Congenital Heart Center CLINICAL ACTIVITY REPORT
2013
Cardiac Surgery
6
Interventional Cardiology
8
Electrophysiology 9 Fetal Heart Program
10
Adult Congenital Heart Program
11
Non-Invasive Imaging
12
Patient Care
14
Advocacy 18 Research 19 Innovation 21
Extraordinary Heart Care for
Children from Around the Nation and Across the Globe
MILESTONES AT MICHIGAN Throughout this book, you will find references to various landmark events for congenital heart care at the University of Michigan. We are proud of our legacy of leadership and honored to have played a role in so many advances in the field of congenital heart care.
44 32 STATES
COUNTRIES
Leaders in Pediatric Heart Care, Discovery and Education As an international referral center for children with complex heart disease, the University of Michigan Congenital Heart Center at C.S. Mott Children’s Hospital is one of the largest and best congenital heart programs in the United States. From diagnosis and medical management of common cardiac disorders to application of the most complex and innovative therapies available, our specialists are committed to providing the most advanced, evidencebased care for infants, children and adolescents with all forms of congenital and acquired heart disease, as well as for adults with congenital heart disease.
Richard G. Ohye, MD Head, Section of Pediatric Cardiovascular Surgery John R. Charpie, MD, PhD Director, Division of Pediatric Cardiology Stefanie L. Peters, MSW, LMSW, MPA Administrative Director
M-LINE 800-962-3555
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37 4 18 26 12
4
n
PEDIATRIC CARDIOLOGISTS PEDIATRIC CARDIAC SURGEONS FELLOWS ADVANCED PRACTICE NURSES CLINIC LOCATIONS
C.S. Mott Children’s Hospital
www.mottchildren.org/congenital
Relentless Commitment to Quality
Keeping Care Close to Home
A Legacy of Innovation
Our work is characterized by a commitment to focusing beyond survival to offer patients the best chance at a robust quality of life, improved long-term outcomes and reduced morbidity. We deliver highly competent, skilled and knowledgeable health care guided by respect for children and families.
Over the last few years, we have made a tremendous investment to developing a statewide network of collaborations and partnerships designed to enable families to receive care close to home. Through partnerships with institutions and practices throughout Michigan, we now see patients at 12 different locations to meet the needs of families and our partners statewide.
Our faculty and staff are committed to improving the procedures, processes and technologies that change the lives of children with heart disease around the world. Through leadership in novel research and device innovation projects, our aim is to push discoveries forward from the laboratory to the clinical setting, and disseminate findings that will benefit children now and in the immediate future.
2013 ACTIVITY SNAPSHOT
7,919
2,309
HOSPITAL CLINIC VISITS
1,034
INPATIENT DISCHARGES
917
TOTAL SURGICAL VOLUME
OUTREACH CLINIC VISITS
Congenital Heart Center
200
FETAL PATIENTS WITH CONGENITAL HEART DISEASE
1,024
ADULT CONGENITAL PROGRAM VISITS M-LINE 800-962-3555
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5
Pediatric Cardiac Surgery Since our pediatric cardiac surgery program began, we have cared for nearly 25,000 patients, making us one of the largest, most experienced programs worldwide. The pediatric cardiac surgeons at C.S. Mott Children’s Hospital have earned international renown for their expertise in treating the most complex congenital heart defects. Our program has become an international referral center for conditions such as hypoplastic left heart syndrome and other single ventricle lesions, high-risk biventricular repairs, complex forms of transposition of the great arteries and many other congenital abnormalities. TOTAL CARDIAC SURGERY VOLUMES
2010 2011 2012
809 791 851
2013
917 0
200
400
600
800
1,000
High-Complexity Patient Case Mix As we have continued to grow as an international destination for complex congenital heart disorders, our patient population has taken on an increasingly high-risk profile. Current outcomes data and benchmarks are stratified by operative case complexity but are not fully adjusted to reflect patient risk characteristics or specific diagnoses. Despite this, our outcomes compare favorably with national benchmarks and are on par or better than Society of Thoracic Surgeons (STS) averages. Transplant and Heart Failure U-M pediatric cardiac surgeons have performed more than 200 pediatric heart transplants since the transplant program began in 1984, consistently reporting low organ rejection rates and patient survival rates that rank among the world’s best. Our dedicated, multidisciplinary team of pediatric cardiac transplant surgeons, heart failure and transplant cardiologists, nurses, pharmacists, nutritionists and social workers provides coordinated and comprehensive evaluation, treatment and follow-up management, including a full spectrum of support services to children and their families. We participate in multiple organ transplant listings and have experience performing combination transplants such as heart/kidney or heart/liver. In addition, our innovative research endeavors give patients access to the newest treatments available, including the full range of ventricular assist devices (VADs).
