Heart Center Outcomes

There’s a family behind every number, percentage and statistic. We never lose sight of that fact.
Achievements
The Heart Center, a comprehensive approach to excellence.
On the day this photo was taken, Catherine was on her way home following a successful heart procedure. As a result of
recent advancements, her procedure no longer requires an overnight stay.
l ead in g t h ro ugh carin g
Dear Colleagues,
The Heart Center’s mission is to focus on providing the highest quality, family centered,
most cost effective and comprehensive care to all patients, regardless of age, with
congenital heart disease. In doing so, the Heart Center at Columbus Children’s Hospital
is one of the leading congenital heart disease centers in the world for infants, children
and adults.
And we are accomplishing that mission without losing site of an important fact: At
the Heart Center, we treat patients and families, not customers. We provide expertise
and diagnostic and therapeutic technology that is second to none. At the same time,
we believe that the patient deserves an ongoing relationship that is built not only on
technical competence, but also on communication and trust. The patient, the family and
the referring physician are at the center of the circle, not off to the side. Thus, our motto:
“Out in front. By your side.”
In the pages that follow, we will provide information about all aspects of our Center.
In each of the sections of the Center we will present data about our outcomes as they
compare to the rest of the state, country or world. We will also display our complication
rates, volumes, information about access to services and stories about individual patients
and families who have used the Center.
Timothy Feltes, MD, FACC, Co-Director of the Mark Galantowicz, MD, FACS, Co-Director of the Heart
Heart Center, Chief of Pediatric Cardiology, Cardiac Center, Chief of Cardiothoracic Surgery, and Associate
Intensivist, and Associate Professor of Pediatrics, Professor of Surgery, The Ohio State University College
The Ohio State University College of Medicine of Medicine
t a b l e of c on ten ts
Outpatient Services. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Diagnostic Imaging. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Cardiothoracic Surgery. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Cardiac Catheterization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
Hybrid Procedures. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
ISHAC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
Electrophysiology. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
Transplantation Services. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
Adult Congenital Heart Disease. . . . . . . . . . . . . . . . . . . . . . . . . 27
Research Programs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31
Education . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32
International Programs. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
The Heart Center Team. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34
Welcome Center. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40
Physician Liaison Program. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40
Referral Information. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40
Out in front.
By your side.
The Heart Center at Columbus Children’s Hospital • www.columbuschildrens.com/heartcenter
2
o u t pat i e nt s e r vice s
1 day
In 2005, patients waited
one day for a routine appoint-
ment despite the huge increase
in volume—the lowest wait
time in the state.
A great Heart Center such as

ours begins with making sure Growth in Outpatient Volume
that access is easy. Through
the efforts of the cardiology
faculty and outpatient nursing
staff, significant growth has
occurred in the total number
of patients seen on an annual
basis.
• • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •
Part of making access easy has to do with geography: how far does a parent have to travel to be
seen by one of the Heart Center cardiologists? Not only are there a number of convenient locations
in the Columbus area, but we have outreach clinics located throughout Ohio and one in Kentucky.
Clinics in the Greater Columbus area Clinics across the region
All of these clinics

have diagnostic
services on site.
With this extensive network of clinics, patients can be seen and evaluated by one of our cardiologists.
If further workup or diagnostic studies are indicated, virtually every modality is available at the
Heart Center. Also, long-term follow up after surgery or transcatheter therapy can be conveniently
scheduled without having to return to the main campus.
3
Diag no stic im agin g
75 %
The percentage of patients in which information from a
Transesophogeal Echocardiogram in the operating room helps guide
post-therapeutic management strategy.
It was not that long ago that a full diagnostic workup consisted of a history, physical examination
with a stethoscope, chest X-ray, EKG, and cardiac catheterization. It is a different world today. Even
though the history and physical examination are still the foundation of the patient’s evaluation,
there are many other non-invasive modalities, frequently making a formal cardiac catheterization
unnecessary.
Perhaps the most useful is Echocardiography providing anatomic and physiologic information about
heart structure, blood flow patterns and estimated pressures inside the heart with essentially no risk
from the Echo itself. Echocardiograms can be obtained in two dimensions (2D) or three dimensions
(3D); they can be obtained from outside the chest (transthoracic), from the esophagus (transesophogeal
echocardiography – “TEE”), from inside the heart on a catheter mounted unit (Intracardiac
Echocardiogram – “ICE”), or even from inside a vessel (Intravascular Ultrasound – “IVUS”).
2D color Doppler echo demon- A 3D transthoracic echo in a A 3D transesophageal echo (TEE)

strating a moderate sized mid- newborn with Hypoplastic Left nicely demonstrates a centrally
muscular VSD. Heart Syndrome is shown. located secundum ASD.
2D Echos are also obtained of patients in utero. This fetal echocardiography can allow the Heart
Center professionals, as well as the parents, time to chart out the optimal course for delivery
and immediate post natal care. In the future it may be possible to intervene in the fetal heart
interventionally or surgically in a way that could increase survival and options. 3D Echocardiograms
are particularly useful in clarifying the anatomy of defects inside the heart in preparation to close
them with a device in the cath lab as opposed to an operation (see “Interventional Cardiology”).
Three dimensional details can help determine the type of device to be used.
4
Diag no stic i m agin g (co nti nue d)
Intracardiac Echocardiography (“ICE”) is most commonly used to assist in the placement of devices
or dilating balloons inside the heart. It can document the internal anatomy and define areas for
intervention. Intravascular ultrasound (“IVUS”) can provide details of the anatomy of vessel wall
and/or define an area of disruption such as a pseudoaneurysm.
Intravascular ultrasound (IVUS) is used during cardiac

catheterization to image abnormalities of the blood
vessel. In this example, an aneurysm has developed
Transesophageal echo (TEE) is used to image a 16 mm after surgical repair of coarctation of the aorta. In the
ASD with deficient retroaortic rim. The TEE will guide adjacent angiogram the posterior aneurysm and residual
transcatheter device closure of the defect. coarctation are seen.
• • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •
The volume of all types of

Growth in Echo Studies n TEE/ICE
Echo studies has increased
n Fetal
n Transthoracic dramatically since 2001,
which is a testimony to the
usefulness of the modality. It
can be performed sequentially
to assess changes over time
in function, flow or pressure.
In 2005, more than 8,200
studies were performed.
5
Diag no stic i magin g (co nti nue d)
Echo services are available not only on Children’s Hospital’s

main campus, but at all Children’s Hospital operated Neonatal
Intensive Care Units around Columbus as well as most of our
outreach clinics.
Anatomy of cardiac and vascular structures can also be evaluated

