2024 Report: Pediatric Cardiac Outcomes

2024 REPORT

PEDIATRIC CARDIAC OUTCOMES

INTRODUCTION

OUR SPECIALTIES

At the Children’s Heart Center at NewYork-Presbyterian, a combined program of NewYork-Presbyterian Morgan Stanley Children’s Hospital and NewYork-Presbyterian Komansky Children’s Hospital, we take a fully integrated approach to the treatment of pediatric heart conditions in people of all ages—from newborns to adults.

As one of the country’s first and most preeminent centers for pediatric cardiology and heart surgery, children and adults from all over the world come to us to receive our care. We have built a reputation for outstanding quality care and have pushed the boundaries of what is possible in the field of pediatric cardiology and cardiac surgery, including pediatric robotic open heart surgery. In addition to performing the most pediatric heart surgeries in the tristate area,1 we also treat some of the most complex cases in the region.

Other programs in the tristate area rely on the Children’s Heart Center at NewYork-Presbyterian when their patients need to be sent elsewhere for their complex care.2 We take immense pride in taking care of these patients and being the trusted center for families and other institutions.

CONGENITAL HEART SURGERIES A YEAR3

30,000

Cardiogenetics Fetal Cardiology Heart Arrhythmia Management Hypoplastic Left Heart Syndrome

Children’s Heart Center Surgery Volume 2019—20233 900 800

854 766

700 600

853

766

Pediatric ECMO & VAD

716 576

632

556

550

500

MORE THAN

Cardiac Catheterization/ Interventional Cardiology

Lymphatic Malformations

OVER

700

Advanced Cardiac Care and Transplantation

509

Pediatric Heart Murmur

400

Pediatric Heart Surgery

300 200

180

136

124

100

147

0 2019

2020

2021

2022

2023

OUTPATIENT VISITS PER YEAR3

Total Congenital Heart

Learn more

Sources: 1. Society of Thoracic Surgeons, 2023. 2. Trilliant, 2021-2023. 3. Society of Thoracic Surgeons, 2023.

Open Heart

Neonatal

Pulmonary Vein Stenosis

SURGICAL PLANNING PROGRAMS: 3D IMAGING Our 3D modeling program at NewYork-Presbyterian Morgan Stanley Children’s Hospital helps our team of physicians and surgeons treat patients with some of the most complex congenital heart conditions. From transplant and ventricular assist devices (VAD) planning to virtual reality for intracardiac visualization, our 3D heart models allow for detailed preparation for each patient’s procedures. This technology helps our team to more accurately diagnose conditions, decide which surgical treatments are necessary, and better educate parents and their children. In addition to displaying intracardiac anatomy, these models also allow us to test potential interventions and simulate surgical procedures. We also use this technology for fetal counseling and education, and we are one of the few centers in the country using this technology.

3D heart models allow for detailed preparation for procedures and more accurate diagnoses.

SURGICAL PLANNING PROGRAMS: CT/MRI Our advanced cardiac imagers at the Children’s Heart Center at NewYork-Presbyterian are specifically trained in the utilization of cardiac MRI and CT for the care of patients with congenital heart disease. They have insight into the techniques that are needed to acquire the highest-quality images while planning scans with the pediatric patient in mind. Our CT/MRI program plays an integral role in the pre-procedural planning of cardiac surgery and catheterization procedures as well as follow-up care of the congenital heart disease patient.

In addition to providing imaging for clinical care, our team is involved with many research collaborations to advance the field. This includes spearheading a multicenter study in the use of parametric mapping to detect fibrosis in children, creating management plans for patients with coronary artery anomalies, and using 4D flow models in complex congenital heart disease.

We complete more than 600 cross-sectional studies per year.

Our group is actively contributing data toward investigations, including those into the effects of the COVID vaccine on the heart muscle of children, data on single ventricle patients after Fontan, and patients with pediatric cardiomyopathies.

CARDIAC CATHETERIZATION PROGRAM Thanks to advancements in the field of pediatric cardiology, we are able to repair many heart abnormalities with the use of minimally invasive cardiac catheterization procedures.