Our pediatric cardiac surgery program is considered one of the highestvolume programs in the nation by the STS. 6
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www.mottchildren.org/congenital
30-DAY MORTALITY BY STAT CATEGORY
30-DAY MORTALITY ACROSS INDIVIDUAL OPERATIONS
Category 1
Ventricular septal defect repair
0
Category 2
Tetralogy of Fallot repair
0
Category 3
Complete atrioventricular canal repair
Category 4
Arterial switch operation
Category 5 0
5
10
15
20
PERCENTAGE ■ C.S. Mott Children’s Hospital
25
Fontan operation
0
Norwood operation
■ STS
0
2010–2013 data. STAT = Society of Thoracic Surgeons-European Association for Cardiothoracic Surgery Risk Stratification System. Category 1 = least complex cases. Category 5 = most complex cases.
5
10
15
PERCENTAGE ■ C.S. Mott Children’s Hospital
20
■ STS
U-M in-hospital mortality (2010–2013), as compared with STS national data.
POST-OPERATIVE LENGTH OF STAY ACROSS INDIVIDUAL OPERATIONS
U-M’s pediatric cardiac surgery mortality rates are lower than national benchmarks for the most complex cases. STAT CATEGORY 5
12.2
%
U-M MORTALITY
Ventricular septal defect repair Tetralogy of Fallot repair Complete atrioventricular canal repair Arterial switch operation Fontan operation
22.3
Norwood operation
%
0
5
10
15
20
25
DAYS ■ C.S. Mott Children’s Hospital
STS AVERAGE
30
35
40
■ STS
U-M median post-operative length of stay (2010–2013), as compared with STS national data.
TRANSPLANT VOLUMES
2010 2011
2012
2013
Total Transplants
8
6
6
14
Congenital Heart Disease
2
2
3
8
Cardiomyopathy
6
4
3
6
U-M has a shorter post-operative length of stay compared to national data across operations. M-LINE 800-962-3555
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CARDIAC CATHETERIZATION VOLUMES
2010 690 2011 696 2012 706
2013 728 HYBRID PROCEDURES
2012
24 cases (including 5 hybrid stage I)
2013
25 cases
(including 4 hybrid stage I) VALVE IMPLANTS
>75 4 1 of 7 1 of 10
Melody® Valve Implant Procedures
SAPIEN Transcatheter Pulmonary Valve Implants ™
Centers in the SAPIEN™ COMPASSION Trial
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Centers in the Melody® Post-Approval Study
C.S. Mott Children’s Hospital
Interventional Cardiology C.S. Mott Children’s Hospital is the region’s most experienced facility offering interventional catheterization for fetuses, infants, children and adolescents, as well as adults with congenital heart disease. Our state-of-the-art diagnostic and interventional suites are staffed by a dedicated team of experienced pediatric interventional cardiologists, technologists, anesthesiologists and nurses. Working seamlessly with our colleagues in pediatric cardiac surgery, we are committed to unparalleled care for our patients and a close collaboration with our referring physician partners. We are one of the first children’s hospitals in the U.S. to offer cardiac MR fusion with fluoroscopy and 3-D reconstruction of rotational angiography to decrease radiation exposure and improve interventional outcomes.
Hybrid Procedures Hybrid interventions combine surgical and transcatheter techniques to provide optimal outcomes. Surgeons work in tandem with our cardiac interventionalists to perform complex procedures less invasively than with traditional surgical techniques and on smaller patients than with catheterization alone.
