The mission of the Division of Pediatric Cardiology at UPMC Children's Hospital of Pittsburgh is to:
- Provide comprehensive, high-quality clinical services for fetuses and children with all forms of heart disease and for adults with congenital heart disease
- Train the next generation of clinical pediatric cardiologists and physician-scientists through a comprehensive fellowship program of superior standards
- Perform high-quality clinical and basic science research in the fields of heart disease and developmental cardiology
- Teach the fundamentals of pediatric cardiology to medical students, pediatric residents, and pediatric and adult cardiology fellows
The Division of Pediatric Cardiology forms an integral part of the Heart Institute service line at UPMC Children's Hospital of Pittsburgh and is the leading provider of comprehensive pediatric cardiovascular services in Western Pennsylvania and the tristate area. It is an internationally recognized center of excellence in pediatric heart failure, cardiomyopathy, mechanical circulatory support, and heart and lung transplantation. The Heart Institute integrates the various divisions and programs necessary to provide state-of-the-art cardiovascular services to children and young adults with congenital heart disease and to children with acquired heart disease. The components of the Heart Institute include the Division of Pediatric Cardiology (Chief Jacqueline Kreutzer), the Division of Cardiothoracic Surgery (Chief Victor Morell), the Cardiac Intensive Care Unit (CICU) (Interim Chief Matthew Bochkoris), and the Division of Cardiac Anesthesia. The CICU is a 12-bed unit and is the only dedicated pediatric CICU in the region. This multidisciplinary team approach has resulted in excellent clinical outcomes.
The Heart Institute actively participates in numerous National Institutes of Health (NIH), foundation, and industry-sponsored clinical and basic research programs. The program has an active pediatric cardiology fellowship program accredited by the Accreditation Council for Graduate Medical Education (ACGME). The program also offers post-graduate training in pediatric cardiac intensive care to fellows who have completed training in pediatric cardiology or pediatric intensive care.
The program continues to expand clinical services to the region, ensuring that children have access to top-quality cardiology services using on-site clinics and telemedicine technology. For the most recent four-year reporting period for the Society of Thoracic Surgeons, the program’s surgical mortality was 2.1% (national average = 3.23%). In fact, the Heart Institute’s success was the best in the country among medium and large programs. The program’s achievements were acknowledged with a #6 ranking cardiology and heart surgery by U.S. News & World Report.
The cardiology research program thrives under the new leadership of Bernhard Kühn, with continued NIH funding to perform multicenter trials in pediatric heart transplantation, development of novel mechanical circulatory support devices for use in children, and expansion of the fellowship program. Strong research collaborations exist with the University of Pittsburgh’s Swanson School of Engineering Department of Biomedical Engineering, the Thomas E. Starzl Transplantation Institute, the Vascular Medicine Institute and the cardiac genetics research program of the University of Pittsburgh’s School of Medicine’s Department of Developmental Biology (Cecilia Lo, chair).
The Division of Pediatric Cardiology provides comprehensive clinical services to children and adults with congenital heart disease, as well as to children with acquired heart disease. This clinical program includes ambulatory diagnostic services at 16 locations: Children’s Hospital in the Lawrenceville neighborhood of Pittsburgh; the three satellite facilities in Wexford, Monroeville, and South Fayette; Magee-Womens Hospital of UPMC; UPMC Presbyterian; and 10 other outreach locations throughout western and central Pennsylvania and the panhandle of West Virginia. With this extensive outreach program, cardiology is taking its services out into the community and has the most extensive outreach effort of any program at Children’s Hospital. This year, office visits amounted to nearly 14,000 in all locations, including almost 2,500 patients seen in remote outreach locations beyond the metropolitan Pittsburgh area. This successful model has served as a “best practices” template for other divisions. Ambulatory services include diagnostic outpatient office visits, noninvasive imaging including echocardiography (more than 18,000 studies), arrhythmia detection including electrocardiography, 24-hour Holter and 30-day event recorder monitoring, cardiopulmonary exercise testing, and preventive cardiology services.
The program supports a comprehensive Perinatal Cardiology Program in collaboration with the obstetrics team at Magee-Women's Hospital. This program has three facets: neonatal cardiology, fetal cardiology, and maternal cardiology. This unique and comprehensive program is one of the busiest in North America. The Division of Pediatric Cardiology also provides inpatient and same-day services at Children’s Hospital, and these services include diagnostic and state-of-the-art interventional cardiac catheterization with the region’s only biplane hybrid catheterization laboratory; diagnostic and therapeutic arrhythmia management, including arrhythmia ablation with radiofrequency or cryoablation (reaching more than 100 electrophysiology patients in fiscal year 2017); and medical management of cardiac dysrhythmias, preventive cardiology, inflammatory diseases of the heart, and heart failure. In fact, the division’s world-renowned pediatric heart and heart-lung transplant program has expanded its focus to encompass methods of heart-failure support and recovery.
The cardiology faculty also follows all children receiving surgical management of congenital or acquired cardiovascular conditions. The pediatric Cardiac Intensive Care Unit (CICU) is dedicated to the medical and surgical management of critically ill patients with congenital and acquired cardiovascular disease. This is the only such unit in the region.
The improved medical and surgical outcomes of children with congenital heart disease have led to a growing number of survivors flourishing in the community. It is now estimated that there are more adults living with congenital heart disease than children. Adult congenital heart disease comprises approximately 10%–15% of the work of the Heart Institute and continues to grow. The Division’s Adolescent and Young Adult Congenital Heart Disease Service introduced a transition program to enable seamless transfers of care for adolescents from pediatric specialists to adult congenital heart disease cardiologists.
The interventional cardiac catheterization program under the leadership of Jacqueline Kreutzer is one of the premier programs in the country, with the incorporation of new procedures and technologies (such as percutaneous valve implantation), the performance of hybrid procedures, and extensive participation in multicenter trials. The program has seen a progressive increase in patient and procedure volume in the catheterization laboratory.
Finally, the cardiology program continues to push state-of-the-art technology, using telemedicine technology to improve access, including a telemedicine echocardiography service that supports the reading of fetal and pediatric transthoracic echocardiograms throughout Western Pennsylvania and West Virginia. This program enables hospitals throughout the region to comply with state law and American Academy of Pediatrics (AAP) recommendations to screen newborn babies for critical congenital heart disease. The cardiology division provides expert consultative services, echocardiography training, and interpretation, and transport of critically ill children from remote sites to the Children’s Hospital facility for advanced cardiac services.
Dr. Gaurav Arora performed the first fluoroless ablation (true zero fluoroscopy) in the history of Children’s Hospital in early 2017 and has continued to perform more procedures with zero radiation.
Cardiology at Children’s Hospital has always been recognized for its excellence in clinical care, service delivery, and communication with referring physicians. Seven pediatric cardiologists have been named to the “Best Doctors in Pittsburgh.” The division, as part of the Heart Institute, has a robust Quality Assurance Process Improvement program with a number of quality initiatives, including protocols to reduce catheter infection rates and ongoing participation in national quality initiatives, including the cardiac catheterization IMPACT and C3PO (Congenital Cardiac Catheterization Outcomes Project Quality Improvement) programs. Cardiology faculty routinely receive the highest levels of patient satisfaction from both Children’s Hospital and national surveys. In 2017, three cardiology faculty were recognized for the Department of Pediatrics Chair’s Distinction: Libby Lanford, Lee Beerman, and Jacqueline Kreutzer.