Cook Children s Heart Center

Cook Children s Heart Center Summary and outcomes Specializing in matters of the heart Specializing in matters of the heart 1

2 Specializing in matters of the heart Cook Children s Heart Center

A message from Deborah Schutte, M.D., and Vincent Tam, M.D. Dear friends and colleagues, It is the Promise of Cook Children s to improve the health of every child in our region through the prevention and treatment of illness, disease and injury. At Cook Children s Heart Center, we take that Promise very seriously. Our team of 17 board certified cardiologists and cardiothoracic surgeons, along with more than 70 specialty trained cardiac nurse practitioners, nurses, managers and support staff, is motivated by the trust that you and our patient families place in us. We strive each and every day to promote and provide excellence and quality through multidisciplinary, patient-centered care and access to leading-edge therapy and research. program that works with expectant moms to our Adult Congenital Heart Disease program, we are here for our patients every step of the way. For our patients that require surgical intervention, our cardiothoracic surgical program provides comprehensive care for even the most complex diagnoses with low morbidity and mortality. We continue to broaden our reach and explore new ways to treat patients through our outpatient clinics, telemedicine consultations and an increased focus on international patients. Our cardiologists and surgeons are renowned leaders in pediatric cardiology and congenital heart surgery. Cook Children s Heart Center is proud to be the second pediatric facility in Texas and the seventh in the nation to become a nationally accredited Pediatric Heart Failure Institute. Construction on our new Heart Center is scheduled to be complete in 2016. The new facility will bring all Heart Center inpatient offerings together in one location, resulting in a truly integrated setting. This will allow for increased efficiencies and improved patient outcomes. Our diagnostic and interventional cardiology programs allow us to test, evaluate and treat even the most complex heart conditions with low risk and minimal invasiveness. From our Fetal Echo We are excited to share with you this information on our programs, outcomes and patient services. Thank you for your interest in Cook Children s Heart Center. Deborah Schutte, M.D. MEDICAL DIRECTOR, CARDIOLOGY Vincent Tam, M.D. MEDICAL DIRECTOR, CARDIOTHORACIC SURGERY Specializing in matters of the heart 3

682-885-1940 To better serve our treating clinicians, we can assist you with: Non-emergent transfer requests Direct admissions Specialist consultations Cook Children s Heart Center Dodson Specialty Clinics third floor 1500 Cooper St. Fort Worth, TX 76104 682-885-2140 cookchildrensheartcenter.org 4 Specializing in matters of the heart Cook Children s Heart Center

Table of contents 7 About Cook Children s 9 Heart Center overview 13 Volumes and outcomes 19 Cardiothoracic surgery 23 Diagnostic and interventional cardiology 27 Adult Congenital Heart Disease program 29 Patient support services 31 Medical center family support services and amenities 33 In the community 35 Teddy Bear Transport Team 37 Heart Center staff Specializing in matters of the heart 5

For nearly 100 years, Cook Children s has cared for children from across the globe. 6 Specializing in matters of the heart Cook Children s Heart Center

About Cook Children s Today, Cook Children s is more than a nationally known medical center. We are one of the country s leading integrated pediatric health care systems. And, we are a connected system of specialists, pediatricians, clinics, a medical center and community programs. This benefits physicians and patient families because it gives them access to all the resources within the system, making for easy communication between them and our companies. Cook Children s is recognized for top-ranked specialty programs, expert care and highly advanced technologies. U.S.News and World Report named Cook Children s to its 2015-2016 America s Best Children s Hospitals list for excellence in six specialties. Additionally, Cook Children s Medical Center is a two-time Magnet designated hospital, an honor only 3 percent of hospitals receive, for its dedication to quality patient care, nursing excellence and innovations in professional nursing practice. We combine the art of caring with the use of leading-edge technology and collaboration to provide exceptional care for every child, every day. By the numbers 1,000,000+ PATIENT ENCOUNTERS 4,403 14,088 INPATIENT SURGERIES OUTPATIENT SURGERIES 506,089 SPECIALTY CLINIC ENCOUNTERS 379,798 PEDIATRIC OFFICE VISITS Based on Oct. 1, 2013 Sept. 30, 2014 Specializing in matters of the heart 7