Valve Implants The University of Michigan pediatric interventional cardiology team has done more than 75 Melody® transcatheter valve implants, including in the pulmonary, tricuspid, mitral and branch pulmonary artery positions, and four SAPIEN transcatheter pulmonary valves, including in the native right ventricular outflow tract. We are one of seven centers in the COMPASSION trial (congenital multicenter trial of pulmonic valve regurgitation studying the SAPIEN Interventional Transcatheter Heart Valve) and one of 10 centers in the Melody® Post-Approval Study.
www.mottchildren.org/congenital
ELECTROPHYSIOLOGY VOLUMES
2010 305 2011 322
Electrophysiology
2012 285
2013 311
1,769
CONSECUTIVE ABLATIONS PERFORMED WITHOUT COMPLETE HEART BLOCK
The electrophysiology team at C.S. Mott Children’s Hospital offers a full range of diagnostic and therapeutic options to evaluate and manage heart rhythm abnormalities. As the Midwest’s highest volume center for pediatric heart rhythm procedures, we provide care to patients referred from the U.S. and abroad.
Heart Rhythm Devices Procedures include pacemaker implantations, cardiac resynchronization systems, implanted defibrillators (conventional and subcutaneous), and implanted monitors for patients whose heart rhythm problems have been difficult to capture. All procedures are performed in the C. S. Mott Children’s Hospital.
Catheter Ablation We maintain success rates that exceed national averages, performing all procedures with 3-dimensional mapping and minimal X-ray, keeping radiation exposure lower than nationally published rates.
Heart Rhythm Clinic Our outpatient Heart Rhythm and Arrhythmia Clinic offers visits to patients with concerns related to their heart rhythm and rate. Patients with palpitations and fainting spells receive consultations and follow-up here. We perform heart rhythm care, pacemaker and defibrillator outreach clinics in Lansing, Marquette, and Toledo, OH.
1960s: U-M pioneers early primary repair for a range of defects, including VSD and tetralogy of Fallot 1990: University of Michigan’s first pediatric transcatheter ablation M-LINE 800-962-3555
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Fetal Heart Program In collaboration with the U-M Fetal Diagnosis and Treatment Center, our fetal heart specialists provide the full spectrum of fetal diagnostic, interventional and delivery planning services. Our specialized interventional services include catheter-based fetal cardiac interventions for babies who are candidates, including those with critical aortic stenosis or hypoplastic left heart syndrome complicated by a restrictive atrial defect. Over the years, we have become established as a high-acuity fetal program offering major fetal interventions that are not widely available. We work closely with referring physicians to comanage the pregnancy and to continue routine care close to home as much as possible.
FETAL ECHO VOLUMES
FETAL PATIENTS WITH HEART DISEASE
2010 647
2010 153
2011 754
2011 169
2012 808
2012 176
2013 850
2013 200
Michigan ranks in the top five fetal heart programs in the world in volume of fetal cardiac interventions. (Source: International Fetal Cardiac Intervention Registry)
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ADULT CONGENITAL VOLUMES
2010 2011 2012
746 743 779
2013
1,024 0
200
400
600
800
1,000
1,200
Adult Congenital Heart Program The University of Michigan Congenital Heart Center provides expert care to adult patients with congenital heart disease throughout the state and region, with extensive experience in adult congenital cardiac imaging, high-risk obstetrics, pulmonary hypertension, cardiomyopathy and heart failure management. Our adult congenital specialists are board-certified in both Pediatrics and Internal Medicine for transition of care from adolescence through adulthood.
Through research, we are working to establish best practices and advance the standards of care for adults with CHDs. Current research includes the study of long-term outcomes in adults with tetralogy of Fallot. Recent research projects include the study of sleep apnea in patients with adult congenital heart disease, as well as the study of quality of life within patients with congenitally corrected transposition of the great arteries.
Percutaneous interventions, among other treatments, offer today’s patients more options for successful outcomes and a higher quality of life. We have performed more than 75 percutaneous valve replacements, avoiding the need for repeated open-heart surgery.
Adult congenital providers also see patients in Ann Arbor, Marquette, Lansing, Traverse City and Petoskey.
1928: First thoracic surgery residency in the United States established at the University of Michigan 1982: University of Michigan’s first arterial switch operation
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MRI VOLUMES
2010 348
Non-Invasive Imaging Our dedicated pediatric cardiac diagnostic services utilize advanced imaging to facilitate interventional and surgical care. Procedures are coordinated whenever possible to allow for convenient, same-day testing. We offer the latest in non-invasive imaging techniques, including 3-D echocardiography, fetal echocardiography, intracardiac ultrasound and on-site cardiovascular MRI. All tests are interpreted by dedicated pediatric cardiologists with advanced training in non-invasive imaging.
