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Cardiology

The history of Pediatric Cardiology at Yale University and Yale-New Haven Hospital

1947 Dr. Ruth Whittemore sets up the first pediatric cardiology referral center in New England at Yale-New Haven Hospital.

1949 Yale medical student William Sewell builds the forerunner of the artificial heart.

1956 Dr. William Glenn performs Connecticut's first open heart surgery.

1958 Dr. Glenn develops a surgical technique that greatly improves the survival rate of patients with congenital cardiac malformations. The "Glenn Shunt" connects the superior vena cava directly into the lung artery, allowing blood to partially bypass the right heart, obtain oxygen in the lungs and provide the body with oxygenated blood.

1958 Dr. Marie Browne joins Dr. Whittemore in Yale's Section of Pediatric Cardiology.

1959-64 Dr. Glenn and associates pioneer the world's first radiofrequency-powered cardiac and diaphragmatic pacemakers for use in children.

1970s Yale's Dr. Michael Berman develops a special "balloon tip" catheter that allows physicians to navigate safely in the heart during cardiac catheterization procedures. The Berman catheter remains a staple catheter for angiographic studies in heart disease throughout the world.

1960's Dr. Horace Stansel operates on pediatric heart patients at Yale. The Damus-Kaye-Stansel procedure later becomes a key component of many pediatric cardiac procedures.

1970's Yale is among the first medical centers worldwide to use ultrasound waves to achieve a clear image of the heart. Non-invasive echocardiography would dramatically transform the diagnosis of heart disease in both children and adults.

1980's Yale School of Medicine physicians and researchers develop techniques for use of human heart valves in children with congenital defects.

1984 Yale opens the nation's first fetal cardiovascular center, making possible the diagnosis of 95 percent of major heart defects in utero. Dr. Charles Kleinman becomes an early leader in the field of fetal echocardiography.

1990's Yale's Dr. William Hellenbrand pioneers the use of therapeutic cardiac catheterization to repair some congenital heart defects without open heart surgery. The next generation of these devices continue to be used by our interventional cardiologists today.

2004 The Yale-New Haven Adult Congenital Heart Program begins. As the first such integrated program in the state, its mission is to care for the many patients who represent the long-term successes of prior surgical interventions performed by Drs. Glenn and Stansel and their successors for congenital heart disease.

The Section of Pediatric Cardiology at Yale has entered an exciting stage of growth and expansion. With the recent recruitment of a new Chief of Pediatric Cardiology, a second Interventional Catheterization cardiologist, Electrophysiologist, Outpatient Cardiologist and Echocardiographer, the group now numbers eight cardiologists. Further physician recruitments are underway for an additional cardiac imaging specialist and cardiovascular surgeon. The Section also has two Nurse Practitioners and an LVN.

Services of Excellence

Cardiac Catheterization The Pediatric Cardiac Catheterization Laboratory at Yale New Haven Hospital is staffed by Drs. John Fahey and Jeremy Asnes. The laboratory routinely performs diagnostic and interventional catheterization procedures in children and adults with congenital heart disease. Procedures commonly performed include closure of atrial septal defect (ASD) and patent foramen ovale (PFO) and patent ductus arteriosus (PDA). In addition to transcatheter device placement, Drs. Fahey and Asnes have expertise in non-surgical transcatheter treatment of aortic and pulmonary valve stenosis, coarctation of the aorta, intravascular stent placement for narrowed arteries and vessels and blood vessel coil occlusion. 1ST PICTURE and caption

The Laboratory is a participant in many pioneering clinical trials and as a result, is expert with a variety of intracardiac devices including the Amplatzer Septal Occluderä device, the Amplatzer PFO Occluderä device, the Amplatzer Ductal Occluderä device, and the CardioSEALä device. Intracardiac echocardiography is frequently used to provide visual guidance during invasive procedures. This technology allows procedures to be performed without the need for general anesthesia. 2nd picture and caption

Future expectations for the catheterization laboratory include transcatheter ventricular septal defect (VSD) closure in selected patients. This procedure has not yet gained FDA approval for routine use in the United States. However, it may be used in very select patients who cannot undergo open heart surgery.

The Pediatric Cardiac Catheterization Laboratory will soon be participating in two pediatric interventional catheterization consortiums. These groups will bring together interventional cardiologists and resources from multiple centers across the country. The combined experience of these groups will allow participating institutions including The Children's Hospital at Yale New Haven Hospital to advance the understanding of congenital heart disease and provide the best possible care for their patients.

