Close at Heart

Close at Heart
Pediatric Cardiac
2010 Outcomes
Report
At the Heart of What We Do
Inova Fairfax Hospital for Children is one of the region’s premiere medical
resources for pediatric cardiac referrals. Our mission is to provide worldclass heart care to the Washington, DC region’s children. Our renowned
expertise, excellent quality care, personal attention and a comforting hand
is at the heart of what we do. Experience the Inova difference today.
Our program continually focuses on clinical expertise through our staff,
unparalleled patient experience through our personal connections
with families, and our superior outcomes. We are proud to
report our pediatric cardiac program successes in
the last three years. Read on and see how we’ve
shined, particularly our top achievements in 2010.
2010 Achievements:
• The 2nd Annual Pediatric Cardiothoracic CME Conference
on the topic of Adult Congenital Heart Surgery occurred
on November 2, sponsored by a gift in honor of Stephen
Shapiro. More than 75 pediatricians and cardiac specialists
attended this educational forum.
• We added the hybrid approach to the management of
hypoplastic left heart syndrome, conducting five in 2010 for
single ventricle patients. The hybrid technique consists of
bilateral PA bands and a PDA stent, later followed by an atrial
septostomy or stent. We are currently assessing outcomes
of the hybrid approach compared to Norwood procedures.
• Two new attending cardiologists joined our staff this year.
Dr. Adrienne Kilgore came from University of Virginia’s
Cardiology Fellowship program and Dr. Steve Herold came
from a practice in Chattanooga, Tennessee.
• Inova Fairfax Hospital for Children was the recipient of a
Quality Improvement of the Year Award from George Mason
University’s College of Health and Human Services. The
Cardiac Feeding Team received a clinical excellence award
for its “Feeding the Way to a Shorter Stay” initiative. The
program uses an evidence-based algorithm to standardize
and improve the feeding of the hospital’s youngest cardiac
surgery patients, working to transition them to a fully oral diet
whenever possible. The team has significantly reduced the
length-of-stay of these patients.
• Our hospital joined the IMPACT Registry™ (IMproving
Pediatric and Adult Congenital Treatments), part of the
National Cardiovascular Data Registry (NCDR®), an initiative
of the American College of Cardiology Foundation. This
will allow us to measure variability in the performance and
outcomes of both diagnostic and interventional cardiac
catheterization procedures in all children and adults
with congenital heart disease. We are one of the first 10
congenital heart centers to participate.
• We developed a pre-operative preparation DVD for patients
and families so they could learn what to expect for their
upcoming surgery or procedure and meet the pediatric
cardiac team members. The DVD, available in both English
and Spanish, is provided to all families.
• We take pride in focusing on quality. We have completed two
key initiatives this year looking at Surgical Care Improvement
Process (SCIP) antibiotic dosing and an in-depth review of
post-operative cardiac arrests. We increased our dosing of
antibiotics using the correct drug at the correct dose within
one hour of any procedure from 76% to 92%. Our goal with
our intensive arrest review was to identify any potential
areas of improvement and our product was a standardized
approach to extubation post-Norwood and an algorithm for
timing of echocardiograms after surgery.
• Our Children’s Hospital was a Bronze Medal Winner for
Operating Unit as part of Inova Health System’s Iams
Memorial Quality Leadership Awards, held in December 2010
for the Cardiac Feeding Team work.
1
Superstar Patient
Josiah, one-month-old,
leaves the hospital
after his first surgery
What was a beautiful October day when strolling
into my routine ultrasound at four months pregnant
to determine the baby’s gender, suddenly changed
for the worse. The sonographer studied my
ultrasound and checked the baby’s heart for a
long time. Having given birth to four healthy babies
previously, I felt that something wasn’t right and
I waited anxiously to hear what the sonographer
had found. She told me that my baby boy’s heart
wasn’t developing properly and she referred me
to Dr. Gauvin, a cardiologist who practices at
Inova Fairfax Hospital for Children.
