heart center outcomes

8/14/2019 Heart Center Outcomes

1/44

AchvmtTh Hat Ct, a cmhv aach t xcc.

Theres a family behind every number, percentage and statistic. We never lose sight of that fact.


2/44

On the day this photo was taken, Catherine was on her way home ollowing a successul heart procedure. As a result orecent advancements, her procedure no longer requires an overnight stay.


3/44

leAding thh ca

Dear Colleagues,

The Heart Centers mission is to ocus on providing the highest quality, amily centered,

most cost eective and comprehensive care to all patients, regardless o age, with

congenital heart disease. In doing so, the Heart Center at Columbus Childrens Hospital

is one o the leading congenital heart disease centers in the world or inants, children

and adults.

And we are accomplishing that mission without losing site o an important act: At

the Heart Center, we treat patients and amilies, not customers. We provide expertise

and diagnostic and therapeutic technology that is second to none. At the same time,

we believe that the patient deserves an ongoing relationship that is built not only on

technical competence, but also on communication and trust. The patient, the amily andthe reerring physician are at the center o the circle, not o to the side. Thus, our motto:

Out in ront. Byyourside.

In the pages that ollow, we will provide inormation about all aspects o our Center.

In each o the sections o the Center we will present data about our outcomes as they

compare to the rest o the state, country or world. We will also display our complication

rates, volumes, inormation about access to services and stories about individual patients

and amilies who have used the Center.

Mark Galantowicz, MD, FACS,Co-Director of the Heart

Center, Chief of Cardiothoracic Surgery, and AssociateProfessor of Surgery, The Ohio State University College

of Medicine

Timothy Feltes, MD, FACC,Co-Director of the

Heart Center, Chief of Pediatric Cardiology, CardiacIntensivist, and Associate Professor of Pediatrics,

The Ohio State University College of Medicine


4/44

Th Hat Ct at Cm Ch Hta www.cmch.cm/hatct

2

ta ConTenTs

Outpatient Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

Diagnostic Imaging . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

Cardiothoracic Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

Cardiac Catheterization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

Hybrid Procedures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

ISHAC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20

Electrophysiology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22

Transplantation Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25

Adult Congenital Heart Disease . . . . . . . . . . . . . . . . . . . . . . . . 27

Research Programs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31

Education . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32

International Programs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33

The Heart Center Team . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34

Welcome Center . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40

Physician Liaison Program . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40

Reerral Inormation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40

Out in ront.By yourside.


5/44

1i 2005, att wat a a t at-

mt t th h ca

vmth wt wat

tm th tat.

a

A great Heart Center such as

ours begins with making sure

that access is easy. Through

the eorts o the cardiology

aculty and outpatient nursing

sta, signicant growth has

occurred in the total number

o patients seen on an annual

basis.

Part o making access easy has to do with geography: how ar does a parent have to travel to be

seen by one o the Heart Center cardiologists? Not only are there a number o convenient locations

in the Columbus area, but we have outreach clinics located throughout Ohio and one in Kentucky.

With this extensive network o clinics, patients can be seen and evaluated by one o our cardiologists.

I urther workup or diagnostic studies are indicated, virtually every modality is available at the

Heart Center. Also, long-term ollow up ater surgery or transcatheter therapy can be conveniently

scheduled without having to return to the main campus.

ouTpATienT vc

Clinics in the Greater Columbus area Clinics across the region

All o these clinicshave diagnosticservices on site.

3

Growth in Outpatient Volume


6/44


7/44

diAgnosTiC ma (cont inued)

5

Intracardiac Echocardiography (ICE) is most commonly used to assist in the placement o devices

or dilating balloons inside the heart. It can document the internal anatomy and dene areas or

intervention. Intravascular ultrasound (IVUS) can provide details o the anatomy o vessel wall

and/or dene an area o disruption such as a pseudoaneurysm.

The volume o all types o

Echo studies has increased

dramatically since 2001,

which is a testimony to the

useulness o the modality. It

can be perormed sequentially

to assess changes over time

in unction, fow or pressure.

In 2005, more than 8,200

studies were perormed.

Transesophageal echo (TEE) is used to image a 16 mmASD with decient retroaortic rim. The TEE will guidetranscatheter device closure o the deect.

Intravascular ultrasound (IVUS) is used during cardiaccatheterization to image abnormalities o the bloodvessel. In this example, an aneurysm has developedater surgical repair o coarctation o the aorta. In theadjacent angiogram the posterior aneurysm and residualcoarctation are seen.

Growth in Echo Studies n Tee/iCen Fta

n Tathacc


8/44

diAgnosTiC ma (cont inued)


6

Echo services are available not only on Childrens Hospitals

main campus, but at all Childrens Hospital operated Neonatal

Intensive Care Units around Columbus as well as most o our

outreach clinics.

Anatomy o cardiac and vascular structures can also be evaluated

by High Denition stop ventilation Computed Tomography

(HDCT) with three dimensional reconstruction. The quality o

these images is quite remarkable and can be viewed rom many

dierent angles. They can be useul or understanding individual

pathology as well as planning a surgical or transcatheter approach.

A volume rendered, 3D multi-slice CT (MSCT) scanbeautiully demonstrates severe transverse aortic archhypoplasia ater complex congenital heart disease

repair in a 7 month old inant.

This 3D MSCT scan was perormed ater serial stentshad been placed in the descending aorta in a 5 year oldwith middle aortic syndrome. A 19 mm long aneurysm

is demonstrated on the scan. Subsequent transcathetertherapy was successully perormed.

With all o the diagnostic imaging available, most patients go to surgery without a cardiac

catheterization or diagnosis, and there are rarely any surprises in the operating room. As discussed

in the next section, all inormation is reviewed on each patient by the entire Heart Center team to

make sure that, when patients are reerred to surgery, all appropriate inormation is available andcurrent.


9/44

CArdioTHorACiC

7

Virtually every type o Cardiothoracic Surgery is perormed at the Heart Center with results that

are outstanding at a national level. All congenital cardiac deormities can be repaired or palliated,

many with techniques that were developed here in Columbus. Working hand-in-hand with the

interventional cardiologists and electrophysiologists, the optimal therapy is individualized or eachpatient, no matter what the complexity o their situation. I no urther options are workable or

practical or selected patients, transplantation o the heart, lungs or both are available, and their

long-term care coordinated by experts in the management o heart and lung transplants.