8 Specializing in matters of the heart Cook Children s Heart Center

SM Cook Children s Heart Center Cook Children s is proud to be the second pediatric facility in Texas and the seventh in the nation to become an Accredited Heart Failure Center. Accredited Pediatric Heart Failure Center The Healthcare Colloquium, A Battelle Company Cook Children s Heart Center focuses on the one patient, the one child that matters most... yours. We offer a comprehensive program of specialized care for neonates, infants, children and adults with congenital and acquired heart diseases. Our multidisciplinary group of specialists works together to meet the full range of our patients needs. We provide early intervention and deliver comprehensive treatments that improve patients quality of life. Cook Children s Heart Center team includes: 14 cardiologists 2 cardiac interventionalists 3 electrophysiologists 3 cardiothoracic surgeons 6 cardiac anesthesiologists 6 cardiac intensivists 5 pediatric nurse practitioners Located right in the heart of Texas, we offer a full-range of cardiology care, including: Cardiology, diagnostics and treatment center» Cardiac catheterization lab» Cardiac magnetic resonance imaging (CMRI)» Echocardiography and fetal echocardiography» Electrocardiography (EKG)» Holter and home EKG monitoring» Stress testing» Sports EKGs Cardiac Specialty Care Unit Cardiothoracic surgical suites and dedicated cardiac anesthesiologists Outpatient care in 11 clinic locations Common referral diagnoses: Congenital heart defects, including but not limited to ventricular septal defects, transposition of the great arteries, heterotaxy heart defects, pulmonary stenosis and Tetralogy of Fallot Murmurs Chest pain Palpitations Syncope or fainting Abnormal ECG/EKG Genetic disorders commonly associated with congenital heart disease Hypertension Cardiomyopathy/heart failure Bacterial endocarditis Kawasaki disease Vascular rings Our locations: Abilene Alliance Arlington Denton Fort Worth Mansfield Midland San Angelo Southlake Waco Wichita Falls Our telemedicine program provides patient families in outlying areas access to cardiology services without the inconvenience or expense of traveling far from home. Specializing in matters of the heart 9

10 Specializing in matters of the heart Cook Children s Heart Center

New Heart Center Construction is underway on our new Heart Center to be housed in Cook Children s Medical Center s South Tower, scheduled to be completed in 2016. The new space includes: LEVEL 4 LEVEL 3 Echocardiography and fetal echocardiography suite An expanded Cardiac Intensive Care Unit from 10 beds to 14 all-private rooms. Dedicated pre- and post-op area. Dedicated cardiac step-down unit. Two dedicated surgical suites. Two catheterization laboratories including a hybrid suite. All inpatient services for cardiac patients will now be located together, including diagnostic testing, operating rooms, the cardiac intensive care unit and step-down unit. The integration of all cardiac services in one building will allow for increased efficiencies and added convenience for our patient families. Specializing in matters of the heart 11

12 Specializing in matters of the heart Cook Children s Heart Center

Heart Center volumes and outcomes 2014 VOLUMES 542 428 395 CATHETERIZATIONS TOTAL SURGICAL CASES CARDIAC INTENSIVE CARE UNIT PATIENTS Cardiac catheterizations Total procedures 2011 2012 2013 2014 450 444 542 587 Diagnostic 2011 2012 2013 2014 384 464 485 585 Interventional cardiac catheterizations 2011 2012 2013 2014 108 128 194 170 Electrophysiology studies and procedures 2011 2012 2013 2014 159 134 146 168 Specializing in matters of the heart 13

