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  1. 1. C O N G E N I T A L C A R D I O L O G Y T O D A Y News and Information for Pediatric and Congenital Cardiovascular Physicians and Surgeons Vol. 5 / Issue 9 WWW .C ONGENITAL C ARDIOLOGY T ODAY . COM September 2007 North American Edition A M P L AT Z E R D U C T O C C L U D E R ® V S C O I L S I N .. INSIDE THIS ISSUE MONGOLIA AMPLATZER Duct Occluder® vs Coils in Mongolia By Hideshi Tomita, MD; Noriyuki Haneda, Central Clinical Hospital, an adult cardiology by Hideshi Tomita, MD; Noriyuki MD; Kenji Kuroe, MD; Shunji Nogi, MD; and cardiovascular surgery center, has the Haneda, MD; Kenji Kuroe, MD; Shunji Nogi, MD; Hideaki Ueda, Hideaki Ueda, MD; Kenji Kishida, MD; only cine angiography machine in Mongolia, to MD; Kenji Kishida, MD; Takashi Takashi Higaki, MD; Yasunori Horiguchi, do catheterizations. Until the fifth visit, we Higaki, MD; Yasunori Horiguchi, MD; Jun Furui, MD; Masamichi Tamura, MD; used only coils; 0.038 or 0.052 inch MD; Jun Furui, MD; Masamichi Tamura, MD; Hidemi Takada, Hidemi Takada, MD; Fumitoshi Tsurumi, MD; Gianturco coils, Flipper coils, or Platinum coils MD; Fumitoshi Tsurumi, MD; Shinichiro Tanaka, MD; Hiroshi Yano, MD (Cook Inc., Bloomington, IN, USA), for patent Shinichiro Tanaka, MD; Hiroshi arterial duct closure, as coils are the only de- Yano, MD ~Page 1 vices available in Japan for this procedure. On AMPLATZER Duct Occluder® or Coils for tran- the sixth visit, in 2005, we introduced the Highlights from the 43rd Annual Meeting of the scatheter occlusion of patent arterial duct; a cost AMPLATZER Duct Occluder® (AGA Medical Japanese Society of Pediatric comparison of devices used by a volunteer Co, MN, USA) for the first time. Cardiology and Cardiac team of Japanese physicians in the setting of a Surgery We analyzed the cost effectiveness of introduc- by Professor Toshio Nakanishi, humanitarian, heart-saving project in Mongolia. ing the AMPLATZER Duct Occluder® for tran- MD and Virginia Dematatis, Congenital Cardiology Today, Introduction scatheter occlusion of patent arterial duct in Staff Editor this voluntary humanitarian heart-saving pro- ~Page 8 Since October 2001, members of a group of ject. Japanese pediatric cardiologists have visited Highlights from the 2007 International Symposium Mongolia once or twice a year to do diagnostic Subjects on the Hybrid Approach to and interventional catheterizations.[1] Consid- Congenital Heart Disease Sixty-one Mongolian patients with patent arte- ering the limited medical resources available in (ISHAC) rial duct, who underwent attempted transcathe- by John P. Cheatham, MD and Japan for this project and the limited resources ter occlusion in the four visits from 2002 to Mark E. Galonwitcz, MD in Mongolia, as well as cost, risk and benefit, ~Page 10 2005 at the same hospital and by the same we focused our activities on screening by team, were included in this study. During this DEPARTMENTS echocardiography, transcatheter closure of period, coils (0.052 and 0.038 inch Gianturco October Symposium Focus patent arterial duct, balloon dilation of pulmo- coil, Flipper coil, Platinum coils) were used in ~Page 2 nary stenosis and coarctation, and diagnostic 41 patients (Coil group), while the catheterization. For the first two visits, there October Webcast Focus AMPLATZER Duct Occluder® was first used in ~Page 12 was no cine, no video, nor any other X-ray 2005 and applied in 20 patients (AMPLATZER recording or replaying equipment; conse- CONGENITAL CARDIOLOGY TODAY group), whose minimum ductus diameter was quently, we judged the size and morphology of Editorial and Subscription Offices: estimated to be greater than 2.5 millimeters 16 Cove Road, Ste. 200 the patent arterial duct by rapid hand injection. Westerly, RI 02891 USA by Doppler echocardiography. For the third visit, we moved to the Shastin Corporate Offices: 9008 Copenhaver Dr., Ste. M Potomac, MD 20854 USA www.CongenitalCardiologyToday.com www.CHDVideo.com Do you or your colleagues have interesting research results, © 2007 by Congenital Cardiology Today (ISSN 1554-7787-print; ISSN 1554-0499- observations, human interest stories, reports of meetings, etc. that online). Published monthly. All rights reserved. Congenital Cardiology provides you would like to share with the congenital cardiology community? timely news and information for pediatric and congenital cardiologists. Statements or opinions expressed in Congenital If so, submit a brief summary of your proposed article to Cardiology Today reflect the views of the authors and sponsors, and are not nec- essarily the views of Congenital Congenital Cardiology Today at: Article-SEP@CCT.bz Cardiology Today. The manuscript may be between 400-3,500 words, contain See Recruitment Ads on pictures, graphs, charts and tables. pages: 2, 4, 5, 6, 7, 9, 11, 12, 13, 14 and 15
  2. 2. SEPTEMBER 2007 2 CONGENITAL CARDIOLOGY TODAY OCTOBER SYMPOSIUM FOCUS Evolving Concepts in the Management of Complex Congenital Heart Disease October 5-6, 2007; San Diego, CA USA Director of Pediatric Cardiovascular www.chsd.org/cm e/ Critical Care Pr ogr am C oordi n at ors : J ohn J . L am b ert i, MD, E ug en e and J oyc e Kl ei n Dir ec t or of t h e Chi ldr en ’s H ear t I ns titu t e R ad y Major Medical Center in Dallas seeks a Pediatric Cardiovascular Chil dr en’s H os p it al - S an Di eg o Pr of es s or of Sur g er y - Critical Care Director. Preferred candidate will possess a charis- Uni vers it y of C alif orn i a, S an Di eg o, Sc h ool of M ed ic in e - S an D i eg o, CA; J ohn W . Moor e, MD , MPH, D ir ec t or , Di vi- matic personality, leadership attributes with evidenced experi- s ion of C ardi ol og y - R ad y Ch il dr en’s H os p it al - S an Di eg o ence, strong clinical skill set for a complex patient population and Pr of es s or of C lin ic al P ed i atric s Chi ef , S ec ti on of C ardi ol- board certification in Pediatric Cardiology and Critical Care. Can- og y - D ep ar tm en t of P edi atric s Uni v ers it y of C al if or ni a, didates with board certification in one discipline and solid experi- S an D i eg o, Sc h ool of M edic i n e - S an Di eg o, CA; Ant h on y C. Ch ang , MD , M edic al Dir ec t or, H eart Ins ti tut e - C hil- ence in the alternate subspecialty should also apply. The incom- dr en 's H os p it al of O r an g e C ount y O r ang e, C A ing Director will serve as the Medical Director of the existing 10 bed Pediatric Cardiovascular ICU and the new, state-of-the-art Pr ogr am M on it or : R ayb urn R. S k oglu nd , MD, Dir ec t or, Cont inu in g M edic al Ed uc ati on R ad y C hil dr en’s H os pit al - unit due for completion in late 2008. Additional responsibility in- S an D i eg o, CA. cludes coordinating a collegial collaboration with pediatric cardiol- ogy physicians/subspecialists and nursing staff. Incoming physi- Cours e C o-Dir ec t ors : Drs . E mi l e B ac h a, Dr. P et er B l oc k, M ar i o C arm in ati , J oh n Ch eat h am, T ed F el dm an , C ar l os cian will be provided an outstanding financial package and the P edr a, M ar k R eis m an, and R ob ert S om m er. opportunity to advance their medical and/or research career. G u es t F ac ult y I nc lu d es : D ani el B er ns t ei n, MD; A lf r ed The Congenital Heart Surgery program performs more than 300 W oodl ey; Ed ward L. B ove, MD R on al d Br onic ki, MD; surgeries each year. Two thirds of the surgeries are pump Chris t oph er C ald ar on e, MD ; J oh n P. Ch eat h am, MD; P au l A. Ch ec c h i a, MD; An n e D ub in, MD J ef f rey R. F in em an, cases. The program provides care to neonates (approximately MD; M ar k G al ant