Dr. Gauvin performed an ECHO on the baby and informed me
that he had Hypoplastic Left Heart Syndrome. He explained
that this condition occurs when parts of the left side of the
heart do not develop completely and told me that my baby
would have to undergo several surgeries to correct the
problem. I was in shock and will never forget that day when
I learned what was ahead for me, my baby and the rest of
my children at home.
Although I was sometimes afraid or worried during the
remainder of my pregnancy, I knew I had to stay strong for
my family and for my little guy who would have to undergo
surgery soon after delivery. To relieve my mind, I decorated
the baby’s room wall-to-wall with expressions of my love
and brainstormed strong-willed boy names.
On March 5, 2010, I gave birth to Josiah. I choose this name
because it means “The Lord Saves” and I truly believe his
strength was behind delivering my child. Upon delivery, I felt
peace and was filled with love. I held Josiah for a minute and
then the nurses took him to the NICU to monitor his heart.
Four days later, it was the day of his first surgery, a Norwood
procedure. Drs. Shen and Collazo, the two heart surgeons,
prepared me by showing me pictures of the heart and
mapping out a surgery plan. They were so sincere when
telling me that they would do everything they could to heal
my child. Outside the OR, I gave Josiah a kiss and left him in
the secure hands of the cardiac surgery team, while I waited.
2
After a 5-hour surgery and three weeks recovery in the
hospital, my little Josiah came home.
“During his hospital stay, the nurses called him
a “Superstar patient” because he progressed so well
with his feeding regimen, had no complications
and was a very strong boy.”
When he arrived home, his brothers and sisters greeted him
with hugs and kisses and were very protective of him. As a
mother, I couldn’t have been happier.
However, I knew our journey to fully fix Josiah’s heart would
require a second and third surgery. The second surgery,
a Glenn procedure took place in November 2010 when
Josiah was seven months old. He had a diagnostic cath
with Dr. Abdallah, a cardiologist and they learned his heart
was worsening as he grew bigger, so they scheduled the
Glenn immediately. For me, this second surgery was not
as shocking and devastating as the first, however this time
Josiah was old enough to recognize and express his fear.
To no surprise, Josiah persevered
and had a great outcome from the
surgery, only staying in the hospital
5 days to recover.
Josiah is now a thriving one year old.
He is always smiling and giggling to
get my attention. Every night when
he goes to bed, I lay with him and
he plays with my hair – sometimes
even pulling it tight, which reminds
me of his strength. I am so proud
of him and each day he brings the
most joy into my life. When Josiah
turns two and a half, he will need
to have his third and hopefully final
heart surgery, but I have faith he will
do well and make me proud, like he
does every day.
- Betsy Taylor, Josiah’s mother
Josiah, a thriving one-year-old
“Our pediatric heart team is passionate
about treating children and adolescents
with heart defects so they can continue
to grow and lead healthy lives.”
Lucas Collazo, MD, Cardiac Surgeon
Lucas Collazo, MD (left) and Irving Shen, MD
Congenital Heart Surgery
The cardiac surgery program continues to
produce high quality care with low surgical
mortality. In 2010, our surgeons performed
303 pediatric and 28 adult congenital
surgeries with a 97.6% survival. As a
large surgical center, we participate in the
Society of Thoracic Surgeons Congenital
Heart Surgery National Database. Although
there is no official benchmark for pediatric
outcomes because of the variation in risk
of mortality for different types of congenital
surgery, Inova Fairfax Hospital for Children
takes on the most difficult cases and is
advancing the field using new techniques.
Our team is supported by dedicated
pediatric cardiac anesthesiologists with the
assistance of cardiac nurse anesthetists,
cardiac perfusionists and cardiac operating
room nurses. Once our patients leave
the OR, they are cared for by a superior
intensive care team. This multidisciplinary
collaboration results in the best care
possible for children with congenital defects.
In 2010, we continued to perform surgeries
on the smallest of newborns with more than
70 infants weighing less than 5 kg at the
time of surgery. This speaks to our ability
to surgically treat the most acute heart
conditions soon after birth, in the smallest
of patients.
