Pediheart: Pediatric Cardiology Today

This week we discuss a recent report from the team at SickKids in Toronto on minimally invasive cardiac surgery. What sorts of operations are most common for this approach? Why are length of ICU and length of hospitalization periods lower in this surgical cohort than more traditional midline sternotomy approaches? How does one train a surgeon to perform these operations if the surgical exposure is so small, allowing only the priimary surgeon to see the majority of the surgery? What are the limits of this sort of surgical approach? These are amongst the questions posed to the first author of this work, Associate Professor of Surgery at University of Toronto, Dr. Christoph Haller. 
DOI: 10.1016/j.jtcvs.2025.12.009

This week we review a recent report using data from the IMPACT registry assessing the rates of major adverse events during cath of the pediatric cardiomyopathy patient. How commonly are complications encountered and who is at greatest risk? How much additional risk is incurred by performance of an endomyocardial biopsy at the time of catheterization? Pediatric critical care expert, Dr. Alejandro Martinez Herrada of Nicklaus Children's Hospital provides his insights this week. 

doi: 10.1161/JAHA.125.047780.

This week we delve again into the world of adult congenital heart disease and specifically the realm of biomarkers when we review a recent report of the proteomics of the adult Fontan patient. What is proteomics and how can this inform our understanding of the pathophysiology and adaptive pathways of the Fontan circulation? Are there meaningful differences in the patterns of protein expression between the adult Fontan patient and control 2 ventricle subjects? What might account for differences and how can we understand these differences to explain outcomes in the Fontan adult patient? We speak with the first and senior authors of this week's work, Professor Alexander Opotowsky of the University of Cincinnati and Mr. Ismael Assi who is a Sarnoff Fellow and soon to be 4th year medical student at the University of Cincinnati. 
DOI: 10.1016/j.jacadv.2026.102810

This week we speak with a true pioneer in pediatric cardiology, Professor Rica Arnon of Mount Sinai in NYC. Dr. Arnon's career has spanned from the mid 1970's right up to the present time where she is still working as a cardiology consultant and educator at Mount Sinai in Pediatrics after more than 50 years. In this episode we learn the travails of a pioneering women in medicine/cardiology as Dr. Arnon shares with us the challenges and triumphs of a career that balanced outstanding clinical excellence with a rich family life. Why did she travel from Israel to the US to train? How did she choose to become a pediatric cardiologist and who were her mentors? What makes a good teacher of cardiology for young learners? What advice can this master of cardiology provide regarding 'balance' in a clinically active life when one is also devoted to their family? What is better in our field today and what does Dr. Arnon believe may have been lost along the way? Dr. Arnon tells it to us 'straight' in a delightful conversation with a master clinician and teacher. 

A conversation with Dr. Michael Freed:
https://podcasts.apple.com/us/podcast/pediheart-podcast-replay-of-203-a-conversation/id1341472214?i=1000681074493

A conversation with Dr. Welton Gersony:
https://podcasts.apple.com/us/podcast/pediheart-podcast-247-a-conversation-with-living/id1341472214?i=1000607813461

This week we review a recent meta-analysis of studies assessing efficacy of adenosine in children to terminate SVT. Does the PALS recommendation of 100 mcg/kg as a starting dose for SVT management make scientific sense given what we know about the efficacy rates of this dose? Why might inadequate doses be potentially dangerous for children with acute SVT? Is there adequate data to consider changes to the recommended starting dose in this situation? Dose adenosine work well for all forms of tachycardia involving the AV node? Pediatric emergency physician and family medicine physician, Dr. Lais dos Santos of Mossoro', Brazil shares the results of a large scale meta-analysis that she performed and offers some answers to these and other questions. 

DOI: 10.1007/s00246-026-04281-5