Pediheart Podcast #282 Replay: Very Long Term Follow-Up After ASD Repair

This week we review a recent report from the team at UTSW comparing early outcomes following biventricular repair vs. Fontan palliation for complex congenital heart disease with borderline ventricles or complex cardiac anatomy that may, in the past, have been immediate triggers for single ventricle palliation. Who is a good candidate for this sort of two ventricle approach and what anatomical types could be viewed as 'low lying fruit' for two ventricle palliation? How do early outcomes compare between these two very different approaches? Are we choosing Fontan approaches more commonly because of a perception of greater predictability? Is this true or accurate? Dr. Nicholas Andersen and Dr. Abhay Divekar of UTSW share their deep insights into this fascinating study and approach.

This week we delve into the world of fetal cardiology to review a recent work on mild aortic stenosis in fetal life. This is a rare finding and the outcomes of this varied. How commonly does this finding result in severe or critical aortic stenosis? Is there a risk for hypoplastic left heart syndrome? Are there findings that would auger and better or worse outcome for this observation? How should patient families be counseled when encountering this finding on a fetal scan? Associate Professor of Pediatrics at Stanford University, Dr. Michelle Kaplinski shares her deep insights this week.

This week we explore a recent PHIS database study assessing clinical outcomes for transcatheter balloon dilation of the aortic valve in the setting of aortic valve stenosis in early life. Why do critical AS patients fare less well than those with severe AS? Is this an issue of procedural failure or patient characteristics? Is there adequate equipoise for a study comparing surgery to balloon dilation? Is such a study even feasible given the present day levels of surgical experience with neonatal aortic valve surgery? These are amongst the questions posed to Associate Professor of Pediatrics at Vandarbilt University, Dr. George Nicholson who is the senior author of this week's work.

This week we replay an episode from 2022 i which we reviewed a then recent report on the differences between pulse oximeter Sp02 and arterial Sa02. Are there patient specific factors that may result in inaccuracies of measurement? What single ventricular factors may also result in more significant inaccuracies and how should these data be used at the bedside when assessing a child who is cyanosed? We speak with Dr. Cara Pritchett, critical care fellow at Lurie Children's Hospital - Northwestern University about a recent work she co-authored on this important and practical topic.

This week we note and mourn the passing of pediatric cardiologist and thought leader Dr. Steven Lipshultz who passed on September 4, 2026. Dr. Lipshultz was one of the most significant cardiologists of the past half century and his contributions to the fields of pediatric cardiomyopathy, HIV cardiomyopathy and cardio-oncology were gigantic and meaningful. This week we turn back the clock and review a landmark work of Dr. Lipshultz from the Pediatric Cardiomyopathy Registry that was published in 2003 in the NEJM and we speak with 3 pediatric cardiomyopathy experts as well as friends and colleagues of Dr. Lipshultz - namely Dr. Neha Bansal of NYU, Dr. Daphne Hsu of the Albert Einstein College of Medicine and Dr. Joseph Rossano of the Children's Hospital of Philadelphia. Each shares their remembrances of this work and provide insights into the legacy of Dr. Lipshultz.