Predicting Postoperative Thrombosis after Congenital Heart Surgery

Prince J. Kannankeril, MD - Vanderbilt University Medical Center

Postoperative thrombosis complicates roughly 10% of congenital heart disease (CHD) surgeries and is associated with increased mortality and hospital length of stay. Despite the widespread availability of effective medications to prevent thrombosis, we currently lack the ability to predict which patients are at sufficient risk for postoperative thrombosis during routine care. Our goal is to improve the lives of patients with CHD by reducing the impact of postoperative thrombosis on mortality, morbidity, and resource utilization.

Building a Non-Invasive Cardiac Output Monitor for Infants and Children with Congenital Heart Disease

Danielle Gotlieb Sen, MS, MD, MPH - Johns Hopkins Medical Institute

Congenital heart disease (CHD) remains the single most common congenital anomaly, affecting nearly 1% of all annual births in the United States. Infants and children with CHD can have complex abnormalities in cardiac anatomy and physiology requiring surgical intervention and close hemodynamic monitoring. Cardiac output (CO), the amount of blood the heart can pump every minute, is a key variable - low CO is associated with significant morbidity and mortality. The current gold standard for calculating CO requires invasive cardiac catheterization. Though useful, catheterization produces an instantaneous value at a single discrete time point that almost certainly misses dynamic and clinically important variations. There are non-trivial procedural risks associated with cardiac catheterization, and catheterization is performed under general anesthesia, which itself alters the patient’s physiology. Non-invasive alternatives to catheterization have been tested in intensive care units but their accuracy and precision is highly variable; such devices are not fully validated against invasive measurements, and none are designed specifically for young children with CHD. We seek to develop a first-of-its-kind cardiac output monitoring device to give healthcare teams the power to non-invasively, accurately, and continuously measure and monitor CO in patients with CHD.

Minimally Invasive Epicardial Pacing in Infants and Children with Congenital Heart Disease

Charles Berul, MD - Children’s National Hospital

We are proposing a novel lead attachment mechanism to improve chronic stability for pacing leads that are implanted on the outside of the heart without open chest surgery. This mechanism is targeted at infants, small children, and individuals with congenital heart disease who are unable to have a pacemaker placed through the traditional transvenous approach and for those who require temporary pacing wires not immediately concurrent with open cardiac surgery. We have developed four unique solutions that rely on an improved grasping mechanism of the cardiac tissue, increased surface area contact, and strain relief. The goal of this project is to demonstrate the feasibility of manufacturing such device, evaluate the fixation integrity and investigate the long-term stability of the prototype attachment mechanisms compared to standard leads in a chronic pig study.

Partial Heart Transplantation with Reduced Levels of Immunosuppression – A New Treatment Paradigm for Newborn Babies with Unrepairable Heart Valve Dysfunction

Taufiek Konrad Rajab - Medical University of South Carolina

Despite decades of intensive research focusing on tissue engineering with stem cells, attempts to deliver growing heart valve replacements for newborn babies have failed in clinical translation. This is a critical barrier to progress of the field. Our overall goal is to overcome this barrier using an entirely new approach based on partial heart transplantation. Partial heart transplantation involves transplantation of a heart valve only.  The objective of the proposed project is to determine the minimum level of immune suppression required for partial heart transplants. Our central hypothesis is that partial heart transplants require lower levels of immunosuppression than conventional heart transplants.