owic z, MD; N anc y S. G h an ayem , MD; 30%) and children under 2 yrs of age (approximately 70%). Fr an k L. H anl ey, M D; J ef f rey P. J ac obs , MD; M ars h al l L. J ac obs , MD ; J am es L oc k, MD; C ons t ant in e M avr oud is , A team of nine pediatric intensivists and eleven pediatric cardiolo- MD; R alp h S. M os c a, MD; J am es C. P err y, MD; V aug hn A . gists cover the congenital heart surgery unit. A dedicated 10-bed St arn es , MD; S ar ah T ab butt , MD, P hD; J am es S. pediatric cardiovascular intensive care unit opened in 2004. Con- T wed d ell, MD; an d W illi am G . W illi ams , MD. struction has begun on a newer unit with a completion date in late T he pr ogr am ex am in es th e earl y s ur gic al m an ag em en t of 2008. th e m os t c om pl ex d ef ec ts and th e l at e s u rgic al m an ag e- m ent of pr e vi ous l y r ep air ed c om pl ex c on g enit al h eart d is - The program participates extensively in research initiatives and i- eas e. Int ern ati on all y r en own ed au th oriti es i n c ard i ovas c u- Rounds, a web based informatics system allowing second to sec- l ar s ur g er y, c ar di ol og y and c ri tic al c ar e m edic i n e h av e ond tracking of clinical data and shares information with outside b een i n vit ed t o p art ic ip at e in th e pr ogr am . referring physicians. The center employs all of the latest tech- O bj ec ti ves : ♥ E val u at e c ont em p or an eou s m an ag em en t nologies for monitoring patients and performing point of care test- s trat eg i es f or H LHS b y c omp ari ng ear l y, mid- t er m and l at e m or bi dit y and m ort alit y, inc l udi ng L at e N eur o- ing. The Medical Center operates a very busy research entity in d evel op m ent al As s es s m ent. ♥ Und ers t and t h e r ol e of t h e which the Pediatric Cardiovascular Surgery Director, actively par- s tag e I H ybri d Pr oc ed ur e in th e m od er n m an ag em en t of ticipates. HJ HS. ♥ Und ers t an d t h e m an ag em ent op ti ons f or ol d er p at i en ts wit h l at e ons et c ompl ic ati ons of t h e F ont an c irc u- l ati on . ♥ Und ers t and th e l at es t c onc ep ts in th e m an ag e- m ent of T etr al og y of F all ot wit h MAPCAS . ♥ Un d ers t and Call or inquire by email today: th e ti min g an d r ol e of s ur g er y i n t h e m an ag em ent of rig ht Kathleen Kyer, Manager, ven tric u l ar d ys f unc ti on oc c urri ng l ong af t er th e s ur gic al Pediatric Subspecialty Recruitment, tr eat m ent of T etr al og y of F all ot or T r ans p os iti on of th e 888-933-1433 or G reat V es s els . ♥ Un d ers t and m od ern c onc epts of c ritic al c ar e m an ag em en t i nc lu di ng t h e us e of t h e n ewes t ph arm a - Kathleen.Kyer@HCAHealthcare.com c ol og ic ag en ts an d m ec h an ic al as s is t d evic es . www.5StarMedEd.org/pda w ww .Co nge n ita lCa rd io log yTod a y.c om
  3. 3. CONGENITAL CARDIOLOGY TODAY 3 SEPTEMBER 2007 Table 1. Cost of medical resources from Japan Table 2. Subjects Devices Cost (US ) Coil (n=41) AMPLATZER® (n=20) P Sheath 51.2 Range Median Range Median Long sheath (6, 8 French) 40.2 Age 7m-29y 3y 11m-16y 2y6m ns Long sheath (6, 8 French) 188.0 Weight (kg) 5.0-7.0 13 6.8-51.0 13.6 ns Guiding catheter for PCI 341.9 Minimum diameter (mm) 0.8-8.0 3.3 2.5-10 < 0.05 Balloon angiographic catheter 170.9 Less than 2.5 7 cases 2 cases Catheter (JR, Multipurpose, Pig-tail) 54.74 2.5-2.9 7 cases 3 cases Guidewire 41.9 3.0-3.4 9 cases 4 cases Contrast (50 millileters) 179.9 Greater than or equal to 3.5 18 cases 11 cases 0.052" Gianturco coil (2 in one package) 129.1 Flipper coil, Platinum coil 568.4 Table 3. Cost for coil occlusion depending on the number of coils in patients with complete occlusion without any complications Delivery system (Flipper coil, Platinum Coil) 180.3 Bioptome (3 French) 726.5 Number of coils n Cost (US $) Goose neck snare 486.3 Range Mean SD 1 8 183.8-995.7 798.1 265.8 2 15 970.9-2042.7 1756.5 273.2 Methods 3 8 1940.2-3285.5 2582.2 446.7 For small patent arterial ducts, we princi- Greater than or equal to 4 6 2300.9-3965.4 3276.1 614.4 pally used a Flipper coil, introduced retro- or pro-gradely, while for medium-sized patent arterial duct, our first choice was Table 4. Cost for coil occlusion depending on the minimum diameter of the ductus prograde deployment of a 0.052 inch Minimum diameter n Cost (US $) Gianturco coil using a bioptome as re- (mm) Range Mean SD ported by Grifka et al.[2] We occasionally 7 183.8-1552.1 849.3 401.4 used a 0.038 inch Gianturco coil or a Plati- Less than 2.5 num coil, depending on the availability of 2.5-2.9 7 995.7-2367.5 1677.7 425.8 coils, which varied with the budget in 3.0-3.4 7 970.9-4679.5 2329.7 1172.3 each year. The AMPLATZER Duct Oc- Greater than or equal to 3.5 17 1673.5-10281.2 3067.6 2004.5 cluder ® was deployed as reported previ- ously.[3, 4] Table 5. Cost for coil occlusion in patients with complications We usually used the following devices Complications Cost (US$) for the diagnostic catheter prior to the Migration, successful retrieval, and successful re-deployment (2 patients) 3354.7, 4679.5 transcatheter closure: two sheaths, one for Migration, unsuccessful retrieval, and surgery 1986.3 plus surgery femoral vein and the other one for the femoral artery, one each of the following: a Two additional sessions following severe hemolysis after the 1st session 10281.2 balloon angiographic catheter, a pig-tail catheter, and a guidewire, and contrast of pharmacy, and physician’s charges were the AMPLATZER Duct Occluder® and its 50-100 milliliters. Cost for these devices not included. Coils and all other medical delivery system was supplied for 1500 were excluded from the cost for tran- resources, except for the AMPLATZER US$/device and 150 US$/ one system, scatheter closure. As our project is staffed Duct Occluder®, were supplied by the respectively Although some devices were by volunteers, we only compiled the cost Japanese distributor, while the AM- supplied at a discount price, we retrospec- of devices for transcatheter occlusion of a PLATZER Duct Occluder® was provided tively calculated the cost based on the patent arterial duct, while hospital charges, by China. Prices for medical resources normal price in each country at the rate of such as catheterization fees, anesthesia, from Japan were listed in Table 1, while 117 yen to the U.S. dollar. For information, please call 1-800-BRAUN2 (227-2862) w ww .b b rau nu sa. co m Working Together to Develop a Better Tomorrow w ww .Co nge n ita lCa rd io log yTod a y.c om
  4. 4. SEPTEMBER 2007 4 CONGENITAL CARDIOLOGY TODAY The leader of our team, Noriyuki Haneda, was given a tempo- rary medical license from the Ministry of Health for Mongolia, while the other doctors were permitted to do any medical ac- tivities in Mongolia under his supervision. The AMPLATZER Duct Occluder ® was approved also from the Ministry of Health for Mongolia, while its implantation was performed with an offi- cial distributor and proctor of AGA Medical Co., Larry Meng. Informed consent for transcatheter occlusion of a patent arte- rial duct either with coils or the AMPLATZER Duct Occluder ® was obtained from the patients or patient’s parents by not only Mongolian but also Japanese doctors. Figure 1: Cost comparison between coils and AMPLATZER Duct Occluder® depending on the number of coils used for occlusion. When we used 3 or more coils, the cost for devices was more expensive in the Coil group than in the AMPLATZER group. Figure 2: Cost comparison between coils and AMPLATZER Duct Occluder® depending on the minimum diameter of the patent arterial duct. The average cost for patent arterial duct greater than or equal to 3.5 millimeters was more expensive in the Coil group than in the AMPLATZER group . Significant differences among the groups were detected by qui- square test of analysis of variance. A post-hoc test was done by Fisher’s PLSD using STATView version 5.0 (SAS Institute Inc. Cary, USA). A probability-value less than 0.05 was taken as statistically significant. Results There was no significant difference in age and body weight between the two groups, while the minimum diameter in the AMPLATZER group (median, 4 millimeters) was larger than in the Coil group (median, 3.3 millimeters, probability-value less than 0.05, Table 2). In the AMPLATZER group, all patent arterial ducts were closed without any complications. In the Coil group, the patent arte-