by High Definition stop ventilation Computed Tomography
(HDCT) with three dimensional reconstruction. The quality of
these images is quite remarkable and can be viewed from many
different angles. They can be useful for understanding individual
pathology as well as planning a surgical or transcatheter approach.
A volume rendered, 3D multi-slice CT (MSCT) scan This 3D MSCT scan was performed after serial stents
beautifully demonstrates severe transverse aortic arch had been placed in the descending aorta in a 5 year old
hypoplasia after complex congenital heart disease with middle aortic syndrome. A 19 mm long aneurysm
repair in a 7 month old infant. is demonstrated on the scan. Subsequent transcatheter
therapy was successfully performed.
• • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •
With all of the diagnostic imaging available, most patients go to surgery without a cardiac
catheterization for diagnosis, and there are rarely any surprises in the operating room. As discussed
in the next section, all information is reviewed on each patient by the entire Heart Center team to
make sure that, when patients are referred to surgery, all appropriate information is available and
current.
6
Ca r d io tho rac ic s urge r y
1.02 %
While mortality rates under 5% for open heart surgery
are considered acceptable, the Heart Center at Columbus Children’s rate
of 1.02% is significantly lower than the 2005 statewide rate of 3.4% for
all other centers.
Virtually every type of Cardiothoracic Surgery is performed at the Heart Center with results that
are outstanding at a national level. All congenital cardiac deformities can be repaired or palliated,
many with techniques that were developed here in Columbus. Working hand-in-hand with the
interventional cardiologists and electrophysiologists, the optimal therapy is individualized for each
patient, no matter what the complexity of their situation. If no further options are workable or
practical for selected patients, transplantation of the heart, lungs or both are available, and their
long-term care coordinated by experts in the management of heart and lung transplants.
Our surgical team includes the perfusionists, who run the heart lung machine, which keeps the
patient’s body supplied with blood while the heart is rested during repair. Our team of four
perfusionists has a combined total of 57 years of service at Columbus Children’s and is also active
on the national and international scene. Fifty-three abstracts and presentations as well as 11
scientific papers have been authored by our perfusion team. Along with the surgeons, they have
developed techniques using very small components and tubing that allows for open heart surgery on
infants and even newborns without using blood. Thus the basis for our “blood conservation program.”
• • • • • • • • • • • • • • • • • • • •
Total Cardiothoracic Surgical Procedures
The perfusion team has miniaturized

the cardiopulmonary bypass circuit
to allow ease of operation during an
open heart procedure performed in
the Hybrid Suite.
7
Ca r d io tho r ac ic s urge r y (co nti nue d)
70 The number of out-of-state referrals for

surgery at the Heart Center in the last year. The
number of referrals per year has increased steadily.
When looking for meaningful outcomes

results in pediatric cardiac surgery, mortality
rate for the Arterial Switch Procedure is
frequently viewed as a good barometer. This
complex operation is typically performed
in the first few weeks of life. All parts of the
system must perform very well to obtain good
outcomes: from preoperative evaluation and
management, to excellence in the operative
suite of anesthesia, perfusion and surgeons, and
meticulous attention to detail in the Cardiac
ICU afterward. The creation of our Heart Center,
related recruitment activities, and consolidation
of all aspects of the clinical services occurred in
late 2002 and early 2003 with a corresponding
and marked decrease in operative mortality.
Mortality Rate of Arterial Switch Operation for

Transposition of the Great Arteries
n Statewide Average
n Columbus Children’s
8
A great deal of attention is

paid to safety and prevention Cardiac Surgical Infection Rate
of complications. One of
the most common and
worrisome complications
is infection. The Heart
Center is represented on a
national panel of experts for
the prevention of surgical
wound infections. Recently,
even more progress has been
made toward minimizing
this complication using
innovations in and out of the
operating room.
• • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •
Results like these require

more than great surgery,
they require great teamwork
at every stage of the
process. That starts with
a collaborative approach
to planning the therapy,
where all members of the
multidisciplinary team have
input to planning the care.
With the large amount of
expertise available at the
Heart Center there may well
be several different ways
to potentially solve the
patient’s problem. These
options are discussed at our
bi-weekly case management
Team members consider treatment of a patient during our bi-weekly case conferences.
management conference.
9
One indication of how well we are doing treating our patients and families is the growth in referrals
to the Center, which have more than doubled and widened regionally, nationally, and now include
referrals from other countries. Our surgical and interventional cardiology programs are now
internationally renowned.
• • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •
Referred patients in 2000 Referred patients in 2005
10
It also takes considerable

expertise to make sure the
patient is “tuned up” prior to
and after surgery and managed
with exquisite attention to
detail in the dedicated Cardiac
ICU. Staffed by Cardiac
Intensivists, Critical Care
Physicians and advanced level
Nurse Practioners, dedicated
rooms staffed by dedicated
nurses provide comprehensive
and professional care. All
types of mechanical heart
and lung support devices and
technicians are also available
if necessary. Nurse practitioners working in the CICU during rounds.
• • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •
And through all of this, we remain centered on the patient and the family. Our brand new operating
suites not only include spacious rooms with the finest of equipment, but also are designed for parental
presence. A parent can accompany their child, in their street clothes, to the induction room and
be with him or her until they fall asleep – a great comfort for both child and parent. After cardiac
surgery, the patient goes directly to the CICU where the parent can be with them as soon as they
are checked in and connected to monitors. The new CICU has 24-hour parental presence as part of
the way we do business. And we just moved into our newly remodeled step down unit, which has
all private rooms with showers. This is what our parents think of us:
Questions on Parent Satisfaction Survey (2005) % Positive

Answers to questions were understandable 98%
Risks and benefits were discussed prior to surgery 98%
Doctors and nurses worked well together 97%
Rate policy for visiting/staying with child 97%
New Cardiac Step Down unit with

Private Rooms
11
Ca r d iac cath eTerizat ion
.39 %
A total of 339
diagnostic catheterizations were
performed in the cath lab during the
last three years with both mortality
and complication rates of 0.39%.
The cardiac catheterization suite serves three different functions that are becoming increasingly
separate and distinct: diagnosis, intervention, and electrophysiology study and treatment.
Diagnostic catheterization is the traditional study of the gathering of pressure and oxygen
saturations in all chambers and vessels, as well as visualization of anatomy and flow by introducing
contrast agent and obtaining digital angiography. Calculations based on these measurements can
frequently be used to calculate flow, shunts, and resistance. This information allows the planning of
medical, interventional or surgical options for patient treatment.
Interventional catheterization employs the use of specially designed catheters and devices
(balloons, stents, occlusion devices, etc.) to actually treat an intracardiac or vascular problem, as
opposed to just diagnosing it. Most of the time, the interventional procedure is accomplishing a
task that would otherwise require a heart operation.
Electrophysiology studies use

specialized catheters guided Catheterizations by type
to the inner surface of the n Interventional
n Diagnostic
heart to analyze the electrical n Electrophysiological
characteristics and pathways
that are creating rhythm
disturbances in patients.
If an abnormal pathway
is detected and causing
arrhythmias, it can be ablated
with radiofrequency energy.
In addition, pacemakers and
defibrillators are implanted in
patients with life threatening
rhythm distrubances.
12
Ca r d iac cath e t e rizat ion (co nti nue d)
895 During the last

three years Children’s completed
895 interventional procedures
with a 0.02% complication rate
and a mortality rate of 0.48%.
Since the creation of the