Our surgical team includes the perusionists, who run the heart lung machine, which keeps the

patients body supplied with blood while the heart is rested during repair. Our team o our

perusionists has a combined total o 57 years o service at Columbus Childrens and is also active

on the national and international scene. Fity-three abstracts and presentations as well as 11scientic papers have been authored by our perusion team. Along with the surgeons, they have

developed techniques using very small components and tubing that allows or open heart surgery on

inants and even newborns without using blood. Thus the basis or our blood conservation program.

The perusion team has miniaturizedthe cardiopulmonary bypass circuitto allow ease o operation during an

open heart procedure perormed inthe Hybrid Suite.

Total Cardiothoracic Surgical Procedures

1.02Wh mtat at 5% hat a c accta, th Hat Ct at Cm Ch at

1.02% cat w tha th 2005 tatw at 3.4%

a th ct.

%


10/44

When looking or meaningul outcomes

results in pediatric cardiac surgery, mortality

rate or the Arterial Switch Procedure is

requently viewed as a good barometer. Thiscomplex operation is typically perormed

in the rst ew weeks o lie. All parts o the

system must perorm very well to obtain good

outcomes: rom preoperative evaluation and

management, to excellence in the operative

suite o anesthesia, perusion and surgeons, and

meticulous attention to detail in the Cardiac

ICU aterward. The creation o our Heart Center,related recruitment activities, and consolidation

o all aspects o the clinical services occurred in

late 2002 and early 2003 with a corresponding

and marked decrease in operative mortality.

CArdioTHorACiC (cont inued)


8

Mortality Rate of Arterial Switch Operation for

Transposition of the Great Arteriesn statw Avan Cm Ch

70Th m t--tat a at th Hat Ct th at a. Th

m a a ha ca ta.


11/44


9

A great deal o attention is

paid to saety and prevention

o complications. One o

the most common andworrisome complications

is inection. The Heart

Center is represented on a

national panel o experts or

the prevention o surgical

wound inections. Recently,

even more progress has been

made toward minimizingthis complication using

innovations in and out o the

operating room.

Results like these require

more than great surgery,they require great teamwork

at every stage o the

process. That starts with

a collaborative approach

to planning the therapy,

where all members o the

multidisciplinary team have

input to planning the care.With the large amount o

expertise available at the

Heart Center there may well

be several dierent ways

to potentially solve the

patients problem. These

options are discussed at our

bi-weekly case managementconerences.Team members consider treatment o a patient during our bi-weekly casemanagement conerence.

Cardiac Surgical Infection Rate


12/44



10

One indication o how well we are doing treating our patients and amilies is the growth in reerrals

to the Center, which have more than doubled and widened regionally, nationally, and now include

reerrals rom other countries. Our surgical and interventional cardiology programs are now

internationally renowned.

Referred patients in 2000 Referred patients in 2005


13/44


11

And through all o this, we remain centered on the patient and the amily. Our brand new operating

suites not only include spacious rooms with the nest o equipment, but also are designed or parental

presence. A parent can accompany their child, in their street clothes, to the induction room and

be with him or her until they all asleep a great comort or both child and parent. Ater cardiac

surgery, the patient goes directly to the CICU where the parent can be with them as soon as they

are checked in and connected to monitors. The new CICU has 24-hour parental presence as part o

the way we do business. And we just moved into our newly remodeled step down unit, which has

all private rooms with showers. This is what our parents think o us:

New Cardiac Step Down unit with

Private Rooms

Questions on Parent Satisfaction Survey (2005) % Positive

Aw t qt w taa 98%

rk a t w c t 98%

dct a wk w tth 97%

rat c vt/ta wth ch 97%

It also takes considerable

expertise to make sure the

patient is tuned up prior to

and ater surgery and managedwith exquisite attention to

detail in the dedicated Cardiac

ICU. Staed by Cardiac

Intensivists, Critical Care

Physicians and advanced level

Nurse Practioners, dedicated

rooms staed by dedicated

nurses provide comprehensiveand proessional care. All

types o mechanical heart

and lung support devices and

technicians are also available

i necessary. Nurse practitioners working in the CICU during rounds.


14/44

The cardiac catheterization suite serves three dierent unctions that are becoming increasingly

separate and distinct: diagnosis, intervention, and electrophysiology study and treatment.

Diagnostic catheterization is the traditional study o the gathering o pressure and oxygensaturations in all chambers and vessels, as well as visualization o anatomy and fow by introducing

contrast agent and obtaining digital angiography. Calculations based on these measurements can

requently be used to calculate fow, shunts, and resistance. This inormation allows the planning o

medical, interventional or surgical options or patient treatment.

Interventional catheterization employs the use o specially designed catheters and devices

(balloons, stents, occlusion devices, etc.) to actually treat an intracardiac or vascular problem, as

opposed to just diagnosing it. Most o the time, the interventional procedure is accomplishing atask that would otherwise require a heart operation.

Electrophysiology studies use

specialized catheters guided

to the inner surace o the

heart to analyze the electrical

characteristics and pathways

that are creating rhythm

disturbances in patients.

I an abnormal pathway

is detected and causing

arrhythmias, it can be ablated

with radiorequency energy.

In addition, pacemakers and

debrillators are implanted in

patients with lie threatening

rhythm distrubances.

CArdiAC CATHeTerizATion


12

Catheterizations by type

.39A tta 339atc cathtat w

m th cath a th

at th a wth th mtat

a cmcat at 0.39%.

n itvtan datcn ecthca

%


15/44

Since the creation o the

Heart Center, the use o the

cardiac catheterization suite

has changed considerably.The number o diagnostic

catheterizations has decreased

because ECHO and other

imaging modalities have

provided the relevant

inormation without the

risk o catheterization. This

means that patients who docome to the cath lab will be

more complex, requently

more compromised patients.

A dedicated interventional

cardiology team was recruited

in 2002 to oer cutting edge,

transcatheter therapies to all

children and adults with complex congenital heart disease. As a result,the number and complexityo interventions has increased dramaticallymany times avoiding an operative procedure.

CArdiAC CATHeTerizATion (cont inued)

13

895 d th atth a Ch cmt

895 tvta c

wth a 0.02% cmcat at

a a mtat at 0.48%.

The Amplatzer Occlusion Devices are shown and are used to non-surgicallyclose intracardiac deects associated with congenital heart disease.

A right upper pulmonaryvein angiogram nicelydemonstrates a largesecundum ASD in a 2 yearold. Ater balloon sizing othe deect, an AmplatzerSeptal Occluder is success-ully implanted. Nearly 100patients each year undergosuccessul non-surgical

device closure o ASD inour catheterization suite.


