression on a case-by-case basis.
their grafts in the presence of donor-specific antibody and
a positive donor-specific cross-match.
Determination of Expression of Blood Group Antigens (ABO)
on Cryopreserved Aortic and Pulmonary Artery Homografts.
Homografts used in repair of congenital heart defects
invariably fail, and the importance of ABO mismatching
in this setting is unclear. The research team has therefore
studied blood group antigen expression on cryopreserved
homografts and have shown that A and B blood group
antigens are strongly expressed in the medial and adventitial vaso vasorum. This may have important implications for homograft failure, as well as for the induction
of tolerance to blood group antigens when infants are
exposed to incompatible blood group antigens in early life.
In a continuation of this line of research, there has been
no evidence of tolerance to incompatible A and B blood
group antigens after homograft placement in infancy. This
was found despite persistence of blood group and HLA
antigens on explanted homograft specimens, as late as 10
years following implantation. These results were recently
published in Human Immunology.
Advisory Committee Memberships
Epstein-Barr Virus (EBV) Infection in the Immuno-compromised
Host. Primary EBV infection is a major cause of morbidity
and mortality after pediatric thoracic organ transplantation
and frequently is associated with the development of posttransplant lymphoproliferative disorder (PTLD). Feingold
serves as a coinvestigator on Diana Metes’ R01 looking at
Chronic High EBV Load and Risk of PTLD in Pediatric
Thoracic Transplant Patients.
• Review Board, United Network for Organ Sharing
Region 2
• Fellow Research Day Task Force, American
Heart Association
Major Lectureships and Seminars
• “Pediatric Pulmonary Hypertension,” University of
Pittsburgh Department of Pediatrics grand rounds,
July 2011
• “Current Management of Pediatric Heart Failure,”
Fundación Cardiovascular de Colombia: 3rd Symposium
on Pediatric Cardiology and Cardiovascular Surgery,
August 2011
• “Key Issues and Experiences in Pediatric Cardiac
Transplantation,” Fundación Cardiovascular de
Colombia: 3rd Symposium on Pediatric Cardiology and
Cardiovascular Surgery, August 2011
• “Innovations in the Monitoring and Treatment of
Children Who Require Transplantation,” Fundación
Cardiovascular de Colombia: 3rd Symposium on
Pediatric Cardiology and Cardiovascular Surgery,
August 2011
229
Role of Alloantibodies in Cardiac Transplantation: Intervention,
Outcomes, and Mechanisms. Feingold is the Children’s
Hospital site primary investigator on this NIH National
Institute of Allergy and Infectious Diseases award. This
program (CTOT-C) of seven pediatric heart transplant
centers seeks to enhance understanding of the role of alloantibodies in pediatric heart transplantation. Antibodies
directed against allograft antigens are being increasingly
recognized as critical determinants of allograft outcomes in
adults. Pediatric heart transplant candidates are frequently
allosensitized based on prior exposure to blood products
and homografts, and this has led to increased pre- and
post-transplant mortality. This research program brings
together a group of seven leading heart transplant centers
and leading transplantation scientists to study the impact
of preformed and de novo alloantibodies on pediatric
heart transplant outcomes. Mechanistic studies are being
performed to seek explanation for why some children
develop graft injury while others appear to “accommodate”
DEPARTMENT OF PEDIATRICS 2012 ANNUAL REPORT
division of Pediatric Cardiology
Professional Affiliations/Society Memberships
• American Heart Association
• International Pediatric Transplant Association
• American Society of Transplantation
• International Society for Heart and Lung
Transplantation
Honors
• KL2 Award from the NIH/National Center for
Research Resources
Jacqueline Kreutzer, MD, FACC, FSCAI
Research
230
Jacqueline Kreutzer’s research interests are in the area of
novel technologies for transcatheter intervention including
percutaneous valve therapy, device and stent development,
and their clinical applications. Kreutzer has been principal
investigator for the following projects.
The Medtronic Melody Transcatheter Pulmonary Valve Postapproval Study. Kreutzer serves as the principal investigator
for this multicenter study on post-market surveillance of
the Melody Pulmonary Valve.
AGA Atrial Septal Occluder Post-market Study II. A postmarketing surveillance study of an atrial septic defect (ASD)
occlusion device placed by cardiac catheterization that
is approved by the U.S. Food and Drug Administration
(FDA).