Heart Center, the use of the
cardiac catheterization suite
has changed considerably.
The number of diagnostic
catheterizations has decreased
because ECHO and other
imaging modalities have
provided the relevant
information without the
risk of catheterization. This
means that patients who do
come to the cath lab will be
more complex, frequently
more compromised patients.
A dedicated interventional The Amplatzer Occlusion Devices are shown and are used to non-surgically
cardiology team was recruited close intracardiac defects associated with congenital heart disease.
in 2002 to offer cutting edge,
transcatheter therapies to all
children and adults with complex congenital heart disease. As a result,the number and complexity
of interventions has increased dramatically—many times avoiding an operative procedure.
• • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •
A right upper pulmonary

vein angiogram nicely
demonstrates a large
secundum ASD in a 2 year
old. After balloon sizing of
the defect, an Amplatzer
Septal Occluder is success-
fully implanted. Nearly 100
patients each year undergo
successful non-surgical
device closure of ASD in
our catheterization suite.
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Ca r d iac cath e T e rizat ion (co nti nue d)
The past 15 years have seen an explosion

of non-surgical, transcatheter options to
close intracardiac defects, such as atrial
and ventricular septal defect, as well as
patent ductus arteriosus. Percutaneous valve
implantation is being developed and will
become available in selected centers in the
future, including our own. Adult patients
with neurologic events or migraine headaches
associated with patent foramen ovale requiring
transcatheter closure are being referred to our
Center during clinical trials. As a matter of
fact, adult patients with complex congenital
heart disease comprise over 25% of the
interventional procedures performed in our
Hybrid Cardiac Catheterization Suites. All
transcatheter therapeutic options are available
in our Center, regardless of size, complexity,
or age of the patient. Like the Cardiothoracic Color flow Doppler TEE demonstrates a multi-fenes-
trated ASD. Under an FDA approved clinical trial, a
Surgical Service, patients from across the USA Cribriform Septal Occluder was successfully implanted
and abroad are referred here for transcatheter and is shown in the adjacent TEE image.
therapy.
Since The Heart Center was established in 2002, we have been involved as a Principal Investigator
in over eight FDA sponsored clinical trials, three interventional cardiac registries, and over 50 IRB
approved studies. In addition, our Center is one of eight sites that are involved with establishing
Congenital Cardiac Catheterization Outcomes, which will provide important data to define
expected outcomes for all diagnostic and interventional procedures. Finally, our Interventional
Team has been responsible for 23 manuscripts in scientific journals, nine book chapters, 47
published abstracts, 132 oral and poster presentations given nationally and internationally, and has
been invited to perform live case broadcasts to teach other interventionalists attending scientific
symposia worldwide.
14
C a r d i ac cath e t e r izat ion (co nti nue d)
The interventional cardiology team

works closely during advanced
transcatheter therapies. In these pho-
tographs, IVUS is being performed
to help guide balloon angioplasty
and stent implantation after surgical
repair of tetralogy of Fallot.
• • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •
An aortic angiogram demonstrates near complete

interruption of the aorta in a teenager with CoA. After
compassionate use approval, a covered stent is implanted
and there is complete relief of obstruction.
Volume rendered, 3D MSCT scan is very important after

transcatheter interventions. The above images nicely
demonstrate in-stent stenosis after pulmonary artery
rehabilitation in an infant after tetralogy of Fallot repair.
Additional interventional therapy was required.
15
H yb r i d p ro ce dure s
Mortality Rate for First Stage Palliation of Hypoplastic

Left Heart Syndrome
n Statewide Average
n Columbus Children’s
At the Columbus Children’s

Heart Center, we have
pioneered the concept of
the Hybrid approach to
complex congenital heart
disease. A Hybrid case is one
that combines the talents
of a cardiac surgeon and an
interventional cardiologist.
An example is our new Hybrid

approach for the initial
palliation for Hypoplastic
Left Heart Syndrome. The
traditional approach (The
Norwood Procedure) involves
an extensive open heart
procedure which creates a neoaorta, disconnects the pulmonary arteries and provides pulmonary
blood flow by a Gore-Tex® shunt which provides adequate pulmonary flow while protecting against
overcirculation. Cardiopulmonary bypass and circulatory arrest are typically required. In contrast,
our Hybrid approach protects against pulmonary overcirculation by banding the pulmonary arteries
individually through a limited incision in the chest without cardiopulmonary bypass. The cardiac
surgeon then provides access to the patent ductus through the proximal pulmonary artery, allowing
the interventional cardiologist to place a stent in the ductus arteriosus, thus keeping it open,
serving as the conduit to the aorta. Just prior to discharge, a transcatheter balloon atrial septostomy
is performed, allowing unobstructed flow for the left side to the right side of the heart. The same
objectives are obtained as the Norwood Procedure, but with the Hybrid approach there is no bypass
involved, and no circulatory arrest. Therefore, the procedure can be performed without blood,
which in part explains our international reputation among parents of the Jehovah’s Witness faith.
Avoiding open heart surgery and circulatory arrest in the newborn period has several theoretical
long-term advantages, both in terms of mortality and morbidity as well as long-term neurologic
outcome. The effect on overall outcomes for Stage I palliation at the Heart Center has been
remarkable. In the most recent year, 13 Stage I palliations were carried out, 11 by Hybrid approach
and two with a traditional Norwood Procedure without a mortality. These results are excellent by
both national and regional standards.
16
H yb r id p r oce d u re s (co nti nue d)
This type of innovative approach requires a new

look at space and equipment. Traditional cardiac
catheterization laboratories are not designed to
be operating rooms. The cath tables provide best
access to the patient from the groin area and
have maximum flexibility for the table and
biplane imaging equipment. Access to the chest First-of-a-kind Hybrid Suite and Table
is limited and there is not space and support for
cardiopulmonary bypass equipment. Operating rooms, on the other hand, are set up for bypass,
maximum access to the chest, and plenty of room for anesthesia and diagnostic equipment, but
have only rudimentary imaging equipment. The two Hybrid Suites in The Heart Center have been
specifically designed with both needs in mind. Built to Operating Room standards, all necessary
space and access exist for an open heart surgical team. At the same time, state-of-the-art imaging
and physiologic equipment gives the interventional cardiologist the necessary tools to perform the
intervention. Our two Hybrid Cardiac Catheterization Suites opened in 2004 and were the first in
the world specifically designed for Hybrid procedures.
• • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •
Ben and Veronica Sneesby moved halfway around the world – from
Australia to Columbus, Ohio – to save their daughter’s life. Phelicity was diag-
nosed in utero with hypoplastic left heart syndrome. The Sneesby’s were told
there was no hope for their unborn child. But the family searched and found
Dr. Mark Galantowicz, Co-Director of Columbus Children’s Hospital Heart
Center, and his colleague, John P. Cheatham, MD, Director of Catheterization
and Interventional Therapy, who had achieved excellent results with a new
“Hybrid” technique to treat hypoplastic left heart syndrome without the use
of blood.
The Sneesbys didn’t hesitate; they sold their home and began the 9,000-mile
journey to Columbus. Phelicity Brooke-Lyn Sneesby was born in Columbus on
July 18 and just 12 days later, Dr. Galantowicz and Dr. Cheatham, along with
their teams, performed the first of two procedures that allowed her to breathe without a respirator. Phelicity, only
the 12th child to undergo this new treatment, came through with flying colors. Phelicity has now completed all
three procedures leading to a Fontan circulation without the use of blood!
The Sneesbys have returned to Australia to rebuild their lives at home, where Dr. Galantowicz and his team expect
Phelicity to continue to enchant them with her bright inquisitive ways and energy.
17
Interventional and surgical

teams from all over the
country visit our Hybrid
Suites to learn more about
Hybrid therapies and room
design. In addition, we have
had visitors from Europe,
South America, and Asia visit
our team of specialists.
It is common for visitors from other countries to visit our Hybrid Cardiac
Catheterization Suites. Guests from FuWai Cardiovascular Hospital in Beijing,
China observe a Hybrid Stage I palliation for HLHS by our team.
• • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •
During a Hybrid
procedure for intra-
operative delivery
of an LPA stent on
cardio-pulmonary
bypass, endoscopic
imaging confirms
appropriate placement
of the stent proximal
to the upper and
lower lobe branches.
18
Hybrid Stage 1 palliation has

been performed successfully
by our team in babies as small
as 1.1 kg... not much larger
than your hand.
• • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •
After pulmonary artery bands have been placed, a self-expandable PDA stent is implanted off cardio-pulmonary bypass. An
angiogram confirms excellent placement of the stent and PA bands. A follow up 3D MSCT scan is performed prior to Compre-
hensive Stage II repair and nicely demonstrates the PA bands, PDA stent, and atretic ascending aorta.
19
ISH AC
5 The International Symposium on the Hybrid Approach to

