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Pediatric Cardiovascular Care

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Pioneering Cardiovascular Care for Infants, Children and Adolescents

The WMCHealth Heart and Vascular Institute closely collaborates with WMCHealth member Maria Fareri Children’s Hospital to provide innovative and timely cardiovascular care for infants, children, adolescents and young adults. No other Hudson Valley tandem provides such expert diagnoses, treatment or aftercare blended with a steadfast dedication to quality of life.

For more than three decades, the pediatric cardiovascular team at Westchester Medical Center and Maria Fareri Children’s Hospital has pioneered numerous life-saving therapies by embracing groundbreaking techniques, leading-edge technologies and state-of-the-art equipment.

Learn More About Pediatric Cardiothoracic Surgery

Comprehensive Heart Care for Children

Learn more about these pediatric cardiac care services:

“Maria Fareri Children’s Hospital’s experts in pediatric cardiovascular care energize hope, healing and recovery for every child, every day,” said Michael H. Gewitz, MD, William Russell McCurdy Physician-in-Chief and Chief of Pediatric Cardiology at Maria Fareri Children’s Hospital. “Our renowned medical and surgical teams are sought out to treat the most complex illnesses – and compassionately provide the highest-quality life-saving care. We’re privileged to care for our children, the future of the Hudson Valley; their families; and our patients who come from far away.”

A Multidisciplinary Approach to Children’s Heart Care

Patient care is maximized through close collaboration among pediatric cardiac surgeons and cardiologists, pediatric cardiac anesthesiologists, neonatologists, geneticists and critical care specialists. Patients and their families benefit from uniquely tailored treatment plans, and plain-talk explanations, to maximize well-being.

Maria Fareri Children’s Hospital’s world-class facilities include the Hudson Valley’s only dedicated Pediatric Intensive Care Unit, Level I pediatric trauma program, and the Regional Neonatal Intensive Care Unit.

Pediatric Cardiovascular Surgery

A trusted, renowned team of experts offering revolutionary life-saving cardiac surgical techniques make Maria Fareri Children’s Hospital, a member of the Westchester Medical Center Health Network (WMCHealth), the Hudson Valley’s choice for pediatric cardiothoracic surgery. Visit the Maria Fareri Children’s Hospital website for a full list of pediatric heart-related conditions and cardiac malformations treated. Learn more.

Pediatric Cardiac Catheterization

Interventional cardiologists use high tech equipment and techniques to diagnose complex congenital heart defects in infants, children and young adults – and can address some defects during catheterization procedures without requiring open-heart surgery.

Pediatric cardiac catheterization is a technical, minimally invasive procedure performed with anesthesia, but causing little or no physical discomfort. The procedure enables these cardiologists to identify congenital heart conditions, measure their physiologic impact, determine their severity and plan treatment.

Interventional procedures include:

  • Balloon valvuloplasty and angioplasty, which open a heart valve or a blood vessel with a narrowed opening in order to improve blood flow.
  • Pulmonary valve replacement via delivery of a new valve through a catheter system.
  • Intravascular stent placement in the pulmonary arteries or other blood vessels such as the aorta, during which a small, mesh metal tube is implanted in a blocked or narrowed artery to keep it open and blood flowing.
  • Atrial and ventricular septal defect closure, which closes a hole in the wall separating the right and left chambers of the heart.
  • Occlusion of patent ductus arteriosus to eliminate the excess blood flow caused by this blood vessel.

The specialized hybrid catheterization laboratory provides simultaneous access to cardiac catheterization and advanced surgical technology and equipment. Teams specializing in cardiac catheterization and cardiac surgery work side by side to perform one or both procedures. This means the patient is transported to only one operating suite and experiences potentially only one anesthesia episode. Sometimes this very specialized facility is used when the talents of both cardiac surgeons and cardiologists are needed simultaneously.

Electrophysiology

The dedicated pediatric cardiac electrophysiology team cares for children with presumed or confirmed heart-rhythm disorders. This ranges from remote cardiac telemetry monitoring to the most complex cardiac ablation and mapping procedures, which eliminate tissue causing an abnormal heart rhythm.

Electrophysiologists use proven, cutting-edge techniques, including tailored low-dose fluoroscopy and intracardiac echocardiography that allow precise views of the heart and other vascular structures.

