WINTER 2017

Inside this IssueConnecticut Children’s Heart Program Still Growing....................................2

Jameson’s Journey ...........................................3

Special Thanks to Our Cardiovascular Care Center Donors..........................................4

The Vincent J. Dowling Family Cardiovascular Care Center ...................5

Inpatient Program at Connecticut Children’s a Team Effort ..............................6

Improving Patient Care at the Bedside and Beyond ......................................7

Giving Our Region’s Children the Best Care Possible ...........................................8

Connecticut Children’s Offers Satellite Cardiology Services .................8

Technology & Research at Connecticut Children’s .......................Insert • New Technique Uses Zero Radiation • Researching Customized Valves

Welcome to The Heart BeatWelcome to the The Heart Beat, a publication of Connecticut Children’s Medical Center Foundation, prepared especially for friends and patient families of the hospital’s Heart Program. Read on to learn more about the many programs, services and research that benefit Connecticut Children’s heart patients.

Jameson’s Journey See Story Page 3. . .

From Connecticut Children’s Heart Program

Connecticut Children’s Heart Program. . .

Cardiovascular Care for All Ages

THE HEART BEAT

The Vincent J. Dowling Family Cardiovascular Care Center at Connecticut Children’s, located on the second floor of the Medical Center. Learn more about the new Center on Page 5 of this issue.

Alicia Wang, MD, Director of Fetal Imaging, reviews an echocardiogram with Abraham Khorasani, MD, a pediatric resident.

Continued on page 4.

On a recent Monday at the Vincent J. Dowling Family Cardiovascular Care Center at Connecticut Children’s, Alicia Wang, MD, sat in a darkened room surrounded by a half-dozen glowing computer monitors, intently watching a video of a baby’s beating heart with its faulty valve.

The video was, in fact, an echocardiogram, and the remarkable thing about it was that the baby in question was still inside her mother’s womb. Even though the heart was the size of a walnut and the baby was inside the mother, Dr. Wang, who is Director of Fetal Imaging at Connecticut Children’s, was able to interpret the pulsing image and see exactly what was wrong.

2.

Twenty Years and Counting…

Connecticut Children’s Heart Program Still Growing

By Guest Columnist Felice Heller, MD – Pediatric Cardiologist and Founding Member, Connecticut Adult Congenital Heart Program

Pediatric Cardiology at Connecticut Children’s Medical Center has undergone tremendous growth and transformation over the last 20 years.

When the hospital first opened its doors in 1996, we were a private practice group of four pediatric cardiologists and one nurse, renting office space on the second floor of the hospital. Each doctor performed his own echocardiograms and catheterizations, personally cared for his own patients in the ICU after surgery, and followed them as outpatients throughout childhood, developing lasting relationships.

As our practice got busier and demand grew for more specialized expertise, we added many new faces and developed distinct areas of sub-specialization. Today, our practice consists of 11 doctors, two nurse practitioners, five nurses, six sonographers, a congenital cardiovascular surgeon and a surgical physician assistant, and we are still growing! We merged with the hospital in 2010 and are now fully integrated within Connecticut Children’s.

Subspecialists Bring New Expertise We now have doctors who sub-specialize in rhythm disorders, cardiac catheterization, echocardiography, cardiac magnetic resonance imaging (MRI), fetal cardiology, adult congenital heart disease and inpatient/post-op management. These specialists brought new expertise and technology to Connecticut Children’s.

Our cardiologists are able to close holes in the heart and open blocked blood vessels and valves through a very small catheter, avoiding the need for open-heart surgery. We can place pacemakers and internal defibrillators and implant tiny rhythm monitoring devices in at-risk patients. Some rhythm abnormalities can be cured by delivering a tiny radiofrequency current to the heart muscle. We can also produce spectacular 3-D images of complex anatomy using echocardiograms and MRI.

Fetal Cardiology and Adult Care, Too! We have developed a very successful fetal cardiology program, where accurate prenatal diagnosis of the most complex heart disease has led to better newborn care and improved patient outcomes. When necessary, even the tiniest babies and those with the most severe cardiac defects can undergo corrective heart surgery.

At the other end of the age spectrum, we have a special program for adults with congenital heart disease, including two cardiologists—Dr. Shailendra Upadhyay and myself—who were among the first in the country to become board certified in this emerging field.