16/44



14

The past 15 years have seen an explosion

o non-surgical, transcatheter options to

close intracardiac deects, such as atrial

and ventricular septal deect, as well aspatent ductus arteriosus. Percutaneous valve

implantation is being developed and will

become available in selected centers in the

uture, including our own. Adult patients

with neurologic events or migraine headaches

associated with patent oramen ovale requiring

transcatheter closure are being reerred to our

Center during clinical trials. As a matter oact, adult patients with complex congenital

heart disease comprise over 25% o the

interventional procedures perormed in our

Hybrid Cardiac Catheterization Suites. All

transcatheter therapeutic options are available

in our Center, regardless o size, complexity,

or age o the patient. Like the Cardiothoracic

Surgical Service, patients rom across the USAand abroad are reerred here or transcatheter

therapy.

Since The Heart Center was established in 2002, we have been involved as a Principal Investigator

in over eight FDA sponsored clinical trials, three interventional cardiac registries, and over 50 IRB

approved studies. In addition, our Center is one o eight sites that are involved with establishing

Congenital Cardiac Catheterization Outcomes, which will provide important data to dene

expected outcomes or all diagnostic and interventional procedures. Finally, our InterventionalTeam has been responsible or 23 manuscripts in scientic journals, nine book chapters, 47

published abstracts, 132 oral and poster presentations given nationally and internationally, and has

been invited to perorm live case broadcasts to teach other interventionalists attending scientic

symposia worldwide.

Color fow Doppler TEE demonstrates a multi-enes-trated ASD. Under an FDA approved clinical trial, aCribriorm Septal Occluder was successully implantedand is shown in the adjacent TEE image.


17/44


15

The interventional cardiology teamworks closely during advancedtranscatheter therapies. In these pho-tographs, IVUS is being perormedto help guide balloon angioplastyand stent implantation ater surgicalrepair o tetralogy o Fallot.

An aortic angiogram demonstrates near completeinterruption o the aorta in a teenager with CoA. Atercompassionate use approval, a covered stent is implantedand there is complete relie o obstruction.

Volume rendered, 3D MSCT scan is very important atertranscatheter interventions. The above images nicelydemonstrate in-stent stenosis ater pulmonary arteryrehabilitation in an inant ater tetralogy o Fallot repair.Additional interventional therapy was required.


18/44

16

Hybrid c

At the Columbus Childrens

Heart Center, we have

pioneered the concept o

the Hybrid approach tocomplex congenital heart

disease. A Hybrid case is one

that combines the talents

o a cardiac surgeon and an

interventional cardiologist.

An example is our new Hybrid

approach or the initialpalliation or Hypoplastic

Let Heart Syndrome. The

traditional approach (The

Norwood Procedure) involves

an extensive open heart

procedure which creates a neoaorta, disconnects the pulmonary arteries and provides pulmonary

blood fow by a Gore-Tex shunt which provides adequate pulmonary fow while protecting against

overcirculation. Cardiopulmonary bypass and circulatory arrest are typically required. In contrast,our Hybrid approach protects against pulmonary overcirculation by banding the pulmonary arteries

individually through a limited incision in the chest without cardiopulmonary bypass. The cardiac

surgeon then provides access to the patent ductus through the proximal pulmonary artery, allowing

the interventional cardiologist to place a stent in the ductus arteriosus, thus keeping it open,

serving as the conduit to the aorta. Just prior to discharge, a transcatheter balloon atrial septostomy

is perormed, allowing unobstructed fow or the let side to the right side o the heart. The same

objectives are obtained as the Norwood Procedure, but with the Hybrid approach there is no bypass

involved, and no circulatory arrest. Thereore, the procedure can be perormed without blood,which in part explains our international reputation among parents o the Jehovahs Witness aith.

Avoiding open heart surgery and circulatory arrest in the newborn period has several theoretical

long-term advantages, both in terms o mortality and morbidity as well as long-term neurologic

outcome. The eect on overall outcomes or Stage I palliation at the Heart Center has been

remarkable. In the most recent year, 13 Stage I palliations were carried out, 11 by Hybrid approach

and two with a traditional Norwood Procedure without a mortality. These results are excellent by

both national and regional standards.

Mortality Rate for First Stage Palliation of HypoplasticLeft Heart Syndrome

n statw Avan Cm Ch



19/44

Hybrid c (cont inued)

17

This type o innovative approach requires a new

look at space and equipment. Traditional cardiac

catheterization laboratories are not designed to

be operating rooms. The cath tables provide bestaccess to the patient rom the groin area and

have maximum fexibility or the table and

biplane imaging equipment. Access to the chest

is limited and there is not space and support or

cardiopulmonary bypass equipment. Operating rooms, on the other hand, are set up or bypass,

maximum access to the chest, and plenty o room or anesthesia and diagnostic equipment, but

have only rudimentary imaging equipment. The two Hybrid Suites in The Heart Center have been

specically designed with both needs in mind. Built to Operating Room standards, all necessaryspace and access exist or an open heart surgical team. At the same time, state-o-the-art imaging

and physiologic equipment gives the interventional cardiologist the necessary tools to perorm the

intervention. Our two Hybrid Cardiac Catheterization Suites opened in 2004 and were the rst in

the world specically designed or Hybrid procedures.

First-o-a-kind Hybrid Suite and Table

b a Vca s mv hawa a th w mAtaa t Cm, oh t av th aht . phct wa a- t wth hatc t hat m. Th s w tth wa h th ch. bt th am ach a d. Mak gaatwc, C-dct Cm Ch Hta HatCt, a h ca, Jh p. Chatham, Md, dct Cathtata itvta Tha, wh ha achv xct t wth a wH tchq t tat hatc t hat m wtht th

.

Th s t htat; th th hm a a th 9,000-mj t Cm. phct bk-l s wa Cm J 18 a jt 12 a at, d. gaatwc a d. Chatham, a wthth tam, m th t tw c that aw h t ath wtht a at. phct, th 12th ch t th w tatmt, cam thh wth f c. phct ha w cmt ath c a t a Fta ccat wtht th !

Th s hav t t Ataa t th v at hm, wh d. gaatwc a h tam xct

phct t ct t chat thm wth h ht qtv wa a .


20/44

18



Interventional and surgical

teams rom all over the

country visit our Hybrid

Suites to learn more aboutHybrid therapies and room

design. In addition, we have

had visitors rom Europe,

South America, and Asia visit

our team o specialists.

It is common or visitors rom other countries to visit our Hybrid CardiacCatheterization Suites. Guests rom FuWai Cardiovascular Hospital in Beijing,China observe a Hybrid Stage I palliation or HLHS by our team.

During a Hybridprocedure or intra-operative deliveryo an LPA stent on

cardio-pulmonarybypass, endoscopicimaging conrmsappropriate placemento the stent proximalto the upper andlower lobe branches.