Outpatient clinic patient encounters by location 2013 2014 Fort Worth 4,656 4,744 Mansfield 2,169 2,125 Southlake 1,990 1,979 Arlington 1,903 1,821 Denton 754 755 Waco 264 308 Abilene 222 233 Midland 76 86 Wichita Falls 83 83 San Angelo 29 78 TOTAL 12,146 TOTAL 12,212 14 Specializing in matters of the heart Cook Children s Heart Center

Surgical volumes Volumes and mortality rates by surgical procedure Combined cardiovascular and thoracic surgery cases 2011 2012 2013 2014 400 398 420 428 Atrial septal defect repairs 2011 2012 2013 18 21 23 Total cardiopulmonary bypass operations* 2011 2012 2013 2014 243 239 235 248 2014 4 year average ( 11-14) 15 Mortalities 0 Mortality rate 0.00% STS mortality rate 0.88% *More than 60% of all surgical cases require the use of cardiopulmonary bypass 2011 17 Atrioventricular canal repairs 2012 2013 9 10 We participate in the Society of Thoracic Surgeons (STS) national pediatric cardiac database and actively pursue continuous quality improvement. It is difficult to benchmark pediatric outcomes because of the variety of types of congenital heart surgery. 2014 4 year average ( 11-14) 13 Mortalities 0 Mortality rate 0.00% STS mortality rate 1.36% Specializing in matters of the heart 15

Volumes and mortality rates by surgical procedure 2011 31 2011 9 Ventricular septal defect repairs 2012 2013 19 20 Norwood procedures 2012 2013 15 18 2014 29 2014 15 4 year average ( 11-14) Mortalities 0 Mortality rate 0.00% STS mortality rate 0.70% 4 year average ( 11-14) Mortalities 8 Mortality rate 13.79% STS mortality rate 14.80% 2011 17 2011 13 Tetralogy of Fallot repairs 2012 2013 9 12 Arterial switch procedures 2012 2013 7 11 2014 18 2014 11 4 year average ( 11-14) Mortalities 1 Mortality rate 1.85% STS mortality rate 1.70% 4 year average ( 11-14) Mortalities 0 Mortality rate 0.00% STS mortality rate 6.10% 16 Specializing in matters of the heart Cook Children s Heart Center

Mortality by STAT* categorization 2011 87 2011 98 2011 22 Risk category 1 cases 2012 2013 62 72 1 Risk category 2 cases 2012 2013 83 85 2 1 Risk category 3 cases 2012 2013 25 23 1 2014 75 2014 101 2 2014 29 1 2011-2014 Cook Children s risk category 1 mortality rate 0.34% STS risk category 1 mortality rate 0.6% Cook Children s risk category 2 mortality rate 1.1% STS risk category 2 mortality rate 0.6% 2011-2014 Cook Children s risk category 3 mortality rate 2.0% STS risk category 3 mortality rate 2.8% 2011-2014 2011 65 2 2011 11 Risk category 4 cases 2012 2013 73 65 11 8 Risk category 5 cases 2012 2013 18 17 4 4 2014 56 4 2014 16 Cook Children s risk category 4 mortality rate 9.6% STS risk category 4 mortality rate 7.1% 2011-2014 2011-2014 Cook Children s risk category 5 mortality rate 12.9% STS risk category 5 mortality rate 16.2% Denotes mortality *The Society of Thoracic Surgeons Congenital Heart Surgery Database, in collaboration with the European Association for Cardio Thoracic Surgery, developed a method to compare mortality rates between programs by the difficulty of the operation. The STAT Mortality Categories (STAT) divide operations into 5 categories, 1 5 in order of increasing difficulty. Specializing in matters of the heart 17

On average, our surgical volume is 30% neonates and 30% infants. 18 Specializing in matters of the heart Cook Children s Heart Center