New Research, New Techniques Several members of our Division are also actively engaged in research. One important project uses cardiac MRI for early detection of heart muscle damage during chemotherapy.

Another project is trying to identify markers of susceptibility to infection in newborns with congenital heart disease.

As you will read in this issue, other members of our Division have developed techniques to minimize or eliminate radiation exposure during catheterization procedures. Our inpatient team created standardized care pathways for post-op management in the ICU. Others developed standardized outpatient management of our high-risk babies with single ventricles.

All of these initiatives have improved quality and safety of care. We continually aim to develop best practices throughout our work, while passing on our expertise to the next generation of medical professionals from the University of Connecticut School of Medicine.

We are very fortunate to be able to do all of this work in our newly renovated, state-of-the-art, Vincent J. Dowling Family Cardiovascular Care Center. Learn more about our new Center on page 5 of this issue.

Committed to High-Quality Patient Care Looking back over the past two decades, it is remarkable to see how our Heart Program at Connecticut Children’s has evolved. We have grown from four general pediatric cardiologists to a large group of highly trained sub-specialists using cutting-edge technology, with a developing focus on research and training. What hasn’t changed is our unwavering commitment to high-quality, patient-centered care, and the supportive relationships we develop with our patients and their families.

Felice Heller, MD, of the Connecticut Adult Congenital Heart Program, with patient Tim Carmon, one of 1,800 adult cardiology patients seen at Connecticut Children’s.

3.

Jameson’s Journey . . .

Cardiology Care at Connecticut Children’s Began Before BirthAll Meagan Graham knew was that she was 24 weeks pregnant and there was something wrong with her unborn son’s heart.

Her obstetrician referred her to Alicia Wang, MD, Director of Fetal Imaging at Connecticut Children’s Medical Center, and Dr. Wang began conducting echocardiograms to determine the nature of the problem and start planning treatment.

“Since I was still pregnant, the doctors could not give us much information,” Meagan recalled. “We went through the pregnancy not knowing if it was major heart issues or minor ones, whether he would live for six minutes or six years.”

1 in 20,000 Once her son, Jameson, was born, the full diagnosis was possible: He had Ebstein’s Anomaly with pulmonary atresia, a congenital defect in which the tricuspid valve—the valve between the two right heart chambers (the right atrium and right ventricle)—doesn’t work properly, and the blood cannot effectively get to the lungs. The valve is lower than normal in the right ventricle, and its leaflets are misshapen and underdeveloped, so they don’t close fully and blood can leak back through the valve. This anomaly occurs in 1 out of 20,000 births.

Dr. Wang explained that Jameson would need three surgeries to stabilize him: one at six days, a second between three and six months and the third at 2 years of age.

“He needed multiple surgeries because his body was developing,” Dr. Wang said. “When you’re first born, the pressure in the lungs is very high initially, but then changes as the body gets used to breathing air over the first couple of months of life. The proportions of the child also change a lot. At first you have a large head compared to the body and then as you grow, that reverses, and your body gets much bigger. So, the surgeries have to adjust for those kinds of things.”

One Day at a Time “We just had to take it one day at a time, Meagan recalled. “I would get very anxious right before a visit and have a knot in my stomach,

because you really never know what’s going to happen. But then we would get cleared for another six months, and I would kind of exhale and thank God that we could have some sort of normalcy.”

One of the things Dr. Wang stressed to Meagan was to let Jameson figure out his own limitations, if any. “We made sure to tell him that just because he has a heart condition he is not any different, just more special, because he has so many people working to make him better,” Meagan said.

Ongoing Care While Jameson shouldn’t require any further surgeries, Dr. Wang said he will need ongoing care, including cardiac catheterizations, for the rest of his life.

Jameson now comes to the Vincent J. Dowling Family Cardiovascular Care Center every six months for routine checkups that include an echocardiogram and an EKG—visits that the whole family looks forward to.

“The staff at Connecticut Children’s are beyond words, especially Dr. Wang, Dr. Frederic Bernstein, who is Director of Interventional Cardiology, and the nurses,” Meagan said. “There are truly no words to describe it. We have been going there so long it doesn’t feel like a doctor’s visit; it’s like visiting friends you haven’t seen in a long time. I personally get really excited to tell them all of Jameson’s milestones because they make it feel like it’s not only a victory for us, but also a victory for them.