Congenital Cardiovascular Interventional Study Consortium.
A multicenter study designed to compare outcomes between
surgery, balloon angioplasty, and intravascular stent placement for recurrent or native coarctation of the aorta.
Coarctation of the Aorta Stent Trial (COAST I and COAST
II) Multicenter Studies. Multicenter study on the use of CP
platinum bare metal stents as well as covered stents for
coarctation of the aorta.
Congenital Cardiac Catheterization Outcomes Project (C3PO).
A multi-institutional quality-improvement project to monitor
outcomes of pediatric cardiac catheterization.
Advisory Committee Memberships
• Congenital Heart Disease Committee, Society
of Cardiac Angiography and Intervention
• Credentialing Committee, Sub-board of Pediatric
Cardiology, American Board of Pediatrics
• Scientific Committee, Fourth World Congress
of Pediatric Cardiology and Cardiac Surgery
DEPARTMENT OF PEDIATRICS 2012 ANNUAL REPORT
division of Pediatric Cardiology
• Congenital Cardiovascular Interventional Study Consortium
• Writing group for the American Heart Association
Scientific Statement, “Anticoagulation in Children”
• Council on Cardiovascular Disease in the Young,
American Heart Association
• Council on Cardiovascular Radiology and Intervention,
American Heart Association
Major Lectureships and Seminars
• Invited speaker, neonatology grand rounds, MageeWomens Hospital, Pittsburgh, Pa., July 2011
• Invited faculty, Pediatric and Adult International Cardiac
Symposium (PICS-AICS) 2011, Boston, Mass., July 2011
• Invited speaker, pediatric grand rounds, Charleston
Area Medical Center Women and Children’s Hospital,
Charleston, W.Va., August 2011
• “Update in Pediatric Interventional Cardiology,” invited
speaker, McGowan Institute Research Retreat lecture,
March 2012
• Invited speaker, American College of Cardiology 59th
Scientific Sessions, Chicago, Ill., March 2012
• Invited speaker/live case session moderator, PICS-AICS,
Chicago, Ill., April 2012
• “Tips and Tricks in Congenital and Structural
Interventions,” invited faculty, September 2012
Professional Affiliations/Society Memberships
• American College of Cardiology
• Congenital Heart Disease and Pediatric Cardiology
Section, American College of Cardiology
• Women in Cardiology Section, American College
of Cardiology
• American Heart Association
• Society for Cardiac Angiography and Interventions
• Sociedad Argentina de Cardiología
• Sociedad Latina de Cardiología
HONORS
• The Heart Center Excellence in Teaching Award, 2011
Lizabeth Lanford, MD
Professional Affiliations/Society Memberships
• American Society of Echocardiography
• Prevention of RSV infection in high-risk patients with
congenital heart disease
• Outcomes after pediatric heart transplantation
Elisa Marcuccio, MD
Professional Affiliations/Society Memberships
Research
Noninvasive Measurement of Cardiac Output during Exercise
in Children with Tetralogy of Fallot. Elisa Marcuccio is
comparing cardiac output data in patients with repaired
Tetralogy of Fallot using the technique in the study above
with normal subjects.
Francis M. McCaffrey, MD
Linda Russo, MD
Professional Affiliations/Society Memberships
• American Society of Echocardiography
Research
Clinical Trial of Coenzyme Q10 and Lisinopril in Muscular
Dystrophies. This is a multicenter study that enrolls
patients with muscular dystrophies early in their disease,
before the onset of cardiomyopathy, into a coenzyme
Q10/lisinopril arm versus a traditional treatment control.
Echocardiographic monitoring is used to determine
whether they qualify for enrollment and to track
cardiac function.
Cardiac Outcome Measures in Children with Muscular
Dystrophy. This is an extension of the above study and
compares inter-observer variability for many of the measures
that are being used for the coenzyme Q10/lisinopril study
to help determine which of those measures would be the
most reproducible across multiple institutions.
Noninvasive Exercise Cardiac Output in Children and Young
Adults. The team is collecting normative data on a new
exercise measurement and eventually will compile,
summarize, and report the data.
Noninvasive Measurement of Cardiac Output During Exercise
in Children with Tetralogy of Fallot. The team is comparing
cardiac output data in patients with repaired Tetralogy
of Fallot using the technique in the study above with
normal subjects.