Cardiothoracic Surgery Our cardiothoracic surgical team of three surgeons, led by Medical Director Vincent Tam, M.D., believes that every child, no matter how complex the condition, deserves a fighting chance. Our surgeons work closely with cardiology colleagues in diagnosing children with complex heart conditions. We use a multidisciplinary approach with a dedicated cardiac anesthesia team and cardiac intensivists. Our surgery services include: Repair of complex congenital heart defects, including corrected transposition of the great artery and heterotaxy syndromes Staged palliation of complex single ventricular heart defects such as hypoplastic left heart syndrome Heart valve repair Aortic translocation, also known as the Nikaidoh procedure Arrhythmia, pacemaker and defibrillator surgery Complex unifocalization Vincent Tam, M.D., medical director, Cook Children s Cardiothoracic Surgery, trained at Johns Hopkins Hospital and Children s Hospital in Philadelphia under William Norwood, M.D., the developer of the Norwood procedure, in the early 1990s. Our mortality rate for the Norwood Procedure is 13.79%, compared to the STS benchmark of 14.8%. i I Reported from 2011-2014. Vinod Sebastian, M.D., trained under Frank L. Hanley, M.D., Heart Center director at Stanford Children s Health, who developed and pioneered the unifocalization procedure. Cook Children s Heart Center is one of a few pediatric heart programs in the country to perform the unifocalization procedure, specifically on neonates and infants. This repairs a complex and potentially fatal congenital defect known as Tetralogy of Fallot with pulmonary atresia and major aorto-pulmonary collaterals. This procedure recreates the child s pulmonary arteries, making it more likely that the heart can be repaired before the child s condition worsens, causing the surgery to be more difficult, or even impossible. The aortic translocation operation, also known as the Nikaidoh procedure, was developed by Hisashi Nikaidoh, M.D., a member of the Cook Children s surgical team. Children diagnosed with the rare triad of transposition of the great arteries, ventricular septal defect and pulmonary stenosis have a significantly improved prognosis after undergoing aortic translocation with reconstruction of the right ventricular outflow tract, commonly called the Nikaidoh procedure. From 2011 to 2014, Cook Children s performed 10 of these procedures with 0% mortality, compared to 62 procedures performed nationally, as reported by the Society of Thoracic Surgeons with a mortality rate of 3.2%. 19

Cardiac Specialty Care Unit Co-medical Directors of the Cardiac Specialty Care Unit, Jay Duncan, M.D., and Susan Davis, M.D., lead the team that cares for our cardiovascular patients in critical care. They specialize in intensive care for patients with congenital heart disease and defects before and after surgery. Other patients cared for in this unit include those with abnormal heart rhythms and heart failure from congenital and acquired cases. The team includes critical care physicians, cardiovascular surgeons, cardiologists, neonatologists, cardiac anesthesiologists, nurse practitioners, critical care nurses, respiratory therapists, pharmacists and nutritionists. Our team practices a multidisciplinary approach to the care of children with heart disease because we realize that each patient presents unique challenges and requires individually tailored therapies. Every morning, our cardiac team participates in multidisciplinary rounds on each patient in this unit and the Neonatal Intensive Care Unit. This allows each team member to contribute his and her unique perspective and experience to create a customized plan for each patient. Parents are invited to participate, as we discuss their child s case during these rounds. Additionally, our cardiac critical care physicians provide 24/7 onsite coverage, so one of them is constantly available to evaluate and treat patients or answer any questions. Our new Heart Center opening in 2016 will have an expanded cardiac intensive care unit with all-private rooms. Cook Children s is the only medical center in Tarrant County that provides extracorporeal membrane oxygenation (ECMO) treatment for patients whose heart/lungs need to recover from anomaly or disease. The ECMO program at Cook Children s Medical Center is one of only two centers in the state of Texas to achieve the Extracorporeal Life Support Organization (ELSO) Center of Excellence Awards. 20 Specializing in matters of the heart Cook Children s Heart Center

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22 Specializing in matters of the heart Cook Children s Heart Center

