The Heart Center Annual Report :: Nationwide Children's Hospital

The Heart Center 2014-2015 Annual Report

View the Nationwide Children's Hospital 2014-2015 Annual Report.

The Heart Center at Nationwide Children’s Hospital combines all clinical and research disciplines under one umbrella in order to meet our mission. We are out in front by discovering the causes of heart disease and developing the therapies of the future for our patients by focusing on them one at a time and providing state-of-the-art care that all patients deserve, regardless of age. We support Nationwide Children’s mission to provide our services in a safe environment.


National and International Reputation

Three years ago, The Heart Center began a quality improvement initiative to transform outcomes for a key chronic illness. The LAUNCH (Lifetime strAtegies and oUtcomes for siNgle ventricle and Complex Hearts) team was organized with a focus of improving care for hypoplastic left heart syndrome (HLHS) patients, with a particular goal of reducing hospital length of stay in the first year of life. Since 2012, the initiative has garnered significant improvements in clinical outcomes through a structured, proactive approach to reliable care and reducing variation. The initiative tracks several process measures, each of which has an associated key driver diagram, physician champion, control chart and multiple plan-do-study-act cycles. Ongoing process measures include parental rooming-in prior to discharge (93 percent), compliance with anticoagulation protocol following comprehensive stage 2 palliation (100 percent compliance since 2012) and compliance with newbornfeeding guidelines (64 percent compliance in 2014).

The initiative continues to expand. A dedicated singleventricle team was formed in 2014 with a goal of reducing variability in the inpatient and outpatient care for patients with single ventricle physiology (including HLHS). We also added several new process measures, including 1) standardized medical management during first procedure; 2) standardized pulmonary artery surveillance following second procedure; 3) standardized hypoxemia management protocol following second procedure; and 4) developed staged neurodevelopmental evaluation protocol.

The primary outcome (hospital length of stay in the first year of life) has improved from 50 percent in 2012 to 82 percent in 2014 for HLHS patients, with less than 60 total hospital days in the first year of life. The initiative’s overall impact reaches far beyond the HLHS patient population since many of the process measures include a much broader patient population.

Heart Center Collaborations

In 2014, we launched our congenital heart disease quality improvement collaboration with Dayton Children’s Hospital. Nine unique initiatives were defined in the Dayton Children’s Hospital – Nationwide Children’s Hospital Heart Service Alliance and measured at each location. We achieved success in all metrics, and in 2015, we defined a new set of QI projects.

This year, The Heart Center and the heart program at Rainbow Babies and Children’s Hospital in Cleveland formed the Congenital Heart Collaborative around the concept of “one program, two campuses.” The two programs enjoy an excellent working relationship and are building a premier congenital heart program centered on quality of care, education and research.

Adult Congenital Heart Disease Sub-Board

The Heart Center was founded on providing care to patients with congenital heart disease regardless of age, and we continue to lead the country in developing transitional care for this growing population. In 2012, the American Board of Internal Medicine and the American Board of Pediatrics approved board certification in adult congenital heart disease (ACHD). The first chair of this sub-board is Curt Daniels, MD. An ever-present voice in the advancement of this subspecialty, Dr. Daniels has worked tirelessly to develop testing metrics and has worked closely with the Accreditation Council for Graduate Medical Education to develop ACHD-subspecialty training. The first certifying ACHD examination will be in 2015.

National and International Recognition

  • Ranked #11 for Heart and Heart Surgery by U.S. News & World Report, 2014-15
  • OptumHealth Center of Excellence designation for CHD and Access Network for Pediatric Heart Transplant
  • CIGNA LifeSOURCE Transplant Network for Pediatric Heart Transplant
  • Aetna Institute of Excellence in Pediatric Congenital Heart Surgery
  • Created world’s first Hybrid Cardiac Catheterization Suites and first Hybrid Congenital Cardiac Operating Room in the nation
  • One of the first children’s hospitals in the nation to utilize 3-D Video Assisted Thorascopy