  5. 5. CONGENITAL CARDIOLOGY TODAY 5 SEPTEMBER 2007 rial duct was closed in a single session in the total cost in the patient who needed 37 patients. Three patients had complica- surgical retrieval of coils and patent arte- tions caused by migration, and one pa- rial duct ligation. However, in the four tient had a complication with hemolysis. patients, who were complicated by migra- tion of coils or hemolysis, the cost for coil Asheville Cardiology Associates Migrated coils were retrieved and the pat- occlusion was double or more than Recruiting BC/BE Pediatric ent arterial duct was closed in a second AMPLATZER Duct Occluder® (Table 5). Non-Invasive Cardiologist session in 2 patients, while one patient The minimum diameter of the patent arte- needed surgical retrieval and patent arte- rial duct in these patients was greater than rial duct ligation. Hemolysis was abol- Known for clinical excellence, Asheville Cardi- or equal to 3 millimeters. ology Associates is seeking a third pediatric ished in an additional two sessions with 14 coils total. In all, the patent arterial duct Discussion cardiologist with advanced skills in both inpa- tient and outpatient arenas. Those with exper- was closed with coils in 40 patients. All Patent arterial duct is a common problem tise in new modality imaging, adult-congenital the patients, other than those who needed cardiology, or interest in exercise physiology in Mongolia because of the high altitude. an additional session because of migration or electrophysiology, are encouraged to con- Prior to 2005, we had visited Mongolia six or hemolysis, were discharged on the day tact us. Development of new programs within times, and had attempted coil occlusion of the practice is encouraged. after the procedure. There was no statisti- a patent arterial duct in 49 patients. In this cally significant difference in the frequency The Peds Division has a complex patient project, both transportation and the cost of of complications and the complete closure base, with active fetal and adult-congenital medical supplies depended on donations ratio, between two groups. programs. Outpatient practice encounters by the Japanese people, making the ~3,000 clinic visits, ~2,000 echoes per year, As we used 20 AMPLATZER Duct budget quite limited. For the first two vis- with a growth rate of 5-7% annually. Inpatient Occluder® devices (1500 US$/device) its, all catheterizations were done at a is performed at Mission Hospitals, consis- and 21 delivery systems (150 US$/one hospital which had no cine angiography tently rated in Top 100 Heart Hospitals in last system) in 20 patients, the cost for machine, but only had a portable X-ray six years. Its new children’s outpatient facility is well represented by subspecialists and AMPLATZER Duct Occluder® closure fluoroscopy machine for the gastrointesti- ancillary services. was 1657.5 US$/patient. nal tract. As this machine had no recording system for graphic data, we only had poor Asheville is a beautiful city of 70,000 (county The average cost for coil occlusion de- has 200,000 plus MSA of 391,000). Located data on the minimum diameter and an- pends on the number of coils used. The in the Blue Ridge Mts. of North Carolina, it giographic morphology of the patent arte- offers excellent public and private schools, actual average cost for a single, 2, 3, and rial duct. [1] Consequently, we analyzed universities and colleges. Amenities such as 4 or more coils was 798.1, 1756.5, 2582.2, the data of the 41 patients treated in the great restaurants, arts, music, & theater put it and 3276.1 US$, respectively (Table 3). last four visits. We used mainly 0.052 inch on the list of best places to live in many publi- When we used 3 or more coils, the cost for cations. A mild four season climate gives Gianturco coils for a moderate-sized pat- devices was more expensive in the Coil opportunities for mountain biking, hiking, ent arterial duct until the fifth visit, because group (Figure 1). The actual average cost camping, fishing, golf, whitewater activities the coil was still the only device for tran- and skiing. for transcatheter occlusion of patent arte- scatheter occlusion of patent arterial duct rial duct with a minimum diameter of less approved in Japan. Multiple coils were than 2.5 millimeters, 2.5-2.9 millimeters, frequently needed, and one patient who 3.0-3.4 millimeters, and greater than or Visit our website, www.avlcard.com had complications due to migration of mul- equal to 3.5 millimeters was 849.3, for more information. tiple 0.052 inch Gianturco coils needed 1677.7, 2329.7, and 3067.6 US$, respec- surgery. Considering cost effectiveness All inquiries remain confidential. tively (Table 4). The average cost for a and the safety of using a single AM- Please send CV to: patent arterial duct greater than or equal to PLATZER Duct Occluder® rather than 3.5 millimeters was more expensive in the James J. McGovern, MD, FACC multiple coils, we decided to introduce the Coil group than in the AMPLATZER group Fax: (828) 277-6350 AMPLATZER Duct Occluder® to our pro- (Figure 2). As the medical cost for patent Email: jimm@avlcard.com ject. Thanks to the AGA Medical Co., 20 arterial duct ligation is only 10 US$ in AMPLATZER Duct Occluders were pro- Mongolia, it is meaningless to calculate vided at a discount price in 2005 from w ww .Co nge n ita lCa rd io log yTod a y.c om
  6. 6. SEPTEMBER 2007 6 CONGENITAL CARDIOLOGY TODAY China, while coils were supplied by the Japanese distributor. CHICAGO - Rush University Medical Center Consequently, we compared cost effectiveness between the The Department of Pediatrics in conjunction with the Cen- coil and the AMPLATZER Duct Occluder® based on the as- ter for Congenital and Structural Heart Disease at Rush Univer- sumption that we had bought these devices for the normal sity Medical Center, located in downtown Chicago, is seeking to price in each country. recruit mid-senior level candidates for the following positions: Because of the limited number of devices, we used AM- Electrophysiology: We are seeking a cardiologist with fel- PLATZER Duct Occluder® for selected patients with a patent lowship training in pediatric and congenital/structural electro- arterial duct of a minimum diameter of 2.5 millimeters. Conse- physiology. The candidate should have expertise in invasive quently, this study has the limitation of being a non- and non-invasive electrophysiology and skills and expertise in randomized retrospective study. The minimum diameter of diagnosis and management of complex arrhythmias. the patent arterial duct was slightly larger in the AMPLATZER group, however, age and body weight were comparable in the Director of Echocardiography for the Center: We are seek- two groups. We mainly used a 0.052 inch Gianturco coil, ing board certified physician candidates with experience in however, we