2008
Procedure
2010
Volume
Survival
Volume
Ventricular Septal Defect (VSD)
26
100%
24
100%
27
100%
Tetralogy of Fallot (TOF)
8
100%
7
100%
10
100%
Atrial Septal Defect (ASD)
10
100%
6
100%
4
100%
Arterial Switch for TGA
7
100%
4
100%
9
78%
Valves/Conduits
25
100%
31
100%
20
100%
Atrioventricular Canal Repair (AVC)
8
100%
8
100%
6
100%
Total Anomalous Pulmonary Venous
Return (TAPVR)
3
66%
4
75%
2
100%
Partial Anomalous Pulmonary Venous
Return (PAPVR)
5
100%
5
100%
5
100%
Caval Pulmonary Connections (Glenns
and Fontans)
15
100%
18
100%
7
100%
Coarctation of the Aorta
10
100%
15
93%
9
100%
Systemic-Pulmonary Shunt
8
100%
2
100%
10
80%
Pacemakers and ICDs (primary and
replacements)
21
100%
14
100%
20
100%
Norwood/Damus-Kaye-Stansel/Hybrids
10
90%
7
85%
10
80%
ECMO Support
9
77%
5
60%
12
55%
Survival Volume
Survival
“When I walk or ride my bike to the hospital most mornings,
I think about my cases that day. I visualize the child’s heart
in three dimensions and replay the impending surgery
anticipating any surprises.”
4
2009
Irving Shen, MD, Medical Director
Pediatric Cardiovascular Surgery
Lucky Thursdays
Our family marks the
passage of time not by
Sundays or the first of the
month, but by Thursdays.
That’s the day our first
child was born - Thursday,
November 18, 2010. After
a healthy and normal
pregnancy, we welcomed
Rishi, at 4 weeks old,
our new little boy, Rishi, into
recovers from surgery
the world. But upon delivery,
his skin appeared blue and
the nursing staff had to provide an oxygen
tube to help his breathing.The medical staff
needed to monitor his heart more closely
and moved Rishi to the hospital’s Neonatal
Intensive Care Unit (NICU).
Dr. Irene Sadr, a cardiologist who practices
at Inova Fairfax Hospital for Children,
drew us a picture of Rishi’s heart to
explain his diagnosis – transposition of
the great arteries. Being new parents,
we were absolutely stunned by the
severity of his condition and thought there
was no light at the end of the tunnel.
Dr. Sadr reassured us that typically with
this condition, a child would undergo
surgery right away. However, Rishi was
suffering from pulmonary hypertension
(abnormally high blood pressure in the
arteries of the lungs) and needed to have
a balloon catheterization first. Dr. Tawfik,
a cardiologist, and Dr. Sadr performed the
catheterization, which temporarily improved
Rishi’s condition.
The next day, however, Rishi’s condition
deteriorated, and he was moved to the
Pediatric Intensive Care Unit (PICU). The
dedicated medical team placed Rishi on
an extracorporeal membrane oxygenation
(ECMO) machine, which provided cardiac
and respiratory support to him because his
own heart and lungs couldn’t continue their
normal function.
“The PICU nurses are living angels
and were our support system,
encouraging us to be part of the
care team, changing Rishi’s diapers
and socks, and caressing and
feeding him.”
After seven days of being on the ECMO
machine, Rishi’s condition stabilized, and
we met with the team who would care
for him before and after his surgery - Dr.
Irving Shen, a pediatric cardiac surgeon;
Beth Suddaby, a clinical specialist; and
Tracy Marrs, a child life specialist. Dr.
Shen explained that Rishi would undergo
an arterial switch operation in which the
pulmonary artery and the aorta are moved
into their proper positions. Having many
dark, emotional days in our recent past,
we were uplifted and eager to see Rishi
through this surgery.
On December 2, a Thursday, Rishi
underwent surgery. We walked with him as
they wheeled him to the OR and gave him
kisses on his chest, knowing that his little
body would never be the same again. We
rejoined Rishi in the PICU for his recovery
and were relieved to learn that that the
four-hour surgery was successful.