Research
Professional Affiliations/Society Memberships
Lizabeth Lanford’s research interest lies in cardiovascular
abnormalities and pulmonary hypertension in children
with sickle cell disease.
• American Society of Echocardiography
Major Lectureships and Seminars
Research
• Course director, “Master Class in Congenital Cardiac
Morphology,” Children’s Hospital, Robert H. Anderson,
“Echocardiographic Features of Congenital Heart
Disease,” October 2011
• American Academy of Pediatrics
• American Heart Association
• International Pediatric Transplant Association
• International Society for Heart and Lung Transplantation
Susan A. Miller, MD
Susan Miller’s research interests include the following:
• AGA Atrial Septal Occluder Post-market Study II, which
is a postmarketing surveillance study of an FDA-approved
ASD occlusion device placed by cardiac catheterization
231
Fred S. Sherman, MD, MBA
Research
Fred Sherman’s research interests include computer-assisted
navigation applied to fetal cardiac intervention and the
examination of causative factors in peripartum cardiomyopathy.
He is developing clinical pathways for fetal supraventricular
tachycardia and participated in developing a clinical pathway
for management of the patent ductus arteriosus. A paper,
“Management of the Single Ventricle Patient during Labor
Delivery” is in press in the Journal of Clinical Anesthesiology.
Professional Affiliations/Society Memberships
• American Academy of Pediatrics
• American Society of Echocardiography
• American Heart Association
• American College of Cardiology
• Society of Pediatric Echocardiography
Sara Trucco, MD
Research
Sara Trucco’s research involves being a:
• Subinvestigator for study titled, Comparison between
Surgical Versus Balloon Angioplasty Versus Intravascular
Stent Placement for Recurrent or Native Coarctation
of the Aorta
• Subinvestigator for a study titled, Covered Cheatham
Platinum Stent for Prevention or Treatment of Aorta Wall
Injury Associated with Aortic Coarctation (COAST II)
• Subinvestigator for a study titled, Amplatzer Atrial
Septal Defect Occluder Post-marketing Study
II-Clinical Study through AGA Medical Corporation
Professional Affiliations/Society Memberships
• American Heart Association
DEPARTMENT OF PEDIATRICS 2012 ANNUAL REPORT
division of Pediatric Cardiology
division of Pediatric Cardiology
T
TEACHING ACTIVITIES
he pediatric cardiology faculty plays an active role in the teaching of medical students, residents, fellows, nurse
practitioners, ultrasound students, and adult cardiology trainees. There is an ACGME-accredited fellowship
training program that has trained more than 60 pediatric cardiologists and currently is training eight fellows.
In addition, predoctoral and postdoctoral trainees form part of the cardiovascular research programs of the Cardiology
Division and the Heart Center. In addition, the pediatric cardiology faculty hosted the fifth annual Cardiology
Morphology Course, in collaboration with world-renowned cardiac pathologist Robert Anderson.
THREE-YEAR BIBLIOGRAPHY
2010
232
Chrysostomou C, Komarlu R,
Lichtenstein S, Shiderly D, Arora G,
Orr R, Wearden PD, Morell VO, Munoz
R, Jooste EH. Electrocardiographic
effects of dexmedetomidine in patients
with congenital heart disease. Intensive
Care Med, 36(5):836-42, 2010.
Crestanello JA, Cook S, Daniels C,
Hitchcock CL, Sai-Sudhakar C. Medial
necrosis in aortic root aneurysm after
repair of tetralogy of Fallot. J Card
Surg, 25(2):230-2, 2010.
Davies ML, Xu S, Lyons-Weiler J,
Rosendorff A, Webber SA, Wasil
LR, Metes D, Rowe DT. Cellular
factors associated with latency
and spontaneous Epstein-Barr virus
reactivation in B-lymphoblastoid
cell lines. Virology, 400:53-67, 2010.
Doshi AA, Cook SC, Hummel JD.
Implantation of a bi-ventricular pacing
system in the setting of dextrocardia
with situs inversus totalis. Indian Pacing
Electrophysiol J,10(1):58-61, 2010.
Feingold B, Arora G, Webber SA,
Smith KJ. Cost-effectiveness of
implantable cardioverter-defibrillators
in children with dilated cardiomyopathy.
J Cardiac Fail, 16(9):734-41, 2010.