Hybrid


21/44


19

Ater pulmonary artery bands have been placed, a sel-expandable PDA stent is implanted o cardio-pulmonary bypass. Anangiogram conrms excellent placement o the stent and PA bands. A ollow up 3D MSCT scan is perormed prior to Compre-hensive Stage II repair and nicely demonstrates the PA bands, PDA stent, and atretic ascending aorta.

Hybrid Stage 1 palliation has

been perormed successully

by our team in babies as small

as 1.1 kg... not much largerthan your hand.

isHAC


22/44

20

isHAC


5Th itata smm th H Aach tCta Hat da attact tvta cat a

cathacc m 5 ctt.

Interventional cardiologists and cardiothoracic surgeons rom throughout the United States, North

and South America, Europe, Australia and Asia gathered at Columbus Childrens Hospital rom June

28-30, 2006, or the inaugural International Symposium on the Hybrid Approach to Congenital

Heart Disease (ISHAC). This conerence was the rst o its kind dedicated to exploring advance-ments in Hybrid management strategies which combines surgical and transcatheter therapies in

order to minimize the cumulative impact o treatment or complex congenital heart disease (CHD).

Columbus Childrens Hospital is considered a benchmark institution in this area where two

uniquely designed Hybrid Cardiac Catheterization Suites opened in June, 2004the rst in the

world dedicated to this new therapy.

isHAC (cont inued)


23/44

isHAC (cont inued)

21

The two-day Symposium eatured lectures and panel discussions

rom international pioneers in the eld, as well as live case

demonstrations broadcast rom Miami Childrens Hospital,

University o Chicago Comer Childrens Hospital, and theHybrid Suites at Columbus Childrens Heart Center. A special

one day hands on Workshop was attended by selected participants and the aculty.

Symposium directors were John P. Cheatham, MD, Director o Cardiac Catheterization and Inter-

ventional Therapy at Columbus Childrens Heart Center, and Mark Galantowicz, MD, Co-Director

o The Heart Center and Chie o Cardiothoracic Surgery at Childrens. Both are aculty members

o The Ohio State University College o Medicine. Drs. Cheatham and Galantowicz have organized

this world-class event to encourage international discussion or potential Hybrid cardiac proceduresthat will result in improved outcomes while decreasing risks.

During the ISHAC hands-on Workshop, cardiothoracic surgeons, interventional cardiologists, and nurse practitioners receivetraining by our team or Hybrid Stage I palliation or HLHS.

eleCTropHysiology


24/44

eleCTropHysiology


22

The Electrophysiology service is devoted to caring or patients

with heart rhythm abnormalities. The abnormal rhythms can

be divided into two broad groups, those with heart rates that

are too slow and those that have ast heart rhythm problems.The key to caring or this group o patients is to oer state-o-

the-art acilities and equipment in order to adequately diagnose

the abnormal rhythm and provide eective intervention to

treat the abnormalities. To provide this level o care, oten or

complicated patients, the Electrophysiology team provides

a wide range o services. They include diagnostic tests and

interventional procedures. Diagnostic services include

telemetry review o cardiac patients admitted to the hospital,transesophogeal and intracardiac electrophysiology testing, and

tilt table tests. Other diagnostic tests include EKGs, Holters and

Event monitors.

Fluoroscopy Image

200 na 200att wth acmak a

mt th ep svc.

eleCTropHysiology (cont inued)


25/44

eleCTropHysiology(cont inued)

23

The Heart Center at the Columbus Childrens Hospital has a

ull complement o diagnostic capabilities. Invasive diagnostic

electrophysiology testing is perormed in a state-o-the-art

catheterization laboratory. The acilities oer both a conventionalmapping system, as well as three-dimensional electroanatomic

reconstruction o the abnormal substrate that is the cause o

abnormally ast heart rhythm. Because we have these tools

available, we can ablate the abnormal electrical impulse that is

the cause o the palpitations. One o the two tools with their

unique advantages is chosen based on individual patient needs.

This approach aords maximal eectiveness in success and, justas importantly, minimizes the potential or serious complications.

To date we have had no patients require pacemaker implantation

as a result o ablative therapy. The Heart Center achieves an

80% to 95% success rate on routine SVT ablation interventional

procedures depending on the area to be ablated: a rate that is

comparable or better than the national average.

Electrophysiology Service

0Th m attwh hav q acmak

tha at aatv tha.

n itvta epn epsn dvc imatat

The high level o activity indicated below demonstrates the need,

as well as the eectiveness, o Electrophysiology Services.

Electrical Map created by computer

eleCTropHysiology(cont inued)


26/44

24

For patients with slow heart rates that are potentially harmul, a

pacemaker may be needed. The pacemakers o the present era are

sophisticated devices that allow tailoring o the settings to the

needs o each patient. Due to the changing needs o our patients,settings are directly related to their age and associated cardiac

problems, and our sta are experienced in adjusting the settings

o these devices accordingly. We implant cutting-edge devices

and leads or our patients. There are patients who require devices

that have the capabilities

to detect abnormally ast

rhythm and deliver the

appropriate therapy. Asour survivors o congenital

heart surgery age into young

adulthood, there is clearly a

growing need or these lie

saving devices. Determination

or the patient who needs

such a device is perormed

systemically and througha team approach involving

almost all the services o the

Heart Center. Follow-up is

perormed by a very capable

and highly trained sta to

ensure the device is operating

properly.

( )

Dr. Pamela Ro with a amily.

Medical illustration o apacemaker device

TrAnsplAnTATion vc


27/44

25

When no other options are available with

conventional medical or surgical therapy,

transplantation o a heart, a lung, or heart and

lungs is a lie saving option. Transplantationservices began at the Heart Center in 2002,

and the program has grown rapidly. We began

the services only ater assembling all necessary

experts.

In addition to surgeons and transplant

cardiologists and pulmonologists, intensivists

and anesthesiologists, the team includestransplant coordinators, a child psychologist,

and the entire array o other supporting

services such as pathology, pharmacy, nutrition, rehabilitation service, and occupational and

physical therapy. Once in place, program approval was gained rom the United Network or

Organ Sharing (UNOS) at the national level and The Ohio Solid Organ Transplant Consortium

at the state level.

Volume of Transplant Procedures

The volume o transplantation has grown dramatically.

TrAnsplAnTATion vc (cont inued)


28/44


26

O course, the nature o the patients awaiting transplantation is such that the ull array o support

must be available including mechanical support. It is o note, that even though wait times in

general were relatively low, there were 3 patients who required Extra Corporeal Membrane

Oxygenator (ECMO) support while waiting or an organ, including one who was on ECMO or10 days.