A few days later, the team performed
a cardiogram to measure Rishi’s heart
pumping activity and noticed that his
diaphragm was paralyzed. We were
crushed to think our little boy would have
to undergo another procedure – this time
to fix his diaphragm. Exactly one week
later on Thursday, December 9, we put
our trust in Dr. Shen and his colleague,
Dr. Lucas Collazo, to do a diaphragm
plication procedure. All went well.
Our journey with Rishi from birth through
his developing heart condition is framed
around what we now call “Lucky
Thursdays.” His birth and each monumental
surgery or procedure happened to be on
a Thursday. We were lucky and blessed
to get through each Thursday during the
first month of Rishi’s life in the hospital
and when we got home, each Thursday
reminded us how strong Rishi was and
would continue to be. He’s our little trooper.
Rishi means the
world to us. We
consider him our
Thanksgiving
baby. Each
Thanksgiving,
beginning this
year, we plan
to visit Inova
Fairfax Hospital
for Children to
share our story
Rishi, at 6 months, grins
from ear to ear
with families who
might be going
through something similar and to thank
the staff who cared for Rishi. The smiling
grins he gives us each day remind us of
the exceptional care he received and the
reason he is here today.
- Divya Shyam and Shyam Radhakrishnan
Rishi’s parents
5
“When I observe blood streaming through the pulmonary valve
to the lungs for the first time, I see a tiny heart suddenly come
to life. It’s an amazing feeling.”
James Thompson, MD, Section Chief Pediatric Cardiology
James Thompson, MD
Interventional Catheterization Volume by Procedure
2008-2010
Cardiac Catheterization
In addition to technical expertise, our cardiac
child life specialist provides support to children
undergoing catheterization with pre-procedural
tours and preparation on the day of the procedure.
Our team also extends to family and emotional
support of families as well with a dedicated cardiac
child life specialist to work with older children.
0
1
Hybrid Procedures
5
6
Coil Occlusion
of Vessels
4
7
TYPE OF PROCEDURE
Our pediatric cardiac catheterization team
performed 208 cardiac catheterizations in
2010. Interventional catheterization cases
totaled 120 and diagnostic cases totaled 88.
The addition of the hybrid approach for
hypoplastic left heart syndrome also promotes
procedural collaboration with simultaneous
catheterization and surgery being conducted
on these newborns.
2
1
Atrial Septostomies
7
39
48
Balloon Dilations
32
28
48
ASD Device Closures
20
40
62
PDA Occlusions
48
0
5
10
15
20
25
30
35
VOLUME
2008
6
2009
2010
40
45
50
55
60
65
Growing Up with a Different Heart
up with her growth. He diagnosed her
with supravalvar pulmonary stenosis.
He informed us that Addie would need
another intervention to fix her heart.
Growing up, Addie knew she had a
different heart. “While playing soccer,
I would get tired more quickly than my
teammates when running for the ball,”
says Addie. “I had to learn to slow down
a bit with my activities.”
Addie, 10-years-old, plays the flute
in her school’s band
Ten years ago, our daughter Addie was
born with a congenital heart defect known
as transposition of the great arteries. Four
days after birth, she underwent an arterial
switch operation at Inova Fairfax Hospital
for Children. This procedure involved
cutting off the aorta and pulmonary
arteries and reconnecting them to the
proper ventricle. Dr. Frank Galioto, Addie’s
cardiologist, has continued to follow
her the past 10 years. Just last year on
a routine echocardiogram (sonogram
of the heart), Dr. Galioto noticed that
Addie’s pulmonary artery wasn’t keeping
The first intervention to treat Addie was a
diagnostic catheterization performed by
Dr. James Thompson, a cardiologist, in late
June. The day of the catheterization, we
learned that Addie would have to undergo
a second surgery, so we immediately met
with Dr. Lucas Collazo, a cardiac surgeon
(who performed Addie’s first surgery) and
discussed her course of treatment. We
were so relieved to be in the most capable
hands of Drs. Thompson and Collazo, who
worked seamlessly together and without
hesitation to determine Addie’s next steps.