Congenital Heart Disease attracted interventional cardiologists and
cardiothoracic surgeons from 5 continents.
Interventional cardiologists and cardiothoracic surgeons from throughout the United States, North
and South America, Europe, Australia and Asia gathered at Columbus Children’s Hospital from June
28-30, 2006, for the inaugural International Symposium on the Hybrid Approach to Congenital
Heart Disease (ISHAC). This conference was the first of its kind dedicated to exploring advance-
ments in “Hybrid” management strategies which combines surgical and transcatheter therapies in
order to minimize the cumulative impact of treatment for complex congenital heart disease (CHD).
Columbus Children’s Hospital is considered a benchmark institution in this area where two
uniquely designed Hybrid Cardiac Catheterization Suites opened in June, 2004—the first in the
world dedicated to this new therapy.
20
ISH AC ( c onti nue d)
The two-day Symposium featured lectures and panel discussions

from international pioneers in the field, as well as live case
demonstrations broadcast from Miami Children’s Hospital,
University of Chicago Comer Children’s Hospital, and the
Hybrid Suites at Columbus Children’s Heart Center. A special
one day hands on Workshop was attended by selected participants and the faculty.
Symposium directors were John P. Cheatham, MD, Director of Cardiac Catheterization and Inter-
ventional Therapy at Columbus Children’s Heart Center, and Mark Galantowicz, MD, Co-Director
of The Heart Center and Chief of Cardiothoracic Surgery at Children’s. Both are faculty members
of The Ohio State University College of Medicine. Drs. Cheatham and Galantowicz have organized
this world-class event to encourage international discussion for potential Hybrid cardiac procedures
that will result in improved outcomes while decreasing risks.
During the ISHAC hands-on Workshop, cardiothoracic surgeons, interventional cardiologists, and nurse practitioners receive
training by our team for Hybrid Stage I palliation for HLHS.
21
E l e ctr o p h ysiol og y
200 Nearly 200

patients with pacemakers are being
monitored by the EP Service.
The Electrophysiology service is devoted to caring for patients

with heart rhythm abnormalities. The abnormal rhythms can
be divided into two broad groups, those with heart rates that
are too slow and those that have fast heart rhythm problems.
The key to caring for this group of patients is to offer state-of-
Fluoroscopy Image
the-art facilities and equipment in order to adequately diagnose
the abnormal rhythm and provide effective intervention to
treat the abnormalities. To provide this level of care, often for
complicated patients, the Electrophysiology team provides
a wide range of services. They include diagnostic tests and
interventional procedures. Diagnostic services include
telemetry review of cardiac patients admitted to the hospital,
transesophogeal and intracardiac electrophysiology testing, and
tilt table tests. Other diagnostic tests include EKG’s, Holters and
Event monitors.
• • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •
22
E l e ctr o p h ys i o l og y (co nti nue d)
0 The number of patients

who have required pacemaker
therapy after ablative therapy.
The Heart Center at the Columbus Children’s Hospital has a

full complement of diagnostic capabilities. Invasive diagnostic
electrophysiology testing is performed in a state-of-the-art
catheterization laboratory. The facilities offer both a conventional
mapping system, as well as three-dimensional electroanatomic
reconstruction of the abnormal substrate that is the cause of
abnormally fast heart rhythm. Because we have these tools
available, we can ablate the abnormal electrical impulse that is
the cause of the palpitations. One of the two tools with their
unique advantages is chosen based on individual patient needs.
This approach affords maximal effectiveness in success and, just

as importantly, minimizes the potential for serious complications.
To date we have had no patients require pacemaker implantation
as a result of ablative therapy. The Heart Center achieves an
80% to 95% success rate on routine SVT ablation interventional
procedures depending on the area to be ablated: a rate that is
comparable or better than the national average.
• • • • • • • • • • • • • • • • • • • •
The high level of activity indicated below demonstrates the need,

as well as the effectiveness, of Electrophysiology Services.
Electrophysiology Service
n Interventional EP Electrical Map created by computer
n EPS
n Device Implantation
23
E l e ctr o p h ys i o log y (co nti nue d)
For patients with slow heart rates that are potentially harmful, a
pacemaker may be needed. The pacemakers of the present era are
sophisticated devices that allow tailoring of the settings to the
needs of each patient. Due to the changing needs of our patients,
settings are directly related to their age and associated cardiac
problems, and our staff are experienced in adjusting the settings
of these devices accordingly. We implant cutting-edge devices Medical illustration of a
pacemaker device
and leads for our patients. There are patients who require devices
that have the capabilities
to detect abnormally fast
rhythm and deliver the
appropriate therapy. As
our survivors of congenital
heart surgery age into young
adulthood, there is clearly a
growing need for these life
saving devices. Determination
for the patient who needs
such a device is performed
systemically and through
a team approach involving
almost all the services of the
Heart Center. Follow-up is
performed by a very capable
and highly trained staff to
ensure the device is operating
properly.
Dr. Pamela Ro with a family.
24
T r an sp l an tat ion s e r vice s
When no other options are available with

conventional medical or surgical therapy,
transplantation of a heart, a lung, or heart and
lungs is a life saving option. Transplantation
services began at the Heart Center in 2002,
and the program has grown rapidly. We began
the services only after assembling all necessary
experts.
In addition to surgeons and transplant