Foerster SR, Canter CE, Cinar A,
Sleeper LA, Webber SA, Pahl E, Kantor
PF, Alvarez JA, Colan SD, Jeffries JL,
Lamour JM, Margossian R, Messere
JR, Rusconi PG, Shaddy RE, Towbin
JA, Wilkinson JD, Lipshultz SE.
Ventricular remodeling and survival are
more favorable for myocarditis than for
idiopathic dilated cardiomyopathy in
childhood: An outcomes study from
the pediatric cardiomyopathy registry.
Circ Heart Fail, 3:689-97, 2010.
DEPARTMENT OF PEDIATRICS 2012 ANNUAL REPORT
Holzer R, Marshall A, Kreutzer J,
Hirsch R, Chisolm J, Hill S, Galantowicz
M, Phillips A, Cheatham J, Bergerson L.
Hybrid procedures: Adverse events
and procedural characteristics—
Results of a multi-institutional registry.
Congenit Heart Dis, 5(3):233-42, 2010.
Johnson MR, Haft J, Kinder D,
Webber SA, Meyer K, Shervin C, Pitts
N, Dyke DB. Heart transplantation in
the United States 1999-2008. Am J
Transplant, 10(4 Pt 2):1035-46, 2010.
Jooste EH, Muhly WT, Ibinson
JW, Suresh T, Damian D, Phadke
A, Callahan P, Miller S, Feingold
B, Lichtenstein SE, Cain JG,
Chrysostomou C, Davis PJ. Acute
hemodynamic changes following
rapid intravenous bolus dosing of
dexmedetomidine in pediatric heart
transplant patients undergoing
routine cardiac catheterization.
Anesth Analg,111(6):1490-6, 2010.
Khairy P, Aboulhosn J, Gurvitz MZ,
Opotowsky AR, Mongeon FP, Kay J,
Valente AM, Earing MG, Lui G, Gersony
DR, Cook S, Ting JG, Nickolaus MJ,
Webb G, Landzberg MJ, Broberg CS;
for the Alliance for Adult Research
in Congenital Cardiology (AARCC).
Arrhythmia burden in adults with
surgically repaired tetralogy of
Fallot: A multi-institutional study.
Circulation, 868-75, 2010.
Lazol JP, Lichtenstein SE, Jooste EH,
Shiderly D, Kudchadker NA, Tatum
GH, Orr RA, Wearden PD, Morell VO,
Munoz RA, Chrysostomou C. Effect
of dexmedetomidine on pulmonary
artery pressure after congenital
cardiac surgery: A pilot study. Pediatr
Crit Care Med, 11(5):589-92, 2010.
Manrique AM, Arroyo M, Lin Y, El
Khoudary SR, Colvin E, Lichtenstein
S, Chrysostomou C, Orr R, Jooste E,
Davis P, Wearden P, Morell V, Munoz
R. Magnesium supplementation during
cardiopulmonary bypass to prevent
junctional ectopic tachycardia after
pediatric cardiac surgery: A randomized
controlled study. J Thorac Cardiovasc
Surg, 139(1):162-9, 2010.
Moguillansky D, Rome JJ, Schneider
H, Kreutzer J. Role of high-pressure
balloon valvotomy for resistant
pulmonary valve stenosis. Congenital
Heart Disease, 5(2):134-40, 2010.
Newman B, Feinstein JA, Cohen
RA, Feingold B, Kreutzer J, Patel
H, Chan F. Congenital extrahepatic
portosystemic shunt associated with
heterotaxy and polysplenia. Pediatr
Radiol, 40(7):1222-30, 2010.
Ohmann EL, Burckart GJ, Brooks MM,
Chen Y, Pravica V, Girnita DM, Zeevi A,
Webber SA. Genetic polymorphisms
influence mycophenolate mofetil
related adverse events in pediatric
heart transplant patients. J Heart
Lung Transpl, 29:509-16, 2010.
Ohmann EL, Burckart GJ, Chen
Y, Pravica V, Brooks MM, Zeevi A,
Webber SA. Inosine 5’-monophosphate
dehydrogenase 1 haplotypes and
association with mycophenolate mofetil
gastrointestinal intolerance in pediatric
heart transplant patients. Pediatric
Transplantation,14:891-5, 2010.