“They truly are focused on family-centered care, and it really helps in these situations,” Meagan added. “Every time we had an emergency, both of the doctors personally responded and have talked me off the cliff in very tense situations. These are the best doctors because they treat Jameson like he is their own child. You can see it in how well he is doing today.”

Today, Jameson is a typical 7 year old who loves cars and wants to be a paramedic who chases tornadoes when he grows up. “He is so sweet and caring,” said Meagan, “and I believe that a lot of his sweet disposition is due to what he has been through.”

Alicia Wang, MD, a cardiologist and Director of Fetal Imaging, with patient Jameson Graham, whom she has followed since before birth.

Cardiovascular Care for All Ages, continued from page 1.Being equipped with this knowledge beforehand is critical. It means the cardiac team will be standing by when the baby is born with a treatment plan in place and specialists with specialized equipment ready to take action. The treatment plan might include surgery, catheterization, or other interventions.

“About 0.8 percent of all babies are born with structural heart problems, and 22 percent of those require intervention for survival,” Dr. Wang said. “There are other kinds of issues that are not structural, like rhythm issues and infections, which we also treat here.”

Care for Children and Adults The echocardiogram that Dr. Wang was reading that day is one of many advances in medical techniques and technology that have dramatically improved the outcome for babies born with structural heart defects, such as underdeveloped valves or missing chambers. As recently as the 1950s, there were no options for these children and many did not survive. But today, more than 90 percent can be successfully treated and go on to live full lives.

That success story sets up an unusual scenario, however. As these patients grow to adulthood, they develop late complications of their childhood surgeries that are unfamiliar to most adult cardiologists, often compounded by acquired heart disease—either the product of poor decisions about diet, lifestyle, and exercise, or the result of the natural process of aging that affects everyone. If these former pediatric patients go to a cardiologist who specializes in adult conditions, they may find the cardiologist is not familiar with how to care for their unusual cardiac conditions from childhood.

“These patients present to an adult cardiologist with hearts that are backwards or hooked up the wrong way,” said Felice Heller, MD, of the Connecticut Adult Congenital Heart Disease Service at the Dowling Center. “And these cardiologists have never seen

this before; it’s just not on their radar. So, if you are 25 now and have a congenital heart problem, you may think you’re too old to come to the children’s hospital, but when you go the adult hospital, they don’t know about the abnormality, let alone what the late complications are. There’s a whole generation of adults who have grown up with congenital defects, and only pediatric cardiologists know how to treat them,” she said.

An Emerging Field Because the survival of children with complex congenital defects only began in the 1950s and ’60s, caring for these patients as adults is an emerging field.

The American Board of Medical Specialties only recently identified adult congenital heart disease as a distinct subspecialty: The first board exam in this field was offered in October 2015. In the entire country there are now only 197 board-certified adult congenital heart specialists. Connecticut has three of those, and two of them are here at Connecticut Children’s Medical Center: Dr. Heller and Shailendra Upadhyay, MD, who is Director of the Adult Congenital Heart and Arrythmia Service. As a result, the Cardiology division now sees patients with congenital heart defects of all ages, from the fetus to senior citizens in their 70s.

“There are now more adults living with congenital heart disease than there are pediatric patients with congenital heart disease,” Dr. Heller said, “and there are more every year. The estimates are 20,000 to 40,000 pediatric patients every year graduating to adulthood. And we’re learning new things every year as these patients age. I saw a patient recently who was one of the earliest recipients of what’s called the arterial-switch procedure, and I told her, ‘You’re the pioneer. There are many patients coming after you who are going to benefit from what we’re learning about your condition.’”

4.

$1,000,000 The Vincent J. Dowling Family

Foundation, Inc.

$250,000 to $500,000 The Diebold Foundation, Inc.

Robert W. McGowan University of Connecticut

HuskyTHON

$100,000 to $249,999 The Cantor Family

Connecticut Children’s Medical Center Friends

The Dulitsky Family

The Esposito and Hughes Family

LEGO Systems, Inc.

Virtus Investment Partners, Inc.

$50,000 to $99,999C.M. Smith Agency, Inc.

Connecticut Business Systems

Ferrari Club of America/New England Region and Concorso

Ferrari and Friends

Landmark Partners

Mr. Dale Lin

National Guard Association of Connecticut, Inc.