occasionally used other types of coils depending advanced echocardiography. Additional experience in other on availability of coils which was determined by the limited non-invasive imaging modalities would be advantageous to budget. The actual normal price of a Flipper coil and a Plati- the candidate’s application. num coil was more expensive than ordinary Gianturco coils, Director of Pediatric Heart Transplant: We are seeking a but they were supplied at a discount price. Use of such coils pediatric cardiologist with a strong clinical background in heart obviously makes the actual procedure cost more expensive. transplant and heart failure. Despite these limitations, the AMPLATZER Duct Occluder ® was more cost effective when we used 3 or more coils, and Pediatric Cardiologist: Board eligible/certified in pediatric when the minimum diameter of a patent arterial duct was cardiology with interest in outpatient and inpatient aspects of greater than or equal to 3.5 millimeters. Kumar, RK recom- their field, including attending satellite clinics in the Chicago mended using an AMPLATZER Duct Occluder ® or surgery for metro area. For this position recent fellowship graduates are any patent arterial duct greater than 6 millimeters in small encouraged to apply. children (greater than 4 millimeters for children less than 5 These recruitments are part of a key strategic growth initiative kilograms), as coils larger than 10 millimeters tend to be too in a multidisciplinary advanced congenital/structural cardiol- large for the descending aorta.[5] In our previous study, the ogy program with state of the art mechanical support and maximum diameter of patent arterial duct which could be clinical trials. Experience in clinical research is desirable. closed with coils was 5.6 millimeters.[6] Therefore, around 6 Candidates should be eligible for faculty appointment at the millimeters will be the minimum diameter limit which can be Associate Professor or Professor level. Rush is home to one closed even by using multiple 0.052 inch Gianturco coils. The of the first medical colleges in the Midwest and one of the cost for the 4 patients with complications caused by migration of nation’s top-ranked nursing colleges, as well as graduate pro- coils or hemolysis was far more expensive, while one patient grams in allied health, health systems management and bio- needed surgery. As the cost of coil occlusion for the 3.0-3.4 milli- medical research. Rush is an Equal Opportunity Employer. meters patent arterial duct was comparable to the AMPLATZER Duct Occluder®, we believe the AMPLATZER Duct Occluder® Please contact: should be used for smaller patent arterial ducts, around 3 milli- Courtney Kammer meters, in the unique setting of our voluntary activity. Director, Faculty Recruitment Rush University Medical Center Cost effectiveness of medical resources may not be the same 312-942-7376 from country to country, because the system which deter- Courtney_Kammer@rush.edu mines their prices is different. In this study, medical re- sources other than the AMPLATZER Duct Occluder® , were distributed from Japan, while the AMPLATZER Duct Oc- cluder ® came from China. Consequently, we could not com- pare the cost of devices to normal Japanese prices. As our project is volunteer-based, we did not analyze hospital and Evolving Concepts in Management of Complex Congenital Heart Disease A CME Course sponsored by Rady Children's Hospital and University of California, San Diego Course Moderators: John Lamberti, MD; John Moore, MD; and Anthony Chang, MD Faculty consists of 20 of the finest lecturers in the field Attend the conference in San Diego, October 5-6, 2007 For a brochure: www.chsd.org/cme or call Donna Salas at (858) 966-4072; (858) 966-8587 FAX CMA accredited - 13.75 AMA PRA Category TM 1 credits w ww .Co nge n ita lCa rd io log yTod a y.c om
  7. 7. CONGENITAL CARDIOLOGY TODAY 7 SEPTEMBER 2007 physicians charges in the cost. Hospital 5. Kumar RK, Anil SR, Kannan BRJ, et stay after the procedure was similar in 2 al. Biotome-assisted coil occlusion of groups except for patients who needed the moderate-large patent ductus arteri- second session or surgery. We believe osus in infants and small children. these fees are negligible in Mongolia Cath et er Cardiovasc Int erv compared to the cost of devices for tran- 2004;62:266-271. scatheter occlusion of a patent arterial 6. Tomita H, Takamuro M, Fuse S, et al. duct, considering the fact that the total Coil occlusion of patent ductus arteri- medical cost for patent arterial duct liga- osus-Impact of 0.052-Inch Gianturco coil tion is only 10 US$ in Mongolia. without Amplatzer Duct Occluder-.Circ J Outstanding BC/BE Pediatric In conclusion, transcatheter occlusion of a 2006;70:28-30. Cardiology Opportunity in patent arterial duct using an AMPLATZER Duct Occluder® was more cost effective ~CCT~ Beautiful Southern California for a patent arterial duct greater than or Busy private practice group in Orange equal to 3.5 millimeters, or for a patent County seeks additional associate. We arterial duct which needed 3 or more coils are thriving and expanding and are as- to close than the use of coils, in the situa- sociated with a major tertiary cardiotho- tion of a heart saving project in Mongolia, racic surgical program with over 200 where an AMPLATZER Duct Occluder® cases per year. We work closely with was distributed from China, with other surgeons and multiple sub specialists. medical resources from Japan. Non-invasive imaging skills are desir- able, but not mandatory. We offer a Acknowledgements competitive private practice salary with The AMPLATZER Duct Occluder ® could Corresponding Author excellent benefits commensurate with not have been introduced to this project experience. We will be moving into a without support from AGA Medical Cor- Hideshi Tomita, MD brand new office building in the next poration and Dr. Larry Meng from Beijing Cardiovascular Center, few months. Orange County offers fan- Since Medical Scientific Co. Showa University Northern Yokohama tastic recreational opportunities with Hospital pristine beaches, year round sunshine, We thank Dr. Peter M. Olley, Professor 35-1 Chigasakichuo as well as award winning schools. Emeritus of Pediatrics, University of Tsuzuki-ku Alberta, and Dr. Setsuko Olley for lan- Yokohama-shi guage consultation. Kanagawa 224-8503, JAPAN Please send CV, and contact: References Phone: +81-45-949-7000 Fax: +81-45-949-7117 Farhouch Berdjis 1. Haneda N, Tomita H. Heart Saving fberdjis@cox.net Project: Catheter Intervention in Mongo- tomitah@med.showa-u.ac.jp or James Chu lia. Congenital Cardiology Today jchu147@yahoo.com 2005;3:8-10. 714-547-0900 2. Grifka MD RG, Jones TK. Tran- www.childrensheartspecialists.com Noriyuki Haneda, MD scatheter closure of large patent arterial Kenji Kuroe, MD; James Chu, MD duct using 0.052" Gianturco coils: con- Shunji Nogi, MD; Farhouch Berdjis, MD trolled delivery using a bioptome cathe- Hideaki Ueda, MD; Childrens Heart Specialists ter through a 4 French sheath. Catheter Kenji Kishida, MD; 1120 West La Veta, Suite 100 Cardiovasc Interv 2000;49:301-306. Takashi Higaki, MD; Orange, CA 92868 3. Masura J, Walsh KP, Thanopoulus B, Yasunori Horiguchi, MD; et al. Catheter closure of moderate-to- Jun Furui, MD; large-sized patent ductus arteriosus us- Masamichi Tamura, MD; ing new Amplatzer Duct Occluder; im- Hidemi Takada, MD; Do You Want to Recruit a mediate and short-term results. J Am Fumitoshi Tsurumi, MD; Shinichiro Tanaka, MD; Pediatric Cardiologist? Coll Cardiol 1998;31:820-826. Hiroshi Yano, MD; Advertise in the only monthly publication 4. Pass RH, Hijazi Z, Hsu DT, et al. Pediatric Cardiology totally dedicated to pediatric and congeni- Multicenter USA Amplatzer patent duc- Shimane Institute of Health Science tal cardiology. For more information: call tus arteriosus occlusion device trial: ini- Enya-cho 223-7, Izumo, Shimane, +1.301.279.2005, or send an email to: tial and 0ne-year results. J Am Coll Car- 693-0021, JAPAN TCarlsonm d@gm ail.com diol 2004; 44;513-519. w ww .Co nge n ita lCa rd io log yTod a y.c om