Diagnostic and interventional cardiology Thanks to extensive research and major advancements in technology, many complex congenital heart defects can now be diagnosed and treated without the need for surgical intervention. Led by Deborah Schutte, M.D., medical director of Cardiology, the cardiology team at Cook Children s specializes in diagnostic evaluation and treatment of a wide variety of congenital heart conditions. Cardiovascular magnetic resonance imaging (CMRI) program Our CMRI program is led by CMRI Medical Director Steve Muyskens, M.D., who is present at the scanner for all studies. MRIs can be performed on all ages of children and adults with the results being read and interpreted by Dr. Muyskens and given to the referring physician within one to two days of the test. Magnetic resonance imaging is noninvasive and creates images of the heart and surrounding structures using a large magnet, radio waves and a computer. Unlike many imaging modalities, patients of all sizes can be imaged and obtain excellent quality. CMRI is especially useful in diagnosing and managing patients with complex congenital heart disease. The images can be used to further define anatomy that is not well seen by other modalities, monitoring specific cardiovascular changes over time, or in pre-operative staging and postoperative monitoring. Some of the most common referrals we see include: Suspected unknown congenital heart disease Assessment of cardiac tumors Evaluation of certain cardiomyopathies All scans are completed on a 3 Tesla (3T) scanner, the most powerful magnet available. Dr. Muyskens was honored as a Cook Children s Endowed Chair in 2015. This award is allowing him to create advanced cardiac imaging protocols and techniques using a 3 Tesla magnet. A 3-D printing program that will print a hand-held model of a patient s heart is also in development. The images and the model offer superior detail to those previously available and will help our cardiologists and surgeons visualize complex anatomy in order to determine the best treatment plan. Specializing in matters of the heart 23

Cook Children s was the first pediatric facility in the country to use EnSite 3000 computerized mapping and imaging software to help identify the source of an arrhythmia. Catheterization lab Our catheterization lab staff, led by Medical Director Matthew Dzurik, M.D., pride themselves on providing the most advanced diagnostic and interventional cardiac care with the latest in minimally invasive cardiac procedures, including the Melody Transcatheter Pulmonary Valve (Melody TPV) procedure. An interventional catheterization may be performed at the same time as a patient s diagnostic catheterization, depending on the severity and type of defect. Those procedures might include: Balloon angioplasty Balloon valvuloplasty Heart valve placement Septal closures Stent placement Vascular occlusion Melody TPV procedure This procedure can delay surgical intervention of the heart, resulting in fewer surgeries and a faster recovery time. It provides an alternative treatment option for children and adults with failed pulmonary valve conduits, which prevents adequate blood flow from the heart to the lungs. The Melody TPV helps restore pulmonary valve conduit function, including relief of narrowing (stenosis) and leaking (regurgitation). Thanks to this breakthrough medical technology, the hospital stay has been reduced from one to two weeks to only one to two days. James Kuo, M.D., has performed this procedure more than 30 times since June 2012. Cook Children s is currently one of five Heart Centers in Texas to perform this procedure. Electrophysiology program From tiny babies and kids to teens and adults, our team of three electrophysiologists is second to none in diagnosing and treating even the most complex rhythm disorders. With heart rhythm certified electrophysiologists, an award-winning nursing staff and extensive support team, we are among the most advanced programs in the southwest. Electrophysiology studies are conducted to determine the type and location of a specific arrhythmia along the conduction pathway. If certain types of arrhythmias are found, radiofrequency catheter ablation and cryoablation can be used to eliminate the arrhythmia. Catheter ablation is often used to correct abnormal heartbeats or arrhythmias. Because heart rhythm irregularities can often be related to other medical conditions throughout the body, care often goes beyond the walls of our program. When necessary, our team works closely with other cardiologists, as well as other specialties across our system, to assure that our patients receive the most complete care possible. 24 Specializing in matters of the heart