cardiologists and pulmonologists, intensivists
and anesthesiologists, the team includes
transplant coordinators, a child psychologist,
and the entire array of other supporting
services such as pathology, pharmacy, nutrition, rehabilitation service, and occupational and
physical therapy. Once in place, program approval was gained from the United Network for
Organ Sharing (UNOS) at the national level and The Ohio Solid Organ Transplant Consortium
at the state level.
• • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •
Volume of Transplant Procedures
The volume of transplantation has grown dramatically.
25
T r an sp l an tatio n s e r vice s (co nti nue d)
6 months
While the recipients range in age from 2 months to 19 years, the
majority of heart transplant recipients are less than 6 months old. Also, heart
transplant wait times range from 1 to 27 days, with a median wait of 10 days.
Of course, the nature of the patients awaiting transplantation is such that the full array of support
must be available including mechanical support. It is of note, that even though wait times in
general were relatively low, there were 3 patients who required Extra Corporeal Membrane
Oxygenator (ECMO) support while waiting for an organ, including one who was on ECMO for
10 days.
Supporting the service is a whole network of clinics and clinicians that screen and evaluate
patients pre-transplant, and who keep track of the all-important follow-up that is so crucial in
transplantation.
• • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •
At 3-months-old and in need of a heart and lung transplant, time was al-
ready running out on Jason. And while Jason’s family waited, another family at
Children’s waited, as well. Their daughter, Kayla, needed a new heart in order
to survive. Both of their lives were being measured in weeks, rather than years.
It was then that the unlikely occurred. A heart and lungs from an anonymous,
out-of-state donor became available. So the transplant team at Children’s took
advantage of this rare opportunity
to save the lives of two children.
Surgeons transplanted Jason’s
heart into Kayla, then transplanted
the donated heart and lungs into
Jason. Prior to this procedure, a
domino transplant had not been
performed in the United States for
more than a decade and never in
patients this young and small. And
as a result, Jason has now experi-
enced life as an organ donor, and
as an organ recipient.
26
A d ult c on g e n i t al h e art dis e as e
Patients with repaired congenital heart disease are continuing

to live longer, and as they do, the proportion of adults with
congenital heart disease continues to rise and exceeds the number
of pediatric patients with congenital heart disease.
Many patients who have undergone total corrective surgery

will have few, if any, hemodynamic residual lesions requiring
infrequent evaluation and treatment (atrial septal defect,
ventricular septal defect and patent ductus arteriosus). However,
Rachel – Adult congenital heart patient
patients with more complex lesions may have residual shunts,
valvular disease, ventricular dysfunction and arrhythmias, and require more frequent evaluation,
medical treatment and consideration for further surgical or catheter based interventions. As we
follow patients for decades, some patients that were previously considered as “routine” may
develop unforseen problems. Our programs focus resources on these patients.
• • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •
The mission and goals of The Adolescent

and Adult Congenital Heart Disease
Program at Columbus Children’s Hospital
and The Ohio State University is to:
1. Comprehensively evaluate and treat,
both medically and surgically, adolescent
and adult patients with congenital heart
disease.
2. Maintain a detailed patient database to
support clinical and basic research in the
field of adolescent and adult congenital
heart disease.
3. Provide education to medical students,
residents, nurses and physicians at
Columbus Children’s and The Ohio State
University in the subspecialty area of adult
congenital heart disease.
4. Expand the field of experts in adult
congenital heart disease by facilitating a
Combined Internal Medicine and Pediatric
Cardiology Fellowship Program.
27
A d ult con g e n i t a l h e a rt dis e as e (co nti nue d)
Adult Congenital Heart Disease Clinic Patients
To accomplish the goals

set forth requires a team
of experts from several
disciplines including nurse
clinicians, cardiologists
in many subspecialty
areas (electrophysiology,
heart failure/transplant,
interventional cardiac
catheterization), and
cardiothoracic surgery.
In July 2000, an adult

congenital heart clinic was
established at Columbus 2005 total patients = 1,116 (OSU – 521, CCH – 595)
Children’s Hospital with a
parallel clinic at OSU’s Heart Center – Mill Run. Initially, the clinics were scheduled once a month,
but by the year’s end, the clinics had expanded to twice a month. Currently, the Adolescent and
Adult Congenital Heart Disease Clinics evaluate patients in 10 separate clinics per month.
• • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •
In order to accommodate this

Adult Congenital Heart Disease Cardiac MRI’s and CT’s growth, Columbus Children’s
has expanded our clinical
staff. Starting with one
Certified Nurse Practitioner,
and adding a second, as well
as a new RN to act as clinical
coordinator.
Increasing number of studies by year.
28
Adult Congenital Heart Disease Cardiac Catheterizations
The number of diagnostic

studies has increased with
the number of patients. In
addition to traditional cardiac
catheterization, MRIs and
Cardiac CTs have increasingly
yielded useful information for
the team.
Also, as shown to the right,

not only are a greater number
of catheterizations being
Increasing number of cardiac catheterizations on adults for congenital heart
performed each year on adults disease, and increasing % of total catheterizations.
for congenital heart problems,
but they represent a growing
percentage of the total number of catheterizations.
• • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •
The Electrophysiology (EP) service has also become an integral part of the adult congenital
heart disease program. By far the most common problem facing our population is arrhythmias.
Research has shown that the risk of sudden cardiac death is 25 to 100 times greater than
expected in an adult with congenital heart disease compared to a normal adult. Therefore, an
aggressive approach to evaluation and treatment is necessary. We have learned that a combined
cath/EP evaluation can provide valuable information and has lead to many patients receiving
pacemakers, intracardiac defibrillators, and intraoperative ablation. The adult congenital service
has maintained a fairly steady presence in the EP lab running between 30 to 35% of all cases
coming to the EP lab at Columbus Children’s Hospital, with 2005 once again having a growth
rate greater than 50%.
Cardiac Surgery on the adult with congenital heart disease is a growing segment of our
population at the Heart Center. Initially, 5% of cases seen by the Adult Congenital Heart
Disease program were referred for surgery. In the most recent year, 11% were referred. These
patients can be treated either at the Ross Heart Hospital of The Ohio State University or at
Columbus Children’s Heart Center. At the Heart Center, our Cardiac Intensive Care Unit is
designed to accommodate all patients from infants to adults.
29
As patients with previously repaired congenital heart defects

mature, we are now finding and developing new techniques and
procedures to care for this group. As an example, many patients
who have undergone single ventricle surgery with a Fontan
operation may require additional surgery for heart failure
and arrhythmias. We are one of only a few institutions that
perform Fontan revision on adult patients. Additionally, we are
developing new open heart procedures that combine complete Jeff – Adult congenital heart patient
repair with arrhythmia surgery. Previously there were no other
options with congenital cardiopulmonary failure, and now Children’s Heart Center has transplant
options for these patients.
In the future, we will be looking at starting a transition program which essentially invites all CHD
patients from Children’s Hospital to join the ACHD program at the age of 18 which would double
or quadruple our current volume.
The ACHD team remains active in clinical research and has accomplished many academic
achievements for 2005. With the addition of full-time faculty members and ACHD fellows,
the research program will continue to expand. Our plan is to add a research coordinator to the
ACHD program to facilitate our research projects and support the staff of the ACHD program. In
2005, five grants were being run by the program. In addition, two papers, eight abstracts, and 15
presentations and lectures were produced. The nurses in the center produced six publications,
two abstracts and three
presentations.
Volume of Adult Congenital Heart Procedures
30
Research p ro gram s
Cardiovascular Research at Columbus Children’s involves

investigators from The Heart Center and the Center for
Cardiovascular Medicine (within Columbus Children’s Research
Institute), where basic scientists and clinical investigators work
closely on multiple research projects. Since 2003 this active group of researchers have published
more than 150 manuscripts or book chapters in leading journals and given more than 250
presentations of their research findings at national meetings. In addition, more than 30 research
proposals have been submitted to national funding agencies, including the National Institutes
of Health and the American Heart Association, and approximately 20 research projects have
been funded from various sources totaling nearly $2 million. Investigators also have contributed
to several multi-center trials for pharmaceutical development. These activities have helped to
foster collaborative relationships with other specialties within our hospital and Research Institute
(neonatology, pulmonary, general pediatrics, pharmacology, genetics) and involved the training of
research fellows from diverse fields in translational research projects.
• • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •
Areas of research emphasis:

In-hospital patient outcomes Basic research
• Innovations in surgical palliation for • Cell and tissue engineering, blood vessel and
congenital heart defects cardiac
• Prevention, prediction and treatment of poor • Models of disease occurring in children and
outcomes post-surgery neonates
• Biomarkers and predispositions • Inflammation and stress signaling pathways
Outpatient and preventive medicine Clinical research

• Oxidant and inflammatory mechanisms in • Establish animal model for the approach
cardiac and vascular disease to hypoplastic left heart syndrome with
• Childhood antecedents of adult pulmonary artery bands
cardiovascular disease • Establishment of a new animal model for
• Endothelial dysfunction and controllers of ventricular septal defects to facilitate testing
new blood vessel formation of perventricular treatment options.
• Novel therapeutic strategies
31
Ed ucation
As part of one of the nation’s

largest and busiest pediatric
hospitals, The Heart Center
at Columbus Children’s is
engaged in a wide variety
of graduate medical and
continuing education activities.
In collaboration with The
Ohio State University College
of Medicine, faculty teaches
residents and fellows in the
following programs:
• Cardiothoracic Surgery
• Congenital Cardiac Surgery
• General Pediatrics
• Internal Medicine-Pediatrics
• Neonatal-Perinatal Medicine
• Pediatric Cardiology
• Pediatric Critical Care
Medicine
• • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •
The Heart Center staff also serves as mentors and role models for physicians, advanced practice
nurses, perfusionists, and other clinicians and scientists. They give lectures, proctor clinical
procedures, present live case demonstrations at national and international programs, and
teleconference case conferences. Indeed, in 2005 faculty and staff gave over 100 presentations
in 19 different countries outside the United States. Presentations include such diverse topics as
hybrid approaches to complex congenital heart disease, new comprehensive Stage II procedure
for hypoplastic left heart syndrome, and RSV prophylaxis in infants and children with
hemodynamically significant CHD.
32
In ter natio nal p ro gram s
International involvement to enhance pediatric cardiac

care in developing countries is a long standing tradition in
The Heart Center. For more than a decade, cardiac surgeons
have led teams of clinicians to offer humanitarian care in
the Dominican Republic, El Salvador, Guatemala, and Peru.
Typically a multidisciplinary team from Children’s Hospital
assists the clinicians from these countries
while they diagnose, plan treatments, operate,
and coordinate postoperative care and long
term follow-up. These supervised clinical
teaching experiences, coupled with donations
of equipment and supplies, has accelerated
the adoption of new techniques and improved
care to the neediest children. For example,
the team from Lima, Peru has performed over
1,200 operations on indigent patients with a
98% success rate and a 1.5% infection rate,
significant accomplishments for such an
at-risk population. Notably these outcomes
were achieved with a cash outlay of less than
$70 per patient.
• • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •
The Columbus Children’s Hospital China Program officially began in 2005 with written affiliations
in three hospitals: Cardiovascular Institute and Fuwai Hospital, Beijing, Shanghai Children’s
Medical Center – Pudong District, Shanghai and Wuhan Children’s Hospital. To date more than
20 physicians teach and learn in the following areas of The Heart Center:
• Interventional cardiology • Cardiac intensive care • Echocardiology
• Cardiothoracic surgery • Anesthesiology • Cardiopulmonary perfusion
The Heart Center faculty and staff actively teach in China as well, serving as Course Directors
of international scientific programs and proctoring physicians from many institutions in new
techniques.
In addition to China, faculty and staff from The Heart Center have also trained physicians from
Bulgaria, Chile, Ecuador, El Salvador, Ghana, Guatemala, Hungary, India, Mexico, and Peru through
the Stecker International Scholars Program at Columbus Children’s Hospital.
33
T he heart center Te am
The specialists, nurses, technologists and other members of our staff work together to deliver the
finest care to critically ill infants and children, as well as adults with congenital heart disease.
Leading this effort are the members of a remarkable medical team, who are comprehensive in their
scope and compassionate in their approach to care.
Timothy F. Feltes, MD, FACC, Chief of Pediatric Cardiology, Cardiac

Intensivist and Co-Director of the Columbus Children’s Heart Center.
Chief of Pediatric Cardiology at The Ohio State University College of
Medicine. Associate Professor of Pediatrics. Recipient of the Andy Paxton
Endowed Chair in Cardiology.
Dr. Feltes received his medical degree from Medical College of
Ohio, Toledo. He completed a pediatric residency at Emory
University of Atlanta and fellowship at Texas Children’s Hospital,
Houston. He is board certified in Pediatric Cardiology and Pediatrics.
Mark E. Galantowicz, MD, FACS, Chief, Department of Cardiotho-

racic Surgery and Co-Director of the Columbus Children’s Heart Center.
Associate Professor of Surgery at The Ohio State University College
of Medicine.
Dr. Galantowicz received his medical degree from Cornell
University. He completed his residency at Columbia-Presbyterian
Medical Center, New York. He is certified in both Thoracic
Surgery and Surgery.
• • • • • • • • • • • • • • • • • • • • • • • •
Hugh D. Allen, MD, FAHA, FACC, Physician-In-Chief of Columbus
Children’s Hospital. Clinical Cardiologist and Professor of Pediatrics of
the Heart at The Ohio State University College of Medicine.
Dr. Allen received his medical degree from the University of
Cincinnati. After completing his residency, he received fellowship
training at the University of Minnesota. He is certified in both
Pediatric Cardiology and Pediatrics.
Todd L. Astor, MD, Director of the Lund and Lung/Heart Transplant

programs at Columbus Children’s Hospital. Assistant Professor of
Clinical Pediatrics at The Ohio State University College of Medicine.
Dr. Astor received his medical degree from George Washington
University. After completing his residency at Loyola University
Medical Center, he received fellowship training at University
of Colorado Health Sciences Center. He is certified in Internal
Medicine, Pulmonary Medicine and Critical Care Medicine.
34
T he heart center Te am (co nti nue d)
John Anthony Bauer, PhD, Director of the Center for Cardiovascular

Medicine, Columbus Children’s Research Institute
Dr. Bauer received his PhD in Pharmacy from State University of
New York at Buffalo. His central research interest is to conduct
basic science with an opportunity to impact therapy. Dr. Bauer
is also an Associate Professor in the Division of Pharmacy at The
Ohio State University.
Steven C. Cassidy, MD, FACC, Director of Research in the Section of

Pediatric Cardiology and Medical Director of Inpatient Cardiology at
Columbus Children’s Hospital. Associate Professor of Pediatrics at The
Ohio State University College of Medicine.
Dr. Cassidy received his medical degree from State University of
New York, Brooklyn. After completing his pediatric residency
at Brown University in Providence, Rhode Island, he received
fellowship training in Pediatric Cardiology at the University
of California San Francisco. He is certified in both Pediatric
Cardiology and Pediatrics.
David Chan, MD, Director of Electrophysiology. Director of Fellow-

ship Training. Clinical Associate Professor of Pediatrics of the Columbus
Children’s Heart Center and at The Ohio State University College of
Medicine.
Dr. Chan received his medical degree from Wayne State University.
After completing his residency at Wayne State University, he
received fellowship training from both The Ohio State University
Medical Center and the Mayo Clinic. He is certified in both
John P. Cheatham, MD, FAAP, FACC, FSCAI, Director of Cardiac

