An Experienced, Interdisciplinary Team of Pediatric Cardiac Specialists
The clinical insight of the physicians treating pediatric cardiac patients at the Riley Hospital for Chlidren at Indiana University Health Heart Center is matched by few facilities in the United States. This has created an unparalleled level of trust among referring physicians throughout Indiana and the Midwest.
Children receiving cardiac treatment at Riley Hosptial for Children at IU Health do so in the only hospital in the state dedicated exclusively to the acute care of pediatric patients. Pediatric experts in every medical and surgical specialty and subspecialty are available 24 hours a day to address any additional health problems a child may face.
Diagnostic Technologies and Expertise
Complementing their expertise in the hands-on physical exam, pediatric cardiologists at Riley at IU Health employ a variety of tests to evaluate cardiovascular defects — Echocardiography, EKG, X-ray, ambulatory EKG, exercise testing, electrophysiologic testing, magnetic resonance imaging (MRI) and diagnostic heart catheterization, among others.
One of the most useful diagnostic modalities for assessing congenital heart defects is the echocardiogram, which uses noninvasive, high-frequency sound waves to reveal complex cardiac anatomy and physiology. It’s an essential technology that has eliminated the need for cardiac catheterization for many defects. Riley at IU Health clinicians with additional specialized training annually perform more than 10,000 pediatric and fetal echocardiograms, including about 1,100 fetal echos, and a staff of pediatric cardiologists interprets them. Their expertise is widely recognized among other hospitals in the Midwest, which rely on Riley at IU Health cardiologists to interpret more than 3,100 echos from their own institutions.
Riley Hospital for Children at IU Health was the first in Indiana to have a pediatric echo lab accredited by the Intersocietal Commission for the Accreditation of Echocardiography Laboratories. In addition to traditional echos, Riley at IU Health cardiologists dealing with more complex cases often perform transesophageal echos (TEE) when they need additional views. A TEE also can guide interventional catheterizations for immediate assessment in the operating room.
Echocardiograms are performed throughout Riley Hospital for Children at IU Health Heart Center, including the operating room and catheterization lab, for intraoperative assessment, to guide surgical interventional procedures. Moreover, the Riley at IU Health echo lab was one of the first all-digital laboratories in the state. We continue to apply new technologies and systems that ensure studies can be accessed and reviewed 24 hours a day to help with patient care at Riley at IU Health and and throughout the state.
The cardiac MRI program at Riley Hospital for Children at IU Health is unique in the state of Indiana, providing thorough and in-depth details on cardiac structure and function in children and young adults with all varieties of heart disease. At Riley at IU Health, we perform nearly 200 highly specialized cardiac MRI exams annually. Radiation from MRI is not used, and the imaging is not invasive, often providing an alternative to cardiac catheterization. This makes cardiac MRI a very easy procedure for many children to undergo. Cardiac MRI can also answer questions that echocardiography may not be able to answer. Cardiac MRI is often very important in making decisions and planning for heart surgery. Riley at IU Health has the only pediatric cardiologist and pediatric radiologist in the state qualified to perform and interpret cardiac MRI studies.
Rapidly advancing catheterization technology is allowing for the diagnosis and repair of the most complex cardiac defects. Some defects that only a few years ago would require surgery can now be treated with catheter-based techniques. The interventional pediatric cardiologists of Riley at IU Health have been at the forefront of those advancements. A Riley at IU Health cardiologist performed a balloon valvuloplasty on the smallest patient to successfully undergo the procedure — the baby weighed less than 2 pounds. Riley at IU Health cardiologists were among a small group of experts nationwide involved in clinical research trials for Amplatzer Septal and Duct Occluder and Nit-Occlud that treats atrial septal defects (ASD) and patent ductus arteriosus (PDA). Numerous clinical trials of other medical devices are ongoing.
A team model of care shapes the treatment in the catheterization laboratory and recovery within the Riley at IU Health Heart Center. Pediatric interventional cardiologists, anesthesiologists, nurse practitioners and other intensivists are involved at every step. A partial list of procedures includes the following:
Combined interventional and surgical techniques (hybrid procedures) have been performed at Riley at IU Health since 2004. All told, more than 500 pediatric cardiac catheterizations (diagnostic, interventional, biopsy and electrophysiologic) take place each year at Riley at IU Health — more than at any other facility in Indiana and the most in the region.
The Riley Hospital for Children at IU Health Heart Center provides the complete range of state-of-the-art services for the diagnosis and treatment of cardiac rhythm disorders, performing and interpreting more than 6,000 electrocardiograms (EKGs), 450 24-hour, continuous EKG monitors, 200 event recorders and 60 radio frequency catheter ablations annually.
A busy and active service follows about 200 patients with various pacemakers and defibrillator devices. With the guidance of pediatric cardiologists specially trained in pediatric electrophysiology, clinicians ensure that patients receive the best and most current care for heart rhythm problems.
More than 350 cardiac exercise stress tests take place at the Riley at IU Health Heart Center each year in a laboratory dedicated to sophisticated evaluation of children and their responses to maximal exercise. Reasons for exercise stress tests vary from cardiac clearance for school sports to evaluations after fainting episodes, exercise-induced chest pain, abnormal heart rhythms, cardiac surgery or heart transplantation. State-of-the-art equipment used for exercise testing includes treadmills and bicycles with computer-controlled workload adjustments, measurement of peak oxygen consumption, blood oxygen saturation, continuous heart rate and rhythm, blood pressure, and other respiratory and metabolic parameters. Riley Hospital for Children Cardiology at IU Health utilizes an exercise physiologist to coordinate exercise stress tests, provide individualized exercise programs for patients and assist in exercise-related research endeavors.
Adult Congenital Heart Disease Program
As a result of extremely successful diagnostic and treatment strategies developed and employed over the past half century, the number of adults with congenital heart defects in the United States is approaching one million. Of these, at least half are complex enough to require ongoing follow-up and treatment by health care professionals with expertise in the care of these patients. Meeting the unique and complex needs of this special population of patients is the mission of the Riley at IU Health Heart Center Adult Congenital Heart Disease Program. This program was established in 1991 to provide multidisciplinary, continuing care for adolescents and adults with chronic congenital cardiac conditions. The service is jointly staffed by Riley at IU Health Heart Center pediatric cardiologists and adult cardiologists from the Krannert Institute of Cardiology, Indiana University School of Medicine. This collaborative effort among leading physicians ensures our expertise in the wide range of cardiovascular problems facing these patients. Specially trained technicians, sonographers, and nurse clinicians complete the team and provide the breadth of services necessary for optimal health care. Other subspecialty services such as hematology, pulmonology, psychology, neurology and obstetrics are readily available.
Preventive Pediatric Cardiology Program
Riley Hospital for Children at IU Health Preventive Pediatric Cardiology Program aims to identify and manage risk factors in children that contribute to heart disease as adults. Modifying behaviors and medically managing high cholesterol and blood pressure during childhood will significantly decrease the chances of a heart attack or other cardiac-related concerns in the future. Riley at IU Health Preventive Cardiology Program treats children with abnormal cholesterol and hypertension, primarily on an outpatient basis. During the course of treatment, patients and their families will meet with a multidisciplinary team, including a pediatric cardiologist, a dietitian, a nurse specially trained in blood pressure assessment and an exercise physiologist.