The Division of 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:
- UPMC Children’s Hospital of Pittsburgh in Lawrenceville and three satellite facilities in Wexford, Monroeville, and South Fayette
- UPMC Magee-Womens Hospital
- UPMC Presbyterian
- 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.
Inpatient and Outpatient Services
The program supports a comprehensive Perinatal Cardiology Program in collaboration with the obstetrics team a UPMC 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 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.
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.
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.
Interventional Cardiac Catheterization
The interventional cardiac catheterization program under the leadership of Jacqueline Kreutzer, MD 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.
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 Congenital Cardiac Catheterization Outcomes Project Quality Improvement (C3PO) 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.