Ohmann EL, Brooks MM, Webber
SA, Girnita DM, Ferrell RE, Burckart
GJ, Chinnock R, Canter C, Addonizio
L, Bernstein D, Kirklin JK, Naftel
D, Zeevi A. Association of genetic
polymorphisms and risk of late posttransplant infection in pediatric heart
recipients. J Heart Lung Transplant,
29:1342-51, 2010.
Parent B, Munoz R, Shiderly
D, Chrysostomou C. Use of
dexmedetomidine in sustained
ventricular tachycardia. Anaesth
Intensive Care, 38(4):781, 2010.
Sanchez de Toledo J, Gunawardena S,
Munoz R, Orr R, Berry D, Sonderman
S, Krallman S, Shiderly D, Wang L,
Wearden P, Morell VO, Chrysostomou
C. Do neonates, infants and young
children need a higher dose of
enoxaparin in the cardiac intensive
care unit? Cardiol Young, 20(2):
138-43, 2010.
Sanchez de Toledo J, Chrysostomou
C, Wearden PD. Acute compartment
syndrome in a patient on extracorporeal support: Utility of near-infrared
spectroscopy. J Cardiothorac Vasc
Anesth, September 8, 2010. [Epub
ahead of print]
Sanchez de Toledo J, Munoz R,
Landsittel D, Shiderly D, Yoshida
M, Komarlu R, Wearden P, Morell
VO, Chrysostomou C. Diagnosis
of abnormal diaphragm motion after
cardiothoracic surgery: Ultrasound
performed by a cardiac intensivist
vs. fluoroscopy. Congenit Heart
Dis, 5(6):565-72, 2010.
Seale AN, Uemura H, Webber SA,
Partridge J, Roughton M, Ho SY,
McCarthy KP, Jones S, Shaughnessy
L, Sunnegardh J, Hanseus K, Berggren
H, Johansson S, Rigby ML, Keeton
BR, Daubeney PEF. Total anomalous
pulmonary venous connection:
Morphology and outcome from an
international population-based study.
Circulation, 122:2718-26, 2010.
Valente AM, Bhatt A, Cook S, Earing
MG, Gersony DR, Aboulhosn J,
Opotowsky AR, Lui G, Gurvitz M,
Graham D, Fernandes SM, Khairy
P, Webb G, Gerhard-Herman M,
Landzberg M. The CALF (Congenital
Heart Disease in Adults Lower
Extremity Systemic Venous Health
in Fontan Patients) Study. JACC,
56:144-50, 2010.
Verheart D, Arruda J, Thavendiranathan
P, Cook SC, Raman SV. Truncus
arteriosus with aortic arch interruption:
Cardiovascular magnetic resonance
findings in the unrepaired adult. J
Cardiovas Magn Reson, 12(1):16, 2010.
2011
Alvarez JA, Orav EJ, Wilkinson JD,
Fleming LE, Lee DJ, Sleeper LA,
Rusconi PG, Colan SD, Hsu DT,
Canter CE, Webber SA, Cox GF,
Jeffries JL, Towbin JA, Lipshulz SE.
Competing risks for death and cardiac
transplantation in children with dilated
cardiomyopathy: Results from the
Pediatric Cardiomyopathy Registry.
Circulation, 124:814-23, 2011.
Bergersen L, Gauvreau K, Marshall
A, Kreutzer J, Beekman R, Hirsch
R, Foerster S, Balzer D, Vincent J,
Hellenbrand W, Holzer R, Cheatham J,
Moore J, Lock J, Jenkins K. Proceduretype risk categories for pediatric and
congenital cardiac catheterization. Circ
Cardiovasc Interv, 4(2):188-94, 2011.
Białkowski J, Glowacki J, Zabal C,
Garcia-Montes A, Bermudez-Canete R,
Flores-Arizmendi R, Sagado-Sandova
A, Diaz-de Leon H, Menacho-Delgadillo
R, Kreutzer J. Patent ductus arteriosus
at low and high altitudes: Anatomical
and hemodynamic features and their
implications for transcatheter closure.
Kardiol Pol, 69(5):431-6, 2011.
Chrysostomou C, De Toledo JS,
Wearden P, Jooste EH, Lichtenstein
SE, Callahan PM, Suresh T, O’Malley E,
Shiderly D, Haney J, Yoshida M, Orr R,
Munoz R, Morell VO. Perioperative use
of dexmedetomidine is associated with
decreased incidence of ventricular and
supraventricular tachyarrhythmias after
congenital cardiac surgery. Ann Thorac
Surg, 92(3):964-72, 2011.