Supporting the service is a whole network o clinics and clinicians that screen and evaluate

patients pre-transplant, and who keep track o the all-important ollow-up that is so crucial in

transplantation.

At 3-mth- a a hat a taat, tm wa a-a t Ja. A wh Ja am wat, ath am atCh wat, a w. Th aht, Kaa, a w hat t vv. bth th v w ma wk, ath tha a.it wa th that th k cc. A hat a m a am,t--tat cam avaa. s th taat tam at Ch tk

avata th a ttt av th v tw ch.

s taat Jahat t Kaa, th taatth at hat a tJa. p t th c, am taat ha t m th ut stat m tha a ca a v att th a ma. Aa a t, Ja ha w x-c a a a , aa a a ct.

6Wh th ct a a m 2 mth t 19 a, thmajt hat taat ct a tha 6 mth . A, hat

taat wat tm a m 1 t 27 a, wth a ma wat 10 a.

mth

AdulT cta hat a


29/44

27

Patients with repaired congenital heart disease are continuing

to live longer, and as they do, the proportion o adults with

congenital heart disease continues to rise and exceeds the number

o pediatric patients with congenital heart disease.

Many patients who have undergone total corrective surgery

will have ew, i any, hemodynamic residual lesions requiring

inrequent evaluation and treatment (atrial septal deect,

ventricular septal deect and patent ductus arteriosus). However,

patients with more complex lesions may have residual shunts,

valvular disease, ventricular dysunction and arrhythmias, and require more requent evaluation,

medical treatment and consideration or urther surgical or catheter based interventions. As weollow patients or decades, some patients that were previously considered as routine may

develop unorseen problems. Our programs ocus resources on these patients.

The mission and goals of The Adolescentand Adult Congenital Heart Disease

Program at Columbus Childrens Hospitaland The Ohio State University is to:

1. Comprehensively evaluate and treat,

both medically and surgically, adolescent

and adult patients with congenital heart

disease.

2. Maintain a detailed patient database to

support clinical and basic research in the

eld o adolescent and adult congenital

heart disease.

3. Provide education to medical students,

residents, nurses and physicians at

Columbus Childrens and The Ohio State

University in the subspecialty area o adult

congenital heart disease.

4. Expand the eld o experts in adultcongenital heart disease by acilitating a

Combined Internal Medicine and Pediatric

Cardiology Fellowship Program.

Rachel Adult congenital heart patient

AdulT cta hat a (cont inued)


30/44


28

To accomplish the goals

set orth requires a team

o experts rom several

disciplines including nurseclinicians, cardiologists

in many subspecialty

areas (electrophysiology,

heart ailure/transplant,

interventional cardiac

catheterization), and

cardiothoracic surgery.

In July 2000, an adult

congenital heart clinic was

established at Columbus

Childrens Hospital with a

parallel clinic at OSUs Heart Center Mill Run. Initially, the clinics were scheduled once a month,

but by the years end, the clinics had expanded to twice a month. Currently, the Adolescent and

Adult Congenital Heart Disease Clinics evaluate patients in 10 separate clinics per month.

In order to accommodate this

growth, Columbus Childrens

has expanded our clinical

sta. Starting with one

Certied Nurse Practitioner,

and adding a second, as well

as a new RN to act as clinicalcoordinator.

Adult Congenital Heart Disease Clinic Patients

Adult Congenital Heart Disease Cardiac MRIs and CTs

Increasing number o studies by year.

2005 total patients = 1,116 (OSU 521, CCH 595)



31/44

29

The number o diagnostic

studies has increased with

the number o patients. In

addition to traditional cardiaccatheterization, MRIs and

Cardiac CTs have increasingly

yielded useul inormation or

the team.

Also, as shown to the right,

not only are a greater number

o catheterizations being

perormed each year on adults

or congenital heart problems,

but they represent a growing

percentage o the total number o catheterizations.

Adult Congenital Heart Disease Cardiac Catheterizations

Increasing number o cardiac catheterizations on adults or congenital heartdisease, and increasing % o total catheterizations.

The Electrophysiology (EP) service has also become an integral part o the adult congenital

heart disease program. By ar the most common problem acing our population is arrhythmias.Research has shown that the risk o sudden cardiac death is 25 to 100 times greater than

expected in an adult with congenital heart disease compared to a normal adult. Thereore, an

aggressive approach to evaluation and treatment is necessary. We have learned that a combined

cath/EP evaluation can provide valuable inormation and has lead to many patients receiving

pacemakers, intracardiac debrillators, and intraoperative ablation. The adult congenital service

has maintained a airly steady presence in the EP lab running between 30 to 35% o all cases

coming to the EP lab at Columbus Childrens Hospital, with 2005 once again having a growth

rate greater than 50%.

Cardiac Surgery on the adult with congenital heart disease is a growing segment o our

population at the Heart Center. Initially, 5% o cases seen by the Adult Congenital Heart

Disease program were reerred or surgery. In the most recent year, 11% were reerred. These

patients can be treated either at the Ross Heart Hospital o The Ohio State University or at

Columbus Childrens Heart Center. At the Heart Center, our Cardiac Intensive Care Unit is

designed to accommodate all patients rom inants to adults.



32/44

As patients with previously repaired congenital heart deects

mature, we are now nding and developing new techniques and

procedures to care or this group. As an example, many patients

who have undergone single ventricle surgery with a Fontanoperation may require additional surgery or heart ailure

and arrhythmias. We are one o only a ew institutions that

perorm Fontan revision on adult patients. Additionally, we are

developing new open heart procedures that combine complete

repair with arrhythmia surgery. Previously there were no other

options with congenital cardiopulmonary ailure, and now Childrens Heart Center has transplant

options or these patients.

In the uture, we will be looking at starting a transition program which essentially invites all CHD

patients rom Childrens Hospital to join the ACHD program at the age o 18 which would double

or quadruple our current volume.

The ACHD team remains active in clinical research and has accomplished many academic

achievements or 2005. With the addition o ull-time aculty members and ACHD ellows,

the research program will continue to expand. Our plan is to add a research coordinator to the

ACHD program to acilitate our research projects and support the sta o the ACHD program. In

2005, ve grants were being run by the program. In addition, two papers, eight abstracts, and 15

presentations and lectures were produced. The nurses in the center produced six publications,

two abstracts and three

presentations.


