New UF center at heart of care for congenital cardiac conditions

UF surgeons and pediatric cardiologists have joined forces to establish the UF Children's Heart Center, a move officials say will improve care for both children and adults born with complex cardiac conditions.

The center will provide coordinated care to patients with congenital heart disease at UF - from diagnosis to treatments that incorporate medical and surgical management and follow-up.

With more than $3 million in funding from Shands at UF, the UF College of Medicine and Children's Medical Services, the center represents a major new investment in pediatric cardiology and congenital heart surgery programs and unites the expertise of specialists in pediatric cardiology, invasive electrophysiology, cardiac imaging and interventional procedures, heart transplantation, congenital heart surgery, nursing and more.

Cardiac surgeon Mark Bleiweis, M.D., former director of the Children's Heart Institute at the Children's Hospital of Orange County in California, is heading the center.

"Our center will be able to provide care for the entire spectrum of congenital heart disease, from the smallest premature newborn to the adult with congenital heart disease, which would include complete repair of very complex heart problems to heart transplantation if necessary," Bleiweis said.

Approximately 225,000 babies are born in Florida every year. Of those, about 1 of every 150 newborns has some form of congenital heart disease, including structural problems of the heart and its vessels, and heart rhythm abnormalities.

"The approach to care provided through this center will enable even the most complex patient to be cared for by UF physicians," said Barry Byrne, M.D., Ph.D., professor and associate chairman of pediatrics and a pediatric cardiologist whose research focuses on developing genetic therapies for cardiovascular disease.

Terry Flotte, M.D., chairman of pediatrics on the Gainesville campus, said the center represents "a modern model," and called Bleiweis "a very gifted surgeon and somebody who has a very positive approach to this integration of care between the different disciplines."

"We're extremely enthusiastic about his ability to make this program successful," Flotte said.

Bleiweis also is an associate professor of surgery and pediatrics at UF's College of Medicine. While in California, he introduced new programs such as the comprehensive treatment for hypoplastic left heart syndrome and completed complex cardiac repairs in very small babies, including a premature neonate weighing less than 3 pounds.

As more children with congenital heart disease survive longer, pediatric cardiologists are increasingly overseeing their care well into adulthood. In fact, in the United States, there are now more adults than children living with congenital heart disease. In addition, these physicians also are caring for adults with previously untreated congenital heart diseases. These patients have their own unique set of problems.

"We do have a large population of adults with congenital heart disease," Byrne said. "For the most part, those patients are cared for by pediatric cardiologists. It's an emerging specialty within pediatric cardiology."

The center will seek to recruit additional faculty and personnel, including a Shands Children's Hospital pediatric cardiac anesthesiologist, an additional cardiac surgeon, a congenital heart surgery nurse practitioner and a research coordinator. In addition, six intermediate-care pediatric beds in the pediatric intensive care unit on the 10th floor of Shands at UF will be upgraded to pediatric intensive care unit beds. The intermediate care beds will revert back to a fourth-floor unit, where they were previously located. Hospital officials also anticipate dedicating an operating room and a cardiac perfusion team to pediatric cardiac cases.

The UF College of Medicine faculty in Jacksonville has for a number of years teamed with Wolfson Children's Hospital to provide advanced pediatric cardiology care and cardiac surgery to patients in the region and will work with the center to offer a seamless set of services.

"UF and Wolfson Children's Hospital have worked together traditionally in many ways and are helping to coordinate the care of these patients," Flotte said.

"They do have a joint cardiac catheterization conference and use a lot of teleconferencing and telemedicine technology to make the relationship work."

The center will draw patients from the primary referral areas of south Georgia, the Panhandle east to Jacksonville, the Space Coast south to Melbourne and West Palm Beach, and the Gulf Coast south to Ocala.

Many cardiac services are provided by UF physicians in Gainesville and Jacksonville, but each locale also has its areas of emphasis. In Gainesville, for example, faculty have special expertise in heart transplantation and cardiac magnetic resonance imaging, while those in Jacksonville are particularly noted for pediatric cardiac electrophysiology. Both campuses have strong programs in echocardiography and catheter-based interventional procedures. Patient care also will be bolstered by a range of clinical and basic science research programs, particularly efforts focused on the study of cardiomyopathies.

UF physicians, for example, can review echocardiograms sent to them by community physicians around the state, and if they are normal, patients who otherwise would have had to travel to be seen can save the trip, said Thomas Chiu, M.D., a professor and chairman of the department of pediatrics on the Jacksonville campus.

With the recent addition of a new surgeon to the Jacksonville campus, Chiu added, officials also hope to double the number of open-heart surgeries performed annually.

William Cance, M.D., a professor and chairman of the department of surgery in Gainesville, called the development of a multidisciplinary center of excellence with a team of physicians from multiple specialties "a critical step to provide the best care to children with heart disease."

Flotte said, "As much as we're excited about the growth in patient volume and high-tech developments associated with this new center, the bottom line is we're very confident this will let us give better care to our patients, to kids who are born with congenital heart disease in the region."