  8. 8. SEPTEMBER 2007 8 CONGENITAL CARDIOLOGY TODAY H I G H L I G H T S FRO M T H E 4 3 R D A N N UA L M E E T I N G O F T H E J A PA N E S E S O C I E T Y O F P E D I A T R I C C A R D I O L O G Y A N D C A R D I A C SURGERY By Professor Toshio Nakanishi, MD and Virginia Dematatis, Congenital Cardiology The fact that this meeting is the 43rd Today, Staff Editor joint meeting of a society that includes over 2000 members (both pediatric car- diologists and cardiac surgeons) is of The 43rd Annual Meeting of the Japa- particular note, as it is only recently in nese Society of Pediatric Cardiology and the United States and other countries Cardiac Surgery (JSPCCS) was held at that joint meetings have begun to be the Keio Plaza Hotel in Shinjuku, Tokyo, held. The Japanese understood early Japan on July 3-7, 2007. The meeting on the advantages of having these two was attended by over 1400 pediatric car- groups meet together to discuss topics diologists, cardiac surgeons, pathologists, concerning congenital heart disease nurse-practitioners and others from and issues unique to the pediatric population. Left to right: Drs. John Cheatham, Toshio Japan, Canada, England, Scotland, Nakanishi, Prof. Hiromi Kurosawa, and Gil Brazil, Italy, Germany, Poland, the Wernovsky . Netherlands and the United States. The size, quality and scope of the meeting were very impressive. The majority of the meeting was in Japanese and in- cluded talks on a wide range of topics given by distinguished faculty from ma- jor cardiac centers in Japan including: The Heart Institute, Tokyo Women’s Medical University; National Cardiovas- cular Center, Osaka and Fukuoka Chil- dren’s Hospital, Fukuoka. “Long-term Problems in Complex Congenital Heart Disease,” “Management of Arrhythmia Left to right: Drs. Edward L. Bove, Robert H. Left to right: Drs. Hideshi Tomita and Toshio in Congenital Heart Disease,” and “20 Anderson, Prof. Hiromi Kurosawa and Nakanishi. Years After Fontan Operation” were Yasuharu Imai some of the topics discussed. The Eng- lish language sessions covered a broad diologists and surgeons, foreign faculty The meeting was planned by Prof. Hi- range of topics such as: “Long Term and guests gathered at both formal and romi Kurosawa, President of the Orga- Outcome of Hypoplastic Left Heart Syn- informal events where they were nizing Committee, Prof. Kazuaki Ishi- drome,” “What Every Ablationist Needs treated to traditional Japanese cui- hara, Secretary General and Prof. To- to Know about Cardiac Anatomy,” sine and enjoyed the opportunity to shio Nakanishi, Chief of the Department “Surgery without Heart Block,” “Medical get to know one another. One social of Pediatric Cardiology of the Tokyo Management of Dilated Cardiomyopa- highlight was the W elcoming Dinner, Women’s Medical University. These thy in Children,” “Hybrid Approach to which included both Japanese and gentlemen organized and hosted a Congenital Heart Disease,” “How to Set foreign faculty. It began with warm comprehensive and interesting pro- up a Hybrid Catheterization Laboratory greetings from Prof. Kurosawa and gram, as well as a variety of congenial in a Small Space,” “ASD Closure by Prof. Nakanishi and was followed by a social events. Japanese pediatric car- Catheter Intervention,” to name a few. number of toasts and brief speeches w ww .Co nge n ita lCa rd io log yTod a y.c om
  9. 9. CONGENITAL CARDIOLOGY TODAY 9 SEPTEMBER 2007 from some of the English-speaking fac- ulty, including: Drs. Edward L. Bove, Anton E. Becker, Robert H. Anderson, John Cheatham, Zahid Amin and John Attention Moore. One highlight of the dinner was Non-Invasive Pediatric Cardiologist the presentation of flowers from Michigan State University Pediatric Cardiology Masataka Nakayama, the grandson of Fellows This is an Assistant/Associate Professor Dr. Toshiko Nakayama, Executive Trus- position with a tenure or non-tenure track. tee of the Alumni Association, Tokyo Women’s Medical University, to Prof. Located in East Lansing, Michigan, this Kurosawa, who had successfully per- position offers a flexible and stimulating Just finishing your fellowship formed heart surgery on the young boy. balance between clinical practice, teach- and looking for a great job The room erupted into warm applause ing and research in an area that offers all opportunity? as Prof. Kurosawa accepted the flowers. of the amenities of a Big Ten University in a friendly and livable community. The 44th Annual Meeting (JSPCCS 2008) will be held on July 2-4, 2008 in The Division of Pediatric Cardiology of- We are looking for a non-invasive Koriyama City, Fukushima Prefecture, fers a wide-range of non-invasive cardiol- Pediatric Cardiologist (BC/BE) with Japan. Abstract submission is wel- ogy services throughout the mid- experience in Pediatric and Fetal come from all over the world. All in- Michigan region. This is a well-respected Echocardiography to join our quiries should be sent to the home- program featuring a preventive care fo- established Pediatric Cardiology pa g e of the JSPCCS (http:// cus. Private Practice Group. We have JSPCCS.umin.ac.jp/). offices located in the suburbs of The ideal candidate must be Board Certi- ~CCT~ fied/Eligible in pediatric cardiology and a major metropolitan area in the have an interest teaching. Expertise in Midwest. Corresponding Author echocardiography and fetal echocardi- ography is preferred. This opportunity This position offers the opportunity offers schedule flexibility and is ideal for to admit and manage your own Professor Toshio Nakanishi, MD those with an interest in academics. patients in a large Pediatric Chief, Department of Pediatric There are also excellent research oppor- Cardiology Center with participa- Cardiology Heart Institute tunities in conjunction with the clinical, tion in weekly Cardiovascular Tokyo Women's Medical University epidemiology and basic science depart- Conferences among Cardiac 8-I Kawada-cho, Shinjuku ments. Surgeons, Pediatric Interventionists Tokyo, Japan To apply or recommend a candidate, and Pediatric Cardiologists. TEL (81-3) 3353-8111 please contact: TAX (81-3)3356-0441 Kenyea Zimmermann, Attractive salary and benefits. pnakanis@hij.twmu.ac.jp Search Consultant Aegis Group Search Consultants, LLC 41451 W. 11 Mile Rd., Novi, MI 48375 Phone (248) 344-1450 If you are interested, please email FAX (248) 347-2231 your CV to: PC1@CCT.bz Virginia E. Dematatis, Staff Editor kzimmermann@aegis-group.com Congenital Cardiology Today MSU is strongly committed to achieving excellence through cultural diversity. The VDematatis@CCT.bz University actively encourages applications and nominations of women, minorities, veterans, and persons with disabilities w ww .Co nge n ita lCa rd io log yTod a y.c om