Two weeks after her catheterization,
Addie had a repair of the narrowing above
the pulmonary valve. This surgery involved
opening up the narrow area and adding
a patch of gore-tex fabric to make the
area wider.
Addie, a vibrant 10-year-old, remembers
the surgery well and her experience in the
hospital. “At first, I was scared to have
surgery because I was unsure how I would
feel afterwards,” says Addie. “But, during
my 2-day hospital stay, I really liked Tracy,
my child life specialist, Dr. Collazo and
all the nurses who helped me get better.
Tracy was always there for me, explaining
what was happening and telling me it
would be okay. My favorite times with her
were watching TV and eating ice cream.”
Addie is nearing her one year post-surgery
date and doing well.
“I’ve been cleared by my doctors
and parents to do everything I
want to do, including playing the
flute, soccer, tennis and swimming
at the pool. I am so thankful to
everyone at the hospital who
helped heal my heart.”
When we look at Addie, we see a very
confident girl. Both surgeries are a big
part of her life and she is often asked
about her scars. She is open and willing to
share her story, which only makes her a
more confident person. We look forward
to Addie leading a healthy life without the
need for further interventions. She is so
talented and has many interests, but
she especially loves playing flute in the
school band. Nothing will stop her –
she’s just a gem!
- JoBeth and Donald Bathurst
Addie’s parents
Learn more about
Addie’s story.
Use your smartphone to
access her video or visit
inova.org/childheart.
7
“Many things in medicine cannot be cured.
Fortunately we are in a field where we can
actually cure children of their rhythm disturbances.”
Ted Friehling, MD
Director, Electrophysiology
Ted Friehling, MD
Electrophysiologist
Margaret Bell-Fischer, MD
Electrophysiologist
Electrophysiology
Electrophysiology Volume by Procedure
2008-2010
Our electrophysiology program continues to excel
in providing interventional techniques to address
arrhythmias in children. In 2010, our electrophysiology
team conducted 89 procedures, the majority being
radiofrequency ablations.
TYPE OF PROCEDURE
From infancy through adolescence, rhythm
disturbances can cause sudden and devastating
effects. Our highly specialized team identifies and
cures these problems allowing children to lead
normal active lives.
7
AICD
Placements
7
5
12
Pacer
Procedures
14
13
10
Electrophysiology
Studies
12
15
73
69
Ablations
56
0
10
20
30
40
50
60
70
VOLUME
2008
8
2009
2010
80
Adult Congenital Surgery Volumes
2008-2010
42
Volume
27
26
2
0
0
8
2
0
0
9
Adult Congenital Heart Clinic
One of the unique aspects of our program is the ability to provide congenital
cardiac care from before birth through adulthood. With improved survival
of children into adulthood, there are now more adults with congenital heart
disease than children. We believe it is critical that the care of these patients
continues throughout their lifetime. An adult patient can be treated by experts
in congenital heart disease within an environment that specializes in adult
cardiac care.
Our Adult Congenital Heart Clinic consists of congenital surgeons, pediatric
cardiologists, adult cardiologists and nurses who manage the care of these
patients at Inova Fairfax Hospital – a service shared by experts of Inova
Fairfax Hospital for Children and Inova Heart and Vascular Institute.
2
0
1
0
To refer a patient to our Adult Congenital Heart Clinic, call 703-776-3599.
Adult Congenital Catheterization
In 2010, the cardiac catheterization team performed 110 catheterizations for adult congenital heart disease. We continue
to close atrial septal defects for adults at risk for strokes or transient ischemic attacks. Other unique procedures include
closing perivalvar leaks, particularly of the mitral valve and mitral valve dilations.