Feingold B, Raval J, Galambos C,
Yazer M, Zeevi A, Bentlejewski C,
Morell VO, Wearden PD, Webber
SA. Tolerance to incompatible ABO
blood group antigens is not observed
following homograft implantation.
Human Immunology, June 15, 2011.
[Epub ahead of print]
Feingold B, Irving C, Tatum GH,
Webber SA. Prognostic significance
of recurrent grade 1B rejection
in the first year after pediatric
cardiac transplantation: A case for
reinstatement of the 1B rejection grade.
Pediatr Transplant,15:589-93, 2011.
Gaur L, Madan S, Morell V, Arora G.
Formation of ventricular aneurysm after
endocarditis in a child with methicillinresistant Staphylococcus aureus
(MRSA) bacteremia. Pediatr Cardiol,
July 26, 2011. [Epub ahead of print]
Girnita DM, Ohmann EL, Brooks MM,
Webber SA, Burckart GJ, Ferrell
RE, Ranganathan S, Chinnock R,
Canter C, Addonizio L, Bernstein
D, Kirklin JK, Naftel DC, Zeevi A.
Gene polymorphisms impact the
risk of rejection with hemodynamic
compromise: A multicenter study.
Transplantation, 91:1326-32, 2011.
Guglani L, Tadros S, Morell VO, Spahr
JE, Webber SA, Kurland G. Lobar
displacement following pediatric
heart-lung transplantation. Pediatric
Transplantation, January 12, 2011.
[Epub ahead of print]
Holzer RJ, Gauvreau K, Kreutzer J,
Leahy R, Murphy J, Lock JE, Cheatham
JP, Bergersen L. Balloon angioplasty
and stenting of branch pulmonary
arteries: Adverse events and procedural
characteristics: Results of a multiinstitutional registry. Circ Cardiovasc
Interv, 4(3):287-96, 2011.
233
Komarlu R, Beerman LB, Freeman
D, Arora G. Fetal and neonatal
presentation of long QT syndrome.
PACE, March 14, 2011. [Epub ahead
of print]
Lapage MJ, Reed JH, Collins KK, Law
IH, Pilcher TA, Tanel RE, Anderson CC,
Young ML, Emmel M, Paul T, Blaufox
AD, Arora G, Saul JP. Safety and
results of cryoablation in patients
<5 years old and/or <15 kilograms.
Am J Cardiol, 108(4):565-71, 2011.
Lawrence KS, Stilley CS, Pollock JA,
Webber SA, Quivers E. A familycentered educational program to
promote independence in pediatric
heart transplant recipients. Progress in
Transplantation, 21:61-6, 2011.
Macedo C, Webber SA, Donnenberg
A, Popescu I, Hua Y, Green M, Rowe
D, Smith L, Brooks MM, Metes D.
EBV-specific CD8+ T Cells from
asymptomatic pediatric thoracic
transplant patients carrying chronic
high ebv loads display contrasting
features: Activated phenotype and
exhausted function. J Immunology,
186:5854-62, 2011.
Misra N, Webber SA, DeGroff CG.
Adult definitions for dyssynchrony are
inappropriate for pediatric patients.
Echocardiography, 28:468-74, 2011.
DEPARTMENT OF PEDIATRICS 2012 ANNUAL REPORT
division of Pediatric Cardiology
Parent B, Wearden P, Kounis GA,
Chrysostomou C. Kounis syndrome
or allergic coronary vasospasm in
a two-year old. Congenital Heart
Disease, March 21, 2011. [Epub
ahead of print]
Picarsic J, Jaffe R, Mazariegos G,
Webber SA, Ellis D, Green MD, ReyesMúgica M. Post-transplant Burkitt
lymphoma is a more aggressive and
distinct form of PTLD. Cancer, March
28, 2011. [Epub ahead of print]
Sanchez MA, DeBrunner M, Cox E,
Caldwell R. Acquired toxoplasmosis
after orthotopic heart transplantation
in a sulfonamide-allergic patient.
Pediatric Cardiology, 32(1):91-3, 2011.
234
Trucco SM, Jaeggi E, Cuneo B, MoonGrady AJ, Silverman E, Silverman N,
Hornberger LK. Use of intravenous
gamma globulin and corticosteroids in
the treatment of maternal autoantibodymediated cardiomyopathy. J Am Coll
Cardiol, 57(6):715-23, 2011.