Echocardiography Outreach Our goal, whenever possible, is to reduce travel burden and costs for patients, while creating a more meaningful, efficient consultative relationship with our partners throughout the state. We have worked to establish a strong outreach program providing echocardiography services at 11 locations throughout the state. In addition, through our cardiology telemedicine program, U-M pediatric cardiologists are available to provide remote echo interpretation and cardiovascular consultation as needed for referring providers located outside the Ann Arbor area.
2011 374 2012 421
2013 435 ECHOCARDIOGRAPHY VOLUMES
TTE
TEE ICE TOTAL*
2010 7,330 591 17 7,938 2011 7,679 556 19 8,254 2012 7,955 557 21 8,533
2013 8,592 543 15 9,150 * Total includes only echos performed at C.S. Mott Children’s Hospital. It does not include fetal or outreach echos. TTE = transthoracic echocardiogram TEE = transesophageal echocardiogram ICE = intracardiac echocardiogram
FETAL ECHOCARDIOGRAPHY VOLUMES
2010 2011 2012
647 754 808
2013
850 0
200
400
600
800
1,000
ECHOCARDIOGRAMS PERFORMED AT OUTREACH CLINIC LOCATIONS*
2010 2011 2012
898 1,133 1,663
2013
2,514 0
500
1,000
1,500
2,000
2,500
3,000
*Data is measured by fiscal year vs. calendar year.
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ECHO OUTREACH LOCATIONS: MICHIGAN
Alpena Ann Arbor Charlevoix Dickinson Grand Rapids Jackson Lansing Marquette
Northville Otsego Petoskey Traverse City West Branch Ypsilanti OHIO
Toledo
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OUTREACH CLINIC VISITS*
2010 2011 2012
Patient Care
829 1,426 1,442
2013
2,309 0
500
1,000
1,500
2,000
2,500
*Data is reported by fiscal year.
Clinic Outreach: Partnerships Keeping Care Close to Home Our goal is to coordinate with referring physicians to keep care close to the patient’s home through their existing providers whenever possible. Our providers see patients at a number of convenient locations throughout Michigan. We also offer telemedicine capabilities to connect you and your patients with team members at C.S. Mott Children’s Hospital in real time, without the expense and stress of traveling far from home. Ready to Move In July 2012, Survival Flight upgraded helicopters to three EC-155 helicopters flying at an average speed of 175 miles per hour, serving an air mile radius around Ann Arbor of approximately 350 nautical miles on a single tank of fuel. For more distant destinations in Michigan, United States, Canada, Mexico and the Caribbean, transport by fixed-wing aircraft is used.
TOTAL NUMBER OF INPATIENT DISCHARGES PER YEAR*
Marquette
World-class pediatric heart care, where and when you need it.
2010 990 Petoskey Alpena Traverse City
2011 966 2012 1,006
2013 1,034 *Includes discharges and observation cases, as well as some congenital heart discharges from other units.
Grand Rapids Lansing Ann Arbor Jackson
Northville Ypsilanti
Toledo, OH
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Our Survival Flight helicopters and jet can accommodate all types of pediatric heart patients, including highcomplexity transports and patients on ECMO. Our dedicated transport staff is also trained and equipped to care for patients on intra-aortic balloon pumps and ventricular assist devices. Voices of Our Families Patients and families are integral members of our team. We are committed to partnering with families on every aspect of care, from ensuring family-centered bedside rounding to having parent advisors serve as committee members on every aspect of our work, including process improvement and strategic planning.
NEARLY
60%
(APPROXIMATELY 2,200 A YEAR)
of all guests at the Ronald McDonald House are congenital heart disease families.
150
PEER SUPPORT VISITS TO INPATIENT FAMILIES
We also instituted a new Peer-Mentor program in which a parent of a patient visits the inpatient units and hospital outpatient clinic weekly to connect with families, offer support and answer questions from a parent’s perspective.
