Carolinas HealthCare System

A Congenital Heart Program for Our Region


Benjamin B. Peeler, MD, FACS
Chief, Pediatric and Adult
Congenital Cardiac Surgery

In this issue of The Sanger Report, we're providing an overview of the Adult and Pediatric Congenital Heart Program at Levine Children's Hospital and Sanger Heart & Vascular Institute. In coming months, we'll provide detailed information about the services, physicians and teams that define us. We will share with you outcomes data and education on emerging technologies and introduce you to newly hired specialists who can care for your patients, should they need our services. As you consider our program and wish to learn more, contact me at benjamin.peeler@carolinashealthcare.org or 704-381-3916.

As the cardiac community well knows, incredible advances in the treatment of congenital heart disease (CHD) over the last half-century have resulted in an emerging patient population—adults with CHD. Since the year 2000, adults with CHD are outnumbering those younger than 18 years of age. This population is increasing at a rate of 5 percent per year. "It's not that young children don't survive," says Joseph A. Paolillo Jr., MD, director, Pediatric Cardiac Catheterization Program. "It's that adults are surviving too—and looking for treatments to help them thrive."

With 90 percent of children with CHD surviving into adulthood, Carolinas HealthCare System, in partnership with Levine Children's Hospital and Sanger, recognized the need to develop a comprehensive adult and children program to serve the region. That's how our story began. However, we quickly realized that Carolinas HealthCare System is home to some of the nation's most talented physicians and clinical staff. With the team's collective talents, ambition and dedication aligned, we expanded our vision to become a national leader in congenital heart care.

Five years later, Levine Children's Hospital provides a full scope of services, integrated care and industry-leading outcomes that's changing the landscape for CHD patients in our backyard—and across the nation.

A Team United

Congenital Heart Disease Services
  • Pediatric Cardiology
  • Advanced Diagnostics
  • Pediatric Cardiothoracic Surgery
  • Pediatric Heart Transplant
  • Cardiac Catheterization and Intervention
  • Cardiac Intensive Care Unit
  • Fetal Cardiology
  • Adult Congenital Care
  • Echocardiography
  • Cardiac Electrophysiology Care

Sanger's Pediatric Cardiac Program has long been involved in the treatment of congenital heart disease. Francis Robicsek, MD, a true pioneer and innovator in cardiothoracic surgery, was among the first to introduce many of the operations we commonly perform today.

In 2007, CHS opened Levine Children's Hospital and invested in developing the region's preeminent congenital heart program.

Immediately, we recognized the talent within and began recruiting experts from around the country. Staff members include cardiac surgeons, cardiologists and intensive-care providers.

In coming months, the team will be rounded out with pediatric heart transplant, heart failure and adult congenital heart specialists.

Collaboration is at the heart of our approach to patient care. During weekly patient management  conferences with participation from providers from across the state, we discuss upcoming cases, vet new ideas and call on expertise from around the table to develop unique treatment plans.

It's common for children to need staged treatments, which require both surgical and nonsurgical procedures, as well as close intercurrent monitoring. We work side-by-side in our clinic, cath lab, ICU and operating rooms. The spirit of team work at Levine Children's Hospital is by far one of the program's differentiating traits and it's at the core of our culture.

Big Successes, Short Timeline

Although Levine Children's Hospital and the CHD program have only been in operation for five years, we've experienced incredible results and are ranked by U.S. News & World Report as a top hospital for pediatric cardiology and cardiac surgery. In 2011, we performed 302 congenital cardiothoracic surgeries with a mortality rate of 2.4 percent, which is lower than the national STS average of 3.2 percent. For neonatal patients (younger than 30 days old), our mortality rates were 3.6 percent compared with the 2011 national average of 9.6 percent.

Our drive to build quality is exemplified in our improved results for patients at the high end of the complexity spectrum. For example, our results for the Norwood procedure to treat hypoplastic left heart syndrome (HLHS), show less than 3 percent mortality versus the national average of 18 percent clearly setting the standard for results across the nation.

We attribute our outcomes to a disciplined focus on quality and best practices. The congenital heart program has developed its own quality committee and task forces, led by Kshitij P. Mistry, MD, MS, medical director of the pediatric CVICU, has formal training and a background in quality implementation and management. As the program grows and our breadth of services deepens, we expect outcomes to continue to be a point of pride.

A Glimpse Into the Future

In 2011, CHS experienced 8,900 pediatric-cardiology visits, and interventional and surgical volume is expected to grow 25 to 50 percent over the next five years. Funding from charitable donors will add talent and resources to the program in the future.

Levine Children's Hospital recently received close to $2.5 million in local funding to support pediatric cardiovascular services and the pediatric congenital heart program. These significant commitments came through the Partnership for Pediatric Hearts, a group of individuals and businesses dedicated to supporting pediatric care in the community.

The Partnership was established earlier this year by an initial gift of $1 million from NASCAR and automotive business owner Rick Hendrick and his family. Two additional $500,000 pledges—one from the Tansukh Ganatra Family and the other from the Dreamcatcher Society; a recent $300,000 pledge from Showmars in honor of their 30th anniversary in business; and a matching commitment from Carolinas HealthCare Foundation brings the total amount pledged for Levine Children's Hospital cardiac programs to almost $5 million.

The hospital has also committed to invest substantial resources in this initiative. Partnership funding has initially been allocated to develop an in-hospital echocardiology lab with an additional 3-D echocardiography machine. It's also being directed to provide pilot funding for expanded subspecialty care, such as fetal echocardiography.

Significant progress has been made in establishing the congenital heart center at Levine Children's Hospital. Our goal is to provide elite level care in a family centered environment. Frankly, our patients, our community and our region deserve it. We appreciate the support we have within CHS and among our community, which is critical to our continued growth and success.

 

In This Issue: Fall 2012
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