Echocardiography and fetal echocardiography In order to treat patients in the safest and most convenient way possible, we conduct echocardiograms in a variety of different places, including our echocardiography lab, clinic, Emergency Department, catheterization lab and our Cardiac, Neonatal and Pediatric Intensive Care Units. For patient families who aren t able to travel to the medical center, we have mobile echo units in our outlying clinic locations. Services provided include: 2-D and 3-D transthoracic echocardiography 2-D and 3-D real-time transesophageal echocardiography Transthoracic echocardiography Fetal echocardiography Transesophageal echocardiography Fetal program With our Fetal Echocardiography program, led by Medical Director Lisa Roten, M.D., we take care of the tiniest hearts before they are even born. The fetal echo team works to give a high level of care to the expectant mother by providing the fetal ultrasound, diagnosis and counseling all during the initial visit. Follow-up consultations take place as necessary. These may include a cardiothoracic surgeon, neonatologist, geneticist and general surgeon. This team approach involves the parents every step of the way, helping them understand the diagnosis, ask questions and make informed decisions. Our fetal coordinator is there to help the family through the entire process. If a congenital heart defect is detected, we are able to provide care for the parent, who may be a carrier for a heart defect, as well as the unborn child through our Adult Congenital Heart Disease program. Cook Children s Heart Center is one of only three fetal heart programs in Texas and maintains accreditation in fetal echocardiography from the Intersocietal Accreditation Commission. 2014 ECHO VOLUMES 14,077 525 176 ECHOS TRANSESOPHAGEAL ECHOS FETAL ECHOS Specializing in matters of the heart 25

26 Specializing in matters of the heart Cook Children s Heart Center

Adult Congenital Heart Disease (ACHD) program Our program is led by ACHD Medical Director Scott Pilgrim, M.D., who has training in both internal medicine and pediatric cardiology. As a member of the Adult Congenital Heart Association and a recognized treatment facility for adult congenital patients, our ACHD program provides specialized, state-of-the-art, medical and surgical care to adolescent and adult patients with congenital heart disease Additionally, the ACHD program provides women of child-bearing potential with important education regarding birth control options, pre-pregnancy counseling and risk assessment. Women who are already pregnant are followed in conjunction with the obstetrician, maternal fetal medicine, fetal cardiology and anesthesia teams with a coordinated delivery plan. 647 2014 ADULT CONGENITAL HEART DISEASE PATIENTS Cook Children s ACHD program is one of just six in Texas. Since the program s inception in 2013, the number of adult congenital patients has doubled. 27

28 Specializing in matters of the heart Cook Children s Heart Center

Heart Center patient services We know that caring for a child with a congenital or acquired heart defect doesn t stop when a patient family leaves the hospital or clinic. We want to ensure patient families have everything they need so their child can get back to the business of being a kid. We believe in taking care of the whole patient, not just their heart, and making sure our patient families have all the support they need. Patient education Hospital stays can be long and overwhelming. When a patient family is preparing for discharge, it can be challenging for them to receive large amounts of information about how to care for their child and their condition. Our Discharge Planner provides ongoing education and teach-back opportunities to our inpatient Heart Center families throughout the hospital stay. That way, when a child is well enough to go home, they feel prepared and can get home as quickly as possible. Nutrition Services Heart conditions can bring about unique nutrition, feeding and eating challenges. For that reason, we have two registered dieticians on staff in our Heart Center to provide customized nutrition assessments, planning and advice for our patients. Home Monitoring Our Home Monitoring program monitors patients with shunt-dependent blood flow and complex congenital heart anatomy during the period between staged cardiac surgeries. The program transitions patients with complex congenital heart disease from inpatient to home and helps detect problems before they become urgent, life-threatening situations. This keeps emergent visits to a minimum and allows for clinic evaluation or direct hospital admission. Families are able to communicate directly with Cook Children s physicians. The patient s primary care physician also is able to access all information about the patient s status and treatment plan through an online portal. Our staff facilitates the arrangements for home care when a patient is ready to go home and provides supportive individualized education to each family. Each family is given individualized when to call parameters, as well as 24/7 contact phone numbers. The program s nurse coordinator keeps close contact with each family and remains available for assistance. NICU Early Support and Care Transition (NEST) Developmental Follow-up Center Many babies born with heart conditions have to spend a significant amount of time in our Neonatal Intensive Care Unit (NICU). These babies have a higher risk of future challenges with hearing, seeing, talking, feeding, motor skills and intellectual development. Our NEST Center provides support, planning and care coordination for these high-risk babies. The NEST staff also works closely with all the specialists and therapists involved in the child s care. Because some developmental issues may not be apparent right away, the child s growth and development is monitored through age 5. Heart and Souls family support group This parent-led support group for parents of children with congenital heart defects provides a way for parents to talk one-on-one with each other, sharing their experiences, concerns and questions. Through collaboration with the medical center, there are guest speakers such as cardiology nurses, ICU staff, OR nurses, cardiothoracic surgeons, cardiologists or Child Life staff to answer questions parents may have related to surgery and the care of their child. Specializing in matters of the heart 29