PATIENT SATISFACTION RATING* (ON A SCALE OF 100)
97.1 99.3 CARE GIVEN AT THIS HOSPITAL
RECOMMEND HOSPITAL TO OTHERS
*Reported in March 2014 Press Ganey Survey
112
832
OCTOBER 2013
JUNE 2014
PARTICIPANTS IN OUR ANNUAL ICD PATIENT CONFERENCE
PARTICIPANTS IN OUR BI-ANNUAL CHD REUNION
M-LINE 800-962-3555
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NEURODEVELOPMENTAL FOLLOW-UP VISITS ARE RECOMMENDED AT:
9
15–18
months months
3
years
5
years
8
years
11
years
14
years
And as needed anytime a developmental concern is raised.
Coordinated Care for Every Patient Our new case management program adds value to the care of our patients and families through improved coordination, communication and appropriate utilization of health care resources. Each patient has a nurse case manager and a social worker who together address the transition, discharge and psychosocial needs of both the patient and family. Our highly specialized social work team cares exclusively for Congenital Heart Center patients and offers unique, personalized expertise supporting all of their psychosocial needs throughout their treatment.
24/7
Neurodevelopmental Follow-Up for Surgical Patients Research shows that children who undergo cardiac surgery during the first year of life are at higher risk for developmental, learning and/or behavioral concerns later in life. Our Neurodevelopmental Follow-Up Clinic offers a complete developmental assessment and referral program for children from infancy through age 18 who have had heart surgery prior to one year of age. The program is designed to assist families in the early identification and continuous monitoring of concerns to target appropriate interventions and services.
COVERAGE
by pediatric cardiac intensivists, making us the first in Michigan to offer this level of in-house support for the complex needs of congenital heart patients. 16
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www.mottchildren.org/congenital
State-of-the-Art Facilities Our new hospital, opened in November 2011, features a dedicated cardiac step-down unit, an intermediate care unit and a separate cardiac intensive care unit exclusively for pediatric acquired heart disease and congenital heart patients. The new facility includes a number of patient amenities, including complimentary onsite laundry and work-out facilities for families, as well as a unique 12-room Ronald McDonald “House within the Hospital” for families of children receiving intensive care, in addition to the free-standing 29-room Ronald McDonald House across the street from the hospital.
32 30 26
BED CONGENITAL HEART CARE UNIT BED PEDIATRIC CARDIAC INTENSIVE CARE UNIT ADVANCED NURSE PRACTITIONERS
Clinical Education Our program has hosted several regional and national clinical education conferences, including: • Partners in Pediatric Care • Midwest Pediatric Cardiology Symposium • ODICH 40th Annual Conference (Ohio Doctors Interested in Congenital Hearts) • Joint Conference on Advances in Pediatric Cardiovascular Disease Management (in partnership with the Children’s Hospital of Los Angeles and Children’s Hospital at Montefiore)
1981: Pediatric cardiology and cardiac surgery inpatient unit established 1991: Dedicated pediatric cardiac ICU established 1995: Congenital Heart Center established M-LINE 800-962-3555
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Advocacy Newborn Critical CHD Screening C.S. Mott Children’s Hospital was a leading supporter of new state legislation requiring pulse oximetry screening for all newborns in the State of Michigan. To help implement these new requirements, our Congenital Heart Center team is assisting birthing centers and health care providers establish and implement their protocols for responding to failed pulse oximetry screenings. Further, our specialists are readily available around the clock to help determine if a failed pulse oximetry screening is due to congenital heart disease by assisting with the interpretation of clinical findings and electrocardiographic and echocardiographic testing. If a congenital heart defect is identified, the Congenital Heart Center team can assist with patient management and facilitate further testing or follow-up as needed.
2012: Dr. Edward Bove completes 10,000th surgery
18
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C.S. Mott Children’s Hospital
Sudden Cardiac Arrest Preparedness Together with our colleagues at the University of Michigan Frankel Cardiovascular Center, the Congenital Heart Center team has spearheaded a number of education and preparedness programs in an effort to reduce the incidence of sudden cardiac death in the young. Working closely with the State of Michigan Department of Community Health, the U-M team has educated health professionals and school officials on sudden cardiac arrest preparedness. In 2013, the Congenital Heart Center officially became the designated statewide affiliate of Project ADAM, a nationwide initiative with a mission of providing schools with guidance and support on how to minimize the risk of sudden cardiac death in the schools across the state.
www.mottchildren.org/congenital
Learn more about our current research and innovation projects at
www.mottchildren.org/congenital
Research One of the primary goals of the University of Michigan C.S. Mott Children’s Hospital Congenital Heart Center is to support research and innovation to drive improvements in quality of care and outcomes for children with heart disease. The Michigan Congenital Heart Outcomes Research and Discovery (M-CHORD) program supports research across the heart center. This unique program is composed of multi-disciplinary faculty members from across the University, along with a dedicated research support staff. M-CHORD’s work encompasses the full spectrum of clinical investigation, including translational research, clinical trials of new drugs and devices, long-term outcomes studies, and multi-center collaborative research examining best practices to improve outcomes and reduce resource utilization. Our aim is to push discoveries forward from the laboratory to the clinical setting, and disseminate findings that will benefit children as quickly as possible.