Adult Congenital Catheterization Data
2008-2010
Volume Average
Age
Diagnostic
Interventional
ASD
Devices
Other
2008
68
47.1
19
49
46
3
PDA, Retrieve device, MV leak
2009
80
44.9
25
55
51
4
3 vascular stents, 1 PV dilation
2010
110
47.4
34
76
61
15
5 PDAs, 1 VSD device, 2 PV dilations,
5 Mitral Valve dilations, 1 Mitral Valve
leak, 1 RCA to SVC fistual occlusion
9
The Center for Coordinated Fetal Care at
Inova Fairfax Hospital for Children was our
family’s answer when we learned during a
routine prenatal ultrasound in early 2010 that
our son had a congenital heart defect. We were
shocked to learn that something might be wrong
with our little son’s heart. It was the beginning
of an amazing, yet surreal experience. I praise
the coordinated care my family received from
patient navigator Kelly Gallo, RN, who helped us
throughout the entire process of the hospital
visit, delivery, surgery and arrival home.
We did not have to coordinate one meeting or
appointment ourselves. Someone was following
up, handing us information, calling us or just
dropping by the hospital to say ‘hello’. Having
a newborn with a heart condition requiring
surgery is never easy, but with the excellent
care we received, it is bearable.
- Cindy and Dave
10
The Center for
Coordinated Fetal Care
Using a multidisciplinary approach,
the Center for Coordinated Fetal
Care provides prenatal consultation
Kelly Gallo RN, Patient Navigator,
and pediatric care planning for
Center for Coordinated Fetal Care,
pregnant women carrying babies
plays with one of her patients.
with fetal heart abnormalities,
birth defects or medical problems.
The Center combines the high-risk pregnancy expertise
available at Inova Health System with our pediatric surgical
and medical specialties to provide a continuum of care.
When problems are identified, virtually all of our surgical and
medical specialties are available for prenatal consultation,
coordinated by our patient navigator, Kelly Gallo, RN, who
helps the expectant mother throughout the entire process of
her hospital visit, delivery and surgery. Because the fetal care,
birth and pediatric care can all occur in the same setting, the
family does not have to be separated from their baby at this
momentous time.
In 2010, The Center for Coordinated Fetal Care diagnosed
fetal heart defects in more than 45 expectant moms and
facilitated their delivery and ongoing care of their child.
To refer a patient to The Center for Coordinated Fetal Care,
contact Kelly Gallo, RN, Patient Navigator at 703-776-6371
or ccfc@inova.org. Learn more at inova.org/ccfc.
Research
Inova Fairfax Hospital for Children
is an outstanding site for clinical
research because of the size of the
patient population served throughout
the Washington, DC metro region.
Studies completed in 2010 include:
∙
Feeding the Way to a Shorter
Stay: Achieving Clinical
Excellence with a Feeding
Algorithm. This study used
an evidence-based algorithm to
standardize and improve the feeding of our cardiac
surgery patients, presented at Society of Thoracic
Surgeons Quality and Outcomes conference.
Jaime Langdon, RN, BA, AAS
• Morbidity Indicators in Congenital Heart Surgery.
Multi-institutional collaboration to define the rate of
five specific surgical complications, presented at
Society of Thoracic Surgeons Quality and Outcomes
conference. Beth Suddaby, RN, MSN
Ongoing studies include:
• Multi-institutional Longitudinal Outcome Studies: Four
studies looking at Tricuspid Atresia, Pulmonary Conduit
placement in infants, Left Ventricular Outflow Tract
Obstruction and the newest, Anomalous Aortic Origin
of the Coronary Artery. Irving Shen, MD
• Melody Valve HDE – a study of a pulmonary valve placed
using catheterization techniques instead of surgery.
James Thompson, MD
• Contegra Pulmonary Valve HDE – evaluates the efficacy
of this specific type of replacement pulmonary valve.
Lucas Collazo, MD
• Closure of Atrial Septal Defects with the Amplatzer
Septal Occluder – is a registry to follow long-term
outcome of ASD devices placed in children or adults.
James Thompson, MD
• Assessment of Long-Term Risk of Ablation Therapy in
Children Before It Becomes the Standard Approach –
is a registry to follow the long-term outcome after
ablation in children under 18 years of age.