30 Specializing in matters of the heart Cook Children s Heart Center

Medical center family support services Hospital stays, unforeseen illnesses and surgical procedures all add up to a lot of stress and anxiety for our patient families. We do our best to make patient families feel at home during their stay at the medical center. Our Child Life department offers Child Life specialists, therapy dogs and clowns to help children and families cope with a hospital experience. They provide emotional and developmental support, give honest information geared to the child s level of understanding and coordinate fun activities. We also have a Child Life Zone that includes a television, music and recording studio, game room, kitchen and library where patients can go to just be kids. We have chaplains available 24 hours a day to provide counsel and comfort for people of all faiths and beliefs, as well as a chapel that is always open. The librarians at our Family Health Library help patient families find information on making the best possible health decisions for their children. You will find understandable, up-to-date health information on many topics from parenting to pediatric illnesses. Other amenities offered at our medical center include: Enchanted Castle Gift Shop Build-A-Bear Workshop Starbucks Zooty Fruity Yogurt Shop Camelot Court Food Court Cook Children s Pharmacy Chick-fil-A Mirror Mirror Hair and Nail Salon Specializing in matters of the heart 31

32 Specializing in matters of the heart Cook Children s Heart Center

In the community Heart conditions can often go undetected. It s important to have a child s heart screened for risk factors associated with sudden cardiac arrest. Early detection through a sports EKG screening and secondary prevention through the use of cardiopulmonary resuscitation (CPR) and an automated external defibrillator (AED) can save a child s life. Adding a sports EKG will greatly enhance detection of most conditions that may lead to sudden cardiac arrest. Sports EKGs are for patients with no family history of sudden cardiac arrest, no symptoms and a normal physical exam. We offer $25 sports EKG screenings year round at these locations: Arlington Denton Fort Worth Mansfield Midland San Angelo Southlake And free sports EKG screenings at certain times of the year at our Fort Worth and Arlington locations. When a child does go into sudden cardiac arrest, it s important to have an action plan in place. That s where Project ADAM Texas comes into play. Project ADAM s mission is to educate school systems, nurses, coaches, trainers, parents and others about pediatric sudden cardiac death. Project ADAM helps implement public access defibrillation programs (PAD) across Texas and the nation. Our goal is to increase the awareness of sudden cardiac death and establish emergency programs that help to provide a timely and lifesaving response. Once a school has successfully implemented a quality AED program, they are given a Heart-Safe designation by Project ADAM. These schools receive framed certificates of recognition and monthly updates on regional news, new medical developments and program best practices. Project ADAM will also replace or reimburse the replacement of electrode pads for the school s AED after use in an emergency. Specializing in matters of the heart 33