Echocardiography
The Pediatric Echocardiography Laboratory at the Yale New Haven Children's Hospital provides state of the art non-invasive assessment of cardiac anatomy and physiology in an environment that is designed for the comfort and ease of children and their families. The Pediatric Echo Lab underwent a major renovation in the winter of 2005 which created a second imaging suite, redesigned echo reading area and improved access and space for our patients and their families. The Lab is now completely digital in its image acquisition and each imaging suite is equipped with Television, VCR and DVD players to make children more comfortable during their evaluation. The Pediatric Echo Service performs approximately 3,500 studies per year, which encompass the transthoracic, transesophageal and intracardiac approaches. The Pediatric Echo Service plays an important role in pre- and intraoperative surgical assessment and planning as well as in the interventional cardiac catheterization laboratory.

The Yale Fetal Cardiovascular Center was one of the first Centers of its kind. Each year, nearly 700 fetal echocardiograms are performed in women whose pregnancy may be affected by congenital heart disease or arrhythmia. The Center provides a multidisciplinary approach to comprehensive care with physicians from Maternal - Fetal Medicine, Pediatric Cardiology and Perinatal Medicine as well as Genetic Counselors.

If you have any questions about the Pediatric Echocardiographic Services at Yale New Haven Children's Hospital, please do not hesitate to contact Dr. Alan Friedman or Dr. Bevin Weeks.

Electrophysiology
The Yale Pediatric Electrophysiology and Pacing Service is the busiest in the state and growing. Pediatric and adult congenital heart patients with arrhythmias are cared for at Yale. Patients with congenital arrhythmia syndromes such as Wolff-Parkinson-White, long QT syndrome, Brugada, arrhythmogenic right ventricular dysplasia and other rare "channelopathies" receive care by the team, in addition to those with supraventricular tachycardia and ventricular arrhythmias. The group provides state-of-the-art care including outpatient transcatheter ablation techniques, 3-dimensional arrhythmia mapping and ablation using the Biosense Webster CARTOä mapping system and pacemaker and defibrillator (ICD) device implantation. Arrhythmia and Pacemaker outpatient clinic sessions are provided and staffed by Dr. James Perry and Nicole Boramanand, CPNP. Outpatient arrhythmia monitoring is provided at Yale. 3rd and 4th pictures and captions

Clinical Programs
On July 31, 2004, the Yale-New Haven Adult Congenital Heart Program was initiated. The first dedicated outpatient clinic for adults with complex congenital heart disease was held in the Pediatric Specialty Clinic. Since then, the clinic has moved to the adult setting of the Yale Physician Building where a weekly ACH clinic takes place. The mission of the Yale-New Haven Adult Congenital Heart Program is to provide comprehensive care of the adolescent and adult patient with congenital heart disease in the context of a multidisciplinary environment that blends state of the art pediatric and adult cardiac expertise across inpatient and outpatient settings. This is first integrated program in the state of Connecticut dedicated to the care of adult patients with complex congenital heart disease.

As participants in the Adult Congenital Heart Program, adolescents and adults can expect to have detailed education about their underlying congenital heart defect, its management, and the implications on future functioning. Participation in this program ensures that their pediatric congenital heart disease will be managed in the context of adult medicine with a multidisciplinary team that includes pediatric and adult cardiologists, adult pulmonologists, high-risk obstetrics and perinatology, genetic counselors, and social work. This center will have state of the art diagnostic imaging, to include echocardiography and MRI.

The multidisciplinary team includes interventional experts in congenital cardiac catheterization and electrophysiology who have a combined experience of over forty years in the field. Our cardiothoracic surgical team has extensive expertise in congenital heart disease and adult cardiac surgery with an experience that spans three decades. Other members of the team include experts from the Yale Congestive Heart Failure and Transplant programs in addition to the Yale High Risk Obstetric and Maternal-Fetal Medicine Programs.

The Yale Section of Pediatric Cardiology has had a longstanding interest in International Pediatric Health and improving the cardiac condition of children throughout the world. Members of the Section have been regular participants in Cardiovascular Missions in St. Petersburg, Russia and Egypt and the Section and Department have provided their volunteer services to children from Trinidad, Iraq, the Palestinian Authority and the West Indies. The efforts of the Section in the areas of International health have been supported by the extremely generous efforts of the Yale New Haven Heart Center, the Gift of Life Program of the Rotary Club of Hamden, Connecticut and Healing the Children - Northeast.

The Kawasaki Disease Clinic manages acquired forms of congenital heart disease in children. This newly coordinated effort is lead by Dr. George Porter. The Cardiogenetics Clinic brings together a number of subspecialists in one clinic setting and is staffed by Dr. Martina Brueckner.

How to contact us:
Address:
Yale University School of Medicine
Section of Pediatric Cardiology
333 Cedar Street, P.O. Box 208064
New Haven, CT 06520-8064

Office phone: 203-785-2022
Office fax: 203-737-2786

Adult Congenital Heart Program & all other appointments: 203-737-2110