Margaret Bell-Fischer, MD
• Safety and Efficacy of Intravenous Ketoralac in Infants
and Children Following Cardiac Surgery – a study of the
effectiveness of Ketoraloc to reduce need for narcotics
for pain control after cardiac surgery. Initial pilot showed
no issues with safety. W. Keith Dockery, MD
11
8k
STAR KID 8K RACE
and FAMILY FUN RUN
Inova Fairfax Hospital for Children
Funding for the Future
As a not-for-profit organization, our commitment to world-class
pediatric care is made possible through the generous support
of donors. Each year, several events take place to raise funds
for our pediatric heart program.
In June 2010, the Bob and Lynda Gibbs Family hosted the 7th
Annual Golfing for Grace Tournament. The event raised more
than $28,000 to support the heart program. The event in total
over the past seven years has raised nearly $215,000. These
funds were most recently used to purchase a special pediatric
cardiovascular surgery table specifically designed for children
weighing 75 pounds or less. In addition, funds supported the
development of a video to prepare parents and children for
pediatric cardiovascular surgery.
On October 6, 2010, Dell Services Federal Division
employees, vendors and friends participated in their corporate
golf tournament to support the pediatric cardiology program.
This is the second year that Dell has selected Inova’s pediatric
heart program as their “Charity of Choice” and they will be
holding a third annual tournament in October 2011.
12
On a picture perfect October day, Inova Fairfax Hospital for
Children held its 5th Annual Star Kid 8K Race & Family Fun
Run. A record number of walkers, runners and volunteers were
joined by famed former Washington Redskin, Darrell Green, for
a day of fitness and fun. The event raised more than $100,000
to support the pediatric heart program and the Akl Endowment.
In November, we hosted the 2nd Annual Shapiro Lecture.
The focus of the 2010 conference was Adult Congenital Heart
Disease. Experts from around the country gathered to discuss
leading techniques, research and diagnoses related to the
adult congenital heart disease patient. This conference was
made possible by two major gifts given in honor of Dr. Stephen
Shapiro, which established the Shapiro Endowed Cardiac
Education Fund at Inova Fairfax Hospital for Children.
For more information on how you can support Inova Fairfax
Hospital for Children’s Foundation, call 703-776-3422.
Meet Our Team
Pediatric Cardiac
Electrophysiology
Arrhythmia Associates, LLP
703-849-0770
Margaret Bell-Fischer, MD
Ted Friehling, MD
Pediatric Cardiac Surgery
Cardiovascular & Thoracic
Surgery Associates, LLP
703-208-5858
Irving Shen, MD, Medical Director
Pediatric Cardiovascular Surgery
Lucas Collazo, MD
Chuck Bailey, PA
Shelly Fleischer, PA
Pediatric Cardiology
Child Cardiology Associates
703-876-8410
James Thompson, MD
Section Chief,
Pediatric Cardiology
Patrick Callahan, MD
Frank Galioto, MD
Steven Herold, MD
Adrienne Kilgore, MD
William Kirby, MD
Jennifer Lindsey, MD
Harish Rudra, DO
Stephen Shapiro, MD
James Telep, MD
Children Heart Associates, PC
571-292-9940
Mohamed Mardini, MD
Children’s Heart Institute
866-645-4055
Hasan Abdallah, MD
Rabih Hamzeh, MD
Omar Khalid, MD
Mubadda Salim, MD
Georgetown Pediatric
Cardiology Associates