65
ONGOING CLINICAL RESEARCH PROJECTS SUPPORTED THROUGH M-CHORD
Pediatric Cardiac Critical Care Consortium (PC4) The U-M Congenital Heart Center leads a multi-center, international quality improvement collaborative geared toward improving outcomes for critically ill children with heart disease. By the end of 2014 it is anticipated that 20 sites will be actively submitting data to the PC4 registry, which provides unique real-time performance feedback and benchmarking to member institutions. Participating sites commit to sharing data and collaborating with one another to identify practices associated with high-quality care and outcomes. These practices will be disseminated throughout the collaborative and ICU community with the goal of improving outcomes for these vulnerable children.
U-M ranks in the
TOP 10 in NIH funding among all medical school pediatric departments across the nation.
2014: Congenital Heart Center investigators awarded more than $6 million in NIH research funding
M-CHORD team
M-LINE 800-962-3555
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>40
RECENT MAJOR AWARDS
INCLUDING THREE MAJOR AWARDS FROM NHLBI WITHIN THE PAST YEAR
Novel Micro-Implant to Measure Intracardiac Pressure in Congenital Heart Patients
ACTIVE EXTERNAL GRANTS AND PHILANTHROPIC AWARDS
NHLBI R44
>100
NHLBI R01
MANUSCRIPTS PUBLISHED IN 2013
IN HIGH-IMPACT JOURNALS SUCH AS NEW ENGLAND JOURNAL OF MEDICINE, CIRCULATION, AND PEDIATRICS
Understanding Quality and Costs in Congenital Heart Surgery
NHLBI K08 Explaining Variation in Mortality After Pediatric Cardiac Surgery
Long-Term Outcomes and Neurodevelopment Our ultimate goal is to determine the optimal treatments to allow children with congenital heart disease to thrive and enjoy an excellent long-term quality of life into adulthood. Through projects aimed at understanding longer-term outcomes such as need for re-interventions, neurodevelopment, and long-term cardiac, kidney and liver function, we are making strides in identifying treatments that will improve these outcomes, and allow children with heart disease to lead the fullest and highest-quality lives.
20
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Optimizing Quality and Efficiency of Care Delivery U-M Congenital Heart Center physicians are leading national efforts to better understand health care policies, structure and processes associated with optimal outcomes for children with heart disease. Our research has suggested that highquality care is also likely to be associated with reduced health care costs, and we are collaborating with national partners to develop methods to provide integrated feedback regarding both quality of care and cost for children undergoing heart surgery across U.S. children’s hospitals.
Pediatric Heart Network Core Site The U-M Congenital Heart Center is one of only nine Pediatric Heart Network (PHN) core sites. The PHN, funded through the National Heart, Lung, and Blood Institute (NHLBI), consists of a consortium of congenital heart centers working together to address important clinical questions impacting children with heart disease. Collaboration is key, as it allows study of rare conditions for which any one center may have a limited experience and limited number of patients. The PHN Single Ventricle Reconstruction Trial, led by U-M investigators, was the first multi-center congenital heart surgery randomized trial ever accomplished. U-M investigators also lead the PHN biorepository and the PHN Health Services and Outcomes Collaboratory.