Catheterization and Interventional Therapy at the Columbus Children’s
Heart Center. Clinical Professor of Pediatrics and Internal Medicine at
The Ohio State University College of Medicine.
Dr. Cheatham received his medical degree from the University of
Oklahoma. After completing his residency at Children’s Hospital
Medical Center, Boston, he received fellowship training at Texas
Children’s Hospital, Houston. He is certified in both Pediatric
Cardiology and Pediatrics. Dr. Cheatham has pioneered and
developed new transcatheter devices and techniques, as well as
helped design new imaging equipment.
Stephen C. Cook, MD, Combined Fellow in Cardiovascular Medicine

and Pediatric Cardiology at The Ohio State University College of Medicine.
Dr. Cook received his medical degree from Boston University.
He completed his residency at Albert Einstein Medical Center
(Temple University) and received fellowship training from both
Columbus Children’s Hospital and The Ohio State University
Medical Center. He is certified in both Internal Medicine and
Pediatrics.
35
The heart center Te am (co nti nue d)
Clifford L. Cua, MD, Clinical Cardiologist and Cardiac Intensivist at

the Columbus Children’s Heart Center. Assistant Professor of Pediatrics at
Dr. Cua received his medical degree from Indiana University
School of Medicine. After completing his residency, he received
fellowship training at Columbus Children’s Hospital and Children’s
Hospital Medical Center in Boston. Dr. Cua is certified in Pediatrics.
Curt Daniels, MD, Director of the Adolescent and Adult Congenital

Heart Disease Program at the Columbus Children’s Heart Center.
Assistant Professor of Clinical Cardiology at The Ohio State University
College of Medicine.
Dr. Daniels received his medical degree from The Ohio State
University. He completed his residency and received fellowship
training from Children’s Hospital in Columbus. He is certified
in Pediatrics, Internal Medicine and Cardiology, and is therefore
uniquely qualified to diagnose, treat and provide long-term care
for the growing number of adolescents and adults who are
diagnosed with congenital heart disease.
J. Terrance Davis, MD, FACS, Member of the Division of Cardithoracic

Surgery at Columbus Children’s Hospital. Professor of Clinical Surgery at
Dr. Davis received his medical degree from University of
Pennsylvania. He completed his residency at Hospital of the
University of Pennsylvania. He is certified in Thoracic Surgery.
Dr. Davis originated and developed the world’s most successful
surgical treatment for Jeune’s Syndrome.
David Fisher, MD, Medical Director of Columbus Children’s Hospital.

Professor of Pediatrics and Academic Vice Chairman of the Department
of Pediatrics at The Ohio State University College of Medicine.
Dr. Fisher received his medical degree from Tufts University
School of Medicine. He completed his residency and received
fellowship training at University of California. He is certified in
both Pediatrics and Pediatric Cardiology.
Timothy Hoffman, MD, FACC, Medical Director of the Heart Trans-

plant and Heart Failure Program at Columbus Children’s Hospital.
Assistant Professor of Clinical Pediatrics, Division of Cardiology, at The
Dr. Hoffman received his medical degree from West Virginia
University. He completed his residency at West Virginia University
Medical Center and received fellowship training at Children’s
Hospital of Philadelphia. He is certified in Pediatric Cardiology
and Pediatrics.
36
Ralf J. Holzer, MD, Assistant Director of Cardiac Catheterization and

Interventional Therapy at Columbus Children’s Hospital. Clinical Assistant
Professor of Pediatrics at The Ohio State University College of Medicine.
Dr. Holzer received his medical degree from Johannes Gutenberg
Universitat Mainz in Germany. After completing his residency, he
received fellowship training at Royal Liverpool Children’s NHS
Trust in England and University of Chicago Children’s Hospital.
Katherine Mizelle, MD, FAAP, Director of Outpatient Services Colum-

bus Children’s Heart Center. Clinical Assistant Professor of Pediatrics at
Dr. Mizelle received her medical degree from University of Virginia.
She completed her residency at Madigan Army Medical Center,
Washington. After her residency she received fellowship training
at Oregon Health Sciences University. She is certified in both
Aymen N. Naguib, MD, Director of Heart Center Anesthesiology at

Columbus Children’s Hospital and Clinical Assistant Professor at The Ohio
State University College of Medicine.
Dr. Naguib received a medical degree from Cairo University
School of Medicine, Cairo, Egypt, followed by residency in
surgery at the College of Physicians and Surgeons of Columbia
University at Harlem Hospital, and a residency in anesthesiology
at Illinois Masonic Medical Center. He did his fellowship train-
ing at Children’s Memorial Hospital, Northwestern University,
Chicago, Illinois, in pediatric anesthesiology. He is certified by the
American Board of Anesthesiology.
Alistair Phillips, MD, Attending Surgeon, Department of Pediatric

Cardiothoracic Surgery at Columbus Children’s Hospital. Assistant
Professor of Surgery at The Ohio State University College of Medicine.
Dr. Phillips received his medical degree from Columbia College
of Physicians and Surgeons in New York. After completing
his residency, he received fellowship training at New York
Presbyterian/Weill Cornell, Memorial Sloan Kettering Cancer
Center, and Children’s Hospital of New York. He is certified in
both Surgery and Thoracic Surgery.
Pamela Ro, MD, Clinical Assistant Professor of Pediatrics of the

Columbus Children’s Heart Center and The Ohio State University College
of Medicine.
Dr. Ro received her medical degree from Northwestern University.
After completing her residency at Children’s Hospital of Pittsburgh,
she received fellowship training from Children’s Hospital of
Philadelphia. She is certified in both Pediatric Cardiology and
Pediatrics.
37
Daniel Rowland, MD, FAAP, FACC, Director of Echocardiography

at the Columbus Children’s Heart Center. Associate Professor of
Clinical Pediatrics at The Ohio State University College of Medicine.
Dr. Rowland received his medical degree from University of
Rochester. After completing his residency at Medical University
of South Carolina, he received fellowship training from University
of Virginia, Charlottesville. He is certified in both Pediatric
Cardiology and Pediatrics.
Lawrence I. Schwartz, MD, Director of the Cardiac Intensive Care

Unit and Assistant Professor of Pediatric Anesthesiology and Critical Care
Medicine at Columbus Children’s Hospital and The Ohio State University
College of Medicine.
Dr. Schwartz received his medical degree from University of
Pittsburgh School of Medicine. He completed his residency
and received fellowship training at John’s Hopkins Hospital in
Baltimore, Maryland. He is certified in Anesthesiology, Pediatrics
and Pediatric Critical Care.
Randy Schwartz, MD, Cardiac Intensivist at Columbus Children’s Heart

Center
Dr. Schwartz received his medical degree from Jefferson Medical
College at Thomas Jefferson University in Philadelphia. After com-
pleting his residency at Cincinnati Children’s Hospital Medical
Center, he received fellowship training at Children’s Medical
Center in Dallas. Dr. Schwartz is certified in Critical Care Pediatrics
Christopher J. Sutton, MD, Pediatric Anesthesiologist at Columbus