We have state-of-the-art dedicated cardiac catheterization labs designed to treat even the smallest hearts. This procedure involves inserting a long, flexible tube into blood vessels, guiding to the heart and surrounding blood vessels. This allows our team of interventionalists to examine and treat heart problems without an extensive hospital stay.

The Children’s Heart Center at NewYork‑Presbyterian is one of just a few U.S. centers to offer hybrid heart surgery to our patients. These procedures combine traditional surgical methods with cardiac catheterization.

We have pioneered and trialed several pediatric interventional cardiology procedures that have demonstrated excellent results, such as the use of the Autus Valve, an artificial valve made of stainless steel. Implanted during surgery, the valve can then be expanded using a catheter balloon as the child grows.

To treat Yasin’s congenital heart condition, his doctors implanted one of the first-ever heart valves that can be expanded using a catheter balloon as he grows.

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ELECTROPHYSIOLOGY Our electrophysiology team provides comprehensive and multidisciplinary care to children with a wide range of arrhythmias that include post-surgery for congenital heart disease, those related to hypertrophic and dilated cardiomyopathy, Brugada syndrome, supraventricular tachycardia, ventricular tachycardia, and WolffParkinson-White syndrome. From the occasional episodes of palpitations all the way to complex cardiac arrhythmias, our team is here to provide a customized plan, using the latest diagnostic and therapeutic approaches. Our team takes a collaborative approach when electrophysiology services are needed, partnering with the child’s pediatric cardiologist and other physicians to identify the cause and best treatment plan.

We use many different approaches to treat arrhythmias—from interventional therapies such as ablation to implantable devices such as a pacemaker or implantable cardiac defibrillator. Our team performs these ablation procedures in the catheterization lab using 3D mapping technology, which eliminates the radiation exposure involved in fluoroscopy imaging. In addition to invasive electrophysiological studies, our team also performs non-invasive diagnostic procedures in children, including electrocardiograms (EKG), 24-hour Holter monitoring, event recording, and stress testing.

PEDIATRIC HEART TRANSPLANT PROGRAM As one of the oldest and highest-volume centers in the country, the Pediatric Heart Transplant Program at NewYork‑Presbyterian Morgan Stanley Children’s Hospital is renowned for successfully transplanting children with complex conditions since 1984. Many of our patients are deemed high risk by conventional standards and are sent to us by other heart programs in the tristate area.

In 2023, we surpassed 600 pediatric heart transplants, more than any program in the country.1 We’re proud of the innovations that our team has developed in recent years, such as the use of the total artificial heart as a bridge to transplant and completing the first-ever successful domino heart valve transplant in infants in 2023.

600

PEDIATRIC HEART TRANSPLANTS SINCE 1984 – MOST IN THE COUNTRY

Buddy and Ruby were born with the same genetic heart disease, and both received heart transplants before the age of 2.

Source: 1. Organ Procurement and Transplantation Network, 2024.

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CENTER FOR SINGLE VENTRICLE CARE The medical advances for babies born with single ventricle defects have come a long way. Single ventricle defects can now be diagnosed before birth and successfully treated with a series of open-heart surgeries. Due to our advanced technology, skilled surgeons, and dedicated infant cardiac ICU, babies can receive this series of surgeries all in one place. Our multidisciplinary team includes experts in pediatric cardiology, cardiac surgery, neurodevelopment, maternal fetal medicine, neonatology, social work, nutrition, and child life.

With the advances in imaging techniques, single ventricle defects can now be found during pregnancy from fetal echocardiograms. At the Carmen and John Thain Center for Prenatal Pediatrics, babies will be closely monitored if heart defects are found. Our surgeons partner very closely with this center to make sure babies needing an operation shortly after birth have a successful transition.

Most babies with single ventricle defects will undergo three surgeries, called the Norwood, Glenn, and Fontan procedures during their first few years of life. After successful treatment, babies will be transferred to our state-of-the-art infant cardiac ICU that provides round-theclock monitoring.

INFANT CARDIAC ICU In 2017, NewYork‑Presbyterian created one of the nation’s first infant cardiac intensive care units, treating some of the smallest premature or low-birth-weight newborns. Our staff of neonatal cardiac intensivists and specialized neonatal nurses ensures that our young patients receive the complex care they need.

