Pediheart: Pediatric Cardiology Today

This week we review a recent Fetal Heart Society study on ventriculocoronary connections in the HLHS patient. How common are these encountered? How different are outcomes when these are seen in the HLHS (MS/AA) patient? How easy are they to see in fetal life? What is the proposed mechanism for effect on outcomes in the HLHS patient? What are some tricks for better identification of these important connections in fetal life? Dr. David Barris and Dr. Jennifer Cohen, both of Mount Sinai, are the first and senior authors, respectively, of this work and join us to discuss an important observation and the ramifications of their presence in this already fragile patient group.doi: 10.1161/CIRCULATIONAHA.126.080144

This week we review a recent cardiac pathology/surgical paper on the pathological outcomes of a novel expanded PTFE pulmonary valved conduit (GORE PV1) that is entirely non-biological in nature. Thrombus formation was a serious problem encountered in many patients with this prosthesis. What explains this? What might explain the excellent performance of the valve in comparison to other more common biological valves? What is the present clinical status of this device? How far are we to the development of a better RV to PA valved conduit with excellent longevity and functionality without calcification? Professor Stephen Sanders of Harvard University and Boston Children's Hospital shares his insights into the pathology of those conduits that have been explanted. DOI: 10.1016/j.jtcvs.2026.03.608

This week we review a recent work on the topic of female pediatric cardiology division chiefs and leaders and discuss why there is inadequate female representation in our field. What is the difference between mentorship and sponsorship? How can better representation in leadership roles improve divisions and care for children with CHD? We speak with Dr. Dana Gal of USC/Children's Hospital of LA about her work. Following our conversation with Dr. Gal, we sit down for a panel discussion about the challenges of navigating being a mom and being a pediatric cardiologist and speak with women at different stages of their careers as moms and cardiologists including Dr. Bharti Sharma of Mount Sinai, Dr. Gal of USC, Dr. Elizabeth DeWitt of Harvard University, Dr. Nicole Sutton of The Albert Einstein College of Medicine and Dr. Daphne Hsu, also of The Albert Einstein College of Medicine. Topics discussed include balancing motherhood with busy careers. How does motherhood enhance these leaders' professional lives? How do they prioritize the important personal and professional responsibilities they have? How can we be more supportive of one another? A lot of wisdom is shared in an important and vital conversation this week. https://doi.org/10.1016/j.jacadv.2025.101805

In this week's episode from 3 years ago we review a Dutch study on 50 year follow-up of patients who had ASD repaired at an average age of 7.5 years. How do these patients compare to their middle aged counterparts who did not have congenital heart surgery? Why might the RA or RV be enlarged in these patients, decades after successful ASD closure? How common are arrhythmias seen in this cohort? How common is pulmonary hypertension seen? These are amongst the questions reviewed this week with the work's first author, Dr. Robert Martijn Kauling.DOI: 10.1016/j.ijcard.2023.131616

This week we review a recent report from the team at UTSW comparing early outcomes following biventricular repair vs. Fontan palliation for complex congenital heart disease with borderline ventricles or complex cardiac anatomy that may, in the past, have been immediate triggers for single ventricle palliation. Who is a good candidate for this sort of two ventricle approach and what anatomical types could be viewed as 'low lying fruit' for two ventricle palliation? How do early outcomes compare between these two very different approaches? Are we choosing Fontan approaches more commonly because of a perception of greater predictability? Is this true or accurate? Dr. Nicholas Andersen and Dr. Abhay Divekar of UTSW share their deep insights into this fascinating study and approach. https://doi.org/10.1016/j.athoracsur.2026.07.021

This week we delve into the world of fetal cardiology to review a recent work on mild aortic stenosis in fetal life. This is a rare finding and the outcomes of this varied. How commonly does this finding result in severe or critical aortic stenosis? Is there a risk for hypoplastic left heart syndrome? Are there findings that would auger and better or worse outcome for this observation? How should patient families be counseled when encountering this finding on a fetal scan? Associate Professor of Pediatrics at Stanford University, Dr. Michelle Kaplinski shares her deep insights this week. DOI: 10.1016/j.echo.2025.08.031

This week we explore a recent PHIS database study assessing clinical outcomes for transcatheter balloon dilation of the aortic valve in the setting of aortic valve stenosis in early life. Why do critical AS patients fare less well than those with severe AS? Is this an issue of procedural failure or patient characteristics? Is there adequate equipoise for a study comparing surgery to balloon dilation? Is such a study even feasible given the present day levels of surgical experience with neonatal aortic valve surgery? These are amongst the questions posed to Associate Professor of Pediatrics at Vandarbilt University, Dr. George Nicholson who is the senior author of this week's work. DOI: 10.1007/s00246-026-04196-1

This week we replay an episode from 2022 i which we reviewed a then recent report on the differences between pulse oximeter Sp02 and arterial Sa02. Are there patient specific factors that may result in inaccuracies of measurement? What single ventricular factors may also result in more significant inaccuracies and how should these data be used at the bedside when assessing a child who is cyanosed? We speak with Dr. Cara Pritchett, critical care fellow at Lurie Children's Hospital - Northwestern University about a recent work she co-authored on this important and practical topic.DOI: https://doi.org/10.1016/j.jscai.2022.100394

This week we note and mourn the passing of pediatric cardiologist and thought leader Dr. Steven Lipshultz who passed on September 4, 2026. Dr. Lipshultz was one of the most significant cardiologists of the past half century and his contributions to the fields of pediatric cardiomyopathy, HIV cardiomyopathy and cardio-oncology were gigantic and meaningful. This week we turn back the clock and review a landmark work of Dr. Lipshultz from the Pediatric Cardiomyopathy Registry that was published in 2003 in the NEJM and we speak with 3 pediatric cardiomyopathy experts as well as friends and colleagues of Dr. Lipshultz - namely Dr. Neha Bansal of NYU, Dr. Daphne Hsu of the Albert Einstein College of Medicine and Dr. Joseph Rossano of the Children's Hospital of Philadelphia. Each shares their remembrances of this work and provide insights into the legacy of Dr. Lipshultz. doi: 10.1056/NEJMoa021715.

This week we review a recent work assessing the impact of birth day of the week on neurological outcomes amongst newborns undergoing CHD surgery. Why might certain days of the week be associated with higher degrees of white matter injury in the brain of newborns who have had congenital heart surgery? What are the potential mechanisms for this? What might be the unintended consequences of ‘controlling’ birth day of the week? We speak with the Associate Division Chief for Research within the Division of Cardiac Anesthesiology at Children's Hospital of Philadelphia and author of this week’s work, Dr. Jennifer Lynch.  DOI: 10.1016/j.xjon.2026.101700