Spring 2013

New Options for End-Stage Heart and Lung Disease

Dr. Gordon Cohen

Dr. Gordon Cohen

"As survival rates following open cardiac surgery for children born with heart defects have improved, some of us have turned our attention to minimizing complications, including long-term complications," says Gordon Cohen, M.D., Ph.D., newly appointed chief of the UCSF Division of Pediatric Cardiothoracic Surgery and surgical director of the UCSF Pediatric Heart Center.

Cohen’s arrival, along with that of fellow cardiothoracic surgeon Tara Karamlou, M.D., M.S., significantly improves the ability of the Pediatric Heart Center to pursue that goal.

"We are now building a heart failure and transplant program that will expand our ability to care for children with end-stage heart or lung disease,” says David Teitel, M.D., chief of the Division of Pediatric Cardiology and medical director of the Pediatric Heart Center.

Improving Treatments for Pediatric Heart Failure

infant

"Cohen notes that a shortage of donor hearts and the absence of ventricular assist devices (VADs) for children with heart failure often constrain the choices these families face.

But, he says, things have begun to change. Recently, the FDA approved the Berlin Heart EXCOR VAD, the first approved VAD for small children. And the creation of a pediatric heart failure and transplant program at UCSF Benioff Children's Hospital means that in Northern California, children with advanced heart failure will soon have an expanded set of options.

"Children are still growing, and we should be harnessing that opportunity," Cohen says. He notes that as novel treatments emerge — stem cells, growth factors and new medications — using mechanical devices as a bridge to emerging treatments or transplant is an increasingly sensible option. "If adults can be bridged when their heart is failing, we should be able to do the same with kids."

Cohen says that by the time the new UCSF Benioff Children's Hospital opens at Mission Bay in 2015, the heart failure and transplant program will be firmly in place.

Pulmonary Hypertension and Beyond

Dr. David Teitel

Dr. David Teitel

Teitel adds that the Pediatric Heart Center also is taking full advantage of the new treatments for pulmonary hypertension that have emerged in the last five to 10 years. "We are rapidly expanding our treatment of this condition," Teitel says.

The center has created an expert team that includes world-renowned pulmonary hypertension and critical care expert Jeff Fineman, M.D.; pediatric cardiologist Laura Robertson, M.D.; neonatologist Roberta Keller, M.D.; and pediatric nurse practitioner Emma Olson.

"A team approach is the best way to choose from among oral medications, intravenous medications and inhalational agents that are only available at an academic medical center," Teitel says. "Having the neonatologist involved is critically important, because so many of our lung disease patients are newborns."

Cohen says it is precisely this ability to create expert, cross-functional teams and research new approaches that drew him to UCSF.

He says, "In addition to having one of the best divisions of pediatric cardiology in the country, UCSF is one of the premier research institutions in the world. As one example of how this benefits patients, I can work with an expert in pediatric cardiology, cardiac intensive care or research scientists to develop new therapies for treating young patients with congenital heart disease. It’s exciting to be in a position to make these kinds of advances."

For more information, contact Dr. Gordon Cohen at (415) 476-3535 or Dr. David Teitel at (415) 353-4141.

     

Spring 2013 Table of Contents

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