  10. 10. SEPTEMBER 2007 10 CONGENITAL CARDIOLOGY TODAY H I G H L I G H T S F R O M T H E 2 0 0 7 I N T E R N AT I O N A L S Y M P O S I U M O N T H E H Y B R I D A P P R OA C H TO C O N G E N I TA L H E A R T D I S E A S E (ISHAC) By John P. Cheatham, MD and Mark E. Galantowicz, MD The International Symposium on the Hybrid Approach to Congenital Heart Disease (ISHAC) held its second an- nual meeting on June 27 – 29, 2007 at the Hilton Easton Town Center in Columbus, Ohio. Two hundred fifty congenital heart surgeons, interven- tional cardiologists, nurse practitioners, and other healthcare professionals from 25 states and 17 countries on five con- tinents attended. Over one third of the attendees traveled over 2500 miles to attend ISHAC, while a post meeting survey indicated that 95% plan to return to another ISHAC meeting. ISHAC brings together many of the leaders in Hybrid therapy to discuss how collaboration between interven- tional cardiology and cardiothoracic surgery can enhance care to pediatric proach strives to improve clinical out- cussions of fetal cardiac therapy and and adult patients with complex con- comes by marrying transcatheter thera- new device designs and techniques. genital heart disease. The Hybrid ap- pies of the interventional cardiologist ISHAC concluded with a far-reaching with the operative advances of the car- view of the future. Nine live cases were diac surgeon, thereby reducing the performed from Columbus Children’s “The importance of a risks associated with each individual Hospital Hybrid Cardiac Catheterization global approach to approach. It may also be possible to Suites and the University Laboratory congenital heart disease reduce the accumulated risks over time Animal Resources, Experimental Surgi- for patients with complex congenital was highlighted with heart disease (CHD) by using Hybrid the announcement of therapies. the Fung/Wexner Forty invited speakers discussed how Endowment to foster to begin a hybrid program, outlined cur- international exchange rent perspectives and challenges with Hypoplastic Left Heart Syndrome, mus- in congenital heart cular VSD treatment, complex stent disease.” therapy, and non-surgical implantation of cardiac valves with highlighted dis- w ww .Co nge n ita lCa rd io log yTod a y.c om
  11. 11. CONGENITAL CARDIOLOGY TODAY 11 SEPTEMBER 2007 Rainbow Babies and Children’s Hospital / University Director of Cardiac Intensive Care Program Hospitals/Case Medical Center Florida - The Department of Pediatrics at the University of Flor- The Division of Pediatric Cardiology seeks interested faculty ida College of Medicine – Jacksonville is recruiting an academi- candidates for: cally oriented, full-time faculty member to develop and direct the Cardiac Intensive Care program. This position is in the Division Pediatric Electrophysiology – responsibilities would include of Pediatric Cardiology with a joint appointment in Pediatric Criti- directing and developing the Pediatric Electrophysiology Pro- cal Care Medicine (# 00024069). The successful candidate is gram at UHCMC / Rainbow Babies and Children’s Hospital. This expected to set up a unit dedicated to the care of children with person would be expected to foster and develop an invasive EP cardiovascular disease and to work in close collaboration with program in the northeast Ohio region. Clinical and academic the cardiothoracic surgeons, cardiologists and the pediatric in- collaboration with two busy affiliated adult EP divisions is avail- tensivists. This unit will initially be located within the current 20 able and encouraged. bed Pediatric Intensive Care Unit at Wolfson Children’s Hospi- tal. The successful candidate will have direct input in the design Non-invasive Cardiology / ECHO Lab Director – cardiologist of the Pediatric Cardiac Intensive Care Unit that will be located with imaging interest and expertise to help develop comprehen- in the new tower of Wolfson Children’s Hospital. The Pediatric sive imaging services to include fetal, MRI, TEE, 3-D, and re- Cardiovascular Center of the University of Florida in Jackson- gional telemedicine program. Would join three other full time ville is growing rapidly and currently has 7 full time pediatric non-invasive cardiologists in providing clinical services at Rain- cardiologists and 2 dedicated pediatric cardiac surgeons. We bow Babies and affiliated institutions. are performing approximately 200 surgeries annually and have Critical Care Cardiology / Director – responsibilities will in- recently started in ECMO program. This position requires a MD/ clude establishing, developing, and directing cardiovascular criti- DO degree, Florida medical license eligibility, BE/BC in Pediatric cal care services in collaboration with the Divisions of Cardiotho- Critical Care and/or Pediatric Cardiology with experience in racic Surgery / Cardiology and Pediatric Intensive Care. postoperative cardiac care. Appointment will be at the non- tenure accruing level of Assistant Professor/Associate Profes- The Pediatric Cardiovascular Program at UHCMC/ Rainbow’s sor/Professor. is provides full-service congenital cardiovascular care to the Northeast Ohio region, and currently consists of 6 full time cardi- Deadline for accepting applications will be January 1, 2008 an ologists, 2 cardiothoracic surgeons, 3 certified NPs, 2 full-time anticipated negotiable start date of February 1, 2008. Academic investigators and comprehensive subspecialty and fellowship rank will be commensurate with qualifications and experience. programs. We are academically affiliated with Case Western Salary is negotiable. Reserve University, and interest in clinical and/or basic research Interested applicants should forward letter of intent, curriculum is encouraged. Rainbow Babies and Children’s Hospital is con- vitae, and three letters of recommendation to: sistently ranked among the top children’s hospitals nationally. Mobeen H. Rathore, MD, Professor and Assistant Chairman, Interested applicants should forward cover letter and CV to: Chair Search Committee, Department of Pediatrics, University of Florida College of Medicine - Jacksonville, 653-1 West Eighth Ernest S. Siwik, MD Street, Jacksonville, FL 32209. Phone 904-244-3050 Interim Director, Pediatric Cardiology and/or fax 904-244-3028 RBC 380C – 11100 Euclid Avenue, Cleveland, OH 44106 and/or e-mail: Mobeen.Rathore@jax.ufl.edu ernest.siwik@uhhospitals.org “In Employment, as in education, UHCMC/CWRU are committed to The University of Florida is an Equal Opportunity Institution. Equal Opportunity and world class diversity. Applications from Visit our website at www.hscj.ufl.edu/peds. qualified women and minorities are encouraged.” Healing hearts. Training minds. Bringing hope. 5075 Arcadia Avenue Minneapolis, MN 55436 U.S.A. Toll Free: 888.928.6678; Phone: 952.928.4860; Fax: 952.928.4859 w w w .c hi ld ren sh ea rt l ink .o rg
  12. 12. SEPTEMBER 2007 12 CONGENITAL CARDIOLOGY TODAY OCTOBER WEBCAST FOCUS Innovations in Patent Ductus Arteriosus A free cme live webcast Offered on 3 dates: Oct 2, 9 and 11, 2007 www.5starmeded.org/pda/ To participate, you will need access to a com- puter with sound capability and Internet ac- cess. Registrants will be sent the Web site address so they can access the program online and download all course materials. Faculty: J.V. Aranda, MD, PhD, FRCPC, FAAP, Medical Director, Clinical Research Center, Children's Hospital of Michigan Detroit, MI; Lance A. Parton, MD, Division of Newborn Medicine, NICU, Maria Fareri Chil- dren's Hospital at Westchester Medical Center Valhalla, NY; and C. Michael Cotten, MD Assist.Clinical Professor of Pediatrics Neona- tal-Perinatal Medicine, Duke University Medi- cal Center, Durham, NC. In this live program, the expert faculty will review key epidemiologic and clinical issues involved with PDA; discuss the benefits and risks of surgical and medical therapies; com- pare drug therapies including indomethacin and intravenous ibuprofen; describe the role of prostaglandin inhibitors; and discuss pharma- cologic options and pharmacoeconomic