34 Specializing in matters of the heart Cook Children s Heart Center

Teddy Bear Transport Cook Children s is supported by one of the largest pediatric transport programs in the nation. More than 3,000 children are transported to Cook Children s Medical Center annually from Texas and its surrounding states, most for critical care. Our transport vehicles include a Cessna Citation Encore+ jet*, King Air B200 critical care transport airplane*, an American Eurocopter 145 helicopter* and five ambulances. Each is equipped to transport critical care patients and feature pediatric-oriented technology. Our team of highly specialized nurses, respiratory therapists and paramedics begin giving care to your patient immediately upon our arrival to your location. 682-885-1940 To better serve our treating clinicians, we can assist you with: Non-emergent transfer requests Direct admissions Specialist consultations Cook Children s Teddy Bear Transport staff of 54 neonatal/pediatric nurses, respiratory therapists and paramedics is proud to have more than 400 combined years of transport experience. This team is dedicated to getting the most medically fragile children and neonates to our award-winning medical center quickly and safely. * Aircraft operated by Metro Aviation, Shreveport, Louisiana. Neonatal Intensive Care Unit (NICU) Cook Children s NICU is the only Level IV NICU in Tarrant County. We provide comprehensive care for critically ill infants, born at all gestational ages and birth weights. Our all-private rooms allow parents to be with their baby 24/7. We have a dedicated unit within the NICU for our cardiac patients. Neonatologists and cardiologists round on them daily to discuss their progress and plan of care. We also offer specialized services that are found in only a handful of NICUs across the country. HeRO: A state-of-the-art heart rate observation technology that measures heart rate variability and allows for early detection of potential infection. Extracorporeal membrane oxygenation (ECMO): Treatment for patients whose heart/lungs need to recover from anomaly or disease. Therapeutic hypothermia treatment: A process used to limit organ damage due to the lack of blood flow during the baby s birth. Specializing in matters of the heart 35

Our dedicated Heart Center staff celebrating Heart Awareness month. 36 Specializing in matters of the heart Cook Children s Heart Center

Heart Center Clinical Staff Cardiologists (top to bottom, left to right) Lisa Roten, M.D., Medical Director, Echocardiography and Fetal Echocardiography Deborah Schutte, M.D., Medical Director, Cardiology Stephen Lai, M.D. Matthew Dzurik, M.D., Medical Director, Catheterization Lab and Project ADAM Susan Hess, M.D. Gregory Barker, M.D. Anne Hackman, M.D. James Kuo, M.D. Steve Muyskens, M.D., Medical Director, Cardiac Magnetic Resonance Imaging Scott Pilgrim, M.D., Medical Director, Adult Congenital Heart Disease Richard Readinger, M.D. J. Hudson Allender, M.D.* Christopher Case, M.D.* Corey Mandel, M.D.* *Not pictured Specializing in matters of the heart 37

Cardiac intensivists (left to right, top to bottom) Susan Davis, M.D. Co-medical Director, Cardiac Specialty Care Unit Richard Chemelli, M.D. Lane Lanier, M.D Jose Olarte-Motta, M.D. Jay Duncan, M.D., Co-medical Director, Cardiac Specialty Care Unit Ryan Meyer, M.D. * *Not pictured Cardiothoracic surgeons (left to right) Vinod Sebastian, M.D. Vincent Tam, M.D., Medical Director, Cardiothoracic Surgery Hisashi Nikaidoh, M.D. 38 Specializing in matters of the heart Cook Children s Heart Center

Cardiac anethesiologists (left to right) Randy Watkins, M.D., Medical Director, Cardiac Anesthesia Sam Kleinman, M.D. Teresa Schartz, M.D. Lynne Reynolds, M.D. Jay Tapper, M.D. Juan Grimaldos, M.D. Nurse practitioners (not pictured) Nancy A. Doublin, RN, MSN, CPNP-PC, NNP-BC Janice L. Randel, RN, MSN, CPNP-PC, AC Crystal Flores, RN, MSN, CPNP-PC, AC Shelly R. Devillier, RN, MSN, CPNP-PC, AC Specializing in matters of the heart 39

Cook Children s Heart Center Dodson Specialty Clinics third floor 1500 Cooper St. Fort Worth, TX 76104 682-885-2140 682-885-1940 To better serve our treating clinicians, we can assist you with: Non-emergent transfer requests Direct admissions Specialist consultations cookchildrensheartcenter.org 40 Specializing in matters of the heart Cook Children s Heart Center