$25,000 to $49,999Gabrielle Dinsmore Heart & Hope Fund

Mr. and Mrs. T. Donald Hirschfeld

The Johnson Family Foundation

Mr. and Mrs. Robert M. Le Blanc

Rosemary C. and Peter G. Lombardo

Mrs. Jeannine M. Steucek

$5,000 to $24,999Jill and Cecil Adams

All Waste Charitable Foundation

Mark Bertolini

Client Business Services

Mr. and Mrs. R. Cornelius Danaher, Jr.

Mr. and Mrs. James H. Eacott, III

R&J Eacott Foundation Trust

Richard J. Fasenmyer

Mr. and Mrs. Andrew D. Filler

First Church of Bethlehem

Gabriella’s Scoop Night

Mr. and Mrs. Jeffrey S. Gandel

Dr. M. Katherine Gavin and Mr. Martin J. Gavin

General Electric Company

Golf Fore Your Heart Tournament

H.W.M. Good Friday Open

Mr. Michael E. Haylon and Ms. Carol Dupuis

Dr. and Mrs. Donald W. Hight

Legrand

Mr. and Mrs. Matthew D. Lilly

Mr. John F. Lundgren and Ms. Tamara A. Lundgren

William and Alice Mortensen Foundation

Pediatric Cardiology Associates, LLC

Nicholas V. Perricone, M.D.

George Plocharski Memorial Golf Tournament

Atty. Robert S. Poliner

Dr. and Mrs. William C. Popik

Mr. and Mrs. Eric B. Reed

Robinson + Cole

Linda and David Roth

Anne and Bob Sargent

Mr. and Mrs. Robert J. Shanfield

Mr. and Mrs. Charles W. Shivery

Mr. and Mrs. Mark St. Pierre

John and Lisa Sundean

UNICO of Avon

William A. and Shirley P. Yolles Support Foundation

Special Thanks to Our Cardiovascular Care Center Donors

5.

Redesigned Space a Perfect Fit . . .

The Vincent J. Dowling Family Cardiovascular Care Center

Every hour of every day, children’s lives are being transformed—and saved—at the Vincent J. Dowling Family Cardiovascular Care Center because now world-class doctors, nurses, and technicians have a world-class facility supporting them.

When the Dowling Center opened in August 2015, it doubled the number of Echocardiogram Labs and the number of Patient Exam Rooms previously available for the care of patients. The Dowling Center also includes a host of other essential features. The new space is organized into four pods, each containing two patient exam rooms and an echo lab for conducting echocardiograms, with easy access to one of three patient vital-parameters assessment rooms.

In addition, the new Center features a redesigned and welcoming waiting room, care team consultation rooms, a family consultation room, a Stress Lab for evaluating children’s heart behaviors during exercise, and an Echo Reading Room with every conceivable technological tool, where doctors can evaluate a patient’s imaging in detail.

Each of the four purpose-designed pods has a theme, with

Here in one of the Hands & Hearts exam rooms at the Vincent J. Dowling Family Cardiovascular Care Center, Lisa Cousineau watches as sonographer Hadley Santos and student Jackie Reis conduct an echocardiogram on Lisa’s daughter Jolise.

large colorful photographs on the walls: Hands & Hearts, Baby Animals, Marine Life, and, for adult congenital heart patients and families reviewing echocardiograms and other diagnostics, a contemplative Zen motif. Not only does the design provide a better experience for the children, but it also provides greater efficiency for the care providers. With all essential services only a few steps away, each patient coming to the Center now can get all the services he or she needs during a single visit.

All of the work, design, and effort that went into creating the new Center has one overriding purpose: to give even better care to even more children and adults with congenital heart disease. And that has been happening every day since the new Center opened. From October 2015 to September 2016, the Center logged nearly 9,000 patient care visits and performed more than 70 cardiovascular surgeries, 5,000 echocardiograms, 150 MRI studies, 40 electrophysiology procedures and 60 catheterizations.

For more information about Connecticut Children’s Heart Program, including Cardiology and Cardiac Surgery services, please visit www.connnecticutchildrens.org.

6.

Managing All Aspects of Patient Care . . .