issues. Learning Objectives: Upon completion of this activity, participants should be able to: Review key epidemiologic, pathophysiologic, and clinical issues involving PDA; Examine current practice in the preferred treat- various PDA treatment options; Evaluate clini- cal pharmacology, experience and considera- ment in these cases. For example, the tions involved with the pharmacologic options initial approach to a 5 kg patient with used in treating PDA; and Discuss the role of IV multiple mid-muscular VSD was identi- cyclooxygenase (COX) inhibitor therapy in PDA fied as surgery – complete repair (33%), surgery – PA Band (29%), transcatheter Accreditation and Certification: This activity has been planned and implemented in accor- device (7%), and perventricular device dance with the Essential Areas and policies of (29%) before the live cases demon- the ACCME through the joint sponsorship of strated the ease and advantages of a the Annenberg Center for Health Sciences at Hybrid perventricular approach in selected Eisenhower and Akita Biomedical Consulting. individuals. The Annenberg Center is accredited by the cal Suites (ULAR). Dr. Jeffrey Feinstein, ACCME to provide continuing medical educa- Drs. Dietmar Schranz (Giessen, Germany) tion for physicians. utilizing the audience response system, and Mark Galantowicz (Columbus, OH) documented significant differences in For information, please call 1-800-BRAUN2 (227-2862) w ww .b b rau nu sa. co m Working Together to Develop a Better Tomorrow w ww .Co nge n ita lCa rd io log yTod a y.c om
  13. 13. CONGENITAL CARDIOLOGY TODAY 13 SEPTEMBER 2007 PEDIATRIC CARDIOLOGIST WANTED The Division of Pediatric Cardiology of Sanger Clinic and Levine Children’s Hospital in Charlotte, NC is recruiting a board certified/eligible pediatric cardiologist to perma- nently service one of its busy satellites in Hickory, N.C. The successful candidate should have excellent interper- sonal skills to work well with families, primary care physi- cians, neonatologists and adult cardiologists in a busy out- patient setting. There are also two level three nurseries in Hickory providing in-patient consultations and interpreta- tion of echocardiograms. Hickory is less than one hour north of Charlotte so there is ample opportunity to practice one day per week in Charlotte with coverage in Hickory as needed. The position comes with a generous package of guaranteed salary of greater than $200,000 annually, incen- tive pay, vacation time and exceptional retirement benefits including pension once fully vested. The successful appli- cant will join a rapidly growing practice of seven pediatric cardiologists and two cardiothoracic surgeons. outlined their institutions’ experiences with HLHS to date. These results were discussed along with the traditional Norwood and The Sanger Clinic is the premier congenital heart center in Sano procedures and compared quite favorably. Many centers North Carolina performing over three hundred surgeries are beginning to implement new Hybrid management strategies and cardiac catheterizations per year. The practice is af- filiated with Carolinas Healthcare System, the fourth larg- and report their early results. The experiences from Dante Paz- est hospital authority in the country. The hospital author- zanese (Sao Paulo, Brazil) were outlined by Dr. Carlos Pedra ity is poised to open Levine Children’s Hospital in the fall along with those from Evelina Children’s Hospital (London, UK) by of 2007, an eighty-five million dollar state-of-the-art facil- Dr. Shakeel Qureshi and the Cardiovascular Institute & Fuwai ity. Interested applicants should fax or e-mail their CVs to Hospital (Beijing, China) by Dr. Shengshou Hu. Each presenter Dr. Stern. described an improved outcome at their respective institution with the initiation of Hybrid programs learned from the 1st ISHAC Sym- Herbert J. Stern MD, FACC posium and Workshop in 2006. Director, Division of Pediatric Cardiology Sanger Clinic and Levine Children’s Hospital A session on the Hybrid approach to complex muscular VSD was hstern@sa ng er-clinic.com highlighted with lectures from Dr. Mario Carminati (Milano) and Dr. Zahid Amin (Omaha). Dr. Ziyad Hijazi (Chicago), with the assis- fax # 704-543-0018 tance of Dr. Emile Bacha (Boston) and Dr. Dan Rowland Evolving Concepts in Management of Complex Congenital Heart Disease A CME Course sponsored by Rady Children's Hospital and University of California, San Diego Course Moderators: John Lamberti, MD; John Moore, MD; and Anthony Chang, MD Faculty consists of 20 of the finest lecturers in the field Attend the conference in San Diego, October 5-6, 2007 For a brochure: www.rcshd.org/cme or call Donna Salas at (858) 966-4072; (858) 966-8587 FAX CMA accredited - 13.75 AMA PRA Category TM 1 credits w ww .Co nge n ita lCa rd io log yTod a y.c om
  14. 14. SEPTEMBER 2007 14 CONGENITAL CARDIOLOGY TODAY Golisano Children’s Hospital at Strong Division of Pediatric Cardiology Golisano Children’s Hospital at Strong is the teaching hospital of the University of Rochester School of Medicine and Dentistry. As the area’s re- gional referral center for pediatric heart surgery, ad- ditional faculty are needed for our increasing referral population. Pediatric Cardiologist We are seeking a board certified/ board eligi- ble non-interventional pediatric cardiologist. Oppor- tunities are available for patient care in many areas including exercise testing, echocardiography, con- genital heart disease in adults, and preventive cardi- ology. An interest in clinical and/or basic research is encouraged. Staff Electrophysiologist We are seeking to recruit a pediatric cardi- ologist with fellowship training in cardiac electro- (Columbus), demonstrated a live case of perventricular closure of physiology. The candidate should have training and muscular VSD, while Drs. Amin, Hakan Akintuerk (Giessen), and experience in all aspects of clinical electrophysiology Qi-Ling Cao (Chicago) demonstrated a novel way to treat mem- including ablation, pacemakers, defibrillators, and branous VSD using a Hybrid approach. A comprehensive after- biventricular devices. The successful candidate will noon session on the Hybrid approach to HLHS included different establish an interventional pediatric E-P program. An techniques to control pulmonary blood flow, creation of an ade- interest in clinical and/or basic research is encour- quate- size ASD, and treatment of retrograde aortic arch obstruc- aged. tion were presented by 15 faculty members from South America, Europe, and North America. Live transmission of Hybrid Stage I Interested applicants should forward letter of palliation in a baby with HLHS was demonstrated by Drs. intent, curriculum vitae, and three references to: Cheatham, Galantowicz, and Sharon Hill, ACNP, with a lively Winston E. Gaum, MD discussion amongst attendees and other faculty members. Division Chief, Pediatric Cardiology On the 2nd day of the Symposium, the Hybrid approach to deliv- Golisano Children’s Hospital at Strong ery of stents in the aorta, pulmonary artery, and other unusual 601 Elmwood Avenue, Box 631 locations were discussed by Drs. Evan Zahn (Miami), Audrey Rochester, NY 14642 Marshall (Boston), Redmond Burke (Miami), Frank Ing www.5StarMedEd.org/pda w ww .Co nge n ita lCa rd io log yTod a y.c om
