Close at Heart
Transcription
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 [email protected]. 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
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