Inpatient Program at Connecticut Children’s a Team Effort When you meet Alex Golden, MD, the new cardiologist and Director of the Inpatient Program at Connecticut Children’s Medical Center, your first thought may be, “Here’s a man with a lot of focus.” He is also enormously gentle.

Both are apparent as he examines an infant with intense concentration, resting one hand soothingly on the child’s head while palpating her liver with the other.

“This hands-on approach is very important in my line of work,” said Dr. Golden, who comes to Connecticut Children’s from the Cleveland Clinic, where he served as a pediatric cardiologist for seven years and was Director of the Cardiac Catheterization Program at Rainbow Babies and Children’s Hospital prior to that.

“The key,” he explained to a group of residents and students, “is to apply slight pressure, then release, then a little more pressure and release, until you arrive deep enough to feel the organ. This lets the baby get used to it gradually, and it doesn’t disturb the patient.”

As Director of the Inpatient Program at Connecticut Children’s, Dr. Golden’s job is to manage and coordinate the large team that cares for each cardiology patient before and after surgery—and that includes every aspect of a patient’s care, not just those directly related to their hearts.

It’s coordinated care that requires teamwork between cardiologists, nurses, surgeons, intensivists, anesthesiologists, and many other services throughout the hospital.

Surgical Team Another central part of the Inpatient Program is the surgical team, headed by Mohsen Karimi, MD, the Interim Chief of

Pediatric Cardiac Surgery at Northeast Pediatric Specialists, Inc., a partnership between Connecticut Children’s and Yale New Haven Children’s Hospital.

Dr. Karimi’s special interest is blood-conservation surgery, a technique that minimizes transfusions for patients during heart surgery and produces better outcomes, shorter recovery times, and fewer complications. This technique requires a very finely tuned coordination between the surgeon, profusion technician, and anesthesiologists, in particular.

“We have a team that is really committed to this practice,” Dr. Karimi said.

A Coordinated Approach “Everything has to be coordinated,” Dr. Karimi said. “The inpatient cardiologist comes in at the end of the surgery and partners with us to see what anesthesia has done, what surgery has done, what the echocardiogram has shown before and after the repair, and the decision about what kind of medication the patient should be on. The handoff is extremely important, when the patient goes from the operating room to the ICU and is cared for by the intensivists and nurses.”

With a system that has so many moving parts — and so much at stake — teamwork is critical to a happy outcome.

Alex Golden, MD, Director of the Inpatient Program at Connecticut Children’s, with a patient.

Cardiac surgeon Mohsen Karimi, MD, assisted by Jill Sullivan, PA, closes a defect in the heart of a pediatric patient.

7.

Continuous Improvement Program...

Improving Patient Care at the Bedside and Beyond

Up on the seventh floor of Connecticut Children’s Medical Center, a group of eight people were gathered around the bed of a two-week-old boy who was due for heart surgery.

The group included nurses, interns, medical students, and technicians, along with Alex Golden, MD, who was leading them through rounds—the process in which all team members involved in the child’s care meet to review his condition, progress and treatment plan.

In addition to serving as Director of the Inpatient Cardiology Program, Dr. Golden is Associate Director of Continuous Improvement for Connecticut Children’s, and this version of rounds was an example of how that program works.

Rounding at the Bedside “We used to do rounds at a conference table,” Dr. Golden said, “but we were looking for ways to improve this and there is ample data to support that this is better done at the patient’s bedside, where we can include the family.”

In this case, the team was discussing the boy’s weight gain. He had a hole in the wall separating his ventricles, congestive heart failure, and an arrhythmia, so he needed surgery, but he needed to reach 11 pounds before he would be strong enough to handle it.

It was a balancing act waiting for him to gain weight but not waiting so long that his condition worsened. As the various team members reported on the boy’s condition, it became clear the weight gain was too slow. This suggested that they might have to

go to a feeding tube, a choice they had hoped to avoid because it would be hard on the family. In the end, the team decided to wait just a little longer and continue the hand feeding.

When they finished, Dr. Golden talked to the team about the bedside approach: “It gives more depth to the understanding than just looking at a monitor and watching the numbers change,” he said.

Find and Eliminate Waste The goal of the Continuous Improvement Program is to find and eliminate waste anywhere it is found. “That could be motion waste, time waste, or work waste,” Dr. Golden explained. He is an avid student of the Toyota Production System, which is considered the premiere model for how to improve any operation. Part of that system is making sure employees are involved in the process.