A precise approach minimizes risk to the heart’s normal conduction system. Maria Fareri Children’s Hospital is one of a handful of hospitals in the country performing subcutaneous cardiac defibrillator (S-ICD) implantation in children. This minimizes traumatic damage to veins and other cardiac structures, and almost eliminates device-related infection.

Irfan Warsy, MD, CEPS-P, the region’s only board-certified pediatric cardiac electrophysiologist, has performed more than 400 electrophysiology procedures, including ablations and device implants, since joining the Maria Fareri Children’s Hospital program in 2011. Dr. Warsy and his team prioritize a strong doctor-patient relationship, continuity of care, and communication with families and referring pediatricians.

Electrophysiology services include:

  • Routine and specialized electrocardiography (EKG).
  • Ambulatory (Holter) monitoring and event/loop (transtelephonic) monitoring.
  • Implantation of subcutaneous rhythm-monitoring devices (implantable loop recorder) for extended assessments.
  • Intracardiac electrophysiology study using low-dose fluoroscopy and three-dimensional mapping of the heart.
  • Radiofrequency ablation/cryoablation.
  • Temporary and permanent pacemaker placement. Implantable cardiac defibrillator placement.
  • Non-invasive and invasive arrhythmia management.

Regional Neonatal Intensive Care Unit and Pediatric Intensive Care Unit

A $1.2 million investment in the Regional Neonatal Intensive Care Unit (RNICU) at Maria Fareri Children’s Hospital is expanding life-saving care for the most at-risk and tiniest babies with rare, unusual and complex medical needs. This will increase maternal and newborn support, enhance state-of-the-art technology, and augment family education, clinical research and follow-up services.

The RNICU is part of the Level IV Regional Perinatal Center, which compassionately provides expert obstetrical and neonatal services for patients with the most complex health issues, including open-heart and other pediatric surgical demands. The Level IV designation is New York State’s highest.

The Regional Perinatal Center, one of only 18 statewide, has 49 beds, but the average number of babies on a given day often exceeds that. The RNICU never says no to providing care. The expansion, which maximizes safety, operational efficiency and comfort, includes eight additional beds; a new nurses’ station; centralized bedside monitoring; and a new family waiting area. This expansion will help increase the ability to accept and care for babies with critical congenital heart defects.

The 18-bed Pediatric Intensive Care Unit (PICU) at Maria Fareri Children’s Hospital includes a four-bed Pediatric Cardiothoracic Surgery area. The PICU sees approximately 1,300 patients a year for all pediatric illnesses. Experienced PICU physicians are on site 24 hours a day, seven days a week, every day of the year. The PICU nursing staff has an average of 25 years of pediatric critical-care experience, and the dedicated respiratory therapy team has extensive expertise treating all pediatric patients requiring respiratory support services. These providers work “hand in glove” with the dedicated pediatric cardiothoracic team for the benefit of cardiac patients.

 Adult Congenital Heart Disease

Successful prenatal, childhood and adolescent treatment for congenital heart disease is extending lives, and more patients born with heart defects than ever before are reaching adulthood.

However, congenital heart defects may be diagnosed at any time, including during adulthood. In addition, conditions identified and treated earlier in life may also affect adults. The WMCHealth Heart and Vascular Institute provides specialized care for these patients through a collaboration of Maria Fareri Children’s Hospital and Westchester Medical Center cardiologists, nurse practitioners and support staff.

Echocardiography, interventional cardiac catheterization, interventional electrophysiology, cardiac imaging and surgery are used to diagnose and treat adult congenital heart disease. Symptoms may include abnormal heart rhythm, shortness of breath and chest pain, and may be caused by heart failure, pulmonary hypertension, stroke, infection and heart-valve conditions. Westchester Medical Center offers a dedicated program to transition teenage patients with congenital heart disease from pediatric to adult cardiology care. This program, called The WATCH (Westchester Adult Teen Congenital Heart), provides state-of-the-art cardiac care and ancillary services for this unique group of patients.

Cardiovascular Research

Pediatric cardiology and cardiothoracic specialists develop and participate in cutting-edge research in collaboration with New York Medical College, the academic affiliate of WMCHealth, and with other major academic centers around the world, such as the renowned Boston Children’s Hospital.

