Pediheart: Pediatric Cardiology Today

This week we review a recent work from the CT group at NY Presbyterian assessing the impact of phenylephrine during pediatric congenital CT scans to lower heart rate. Why is a lower heart rate better for CCT's? Should this agent be routinely employed for this indication during CT scans in children? Dr. Yosef Cohen, pediatrics resident at the Children's Hospital at Montefiore shares his insights from a recent work he co-authored. 

doi: 10.1093/ehjimp/qyag023. eCollection 2025 Aug.

In this replay episode from 2 years ago, we delve into the world of adult congenital heart disease to review the topic of liver disease in the Fontan patient and specifically, hepatocellular carcinoma (HCC). What is the prevalence of this disease in the Fontan single ventricle adult patient? How effective are scores like the MELD-XI or Fibrosis-4 Index at identification of HCC in the Fontan patient? How should the Fontan adult patient be surveilled for this form of cancer? What evidence is there that earlier identification of HCC is associated with better outcomes? What may prove to be the most important factor in protection of the liver in the Fontan patient? Dr. Yuli Kim, Director of the ACHD program at The University of Pennsylvania shares her deep insights this week into this important topic.
DOI: 10.1093/eurheartj/ehad788

This week we review a recent Australian prospective assessment of aspirin resistance in children undergoing heart surgery. How common is this seen in this patient group and what are the reasons? What is the best test to perform to assess this and what tests may not be worthwile? Who deserves 'routine' testing for this possible problem? Cardiovascular surgeon Dr. Supreet Marathe of Queensland Children's Hospital in Brisbane, Australia shares the results of this recent publication. 

DOI: 10.1016/j.jtcvs.2025.09.013

This week we speak with Assistant Professor of Pediatrics at Harvard Medical School, Dr. Audrey Dionne about a recent work she co-authored on sinus node dysfunction following congenital heart surgery. How common was this encountered and how often were either temporary or permanent pacing needed? Are there certain surgeries that are more associated with the need for pacing after surgery? Why is this so common following heart surgery? Dr. Dionne shares her deep knowledge this week on this surprisingly common problem.  
DOI: 10.1016/j.hrthm.2026.01.049

In this compelling lecture by Dr. David Winlaw of Northwestern University, we hear his thoughts on the state of the CICU/Surgeon relationship and he offers his thoughts on how to improve care for children with congenital heart disease undergoing surgery. Why does he believe that the more old fashioned approach of having cardiac programs run by academic departments is no longer optimal? What do critical care doctors not understand about surgery and vice versa? Are we asking too much of our CICU practitioners? How can the 'shift work' mentality be abolished and how can we avoid burnout for our critical care front line staff while also improving outcomes for patients? How can we bring joy back into the care of children with critical heart disease? Dr. Winlaw shares his insights from a long career in multiple centers worldwide in the Thomas J. Spray Lecture at the Cardiology 2026 CHOP conference from late February, 2026 in Arizona.