The Culture of Different MKTG_150064494_2018 Service Line Big Book Full_FIN | Page 40

Pei-Ni Jone, MD, a cardiac imaging expert, pioneered 3D
echocardiography guidance for certain heart catheter
interventions, in some cases cutting out fluoroscopy entirely.
HEART INSTITUTE
CARDIOLOGY AND
HEART SURGERY
The Heart in Three Dimensions:
Guiding Catheterization with 3D Echo
Heart Failure and Heart Transplant Program
“The Cannula that
Saved Kylie,” p. 52
Transplant cardiologists
Pediatric (<18 years old) heart transplant survival rate
100%
30-day survival
(N=46)
97.2% 100% 92.4%
30-day survival 1-year survival
(N=40) 1-year survival
Children's Colorado
higher is better
SRTR
For one-year survival, only patients with complete one-year follow-up are included
(transplants performed January 1, 2013 to June 30, 2017).
Median time to transplant
lower is better
(for candidates January 1, 2011 to June 30, 2016)
2.4 months
Children's Colorado
6.8 months
Regional facilities
8.6 months
National facilities
“We invented 3D echo
guidance for these procedures
in pediatrics,” says Dr. Jone.
Back in 2013, Dr. Jone learned
3D echocardiography from
adult cardiologists, who were
using it to plan for catheter
interventions. From there,
she helped make Children’s
Colorado the first pediatric
center to pilot fusion
imaging — a combination of
3D echocardiography and
fluoroscopy — to guide them.
Fusion imaging still guides many
procedures, such as Fontan
fenestration and ventricular
septal defect closures. But for
a few procedures — like ASD
repair — she speculated she
could cut out X-ray entirely.
“We’re not only exposing kids
to radiation, we’re exposing
ourselves,” she says. “Less
radiation makes for a safer
environment.”
The team has managed an 87
percent decrease in absorbed
patient radiation over two
years — with no increase in
procedural time. Even better:
Seeing the heart in all three
dimensions, interventionists can
characterize the morphology
of the heart. Surgeons can
understand valve structures
in advance of surgery.
Cardiologists can characterize
the volume and function of
the ventricles, eliminating
geometric assumptions.
“To be able to really understand
the structures of the heart,”
says Dr. Jone, “3D echo is vital.”
Radiation reduction in heart
catheterizations in percutaneous
ASD closures over two years *
Mean fluoroscopy time per catheterization
14.5
minutes
4.9
minutes
67%
Reduction in mean fluoroscopy time
Mean absorbed radiation per catheterization
READ MORE ABOUT
CARDIOLOGY AND
HEART SURGERY:
“The Future of Single
Ventricle Care Will Be
Engineered,” p. 34
FIVE
The catheter appears in the
superior vena cava, rendered
in skittering, pulsing yellow on
black. Pei-Ni Jone, MD, head
of 3D echocardiography at
Chil dren’s Hospital Colorado,
pulls back the view into
the right atrium, where the
interventionist will close an
atrial septal defect, or ASD,
with no help from radiation.
Eduardo da Cruz, MD,
Associate Medical
Director, Heart
Institute
Our one-year heart transplant outcomes are
among the best in the nation according to the
Scientific Registry of Transplant Recipients (SRTR).
Board-certified congenital
cardiothoracic surgeons
James Jaggers, MD,
Chief, Pediatric
Cardiothoracic
Surgery
The Barton-Elliman
Chair, Pediatric
Cardiothoracic Surgery
THREE
LEADERSHIP:
D. Dunbar Ivy, MD,
Chief, Pediatric
Cardiology
Selby’s Chair,
Pediatric Cardiology
Almost 30 years old, our pediatric heart transplant
program is one of the largest and most successful
programs in the country.
35.4
mGy
4.7
mGy
87%
Reduction in mean absorbed radiation
*2015 data taken from the National Cardiovascular Data
Registry: IMPACT Registry aggregation; 2017 data from
3D echo-guided ASD closures at Children’s Colorado.
The Culture of Different
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