Fetal cardiology research has led to breakthroughs in the understanding, diagnosis, prevention and therapy of neonatal lupus congenital heart block/cardiomyopathy. In addition, pediatric cardiology clinical scientists and clinicians have focused on a condition called orthostatic intolerance. This condition affects the heart rate, causing some children and young adults to faint or experience lightheadedness, fatigue, or visual disturbances. Research, sponsored by the National Institutes of Health for many years, has led to new treatments. Patients travel from around the world to participate.

Research projects also are being conducted on fetal cardiac disorders and in other areas of pediatric cardiovascular medicine, including hypertrophic cardiomyopathy, sports screening, and other problems. Numerous foundation and industry grants help underwrite this research. The pediatric cardiothoracic surgery team also undertakes clinical research to identify ways to limit blood transfusions during heart surgery, and to reduce chest-wall injury from open-heart surgery, thereby speeding recovery. Also, collaborative work with a national network of researchers is exploring treatments to reduce complications from Kawasaki disease, the most frequent cause of acquired (not born with) heart problems in children.

Fetal Cardiology

The Fetal Cardiology Program provides state-of-the-art diagnosis, treatment and aftercare for all fetal pediatric cardiovascular conditions.

A component of both the Maternal Fetal Medicine Center and Maria Fareri Children’s Hospital, the Fetal Cardiology Program delivers the highest level of care. A highly skilled team of experts – including fetal cardiologists, maternal fetal medicine specialists, pediatric cardiothoracic surgeons, neonatal intensive care specialists, social workers, advanced-care nurses and other specialists – provide state-of-the-art surgical techniques and in-depth parental counseling. Fast- tracking protocols that accompany surgeries speed patients’ recovery and hasten release from the hospital, often just two or three days after open-heart surgery. These techniques are unique to the cardiovascular team at Maria Fareri Children’s Hospital and the WMCHealth Heart and Vascular Institute.

Congenital heart defects occur while the heart develops early in pregnancy. They include holes between heart chambers, blocked heart valves, and underdeveloped heart chambers and major vessels. Some defects reduce the amount of oxygen delivered throughout the body. While particular defects can be identified in utero as early as 12 to 14 weeks old, they typically are most clearly recognized in a fetus at 16 to 18 weeks.

Most cardiovascular defects are best treated after birth, but some heart problems, such as heartbeat irregularities, can be addressed before birth. Early diagnosis prepares everyone, including the baby, for after-birth care, and can minimize risks of neurological and other organ damage. Early diagnosis also optimizes pregnancy management to secure the best outcomes for both mother and baby. For more information, download our Fetal Cardiology Brochure.

Services include:

  • Expert evaluation and diagnosis of fetal heart defects using state-of-the-art multi-dimensional technologies.
  • Explanation of, and counseling about, the fetal condition, treatment options and long-term outlook.
  • Collaboration among a variety of medical specialties to plan the baby’s delivery and immediate care.
  • Fetal heart therapies to treat many conditions before birth.
  • A wealth of support services every step of the way, before and after the baby’s delivery, and throughout childhood and the young-adult years.

Successful delivery of the newborn is our goal, as is helping each infant develop into a child who can look forward to a long, productive life.

Echocardiography and Cardiac Imaging

Advances in cardiac ultrasound technology have led to a quantum leap in achieving clearer, high-resolution, cross-sectional imaging, along with important improvements in measuring heart function. This knowledge helps physicians answer complex clinical questions that focus pediatric care and help avoid more complicated, riskier invasive testing and exposure to radiation. Echocardiography evaluations, which are non-invasive and painless, are performed with state-of-the-art equipment wherever needed – as an outpatient, at the hospital bedside, and in the operating room. Technology provides live, real-time three-dimensional imaging, enabling the cardiologist to evaluate heart-valve function, defects and narrowing. These images can also create a three-dimensional “model” of the heart, which shows what the surgeon will see during surgery and enables creation of a precise surgical approach.

Enhancements to the Cardiac Imaging Program include easy-to-view three-dimensional images of children’s hearts and the surrounding vessels, obtained by the most sophisticated magnetic resonance imaging (MRI). These views spare children unnecessary procedures, and are created painlessly and noninvasively often without general anesthesia. There is no potentially harmful radiation — even when performed on tiny babies with complex congenital heart disorders. These images produce multidimensional pictures on a computer screen and, combined with analysis software, provide deepening levels of information. Before the newest technology, for example, specialists could visualize a leaking heart valve by reviewing MRI images, but now doctors can quantify the impact of the leak and determine whether that impact is serious enough to eliminate the problem and the best strategy to do so.