100%

STAT 1 NEONATES SURVIVAL RATE STS Benchmark 97.8%

100%

STAT 2 NEONATES SURVIVAL RATE STS Benchmark 97.6%

98.2%

OVERALL INFANT SURVIVAL RATE STS Benchmark 97.4%

100%

STAT 3 INFANT SURVIVAL RATE STS Benchmark 96.5%

100%

STAT 5 INFANT SURVIVAL RATE STS Benchmark 81.5%

100%

STAT 2 INFANT SURVIVAL RATE STS Benchmark 97.5%

Source: Society of Thoracic Surgeons, 2023.

FETAL CARDIOLOGY Many congenital heart defects can be found during pregnancy, allowing the mother and family to plan for their baby’s care before and after birth. We offer state-of-the-art fetal echocardiography, which allows our team of specialists to accurately monitor the baby’s heart. Fetal cardiology experts provide advanced prenatal diagnosis and fetal therapy for babies who may be at risk for heart problems. Our fetal cardiologists collaborate with our maternal fetal medicine teams at both the Carmen and John Thain Center for Prenatal Pediatrics at NewYork‑Presbyterian Morgan Stanley Children’s Hospital and the Fetal Care Center at NewYork-Presbyterian Komansky Children’s Hospital to provide a comprehensive plan of care for both the mother and the baby through the pregnancy. The close relationship between our pediatric cardiologists, cardiac surgeons, and maternal fetal medicine teams starts as soon as a mother is diagnosed with a high-risk pregnancy due to congenital heart disease. We are proud to be nationally accredited by the Intersocietal Commission for the Accreditation of Echocardiography Laboratories1 for providing exceptional fetal echocardiography according to national standards.

The Carmen and John Thain Center for Prenatal Pediatrics at NewYork‑Presbyterian Morgan Stanley Children’s Hospital was the first in New York State to develop a program in fetal cardiac intervention, making it possible to change how the heart develops in utero and alter the natural course of certain cardiac lesions.

Source: 1. Intersocietal Accreditation Commission, 2023.

PULMONARY HYPERTENSION COMPREHENSIVE CARE CENTER The Pulmonary Hypertension Comprehensive Care Center at NewYork‑Presbyterian Morgan Stanley Children’s Hospital is one of the largest in the world.

The center’s pediatric cardiologists, neonatal and pediatric cardiac intensivists, and cardiac surgeons work collaboratively to help patients with pulmonary hypertension. Each patient has a unique care plan that may include genetic testing, medication, specialized surgeries, and clinical trials. As the only PHA-accredited pediatric pulmonary hypertension center on the East Coast,1 we are one of few centers in the nation offering pulmonary thromboendarterectomy (PTE) and balloon pulmonary angioplasty (BPA) for chronic thromboembolic pulmonary hypertension (CTEPH).

Jonathan was treated at NewYork-Presbyterian Morgan Stanley Children’s Hospital.

Source: 1. Pulmonary Hypertension Association, 2024.

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PULMONARY VEIN STENOSIS Pulmonary vein stenosis is a rare and progressive disease that affects newborns and children of all ages. This type of condition requires surgical, transcatheter, and medical therapy expertise.

Some catheter-based interventions include stent implantation and/or balloon angioplasty to open pulmonary veins. Our surgeons are world renowned for their treatment of pulmonary vein stenosis and offer several different surgical approaches to this condition. This close collaboration between our cardiac surgeons and interventionalists has resulted in improved outcomes for infants and children. Due to research made in this field, medication treatment therapies discovered just a few years ago have drastically changed the outlook for children with pulmonary vein stenosis, and centers all around the country have begun to adopt this form of treatment.