At Connecticut Children’s, every patient floor of the Medical Center has a bulletin board where staff post opportunities for improvements, and there are charts prioritizing the ideas for action and columns marking where each idea is in the implementation process. What’s most impressive is that the staff energetically participate in this system. Most businesses have empty suggestion boxes; here, every board is crammed with cards noting ideas that range from new signage to improved medication systems.

“Patient-centered care is what we’re focused on,” Dr. Golden said, “but the way to get there is by focusing on staff satisfaction.”

Alex Golden, MD (at left) leads rounds as part of Cardiology’s Continuous Improvement Program at Connecticut Children’s.

TECHNOLOGY & RESEARCH AT CONNECTICUT CHILDREN’S

Connecticut Children’s First in State to Use Zero-Radiation Technique

At 8:30 on a December morning, the Cardiac Catheterization Suite at Connecticut Children’s was bustling with activity as nurses, anesthesiologists, and technicians monitored and tended to a 13-year-old boy who was lying on the operating table.

The boy was there because he experienced symptoms of heart racing. He had a condition referred to as supraventricular tachycardia, which caused his heart to beat rapidly—above 200 beats per minute.

It’s not an uncommon problem, but the procedure he was about to undergo was anything but ordinary: The procedure, performed by cardiologist Shailendra Upadhyay, MD, is called zero-radiation catheter ablation of supraventricular tachycardia, and Connecticut Children’s is the first and only place in the state to provide this expertise for children.

Cardiac Catheterization and Ablation Procedure The room looked like something from the set of Star Trek, with the table encircled by a large armature holding lights and equipment and a wall of computer monitors lining the far side of the table. Dr. Upadhyay, who is Director in the Adult Congenital Heart and Arrhythmia Service at Connecticut Children’s, made tiny punctures in the boy’s groin and fed a very thin, flexible catheter into a blood vessel.

The screens showed a three-dimensional moving image of the boy’s vessels and heart, including the electrical signals that identified the spot where the defective cells were causing problems. Another screen showed the boy’s heartbeat, rapid and jagged.

The catheter that Dr. Upadhyay was using had a tip that could emit radiofrequency waves to burn the defective arrhythmia circuitry in the heart. The goal was to use this tip to kill the cells that were misfiring and restore a healthy heart rhythm. This kind of catheterization is a wonderful tool, a relatively painless and very effective way to address the problem.

With the conventional approach, however, there is one drawback: The cardiologist has to see the catheter on screen to guide it to

the right spot, and the traditional method uses x-rays, which means the child is exposed to radiation. A single x-ray, even one lasting 15 to 30 minutes, as is the case with these procedures, won’t do serious damage by itself. Radiation is cumulative in the body—the amount incurred in this procedure is added to the exposure from other x-rays, CT scans, PET scans, and environmental exposure through the patient’s life. Together, those exposures may increase the risk of cancer in later life.

Zero Radiation Used Dr. Upadhyay’s operation is notable because he was using no radiation at all.

“Instead,” he said, “this new procedure with three-dimensional electroanatomic mapping uses small magnetic patches and a magnetic tip on the catheter. The magnetic fields from those patches let us see where the catheter is at all times, and it gives us a much better image: three-dimensional instead of the simple two-dimensional image from x-rays.”

So why aren’t more hospitals using it? “It’s expensive,” Dr. Upadhyay explained, “but it means that the patients are not exposed to radiation, so we think it’s worth it.”

Using the electroanatomic mapping system, Dr. Upadhyay guided his catheter to the troublesome cells and burned them. Instantly, the monitor registering the boy’s heartbeat settled into a regular, even pattern.

Two hours after the procedure started, it was over and the boy returned home the same day with a now-healthy heart rhythm.

Shailendra Upadhyay, MD, uses an electroanatomic mapping system that provides a three-dimensional color-coded image of the heart.

Research Spotlight . . .

The Art of Creating a Customized Valve for Pediatric Patients

By far, the most common birth defect is a congenital heart defect—one out of every 100 babies born has one form or another. And fully one fifth of those heart defects involve the right ventricular outflow tract and the valve in the pulmonary artery, the vessel that carries blood from the heart to the lungs.