Quality, Safety, Service

Heart Center leadership conducts top-down review for programmatic improvement, and the center is involved in external quality review such as state and national initiatives related to surgical and catheterization/ intervention outcomes. Other involvement includes:

  • Society of Thoracic Surgeons (STS) Congenital Heart Surgery Database
  • Congenital Heart Surgeons’ Society data center
  • Joint Council on Congenital Heart Disease that is a sponsored collaborative for quality improvement through The Center for Health Care Quality
  • Adult Congenital Heart Association – Alliance for Adult Research in Congenital Cardiology collaborative sponsored by the National Institutes of Health (RO3HL096135) to assess education and access-to-care issues for adults with congenital heart disease
  • Ohio Doctors Interested in Congenital Hearts reporting of all Ohio pediatric cardiology centers’ data related to surgical and catheterization/ intervention outcomes
  • Pediatric Heart Transplant Study Group, Ohio Solid Organ Transplant Consortium
  • Interventional cardiology participation in the IMPACT (Improving Pediatric and Adult Congenital Treatment) registry , C3PO (Congenital Cardiac Catheterization Outcomes Project), one of eight participating centers and MAGIC registries, Congenital Cardiovascular Interventional Study Consortium)
  • American College of Cardiology, Adult Congenital and Pediatric Cardiology Section – noninvasive imaging, adult congenital heart disease, ambulatory cardiology quality metrics work groups
  • American College of Cardiology – Adult Congenital and Pediatric Cardiology Committee Council members • National Pediatric Cardiology – Quality Improvement Collaborative
  • Virtual pediatric ICU system National Cardiovascular Disease Registry – Internal Cardioverter Defibrillator

Education

Our ACGME fellowship program offers both a traditional Pediatric Cardiology Fellowship and a five-year Pediatric/Adult Cardiology Fellowship that is recognized by both the American Board of Internal Medicine and the American Board of Pediatrics. We have nine fellows, all of whom with more than 1.5 years of training are presenting at national/regional peer-reviewed meetings. We also offer advanced training in interventional catheterization and noninvasive imaging.

2014-2015 Grants Awarded

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Center for Cardiovascular Research

Basu, Madhumita
Epigenetic mechanisms underlying maternal diabetes associated cardiac malformations
American Heart Association
$46,000
 
Garg, Vidu
Molecular Mechanisms of Aortic Valve Formation
National Heart, Lung, and Blood Institute (NHLBI)
$373,750
 
Training in Congenital and Acquired Heart Disease
National Heart, Lung, and Blood Institute (NHLBI)
$204,210 
 
Hans, Chetan
Role of Notch1 Signaling in Abdominal Aortic Aneurysm
National Institutes of Health (NIH)
$359,890
 
Role of Notch1 Signaling in Abdominal Aortic Aneurysm - SDG
American Heart Association
$77,000
 
Lincoln, Joy
The Role of Sox9 in Calcific Aortic Valve Disease
National Institutes of Health (NIH)
$373,750
 
The role of Sox9 in calcific aortic valve disease
American Heart Association – National
$77,000
 
Nationwide Children's Hospital Undergraduate Summer Research Program
American Heart Association
$20,000
 
McBride, Kim
Exome sequencing and functional studies in familial CHD
National Heart, Lung, and Blood Institute (NHLBI)
$664,040
 
Genetic Registry for Pediatric Heart Disease: The CCVM Consortium
Children's Hospital Medical Center Cincinnati
March of Dimes
$10,000 
 
Thompson, Michael
Circulating MicroRNAs as a novel biomarker for non-alcoholic fatty liver disease
American Academy of Pediatrics
$3,000
 
Trask, Aaron
Differential Macro- and Micro-Vascular Remodeling in Type 2 Diabetes and Metabolic Syndrome
National Heart, Lung, and Blood Institute (NHLBI)
$129,060

The Heart Center

Berman, Darren
Nit-Occlud PDA Post-Approval Study
Industry Sponsor.
$119,250
 
Closure of Atrial Septal Defects with the AMPLATZER™ septal Occluder (ASO) Post Market Surveillance Study
St. Jude Medical, Cardiovascular Division, Inc.
$50,010
 