30

Volume of Adult Congenital Heart Procedures

Je Adult congenital heart patient

reseArCH am


33/44

31

Cardiovascular Research at Columbus Childrens involves

investigators rom The Heart Center and the Center or

Cardiovascular Medicine (within Columbus Childrens Research

Institute), where basic scientists and clinical investigators workclosely on multiple research projects. Since 2003 this active group o researchers have published

more than 150 manuscripts or book chapters in leading journals and given more than 250

presentations o their research ndings at national meetings. In addition, more than 30 research

proposals have been submitted to national unding agencies, including the National Institutes

o Health and the American Heart Association, and approximately 20 research projects have

been unded rom various sources totaling nearly $2 million. Investigators also have contributed

to several multi-center trials or pharmaceutical development. These activities have helped to

oster collaborative relationships with other specialties within our hospital and Research Institute(neonatology, pulmonary, general pediatrics, pharmacology, genetics) and involved the training o

research ellows rom diverse elds in translational research projects.

Areas of research emphasis:

In-hospital patient outcomes

Innovations in surgical palliation for

congenital heart deects

Prevention, prediction and treatment of poor

outcomes post-surgery

Biomarkers and predispositions

Outpatient and preventive medicine

Oxidant and inammatory mechanisms in

cardiac and vascular disease Childhood antecedents of adult

cardiovascular disease

Endothelial dysfunction and controllers of

new blood vessel ormation

Novel therapeutic strategies

Basic research

Cell and tissue engineering, blood vessel andcardiac

Models of disease occurring in children and

neonates

Inammation and stress signaling pathways

Clinical research

Establish animal model for the approach

to hypoplastic let heart syndrome withpulmonary artery bands

Establishment of a new animal model for

ventricular septal deects to acilitate testing

o perventricular treatment options.

eduCATion


34/44


32

As part o one o the nations

largest and busiest pediatric

hospitals, The Heart Center

at Columbus Childrens isengaged in a wide variety

o graduate medical and

continuing education activities.

In collaboration with The

Ohio State University College

o Medicine, aculty teaches

residents and ellows in the

ollowing programs: Cardiothoracic Surgery

Congenital Cardiac Surgery

General Pediatrics

Internal Medicine-Pediatrics

Neonatal-Perinatal Medicine

Pediatric Cardiology

Pediatric Critical Care

Medicine

The Heart Center sta also serves as mentors and role models or physicians, advanced practice

nurses, perusionists, and other clinicians and scientists. They give lectures, proctor clinical

procedures, present live case demonstrations at national and international programs, and

teleconerence case conerences. Indeed, in 2005 aculty and sta gave over 100 presentations

in 19 dierent countries outside the United States. Presentations include such diverse topics as

hybrid approaches to complex congenital heart disease, new comprehensive Stage II procedure

or hypoplastic let heart syndrome, and RSV prophylaxis in inants and children with

hemodynamically signicant CHD.

inTernATionAl am


35/44

33

International involvement to enhance pediatric cardiac

care in developing countries is a long standing tradition in

The Heart Center. For more than a decade, cardiac surgeons

have led teams o clinicians to oer humanitarian care inthe Dominican Republic, El Salvador, Guatemala, and Peru.

Typically a multidisciplinary team rom Childrens Hospital

assists the clinicians rom these countries

while they diagnose, plan treatments, operate,

and coordinate postoperative care and long

term ollow-up. These supervised clinical

teaching experiences, coupled with donations

o equipment and supplies, has acceleratedthe adoption o new techniques and improved

care to the neediest children. For example,

the team rom Lima, Peru has perormed over

1,200 operations on indigent patients with a

98% success rate and a 1.5% inection rate,

signicant accomplishments or such an

at-risk population. Notably these outcomes

were achieved with a cash outlay o less than$70 per patient.

The Columbus Childrens Hospital China Program ocially began in 2005 with written aliations

in three hospitals: Cardiovascular Institute and Fuwai Hospital, Beijing, Shanghai Childrens

Medical Center Pudong District, Shanghai and Wuhan Childrens Hospital. To date more than

20 physicians teach and learn in the ollowing areas o The Heart Center:

Interventional cardiology Cardiac intensive care Echocardiology

Cardiothoracic surgery Anesthesiology Cardiopulmonary perfusion

The Heart Center aculty and sta actively teach in China as well, serving as Course Directors

o international scientic programs and proctoring physicians rom many institutions in new

techniques.

In addition to China, aculty and sta rom The Heart Center have also trained physicians rom

Bulgaria, Chile, Ecuador, El Salvador, Ghana, Guatemala, Hungary, India, Mexico, and Peru throughthe Stecker International Scholars Program at Columbus Childrens Hospital.

THe HeArT CenTer Tam


36/44


34

Timothy F. Feltes, MD, FACC, Chie o Pediatric Cardiology, CardiacIntensivist and Co-Director o the Columbus Childrens Heart Center.Chie o Pediatric Cardiology at The Ohio State University College oMedicine. Associate Proessor o Pediatrics. Recipient o the Andy PaxtonEndowed Chair in Cardiology.Dr. Feltes received his medical degree rom Medical College oOhio, Toledo. He completed a pediatric residency at EmoryUniversity o Atlanta and ellowship at Texas Childrens Hospital,Houston. He is board certied in Pediatric Cardiology and Pediatrics.

Mark E. Galantowicz, MD, FACS, Chie, Department o Cardiotho-racic Surgery and Co-Director o the Columbus Childrens Heart Center.Associate Proessor o Surgery at The Ohio State University Collegeo Medicine.Dr. Galantowicz received his medical degree rom CornellUniversity. He completed his residency at Columbia-PresbyterianMedical Center, New York. He is certied in both ThoracicSurgery and Surgery.

Hugh D. Allen, MD, FAHA, FACC, Physician-In-Chie o ColumbusChildrens Hospital. Clinical Cardiologist and Proessor o Pediatrics o

the Heart at The Ohio State University College o Medicine.Dr. Allen received his medical degree rom the University oCincinnati. Ater completing his residency, he received ellowshiptraining at the University o Minnesota. He is certied in bothPediatric Cardiology and Pediatrics.

Todd L. Astor, MD, Director o the Lund and Lung/Heart Transplantprograms at Columbus Childrens Hospital. Assistant Proessor oClinical Pediatrics at The Ohio State University College o Medicine.Dr. Astor received his medical degree rom George WashingtonUniversity. Ater completing his residency at Loyola UniversityMedical Center, he received ellowship training at Universityo Colorado Health Sciences Center. He is certied in InternalMedicine, Pulmonary Medicine and Critical Care Medicine.

The specialists, nurses, technologists and other members o our sta work together to deliver thenest care to critically ill inants and children, as well as adults with congenital heart disease.

