|| Pediatric Cardiac Services
Cardiothoracic surgery remains the cornerstone of treatment for infants and children with structural heart disease. Improved pre- and post-operative care, combined with advancements in intra-operative technique, continue to lower mortality rates and broaden the therapeutic possibilities for patients with complex lesions.
The Congenital Heart Surgical program at Maine Heart Center utilizes highly trained individuals from the fields of cardiology, anesthesiology, nursing, perfusion and intensive care to bring comprehensive expertise to the care of each child who undergoes cardiac surgery. "Perhaps no other surgical patient requires the coordinated effort of so many sub-specialized disciplines," says Reed Quinn, M.D., director of the Division of Pediatric Cardiothoracic Surgery.
Maine Heart Center offers all types of curative and palliative surgery for infants, children and adults with congenital heart disease, except for cardiac transplantation. Being the only surgical program in the state translates into an experienced surgical team with a quality of care that is among the best in the country.
Recent developments in cardiac ultrasound have transformed the practice of pediatric cardiology. Advances in transducer design and data processing have made it possible for the first time to image the beating heart in three dimensions, providing the surgeon with a 3-D model of the heart prior to surgery.
"There is simply no substitute for being able to non-invasively look inside the patient's heart and thoroughly understand the problem before the surgeon makes an incision," says Aurelio Reyes II, M.D., director of the Pediatric Echocardiography Laboratory.
Transesophageal echocardiography also provides crucial information during cardiac interventions to provide the best possible procedural outcomes. In addition to performing 3,387 transthoracic and 176 transesophageal studies last year, the Division of Pediatric Cardiology also provides the primary fetal echocardiography service in the state, allowing time for both parents and physicians to plan for the birth of a child with congenital heart disease.
Cardiac MRI is quickly becoming an essential non-invasive imaging modality for the assessment of cardiac function and vascular anatomy. Dr. Adrian Moran, who received his training at Boston Children's Hospital, is the first and only cardiologist in Maine with expertise in cardiac MRI. "Magnetic resonance imaging overcomes some of the shortcomings of ultrasound by enabling the physician to image two-dimensional slices of the heart from any angle. Using complex, post-processing algorithms, the cardiologist can then construct a three-dimensional model of the heart which can be viewed from all sides, as if you were holding a plaster model," says Dr. Moran.
The electrophysiology (EP) services at MHC provide expert care for rhythm disorders in patients from fetal life through adulthood. All diagnostic and therapeutic modalities are available including rhythm surveillance, exercise testing, tilt-table evaluation, pacemaker and defibrillator implantation and follow-up, transesophageal and intracardiac EP testing, and radiofrequency ablation.
"Children are not just small adults" says Michael Epstein, M.D., Maine 's first and only pediatric electrophysiologist. "Issues of small size and patient growth play a vital role in the diagnosis and management of rhythm disorders in kids." In addition to caring for the very young, one of the great challenges faced by pediatric EP is the care of adults with repaired or palliated congenital heart disease. As more patients with complex disease survive into adulthood, rhythm abnormalities have become a common and serious morbidity. Pediatric electrophysiologists, because of their unique knowledge of structural heart disease, are best equipped to manage these difficult problems.
Dr. Epstein is a graduate of Harvard Medical School and performed his residency, fellowship and EP training at Boston Children's Hospital.
Catheter-based intervention is becoming increasingly utilized as a curative therapy for simpler, more common forms of congenital heart defects. Many congenital lesions, such as atrial septal defects or patent ductus arteriosus, can be closed with special devices delivered through catheters that are smaller than a drinking straw.
Similarly, congenitally obstructed blood vessels, such as coarctation of the aorta or pulmonary artery stenosis, can be completely opened with current stent technology. "It is exciting to be able to completely fix a patient's heart defect with no surgical incisions and essentially no recovery time," says Jon Donnelly M.D., director of the Pediatric Catheterization Laboratory. "Our efforts continue to be in collaboration with our surgical colleagues as many of the emerging catheter interventions take place in the operating room to augment a complex surgical repair."
The Pediatric Catheterization Laboratory at the Congenital Heart Center of Maine offers all FDA-approved procedures and devices used to treat children and adults with congenital heart disease. Being the only pediatric catheterization lab in the state helps ensure a sizeable volume and variety of procedures, which translate into experienced operators and quality care for the patient. A recent review of the last 1,000 cases revealed a mortality rate of 0.2% and major complication rate of 1.8%, both of which are well below the national average.
Find out about Precious Heart Support Group for families with congenital heart defects. Click here for Barbara Bush Children's Hospital Pediatric Cardiology Services.