Pediatric and Congenital Cardiology

The Arrhythmia Clinic at Brenner Children’s provides comprehensive treatment for children with heart rhythm problems through medications and medical and surgical technology. Clinical services for arrhythmia pediatric patients include:

• Radiofrequency ablation – The elimination of the heart muscle cells that trigger the arrhythmia through high-frequency radio waves sent into the muscle cells via a catheter
• Pacemaker implantation – The implantation of a small, battery-powered device that sends electrical signals to the heart to maintain a regular heartbeat
• Cryoablation – The use of extreme cold to remove dysfunctional heart tissue
• Advanced electroanatomic mapping –Displaying the interior of the heart in three-dimensional shape to detect the location of the heart problem

The Cardiac Catheterization Lab and Interventional Cardiology team uses minimally invasive procedures to diagnose and treat heart conditions such as atrial septal defect (ASD), ventricular septal defect (VSD) and patient ductus arteriosus (PDA). Procedures offered by the lab include:

• Diagnostic catheterization – a long, thin tube is inserted in a patient’s body to inject a special dye, which shows narrowed areas in arteries and aids in assessing potential pulmonary problems
• Heart Valve Implantation – whether valve leakage, obstruction, or both, some valves can be replaced without open heart surgery
• Pulmonary vasodilator testing – A test to determine how much a patient’s pulmonary blood vessels can relax over a certain period of time
• Heart biopsy – A procedure in which a small piece of heart tissue is removed from the heart to aid in diagnosis
• Stent and coil placement – Treatment in which a tiny tube or coil is inserted into a blocked vessel to prop the vessel open and ensure it stays clear
• Balloon dilation – The opening of a blocked vessel using a balloon-like device at the narrowest spot in an artery

Brenner Children's Echocardiography and Cardiac Imaging Unit utilizes state-of-the art equipment, technology and techniques to diagnose heart problems and conditions in our pediatric patients. Diagnostic services and tools offered by this unit include:

• 3-D, real time echocardiography – Displays real-time images of the heart beating in three dimensions
• Computerized tomography angiography (CTA) – An x-ray in which contrast material is injected into a vein in order to obtain multidimensional images of blood vessels and heart tissues
• Magnetic resonance imaging/magnetic resonance angiography (MRI/MRA) – Detailed images of the heart and major vessels are obtained through the use of magnetic fields and radio waves
• Transesophageal echocardiogram (TEE) – High frequency sound waves are used to obtain images of the heart’s valves and chambers
• Intracardiac echocardiography (ICE) – The exact location of a patent foramen oval (PFO) or atrial septal defect (ASD) is determined in order to accurately close the hole in a clinical procedure

The Exercise Physiology Lab is a testing laboratory in which our health care professionals examine pediatric patients to determine whether or not heart problems affect their ability to run and play. In this lab, we utilize a variety of testing methods, including stress treadmill testing, to ascertain the level of heart health of our pediatric patients.

ECMO support provides oxygen to neonatal and young children during periods when their hearts and lungs are not working properly. The ECMO circuit at Brenner Children’s, one of the busiest ECMO programs in the country, is staffed by a team of trained specialists that uses this powerful treatment system to make sure our pediatric patients receive optimal oxygenation.

The Fetal Cardiology Unit at Atrium Health Levine Children's Brenner Children's Hospital uses the latest in ultrasound technology to diagnose heart defects – the most common form of birth defects – before a baby is born. We then help families prepare for their baby’s arrival, including collaborating to create a plan for the safest delivery and care once the baby is born. Expecting parents can also meet a pediatric cardiologist and surgical team and tour the hospital prior to the special day of birth.

Children with some heart conditions, such as conditions in which the heart beats too slow or too fast, may need to have pacemakers implanted in their bodies to ensure a regular heartbeat. At the Pacemaker Clinic, Matthew Hazle, MD, and his team provide continual monitoring and treatment for children who have had pacemakers installed.

Cardiac MRI (cMRI/CMR) is a non-invasive imaging test utilizing specialized technologies to create both still and moving pictures of the heart. At Brenner Children’s, our cardiac MRI program is supervised by and tests are interpreted by a dedicated pediatric cardiologist with specialized training in performing these studies in infants, children, and adults with congenital heart disease.

Brenner is one of the few hospitals in the state that offers this highly specialized diagnostic service to pediatric and adult patients. The team also consists of MRI technologists who have specialized training in cardiac MRI and will guide you or your child through the potentially unfamiliar process with empathy and compassion.

How a Pediatric Cardiac MRI is Used

In pediatric and congenital cardiology, cardiac MRI is used as a complementary imaging modality to echocardiography (cardiac ultrasound). In some patients, cardiac MRI is utilized because it is difficult to obtain the clarity of images needed for definitive diagnoses with echocardiography alone.

Cardiac MRI testing has the ability to give reproducible quantitative data about:

• the size of the heart chambers
• heart function
• blood flow

In many cases, a contrast agent is used to create 3-D pictures of the blood vessels connected to the heart to help guide medical and/or surgical decision making. The contrast can also help identify areas of scaring in the heart if it has been injured by certain disorders or prior surgeries.

Cardiac MRI is unique in that it does not use radiation and thus has no potential to increase the risk of cancer. This is especially important in infants and children, women, and patients that have already had to receive substantial amounts of radiation in the past because of necessary procedures or tests like cardiac catheterizations’, x-rays and /or CT scans.

The Pulmonary Hypertension Clinic at Brenner is the only clinic in the region that specializes in the diagnosis and treatment of pulmonary hypertension.

Led by Derek Williams, DO, we use all available methods of testing, such as blood tests, chest x-rays, echocardiograms and cardiac catheterization, to effectively diagnose children with pulmonary hypertension. Once a diagnosis is made, our team of pulmonary hypertension clinical experts proceeds with a treatment plan using the most effective medications available.

The pediatric cardiologists at Brenner Children's Heart Program use telemedicine – remote medical examinations conducted via audio and video – to view and interpret echocardiograms (ultrasounds of the heart) performed at doctors’ offices and hospitals throughout the region.

Your child can have his or her echocardiogram conducted close to home, but still have our pediatric cardiology experts review the ultrasound to see if any heart problems exist.