Children’s Hospital and Cardiovascular Anesthesiologist at Columbus
Children’s Hospital Heart Center. Clinical Assistant Professor at The Ohio
State University College of Medicine.
He completed his medical degree, residency and a fellowship in
critical care medicine at The Ohio State University College of
Medicine. He then completed a fellowship in pediatric anesthe-
siology at Columbus Children’s Hospital. He is certified by the
Douglas W. Teske, MD, FACC, Director of Preventive Cardiology,

Quality Control and Outcome for the Columbus Children’s Heart Center.
Assistant Professor of Pediatrics at The Ohio State University College of
Medicine.
Dr. Teske received his medical degree from University of Iowa. He
completed residency training at Columbus Children’s Hospital. He
received fellowship training from Children’s Hospital of Buffalo.
He is certified in both Pediatric Cardiology and Pediatrics.
38
D. Alan Tingley, MD, MBA, Medical Director and Administrator,

Children’s Surgery Center, and Chief of the Department of
Anesthesiology at Columbus Children’s Hospital. Clinical Assistant
Professor at The Ohio State University College of Medicine.
Dr. Tingley received his MD from Southwestern Medical School
and his MBA from Capital University. He is certified by the
John J. Wheller, MD, Faculty Member at the Columbus Children’s

Heart Center. Assistant Professor of Pediatrics and Obstetrics at The
Dr. Wheller received his medical degree from The Ohio State
University. After completing his residency at David Grant USAF
Medical Center, he received fellowship training from University
of California. He is certified in both Pediatric Cardiology and
Pediatrics.
Peter Winch, MD, MBA, Pediatric Anesthesiologist

Dr. Winch received his medical degree from the University of
Cincinnati College of Medicine. He completed a Residency in
Pediatrics at Pittsburgh Mercy Children’s Hospital, Pittsburgh,
Pennsylvania, and became certified in Pediatrics. Dr. Winch
received his MBA from the University of Pittsburgh, Katz
Graduate School of Business. He then went on to complete
an Anesthesiology Residency with specialization in Pediatrics
at Strong Memorial Hospital before coming to Columbus
Children’s Hospital.
39
caring f or t h e wh o le f am ily.
Here, care is delivered with

compassion and understand-
ing. We know the diagnosis
of a heart condition affects
not only the patient, but
also the entire family. Our
family-centered approach to
care involves and includes
every member of the patient’s
family. We also offer the
support of social workers as part of each child’s interdisciplinary health care team.
Our Welcome Center is one of the only patient programs of its kind to offer the Sleep Well, Get
Well program, which is specially designed for international and out-of-town guests. Through the
program, families from outside the central Ohio area receive a free hotel stay the night before any
inpatient or outpatient procedure. In addition, the Welcome Center staff can assist families with
everything from making clinical arrangements to helping find answers to insurance questions.
We believe the well being of the entire family is critical to the success of our patients and yours.
• • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •
Physician Liaison Program

The Children’s Hospital Physician Liaison We welcome the opportunity to discuss
Program is a two-way communication channel, the needs of your patients in greater
and one additional way Children’s is working detail, including the many ways the
better to serve physicians, their office staff and Columbus Children’s Heart Center may
the community. Through personal office visits, be of assistance.
written correspondence, telephone calls, faxes
and e-mail, they provide a critical connection to To arrange a consult or to refer
Children’s Hospital. To speak with a physician a patient, please email us at
liaison, call (614) 722-4585. heartcenter@chi.osu.edu or
1-800-792-8401.
40
Columbus Children’s was recently named one of America’s Best
Hospitals by US News and World Report. More than anything, this
most recent ranking validates the efforts we make each day on behalf of the families we serve.
In addition, Children’s is the first freestanding pediatric hospital in Ohio to achieve Magnet
Status for nursing excellence from the American Nursing Association. Also, Children’s Emer-
gency Services are ranked #2 in the United States, our cancer program is the largest in Ohio,
and the Children’s Research Institute is among the top 10 in the country for NIH funding.
To learn more about Columbus Children’s, we invite you to visit www.columbuschildrens.com
Out in front.
By your side.
700 Children’s Drive • Columbus, Ohio 43205 • (614) 722-2530 • 1-800-792-8401 • www.columbuschildrens.com/heartcenter

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Heart Center Outcomes

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There’s a family behind every number, percentage and statistic. We never lose sight of that fact.

Adult Congenital Heart Disease. . . . . . . . . . . . . . . . . . . . . . . . . 27

The Heart Center Team. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34

Physician Liaison Program. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40

A great Heart Center such as

Clinics in the Greater Columbus area Clinics across the region

All of these clinics

2D color Doppler echo demon- A 3D transthoracic echo in a A 3D transesophageal echo (TEE)

The Heart Center at Columbus Children’s Hospital • www.columbuschildrens.com/heartcenter

Intravascular ultrasound (IVUS) is used during cardiac

The volume of all types of

Echo services are available not only on Children’s Hospital’s

Anatomy of cardiac and vascular structures can also be evaluated

The Heart Center at Columbus Children’s Hospital • www.columbuschildrens.com/heartcenter

Total Cardiothoracic Surgical Procedures

The perfusion team has miniaturized

70 The number of out-of-state referrals for

When looking for meaningful outcomes

Mortality Rate of Arterial Switch Operation for

The Heart Center at Columbus Children’s Hospital • www.columbuschildrens.com/heartcenter

A great deal of attention is

Results like these require

Referred patients in 2000 Referred patients in 2005

The Heart Center at Columbus Children’s Hospital • www.columbuschildrens.com/heartcenter

It also takes considerable

Questions on Parent Satisfaction Survey (2005) % Positive

New Cardiac Step Down unit with

Electrophysiology studies use

The Heart Center at Columbus Children’s Hospital • www.columbuschildrens.com/heartcenter

895 During the last

Since the creation of the

A right upper pulmonary

The past 15 years have seen an explosion

The Heart Center at Columbus Children’s Hospital • www.columbuschildrens.com/heartcenter

The interventional cardiology team

An aortic angiogram demonstrates near complete

Volume rendered, 3D MSCT scan is very important after

Mortality Rate for First Stage Palliation of Hypoplastic

At the Columbus Children’s

An example is our new Hybrid

The Heart Center at Columbus Children’s Hospital • www.columbuschildrens.com/heartcenter

This type of innovative approach requires a new

Interventional and surgical

The Heart Center at Columbus Children’s Hospital • www.columbuschildrens.com/heartcenter

Hybrid Stage 1 palliation has

5 The International Symposium on the Hybrid Approach to

The Heart Center at Columbus Children’s Hospital • www.columbuschildrens.com/heartcenter

The two-day Symposium featured lectures and panel discussions

200 Nearly 200

The Electrophysiology service is devoted to caring for patients

The Heart Center at Columbus Children’s Hospital • www.columbuschildrens.com/heartcenter

0 The number of patients

The Heart Center at the Columbus Children’s Hospital has a

This approach affords maximal effectiveness in success and, just

The high level of activity indicated below demonstrates the need,

Dr. Pamela Ro with a family.

When no other options are available with

In addition to surgeons and transplant

Volume of Transplant Procedures

The volume of transplantation has grown dramatically.

The Heart Center at Columbus Children’s Hospital • www.columbuschildrens.com/heartcenter

Patients with repaired congenital heart disease are continuing

Many patients who have undergone total corrective surgery