DEPARTMENT OF PEDIATRICS 2012 ANNUAL REPORT
Trucco SM, Barnoya J, Larrazabal
LA, Castañeda A, Teitel DF. Detection
rates of congenital heart disease in
Guatemala. Cardiol Young, 21(2):
153-60, 2011.
Zaoutis TE, Webber SA, Naftel DC,
Chrisant MA, Kaufman B, Bennett
Pearce F, Spicer R, Dipchand AI.
Invasive fungal infections in pediatric
heart transplant recipients: Incidence,
risk factors and outcomes. Pediatr
Transplant,15:465-9, 2011.
2012
Beerman L, Kreutzer J, Allada V.
Chapter 5: Cardiology. In: Atlas
of Pediatric Physical Diagnosis,
sixth edition. Zitelli BJ, McIntyre S,
Nowalk A (Eds.). Baltimore, MD:
Mosby-Wolfe, 2012.
West L, Beerman LB, Arora G. “The
natural history of ventricular ectopy in
children.” Presented at American Heart
Association Fellows’ Research Day.
Pittsburgh, Pa., February 17, 2012.
division of Pediatric Cardiology
Wackel P, Beerman LB, Arora
G. “Wolff-Parkinson-White and
adenosine response in pediatric
patients.” Presented at American Heart
Association Fellows’ Research Day.
Pittsburgh, Pa., February 17, 2012.
Beach C, Beerman LB, Sukits V,
Mazzocco S, Hangard A, Brooks MM,
Arora G. “Impact of three-dimensional
mapping system on fluoroscopy
times in pediatric AVNRT: Mid-term
results. Presented at American Heart
Association Fellows’ Research Day.”
in Pittsburgh, Pa., February 17, 2012.
Zeevi A, Marrari M, Feingold B,
Webber SA, Duquesnoy RJ. HLA
epitope analysis to assess complement
and noncomplement binding donor
specific antibody repertoire in a
pediatric heart transplant recipient.
Human Immunol, 73:48-51, 2012.
Holzer RJ, Gauvreau K, Kreutzer J,
Trucco SM, Torres A, Shahanavaz
S, Bergersen L. Safety and efficacy
of balloon valvuloplasty for isolated
pulmonary valve stenosis: A
multicenter experience. Catheter
Cardiovasc Interv, 2012.
Ying X, Reyes-Mugica M, Galambos
C, Zeevi A, Miller SA, Webber SA,
Feingold B. Utility of routine C4d
staining in the first year after pediatric
heart transplantation. Presented at
the International Society for Heart and
Lung Transplantation, Prague, Czech
Republic, April 2012.
Seale AN, Carvalho JS, Gardiner HM,
Mellander M, Roughton M, Simpson
J, Tometzki A, Uzun O, Webber SA,
Daubeney PEF. Total anomalous
pulmonary venous connection: Impact
of prenatal diagnosis. Ultrasound
Obstet Gynecol, Jan 20, 2012. [Epub
ahead of print]
Marcuccio E, Arora G, McCaffrey F.
Noninvasive measurement of cardiac
output during exercise in children with
tetralogy of Fallot. Pediatr Cardiol,
33(7):1165-70, 2012.
Pahl E, Sleeper LA, Canter CE, Hsu DT,
Lu M, Webber SA, Colan SD, Kantor
PF, Everitt MD, Towbin JA, Jefferies JL,
Kaufman BD, Wilkinson JD, Lipshultz
SE; for the Pediatric Cardiomyopathy
Registry. Incidence and risk factors for
sudden cardiac death in children with
dilated cardiomyopathy: A report from
the pediatric cardiomyopathy registry.
J Am Coll Cardiol, 59:607-15, 2012.
Turner Z, Lanford L, Webber SA.
Oral budesonide as a therapy for
protein-losing enteropathy in patients
having undergone fontan palliation.
Congenital Heart Dis, 7:24-30, 2012.
235
Wiesmayr S, Webber SA, Macedo C,
Popescu I, Smith S, Luce J, Metes D.
Decreased NKp46 and NKG2D and
elevated PD-1 are associated with
altered NK-cell function in pediatric
transplant patients with PTLD. Eur J
Immunol, 42:541-50, 2012.
DEPARTMENT OF PEDIATRICS 2012 ANNUAL REPORT