  15. 15. CONGENITAL CARDIOLOGY TODAY 15 SEPTEMBER 2007 (Houston), and Emile Bacha. Live case transmissions of these techniques were performed by the Miami team and Drs. Ralf Holzer and Alistair Phillips from Columbus. Drs. Philipp Bonhoeffer (London) and Ziyad Hijazi discussed possible Hybrid approaches for implantation of a valve stent in the pulmonary and aortic positions, with a highlight of Dr. Hijazi using a 33 French sheath to deliver the Edward’s valve stent perventricularly during a live case demonstration from ULAR. The 2nd day culminated with two very unique demonstrations: (1) the use of real time 3-D Echo guidance for closure of VSD by Dr. Nikolay Vasilyev (Boston), and (2) the use of “Histotripsy” High Intensity Focused Ultrasound to create an ASD by Drs. Achi Ludomirsky (St. Louis) and Zhen Xu (Ann Arbor). A discussion of present and future fetal therapy by Dr. Wayne Tworetzky (Boston) and advanced imaging for Hybrid therapies by Dr. Craig Fleishman (Orlando) followed Dr. Chris Caldarone’s stimulating update of transcatheter Fontan completion at Sick Children’s Hospital, Toronto. One of the many highlights of ISHAC was the keynote presenta- tions by pioneers in the field, Dr. Michael J. Tynan and Dr. Aldo R. Castañeda. Each addressed the question, “How do you safely perform procedures that have never been performed before?” Both speakers gave unique perspectives as to how they per- formed procedures for the 1st time, taking care to insure safety but to go “where no man before has gone”. The lectures were thought-provoking to all who attended and gave everyone aspira- tions of greatness. On the 3rd day, a unique offering of ISHAC is the optional Skills Workshop, which has become the trademark of ISHAC and distin- guishes it from all other meetings. Participants gain practical exposure to common Hybrid procedures through animal models developed by Workshop Directors, Drs. Ralf Holzer & Alistair Phil- lips, and Valerie Bergdall, DVM, along with her spectacular staff. The chosen animal models simulate human anatomy and facili- tate hands-on learning of perventricular closure of muscular VSDs, intraoperative stent placement into branch pulmonary ar- teries, and placement of pulmonary artery bands and/or flow restrictors followed by placement of a PDA stent (for Hybrid Stage I palliation of HLHS). Other Hybrid materials and “wet labs” were also available for all who attended. The Workshop is the true highlight of ISHAC; just ask the attendees and faculty! The importance of a global approach to congenital heart disease was highlighted with the announcement of the Fung/Wexner En- dowment to foster international exchange in congenital heart dis- ease. Mrs. Abigail Wexner, Chair of the Board of Trustees at Columbus Children’s Hospital, successfully completed the Lon- don Marathon. In recognition of this accomplishment, Mr. and Mrs. William Fung of Hong Kong donated the start-up funds that w ww .Co nge n ita lCa rd io log yTod a y.c om
  16. 16. CONGENITAL CARDIOLOGY TODAY 16 . CONGENITAL CARDIOLOGY TODAY © 2007 by Congenital Cardiology Today (ISSN 1554-7787-print; ISSN 1554-0499-online) Published monthly. All rights reserved were matched by Mr. and Mrs. Wexner. Toshiba Medical Systems (Platinum); Headquarters Specific projects supported by the endow- Cook, Inc. (Gold); Beijing Zenomed Scien- 9008 Copenhaver Dr. Ste. M Potomac, MD 20854 USA ment will be determined by Drs. John P. tific Corporation, Cordis, ev3, and Stryker Cheatham, Timothy Feltes, and Mark (Silver); Gore, Medtronic, and Edwards Publishing Management Tony Carlson, Founder & Editor Galantowicz, Co-Directors of The Heart (Bronze); BBraun Medical, Boston Scien- T C arls o n m d @gmail .c om Center. tific, Mobile Aspects, NuMED, pfm of Richard Koulbanis, Publisher & Editor-in-Chief Germany, Phillips, and Scientific Software R ic ha r d K@C CT . b z Tours of the Hybrid Cardiac Catheteriza- John W. Moore, MD, MPH, Medical Editor/ Systems (Contributing). tion and Operating Suites at Columbus Editorial Board Children’s Hospital were available to par- We look forward to seeing everyone at J Moor e@R C H SD . or g Jeffrey Green, Contributing Editor ticipants and extremely well received. ISHAC 2008, scheduled for June 16-18th Editorial Board These suites are equipped with technology in Columbus, Ohio. Dr. Edward L. Bove Teiji Akagi, MD that allows point-to-point connectivity and Dr. Terry D. King will be our Keynote Zohair Al Halees, MD Mazeni Alwi, MD within the campus using the Teleconfer- speakers. So, mark your calendars now! Felix Berger, MD ence Center and to any site inside or out- Fadi Bitar, MD ~CCT~ side the United States. A prototype 5 Axis Jacek Bialkowski, MD Flat Panel Detector C-arm (Toshiba CF-i/ Philipp Bonhoeffer, MD Mario Carminati, MD BP) was designed, tested, and installed in Anthony C. Chang, MD, MBA the Hybrid Catheterization Suites, allowing Corresponding Author John P. Cheatham, MD unparalleled patient accessibility to all Bharat Dalvi, MD, MBBS, DM Horacio Faella, MD members of the team. In addition, a proto- John P. Cheatham, MD Yun-Ching Fu, MD type Hybrid Cardiothoracic Operative Suite Director, Cardiac Catheterization & Felipe Heusser, MD was being built and design plans were Interventional Therapy Ziyad M. Hijazi, MD, MPH made available for participants to review. Columbus Children's Hospital Ralf Holzer, MD Marshall Jacobs, MD While ISHAC is an intellectually stimulat- Professor of Pediatrics and Internal R. Krishna Kumar, MD, DM, MBBS ing, professionally challenging forum to Medicine, Cardiology Gerald Ross Marx, MD Tarek S. Momenah, MBBS, DCH discuss the latest developments in con- The Ohio State University College of Toshio Nakanishi, MD, PhD genital heart disease, it is also a place to Medicine Carlos A. C. Pedra, MD relax and renew the fellowship of old The Heart Center, Columbus Daniel Penny, MD Children's Hospital James C. Perry, MD friends, while enjoying the opportunity to P. Syamasundar Rao, MD make new acquaintances. The Gala Din- 700 Children's Drive Shakeel A. Qureshi, MD ner was held at the historical Rotunda and Columbus, OH, 43205 USA Andrew Redington, MD Carlos E. Ruiz, MD, PhD Capitol Atrium of The Ohio Statehouse Girish S. Shirali, MD where President Abraham Lincoln made a CheathamJ@pediatrics.ohio-state.edu Horst Sievert, MD public address. The evening of fellowship Hideshi Tomita, MD Gil Wernovsky, MD was topped off with a performance by Dr. Zhuoming Xu, MD, PhD Philip Bonhoeffer, who was accompanied William C. L. Yip, MD Mark E. Galantowicz, MD by Casey Westfall of the Columbus Sym- Carlos Zabal, MD Co-Director and Chief, Cardiothoracic phony Orchestra, and The Children’s FREE Subscription Surgery Congenital Cardiology Today is available free to Choir of Columbus. qualified professionals worldwide in pediatric Associate Professor of Surgery and congenital cardiology. International editions ISHAC is an extremely resource-intensive Columbus Children's Hospital available in electronic PDF file only; North symposium that would not be possible The Ohio State University, College of American edition available in print. Send an without the generous support of corporate Medicine email to Subs @CC T.bz. Include your name, title, organization, address, phone and email. sponsors, our hospital administrative lead- The Heart Center, Columbus Contacts and Other Information ers, Board of Trustees, and Foundation. Children's Hospital For detailed information on author submission, Columbus Children’s Hospital would like to 700 Children's Drive sponsorships, editorial, production and sales gratefully acknowledge the major contribu- Columbus, OH, 43205 USA contact, current and back issues, see website: www.CongenitalCardiologyToday.com tions of AGA Medical Corporation & Would You Like to Receive Your Issue of CONGENITAL CARDIOLOGY TODAY on your computer in a PDF file? If Yes, then simply send an email to us at ONLINE@CCT.bz w ww .Co nge n ita lCa rd io log yTod a y.c om