Off-label Use of the Melody Valve in the “Native” Right Ventricular Outflow Tract
The University of Utah
New England Research Center
$5,700
 
Cheatham, John
Transcatheter Pulmonary Valve Surveillance Study
Industry Sponsor
$18,642
 
Covered Cheatham Platinum Stent for Prevention or Treatment of Aortic Wall Injury Associated with Aortic Coarctation (COAST II)
Johns Hopkins University
Food and Drug Administration
$13,201 
 
Daniels, Curt
Medical Therapy for Pulmonary Hypertension
Ohio State University
Gilead Sciences, Inc.
$8,260
 
An Investigator Initiated Study of Biomarkers Ancillary to the Eisenmenger Quality Enhancement Research Initiative (QuERI)
Children's Hospital Boston
Industry Sponsor
$3,500
 
An Investigator Initiated Study of Biomarkers Ancillary to the Adult Congenital Heart Disease Quality Enhancement Research Initiative
Children's Hospital Boston
Industry Sponsor
$3,500
 
Hibino, Narutoshi
A New Generation of Tissue Engineered  Vascular Grafts Using 3D Printing Technology
Childrens Research Institute at Childrens National Medical Center
$15,000
 
Hor, Kan
Native RVOT Retrospective Imaging Study
Industry Sponsor
$26,860
 
Kertesz, Naomi
Hypertrophic Cardiomyopathy in children: Age Specific risk stratification for sudden death
Childrens Hospital of Philadelphia
Industry Sponsor
$2,000


Heart Center Faculty

Timothy F. Feltes, MD
Co-Director
Chief, Pediatric Cardiology

Mark E. Galantowicz, MD
Co-Director
Chief, Cardiothoracic Surgery

John P. Cheatham, MD
Co-Director
Director, Cardiac Catheterization and Interventional Therapy

View Our Faculty »

Selected Heart Center Publications

Duncan DR, Chen PY, Patterson JT, Lee YU, Hibino N, Cleary M, Naiti Y, Yi T, Gilliland R, Kurobe H, Church SN, Shinoka T, Fahmy TM, Simons M, Breuer CK. TGFβR1 inhibition blocks the formation of stenosis in tissue-engineered vascular grafts. Journal of the American College of Cardiology. 2015 Feb;65(5):512-4.


Feltes TF, Roth SJ, Almodovar MC, Andropoulos DB, Bohn DJ, Costello JM, Gajarski RJ, Mott AR, Koenig P. Task Force 5: pediatric cardiology fellowship training in critical care cardiology. Journal of the American College of Cardiology. 2015 Aug;66(6):712-22; and Circulation. 2015 Aug;132(6):e81-90.


Lawless CE, Olshansky B, Washington RL, Baggish AL, Daniels CJ, Lawrence SM, Sullivan RM, Kovacs RJ, Bove AA. Sports and exercise cardiology in the United States: cardiovascular specialists as members of the athlete healthcare team. Journal of the American College of Cardiology. 2014 Apr;63(15):1461-72.


Raman SV, Hor KN, Mazur W, Halnon NJ, Kissel JT, He X, Tran T, Smart S, McCarthy B, Taylor MD, Jefferies JL, Rafael-Fortney JA, Lowe J, Roble SL, Cripe LH. Eplerenone for early cardiomyopathy in Duchenne muscular dystrophy: a randomized, double-blind, placebo-controlled trial. The Lancet. Neurology. 2014 Feb;14(2):153-61.


Tremoulet AH, Jain S, Jaggi P, Jimenez-Fernandez S, Pancheri JM, Sun X, Kanegaye JT, Kovalchin JP, Printz BE, Ramilo O, Burns JC. Infliximab for intensification of primary therapy for Kawasaki disease: a phase 3 randomised, double-blind, placebo-controlled trial. Lancet. 2014 May;383(9930):1731-8.


Webb G, Landzberg MJ, Daniels CJ. Specialized adult congenital heart care saves lives. Circulation. 2014 May;129(18):1795-6.

View Team Publications »

Center for Cardiovascular Research

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