Leading this eort are the members o a remarkable medical team, who are comprehensive in their

scope and compassionate in their approach to care.

THe HeArT CenTer Tam (cont inued)


37/44

35

John Anthony Bauer, PhD, Director o the Center or CardiovascularMedicine, Columbus Childrens Research InstituteDr. Bauer received his PhD in Pharmacy rom State University oNew York at Bualo. His central research interest is to conductbasic science with an opportunity to impact therapy. Dr. Baueris also an Associate Proessor in the Division o Pharmacy at TheOhio State University.

Steven C. Cassidy, MD, FACC, Director o Research in the Section o

Pediatric Cardiology and Medical Director o Inpatient Cardiology atColumbus Childrens Hospital. Associate Proessor o Pediatrics at TheOhio State University College o Medicine.Dr. Cassidy received his medical degree rom State University oNew York, Brooklyn. Ater completing his pediatric residencyat Brown University in Providence, Rhode Island, he receivedellowship training in Pediatric Cardiology at the Universityo Caliornia San Francisco. He is certied in both PediatricCardiology and Pediatrics.

David Chan, MD, Director o Electrophysiology. Director o Fellow-ship Training. Clinical Associate Proessor o Pediatrics o the ColumbusChildrens Heart Center and at The Ohio State University College oMedicine.Dr. Chan received his medical degree rom Wayne State University.Ater completing his residency at Wayne State University, hereceived ellowship training rom both The Ohio State UniversityMedical Center and the Mayo Clinic. He is certied in both

Pediatric Cardiology and Pediatrics.

John P. Cheatham, MD, FAAP, FACC, FSCAI, Director o CardiacCatheterization and Interventional Therapy at the Columbus ChildrensHeart Center. Clinical Proessor o Pediatrics and Internal Medicine atThe Ohio State University College o Medicine.Dr. Cheatham received his medical degree rom the University oOklahoma. Ater completing his residency at Childrens HospitalMedical Center, Boston, he received ellowship training at Texas

Childrens Hospital, Houston. He is certied in both PediatricCardiology and Pediatrics. Dr. Cheatham has pioneered anddeveloped new transcatheter devices and techniques, as well ashelped design new imaging equipment.

Stephen C. Cook, MD, Combined Fellow in Cardiovascular Medicineand Pediatric Cardiology at The Ohio State University College o Medicine.Dr. Cook received his medical degree rom Boston University.He completed his residency at Albert Einstein Medical Center

(Temple University) and received ellowship training rom bothColumbus Childrens Hospital and The Ohio State UniversityMedical Center. He is certied in both Internal Medicine andPediatrics.



38/44


36

Clifford L. Cua, MD, Clinical Cardiologist and Cardiac Intensivist atthe Columbus Childrens Heart Center. Assistant Proessor o Pediatrics atThe Ohio State University College o Medicine.Dr. Cua received his medical degree rom Indiana UniversitySchool o Medicine. Ater completing his residency, he receivedellowship training at Columbus Childrens Hospital and ChildrensHospital Medical Center in Boston. Dr. Cua is certied in Pediatrics.

Curt Daniels, MD, Director o the Adolescent and Adult Congenital

Heart Disease Program at the Columbus Childrens Heart Center.Assistant Proessor o Clinical Cardiology at The Ohio State UniversityCollege o Medicine.Dr. Daniels received his medical degree rom The Ohio StateUniversity. He completed his residency and received ellowshiptraining rom Childrens Hospital in Columbus. He is certiedin Pediatrics, Internal Medicine and Cardiology, and is thereoreuniquely qualied to diagnose, treat and provide long-term careor the growing number o adolescents and adults who are

diagnosed with congenital heart disease.

J. Terrance Davis, MD, FACS, Member o the Division o CardithoracicSurgery at Columbus Childrens Hospital. Proessor o Clinical Surgery atThe Ohio State University College o Medicine.Dr. Davis received his medical degree rom University oPennsylvania. He completed his residency at Hospital o theUniversity o Pennsylvania. He is certied in Thoracic Surgery.Dr. Davis originated and developed the worlds most successul

surgical treatment or Jeunes Syndrome.

David Fisher, MD, Medical Director o Columbus Childrens Hospital.Proessor o Pediatrics and Academic Vice Chairman o the Departmento Pediatrics at The Ohio State University College o Medicine.Dr. Fisher received his medical degree rom Tuts UniversitySchool o Medicine. He completed his residency and receivedellowship training at University o Caliornia. He is certied inboth Pediatrics and Pediatric Cardiology.

Timothy Hoffman,MD, FACC, Medical Director o the Heart Trans-plant and Heart Failure Program at Columbus Childrens Hospital.Assistant Proessor o Clinical Pediatrics, Division o Cardiology, at TheOhio State University College o Medicine.Dr. Homan received his medical degree rom West VirginiaUniversity. He completed his residency at West Virginia UniversityMedical Center and received ellowship training at ChildrensHospital o Philadelphia. He is certied in Pediatric Cardiology

and Pediatrics.



39/44

37

Ralf J. Holzer, MD, Assistant Director o Cardiac Catheterization andInterventional Therapy at Columbus Childrens Hospital. Clinical AssistantProessor o Pediatrics at The Ohio State University College o Medicine.Dr. Holzer received his medical degree rom Johannes GutenbergUniversitat Mainz in Germany. Ater completing his residency, hereceived ellowship training at Royal Liverpool Childrens NHSTrust in England and University o Chicago Childrens Hospital.

Katherine Mizelle, MD, FAAP, Director o Outpatient Services Colum-

bus Childrens Heart Center. Clinical Assistant Proessor o Pediatrics atThe Ohio State University College o Medicine.Dr. Mizelle received her medical degree rom University o Virginia.She completed her residency at Madigan Army Medical Center,Washington. Ater her residency she received ellowship trainingat Oregon Health Sciences University. She is certied in bothPediatric Cardiology and Pediatrics.

Aymen N. Naguib, MD, Director o Heart Center Anesthesiology at

Columbus Childrens Hospital and Clinical Assistant Proessor at The OhioState University College o Medicine.Dr. Naguib received a medical degree rom Cairo UniversitySchool o Medicine, Cairo, Egypt, ollowed by residency insurgery at the College o Physicians and Surgeons o ColumbiaUniversity at Harlem Hospital, and a residency in anesthesiologyat Illinois Masonic Medical Center. He did his ellowship train-ing at Childrens Memorial Hospital, Northwestern University,Chicago, Illinois, in pediatric anesthesiology. He is certied by the

American Board o Anesthesiology.