CARDIAC SURGERY At the Children’s Heart Center at NewYork-Presbyterian, we perform more than 700 congenital heart surgeries every year, the highest of any program in the tristate area.1 Performing a high number of surgical procedures is not only a testament to our skilled surgeons, but it also shows the level of trust families and referring providers have in our program. Oftentimes other heart centers in the area rely on the Children’s Heart Center for second opinions and complex cases.2 In addition to performing traditional open-heart procedures, our surgeons also operate using minimally invasive techniques, including robotic surgery for treating some heart defects. This innovative approach uses a robotic-assisted system, controlling specialized instruments through a console. The high-definition, three-dimensional visualization enhances the surgeon’s accuracy and allows them to access the heart through small incisions, resulting in minimized damage to the surrounding tissues and reduced scarring. This type of surgical approach often leads to shorter stays in the hospital and a faster recovery compared to conventional surgery. Our highly skilled and experienced pediatric heart surgeons are national leaders in complex neonatal surgery, hybrid minimally invasive surgery, and transplant/assisted devices.

Born with half a heart, Jack’s doctors reengineered his heart so the right side could do the pumping.

Read More Sources: 1. Society of Thoracic Surgeons, 2023. 2. Trilliant, 2021-2023.

OUTCOMES When it comes to outcomes data, we compare our program against other top pediatric cardiology programs across the country. We use the registry data we submit to the Society of Thoracic Surgeons to benchmark our quality outcomes. We believe in sharing this information broadly and being transparent with parents, families, and referring providers so that they have the information they need to make an informed decision about their care.

CORE RESULTS WHERE NEWYORK-PRESBYTERIAN MEETS OR EXCEEDS BENCHMARKS

98.25%

99.3%

100%

88.2%

100%

99.2%

98.6%

95.8%

OVERALL CARDIAC SURVIVAL RATE IN 2023 STS Benchmark 97.4%

STAT 3 SURVIVAL RATE STS Benchmark 97.2%

STAT 3 CHILDREN SURVIVAL RATE STS Benchmark 97.9%

ATRIOVENTRICULAR CANAL SURVIVAL RATE STS Aggregate 98.2%

92.5%

NORWOOD SURVIVAL RATE STS Aggregate 88.2%

Source: Society of Thoracic Surgeons, 2023.

STAT 2 SURVIVAL RATE STS Benchmark 97.8%

STAT 5 SURVIVAL RATE STS Benchmark 84.8%

TETRALOGY OF FALLOT SURVIVAL RATE STS Aggregate 99.07%

ASO +VSD SURVIVAL RATE STS Aggregate 95.7%

AVERAGE LENGTH OF STAY

Postoperative LOS vs STS Median by Procedure

We recognize that no one wants to be in the hospital, and we take pride in our length-of-stay data compared to our competitors.

This allows our patients to be where they belong—at school, the playground, and, most importantly, with their loved ones.

70

NYP

60

STS Avg.

50 40 30 20 10

w oo

d

us N

or

nc Tr u

Fo nt an

em

iF on ta n

VS D

O

ff

G

By

le

pa

nn

/H

AS O

+

AS O

AV C

TO F

VS D

ss

C

oa

rc ta tio n

0

Median Postop LOS by STAT Category vs STS Avg. 70

63.99

60

NYP STS Avg.

50

39.17

40

23.19

20 10

31

27.53

30

10.92 5

22 14

9

0

STAT 1

STAT 2

STAT 3

STAT 4

STAT 5

STAT Category 1: Patch repair of Atrial Septal Defect (ASD) or Ventricular Septal Defect (VSD) pulmonic valve replacement STAT Category 2: Ross procedure, Fontan procedure, tricuspid valve repair STAT Category 3: Complete AV Canal (AVC) repair, Arterial Switch Operation (ASO), lung transplant

Aramara was treated at NewYork-Presbyterian Komansky Children’s Hospital.

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STAT Category 4: Blalock-Taussig (BT) shunt, heart transplant, truncus arteriosus repair STAT Category 5: Heart and lung transplant, Norwood procedure, truncus plus interrupted arch repair

We are proud to share more about the Children’s Heart Center at NewYork‑Presbyterian.

Learn More about our pediatric cardiology and cardiac surgery advances.

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Stay Connected

Refer a Patient: NewYork-Presbyterian Morgan Stanley Children’s Hospital: 844-478-3627 NewYork-Presbyterian Komansky Children’s Hospital: 212-746-3561