703-717-4070
Thomas Hougen, MD
Medical Director,
Invasive Cardiology
Pediatric Cardiology
Associates
703-573-0504
Sharon Karr, MD, Medical Director,
Noninvasive Cardiology
Annette Ansong, MD
Alan Benheim, MD
Robert Escalera, MD
Seymour Hepner, MD
Jin Park, MD
Irene Sadr, MD
Sherif Tawfik, MD
Pediatric Preventive
Cardiology and Obesity
The Healthy Heart Center
800-784-8590
Wali Gauvin, MD
Neonatology
Pediatric Critical Care
Fairfax Neonatal Associates
703-776-6020
John North, MD, Medical Director
Margot Ahronovich, MD
Robin Baker, MD
Rajiv Baveja, MD
Robert Beck, MD
D. Spencer Brudno, MD
Ed Doe, MD
Matthew Eig, MD
Mark Fowler, MD
Afsaneh Hessamfar, MD
Tom Hull, MD
Daniele Huntington, MD
Jun Kang, MD
Georgis Kefale, MD
Alex Kline, MD
Raul Lazarte, MD
Fern Litman, MD
Tong Park, MD
Anil Sharma, MD
Alan Silk, MD
Stephen Spurr, MD
Linda Tribble, MD
Rachel Troy, MD
Fegegta Workie, MD
Inova Fairfax Hospital
for Children
703-776-6558 office
703-776-6053 unit
Stephen Keller, MD,
Medical Director
Swati Agarwal, MD
Keith Dockery, MD
Kathleen Donnelly, MD
Craig Futterman, MD
Cynthia Gibson, MD
Peter Grundl, MD
William Stotz, MD
Michael Vish, MD
Pediatric Cardiac Anesthesia
Fairfax Anesthesiology
Associates, Inc.
703-776-3138
John Britton, MD
Ahmed Elrefai, MD
Erin Foley, MD
James Konigsberg, MD
Jennifer Maher, MD
Robert Mesrobian, MD
Pediatric Cardiac Nurse
Anesthetist
Oliver Jordan, CRNA
Tricia Frack-Jordan, CRNA
Kristin Hughes, CRNA
Susan Mesrobian, CRNA
Michelle Munson, CRNA
Karen Ribeiro, CRNA
Nellie Todorova, CRNA
Pediatric Perfusion
703-776-3728
Keith Amberman
Dave Fitzgerald
Amy Ging
Ruben Munoz
John St. Onge
Ron Wittig
Pediatric Cardiac Services
Beth Suddaby, RN, MSN
Quality and Outcomes Clinical
Nurse Specialist
703-776-6920
Meghan Edwards, RN, FNP
Cardiac Nurse Practitioner
703-776-6552
Child Life Services
703-776-2731
Tracy Marrs, CCLS
Cardiac Child Life Specialist
703-776-2731
Adult Congenital Heart Clinic
Penny Kardis, RN, MSN
Clinical Coordinator
703-776-3599
Potom
Lovettsville
ac R.
Waterford
15
Hillsboro
Purcellville
Poolesville
Leesburg
Hamilton
7
Rockville
Ashburn
50
Sterling
Middleburg
inova.org/childheart
Arcola
66
McLean
Arlington
Centreville
Annandale
Burke
Manassas Park
Fairfax
F
xC
County
Co
ou
Manassas
Calverton
Brentsville
Washington D.C.
Fairfax
Haymarket
Nokesville
Silver Spring
Falls Church
Chantilly
The Plains
495
Bethesda
Reston
50
Kensington
Potomac
7
95
395
Franconia
Newington
Lake Ridge
Prince William
a County
Dale City
Montclair
Alexandria
Mount Vernon
Occoquan
Woodbridge
Indian Head
Dumfries
Quantico
Inova Fairfax Hospital for Children
World-Class Pediatric Heart Care
Conveniently Located in Northern Virginia
Inova Fairfax Hospital for Children provides the full spectrum of diagnostic
and interventional cardiac services as well as electrophysiology, cardiac
and thoracic surgery.
To refer a patient, call 703-776-6552.
PHI Aircare transports patients by helicopter to Inova Fairfax Hospital for Children from within
a 200 mile radius. The helicopters, equipped as flying emergency intensive care units, contain
monitoring equipment, ventilators and defibrillators, allowing nurses and paramedics to begin
treatment while in route to the hospital.
3300 Gallows Road
Falls Church, VA 22042
inova.org/childheart
G30508/6-11/12,650