Heart rhythm care for patients with CHD
Children and adults with CHD require specialized techniques to manage their unique heart rhythm abnormalities. Our electrophysiology team has led the way in developing novel strategies to diagnose, treat and manage these complex patients.
- Using machine learning and collaboration with biomedical engineering, our team has sought to discover subtle clues that can predict the onset of diastolic dysfunction and potentially prevent the development of sudden cardiac death or progressive cardiac disease.
- We were the primary international center that evaluated the subcutaneous implantable cardioverter defibrillator (SICD) in those with CHD. This novel device allows for the recognition and treatment of life-threatening arrhythmias without the need to enter the heart.
Cardiovascular genetics is a new and rapidly evolving field within pediatric cardiology. Our active research programs are focused on several projects, including genetic contribution to heart failure in dilated cardiomyopathy and hypoplastic left heart syndrome, the role of genetic diagnosis in heart transplant patients, and outcomes of multidisciplinary care in Turner syndrome. In addition, our program is investigating the role of disease-specific treatment of cardiac, vascular and lymphatic disease in RASopathy disorders.
Advanced cardiac imaging
The advanced cardiac imaging team, made up of cardiologists, radiologists and bioengineers, has been developing new techniques and novel frameworks for understanding acquired and congenital heart disease in innovative and clinically useful ways. We have made major advancements in understanding single ventricle heart disease and pulmonary hypertension:
- In single ventricle heart disease, our team has been able to use cardiac MRI to link ventricular dyssynchrony, aortic arch geometry and flow propagation through the body to important clinical outcomes. This provides important insights into how CMR could be used to help predict adverse outcomes.
- In children and adolescents with pulmonary hypertension, our team has used a combination of 2D, 3D and 4D imaging based on echocardiography and cardiac MRI platforms to validate new ways to measure the many facets of cardiac muscle function. Following these metrics over time helps us identify patients at risk for acute events before they happen.
- Pre-surgical planning of congenital heart disease using 3D echocardiography has advanced our understanding of heart valve repairs and complex surgical baffle repairs for complex congenital heart disease. We are the primary research site for the 3D consortium in the nation and a leading site within the industry to develop pediatric 2D and 3D ultrasound probes.
- 3D echocardiography-guided catheter interventions in congenital heart disease has reduced radiation use. Our team uses fusion imaging to reduce the amount of radiation exposure of our congenital heart disease patients and we are the leading research program in developing this advanced fusion imaging tool to better understand congenital heart disease and structural heart interventions.
Congenital heart disease research
Children’s Colorado is a national leader in CHD research and a member of Cardiac Networks United, a group of collaboratives aimed at improving the outcomes of patients with congenital and acquired heart disease. These collaboratives include:
- Pediatric Cardiac Critical Care Consortium (PC4)
- Pediatric Acute Care Cardiology Collaborative (PAC3)
- Cardiac Neurodevelopmental Outcomes Collaborative (CNOC)
- National Pediatric Cardiology Quality Improvement Collaborative (NPC-QIC)
- Advanced Cardiac Therapies Improving Outcomes Network (ACTION)
- PediPERForm Learning Network (PLN)
- HLHS Consortium
- Pediatric Heart Network
- STeroids to REduce Systemic inflammation After Neonatal Heart Surgery (STRESS trial) Study
Through our work in these multi-institutional collaboratives, we have helped improve the care of with CHD, not only at Children’s Colorado, but across the nation. Our work in these networks has allowed us to identify practice variation between centers and best practices for diagnosis, treatment and prevention of morbidity and mortality.
Through our participation in the Cardiac Networks United, we have successfully decreased our cardiac arrest rate, decreased postoperative chest tube duration, improved outcomes for our single ventricle population and improved outcomes for our patients with ventricular assist devices. We are currently participating in multicenter quality improvement initiatives to:
- Identify and improve health care equity and decrease disparities
- Decrease emergent transfers from the acute care unit to the cardiac intensive care unit
- Define best practice for treatment of chylothorax
- Implement programs in the early postoperative period to enhance long-term neurodevelopmental outcomes