The good news is that this kind of defect can be repaired with a synthetic valve. The bad news is that over time, these valves develop problems of one kind or another, often an issue located where they attach to the tissue of the artery. So patients with this condition typically have to undergo multiple open-heart surgeries to fix the problem. Any of those surgeries may increase the risk of complications and death.

That’s why Frederic Bernstein, DO, Director of Pediatric Interventional Cardiology at Connecticut Children’s, is involved in an innovative research project with the Connecticut-based Dura Biotech Company. Together, they are developing a synthetic tissue-based technology called Dura Valve Leaflet Technology, patented at the University of Connecticut, so that it can be implanted by a small catheter, removing the need for open-heart surgery.

But the innovation doesn’t stop there. The company, which was started by graduates of the University of Connecticut Engineering Program, aims to address the issues that cause the need for valve replacement in the first place.

The Need for a Perfect Fit “Existing implantable valves are generic,” Dr. Bernstein said. “They come in small, medium and large, and that’s it.” That means the valves are never exactly right for the patient, and the compromised fit leads to many of the problems requiring later replacement of the valve.

Moreover, these existing valves were designed for adults, which means there are further compromises when they’re used in pediatric patients. The Dura Biotech valves would be the first ones specifically designed for children. They don’t stop there, however.

“This company,” Dr. Bernstein said, “is going to take the information we gather from MRIs and echocardiograms and create computerized models of the patient’s specific anatomies. Next, they extract the material properties of human tissues by doing mechanical strain testing on these tissues. One of the things we’re going to do is send them tissue samples from surgeries that we do—tissue that would otherwise be discarded—so they can start building models that have these realistic properties. These computerized models allow us to see how the patient structures react to different devices. The end goal is to create stent valves that are appropriately made for specific pediatric patient groups—the right size, causing less damage, and lasting longer. It’s going to be customized medicine.”

Frederic Bernstein, DO (at left), with members of his team, including Krystle Bevan, CST, Gabrielle Young, RN, and Mollie Mullaney, RN.

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NEWSLETTER CONTRIBUTORS: Sharon Napolitano, Senior Editor Mark Cherrington, Writer and Photographer Ed Jalinskas, Creative Services

The Heart Beat is a publication of Connecticut Children’s Foundation, highlighting the programs and services of Connecticut Children’s Heart Program. To be added to or removed from our mailing list, please contact Sharon Napolitano at SNapolitano02@connecticutchildrens.org.

A Gift from the Heart . . .

Giving Our Region’s Children the Best Care PossibleConnecticut Children’s is committed to providing our region’s children with the best care possible. And our donors have played a large part in helping to make that happen. As our Heart Program and facilities have expanded to better serve our patients, we would like to thank our patient families, donors, community partners and others who have so generously helped us provide the care our patients deserve.

At Connecticut Children’s, there are so many ways to help advance cardiac care for our region’s children, from program support to research. If you would like to help, please contact Connecticut Children’s Medical Center Foundation at 860.837.5700. Your act of generosity will help us provide our region’s children with the best care possible— today and every day.

To learn more about the many programs and services supported by Connecticut Children’s Foundation, visit www.connecticutchildrensfoundation.org.

Connecticut Children’s Offers Satellite Cardiology ServicesConnecticut Children’s Medical Center offers a full range of Cardiology Services at 282 Washington Street in Hartford. Connecticut Children’s also offers Cardiology services at several satellite locations throughout the state. These include Specialty Care Centers in Danbury, Farmington, Glastonbury and Shelton at the following addresses:

• Danbury Connecticut Children’s Specialty Care Center 79 Sand Pit Road, Danbury, CT 06106

• Farmington Connecticut Children’s Specialty Care Center 11 South Road, Farmington, CT 06032

• Glastonbury Connecticut Children’s Specialty Care Center 310 Western Blvd., Glastonbury, CT 06033

• Shelton Connecticut Children’s Specialty Care Center 4 Corporate Drive, Suite #282, Shelton, CT 06484

For appointment information, please call the main number in Hartford at 860.545.9400.

Connecticut Children’s Medical Center complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1.800.234.0780 (TTY: 1.800.545.8330).UWAGA: Jeżeli mówisz po polsku, możesz skorzystać z bezpłatnej pomocy językowej. Zadzwoń pod numer 1.800.234.0780 (TTY: 1.800.545.8330).

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