Alistair Phillips, MD, Attending Surgeon, Department o PediatricCardiothoracic Surgery at Columbus Childrens Hospital. AssistantProessor o Surgery at The Ohio State University College o Medicine.Dr. Phillips received his medical degree rom Columbia Collegeo Physicians and Surgeons in New York. Ater completinghis residency, he received ellowship training at New YorkPresbyterian/Weill Cornell, Memorial Sloan Kettering Cancer

Center, and Childrens Hospital o New York. He is certied inboth Surgery and Thoracic Surgery.

Pamela Ro, MD, Clinical Assistant Proessor o Pediatrics o theColumbus Childrens Heart Center and The Ohio State University Collegeo Medicine.Dr. Ro received her medical degree rom Northwestern University.Ater completing her residency at Childrens Hospital o Pittsburgh,she received ellowship training rom Childrens Hospital o

Philadelphia. She is certied in both Pediatric Cardiology andPediatrics.



40/44


38

Daniel Rowland,MD, FAAP, FACC, Director o Echocardiographyat the Columbus Childrens Heart Center. Associate Proessor oClinical Pediatrics at The Ohio State University College o Medicine.Dr. Rowland received his medical degree rom University oRochester. Ater completing his residency at Medical Universityo South Carolina, he received ellowship training rom Universityo Virginia, Charlottesville. He is certied in both PediatricCardiology and Pediatrics.

Lawrence I. Schwartz, MD, Director o the Cardiac Intensive CareUnit and Assistant Proessor o Pediatric Anesthesiology and Critical CareMedicine at Columbus Childrens Hospital and The Ohio State UniversityCollege o Medicine.Dr. Schwartz received his medical degree rom University oPittsburgh School o Medicine. He completed his residencyand received ellowship training at Johns Hopkins Hospital inBaltimore, Maryland. He is certied in Anesthesiology, Pediatricsand Pediatric Critical Care.

Randy Schwartz, MD, Cardiac Intensivist at Columbus Childrens HeartCenterDr. Schwartz received his medical degree rom Jeerson MedicalCollege at Thomas Jeerson University in Philadelphia. Ater com-pleting his residency at Cincinnati Childrens Hospital MedicalCenter, he received ellowship training at Childrens MedicalCenter in Dallas. Dr. Schwartz is certied in Critical Care Pediatrics

Christopher J. Sutton, MD, Pediatric Anesthesiologist at ColumbusChildrens Hospital and Cardiovascular Anesthesiologist at ColumbusChildrens Hospital Heart Center. Clinical Assistant Proessor at The OhioState University College o Medicine.He completed his medical degree, residency and a ellowship incritical care medicine at The Ohio State University College oMedicine. He then completed a ellowship in pediatric anesthe-siology at Columbus Childrens Hospital. He is certied by theAmerican Board o Anesthesiology.

Douglas W. Teske, MD, FACC, Director o Preventive Cardiology,Quality Control and Outcome or the Columbus Childrens Heart Center.Assistant Proessor o Pediatrics at The Ohio State University College oMedicine.Dr. Teske received his medical degree rom University o Iowa. Hecompleted residency training at Columbus Childrens Hospital. Hereceived ellowship training rom Childrens Hospital o Bualo.He is certied in both Pediatric Cardiology and Pediatrics.



41/44

39

D. Alan Tingley, MD, MBA, Medical Director and Administrator,Childrens Surgery Center, and Chie o the Department oAnesthesiology at Columbus Childrens Hospital. Clinical AssistantProessor at The Ohio State University College o Medicine.Dr. Tingley received his MD rom Southwestern Medical Schooland his MBA rom Capital University. He is certied by theAmerican Board o Anesthesiology.

John J. Wheller, MD, Faculty Member at the Columbus Childrens

Heart Center. Assistant Proessor o Pediatrics and Obstetrics at TheOhio State University College o Medicine.Dr. Wheller received his medical degree rom The Ohio StateUniversity. Ater completing his residency at David Grant USAFMedical Center, he received ellowship training rom Universityo Caliornia. He is certied in both Pediatric Cardiology andPediatrics.

Peter Winch, MD, MBA, Pediatric Anesthesiologist

Dr. Winch received his medical degree rom the University oCincinnati College o Medicine. He completed a Residency inPediatrics at Pittsburgh Mercy Childrens Hospital, Pittsburgh,Pennsylvania, and became certied in Pediatrics. Dr. Winchreceived his MBA rom the University o Pittsburgh, KatzGraduate School o Business. He then went on to completean Anesthesiology Residency with specialization in Pediatricsat Strong Memorial Hospital beore coming to ColumbusChildrens Hospital.

CAring th wh am.


42/44


40

We welcome the opportunity to discuss

the needs o your patients in greater

detail, including the many ways the

Columbus Childrens Heart Center may

be o assistance.

To arrange a consult or to refera patient, please email us [email protected] or1-800-792-8401.

Here, care is delivered with

compassion and understand-

ing. We know the diagnosis

o a heart condition aects

not only the patient, but

also the entire amily. Our

amily-centered approach to

care involves and includes

every member o the patients

amily. We also oer the

support o social workers as part o each childs interdisciplinary health care team.

Our Welcome Center is one o the only patient programs o its kind to oer the Sleep Well, Get

Well program, which is specially designed or international and out-o-town guests. Through the

program, amilies rom outside the central Ohio area receive a ree hotel stay the night beore any

inpatient or outpatient procedure. In addition, the Welcome Center sta can assist amilies with

everything rom making clinical arrangements to helping nd answers to insurance questions.

We believe the well being o the entire amily is critical to the success o our patients and yours.

Physician Liaison Program

The Childrens Hospital Physician Liaison

Program is a two-way communication channel,

and one additional way Childrens is working

better to serve physicians, their oce sta and

the community. Through personal oce visits,

written correspondence, telephone calls, axes

and e-mail, they provide a critical connection to

Childrens Hospital. To speak with a physician

liaison, call (614) 722-4585.


43/44

Out in ront.By yourside.

Cm Ch wa ct am Amca bt

Hta US News and World Report. M tha ath, th

mt ct ak vaat th t w mak ach a ha th am w v.

i at, Ch th t ta atc hta oh t achv Matstat xcc m th Amca n Acat. A, Ch em-

c svc a ak #2 th ut stat, cac am th at oh,

a th Ch rach ittt am th t 10 th ct niH .

T a m at Cm Ch, w vt t vt www.cmch.cm


44/44

700 Childrens Drive Columbus, Ohio 43205 (614) 722-2530 1-800-792-8401 www.columbuschildrens.com/heartcenter

heart center outcomes

Documents