www.mottchildren.org/congenital
Learn more about our current research and innovation projects at
Innovation
www.mottchildren.org/congenital
The Michigan Congenital Heart Innovations Collaborative (M-CHIC) is a unique collaborative of physicians, engineers and other scientists across the Congenital Heart Center and the University of Michigan focused on jumpstarting the development of innovative devices and therapies for congenital heart care. Wireless Cardiac Pressure Sensor A team of U-M investigators has collaborated with Ann Arbor-based Integrated Sensing Systems, Inc., to develop a miniature, wireless, battery-free, cardiac pressure sensor for patients with complex forms of congenital heart disease. The team recently received funding from the National Heart, Lung, and Blood Institute to carry out a multi-center clinical trial (the I-AFFIRM study) that will test the safety and functionality of the device in children undergoing the Fontan operation for single ventricle heart defects. This device will allow monitoring of pressure within the Fontan pathway while the patient is at home or while being seen in the outpatient clinic without having to perform an invasive cardiac catheterization. Donor Heart Preservation for Heart Transplantation U-M cardiologists and investigators from the Extracorporeal Life Support laboratory are working to develop a means to improve the availability of donor hearts for patients awaiting cardiac transplantation. The current method of heart preservation limits the availability of hearts to patients farther away from the potential donor and also can result in significant cardiac dysfunction due to prolonged ischemia. Investigators aim to develop technology to artificially perfuse donor hearts with an apparatus that provides oxygen and nutrients to the heart during the transportation process. This technology could revolutionize heart transplantation through increasing organ availability, improving viability, and allowing for the ability to perform functional assessment before proceeding with the transplantation.
1956: University of Michigan’s first successful pediatric openheart surgery 1993: University of Michigan’s first double switch operation
U-M investigators are collaborating with Integrated Sensing Systems, Inc., to develop this wireless cardiac pressure sensor for use in congenital heart patients.
M-LINE 800-962-3555
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Energy Harvesting to Power Pacemakers Working with investigators from the U-M Department of Aerospace Engineering, U-M pediatric cardiologists have developed novel technology to use an energy harvester to power pacemakers through the motion of the beating heart. Investigators hope that this technology can be used to power pacemakers for a much longer period of time than current batteries, and reduce the number of operations that children with pacemakers currently undergo throughout their lifetime to replace the pacemaker battery. Tracheal Splint As reported in the New England Journal of Medicine, the U-M Congenital Heart Center team has collaborated with Pediatric Otolaryngology and the Department of Biomedical Engineering to implant the first bioresorbable external airway splints created using a 3-D laser printer. The novel splints are tailor-made for the patient using 3-D printing technology and constructed of bioresorbable material that suspends the airway, preventing collapse or external compression, while also allowing for growth. To date, three patients with life-threatening bronchomalacia have benefited from this new device and are now thriving. It is hoped that similar technology can be used to design other implantable devices specific to the anatomy and size of a particular patient.
2010: Under U-M leadership, Pediatric Heart Network performs the first multiinstitutional randomized controlled trial ever performed in congenital heart surgery 22
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Executive Officers of the University of Michigan Health System Michael M.E. Johns, MD Interim Executive Vice President for Medical Affairs James O. Woolliscroft, MD Dean, U-M Medical School Kathleen Potempa, PhD Dean, School of Nursing T. Anthony Denton, JD, MHA Acting Chief Executive Officer and Chief Operating Officer, U-M Hospitals and Health Centers
The Regents of the University of Michigan Mark J. Bernstein Julia Donovan Darlow Laurence B. Deitch Shauna Ryder Diggs Denise Ilitch Andrea Fischer Newman Andrew C. Richner Katherine E. White Mark S. Schlissel, MD, PhD (ex officio)
The University of Michigan, as an equal opportunity/affirmative action employer, complies with all applicable federal and state laws regarding nondiscrimination and affirmative action. The University of Michigan is committed to a policy of equal opportunity for all persons and does not discriminate on the basis of race, color, national origin, age, marital status, sex, sexual orientation, gender identity, gender expression, disability, religion, height, weight or veteran status in employment, educational programs and activities, and admissions. Inquiries or complaints may be addressed to the Senior Director for Institutional Equity, and Title IX/Section 504/ADA Coordinator, Office of Institutional Equity, 2072 Administrative Services Building, Ann Arbor, Michigan 48109-1432, 734-763-0235, TTY 734-647-1388. For other University of Michigan information, call 734-764-1817. © 2014, Regents of the University of Michigan. 09/14/14K
RBD12127943
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1540 E. Hospital Drive, 11th Floor | Ann Arbor, MI 48109 To make a referral or speak with one of our specialists, contact M-LINE 24 hours a day, 7 days a week.
M-LINE 800-962-3555 www.mottchildren.org/congenital