Providers at Penn State Health Children’s Hospital constantly innovate to treat pediatric congenital heart disease (CHD). The multidisciplinary care provided at the Complex Fetal Care Center complements their work.
Penn State Health Milton S. Hershey Medical Center was the birthplace of one of the first and most influential left ventricular assist devices (VADs). Physicians at Penn State Health Children’s Hospital have contributed to improved CHD survival through the development of more effective technologies and treatments, while the multidisciplinary team approach delivers optimal care and outcomes that exceed national averages. Just a few such technologies illustrate the range of support available for infants with severe CHD.
Circulatory assist devices
Currently, Brian Clark, MD, chief of pediatric cardiac surgery at Penn State Health Children’s Hospital and professor of pediatrics and surgery at Penn State College of Medicine, and his colleagues are working on an assist device for patients with Fontan circulation following surgical correction of single ventricle heart disease. The device follows other ventricular assist projects, such as a National Heart, Lung and Blood Institute-funded study of an infant VAD system capable of providing univentricular and biventricular support for up to a year.
“We have a lot of ongoing research and development through the College of Medicine and other research efforts that I think will help move the field forward, especially in circulatory support and heart-assist devices,” Dr. Clark states. “We look forward to continuing to grow our program.”
Extracorporeal life support (ECMO)
Penn State Health Children’s Hospital uses neonatal and pediatric ECMO, a cardiopulmonary bypass technology for patients experiencing heart and/or lung failure. A supportive, temporary treatment that provides circulatory support, ECMO is used to sustain patients awaiting other treatments, such as organ transplant. It helps patients avoid problems associated with mechanical ventilation and ischemic damage that may result from use of high-dose vasopressors.
Intraoperative transesophageal echocardiography (TEE) allows surgeons to monitor cardiac function throughout surgery. By deploying TEE in concert with neuromonitoring, surgeons at Penn State Health Children’s Hospital can fully monitor the patient’s cardiovascular status — including blood flow to the brain — as they operate.
“When families are expecting a child with significant heart disease, it is important for them to know that we are present, available, highly skilled, empathetic and exceptionally caring. We will be with them through the whole process.”
— Brian Clark, MD, chief of pediatric cardiac surgery at Penn State Health Children’s Hospital and professor of pediatrics and surgery at Penn State College of Medicine
Multidisciplinary Approach and the Complex Fetal Care Center
Patients in Penn State Health Children’s Hospital’s CHD program benefit from the multidisciplinary care provided by the Complex Fetal Care Center.
“It’s all about the people, in my opinion,” Dr. Clark says. “It certainly takes a large team, and we have providers across an array of specialties that are needed to provide this kind of sophisticated care.”
Penn State Health Children’s Hospital initiated the Complex Fetal Care Center to provide organized, concierge services to expectant mothers who had a fetus diagnosed with issues like CHD that would likely require surgery during the neonatal period or infancy. The Complex Fetal Care Center serves a navigational function, pointing families to the services that will benefit them most.
First, expectant families are assigned a nurse coordinator who navigates them through the process, arranging for consultations with appropriate surgical and medical specialists, such as a cardiologist or a heart surgeon.
“For a number of years, I have offered consultations — either in person or virtually — with mothers who are expecting a baby with CHD that is likely to require early surgery,” Dr. Clark explains. “This allows us to begin the reassuring process of education about the baby’s condition and the expected surgical treatments. It also allows families to ask questions and process the situation.”
Places and Spaces
While Penn State Health Children’s Hospital’s pediatric and congenital heart surgeons save lives using advanced technologies and techniques, for patients and families, the experience of compassionate care also matters deeply. Penn State Health Children’s Hospital delivers the personal touch and ease of navigation more often associated with much smaller programs.
The hospital is thoughtfully designed, with several centers relating to pregnancy and pediatrics in proximity. The labor and delivery center is located close to the neonatal intensive care unit and the cardiac intensive care unit, meaning that parents are not far from their babies with complex needs following delivery. Ease of access within the pediatric heart surgery program makes it simple for families to seek consultations or second opinions for babies or children with CHD via phone, video or in-person visits.
“The number one thing we think about is taking the very best care of our patients that we can,” Dr. Clark says. “We try to shepherd the patient and their family through what is often a very frightening and difficult time. We look after these small humans willingly, proudly and with honor.”
To schedule a consultation with a pediatric and congenital heart surgeon, please call 717-531-1704.
For more information about the Complex Fetal Care Center at Penn State Health Children’s Hospital, please visit pennstatehealth.org/childrens/services-treatments/complex-fetal-care.