For over 25 years, Pediatric Cardiovascular services at the Westchester Medical Center have provided outstanding comprehensive clinical care for infants, children and adolescents from throughout the Hudson Valley and beyond. The opening of Maria Fareri Children's Hospital (MFCH) at Westchester Medical Center has strengthened those services and now provides an unmatched environment of care for children and their families.
Our team pioneered noninvasive and invasive therapies for the entire spectrum of children's cardiovascular problems in the Hudson Valley, and we continue to deliver them to area families in a state-of-the-art children's hospital so close to home. Our pediatric cardiology team has and continues to develop new strategies for treatment and diagnosis of cardiac conditions from fetal life through young adulthood. Examples include the advent of our newest program, the Adult Congenital Heart Disease Center (in collaboration with our Adult cardiology colleagues), and the implementation of 3-D echocardiography nd similar cutting-edge technologes.
The continuum of comprehensive care, from fetus to young adult is possible due to a team-oriented approach. At Maria Fareri Children's Hospital (MFCH) at Westchester Medical Center, 13 pediatric cardiologists work in concert with a dedicated pediatric cardiothoracic surgical team, pediatric cardiac anesthesia experts, cardiovascular nurse specialists, and a uniquely trained technical staff to deliver world-class care.
We provide the full range of pediatric cardiology services. This includes ambulatory consultation and inpatient care that consists of invasive and noninvasive electrophysiology, interventional cardiac catheterization, all modalities of echocardiography, cardiopulmonary exercise stress testing, and syncope analysis with specially designed tilt table testing. Our echocardiography staff performs more than 8,000 studies each year and we have cardiac CT and cardiac MR capabilities. Moreover, Maria Fareri Children's Hospital (MFCH) at Westchester Medical Center is one of the few centers in New York State to provide ECMO (extracorporeal membrane oxygenation) therapy for infants and children.
Whether it's a heartbeat irregularity or a complex heart defect detected in the womb, the pediatric cardiac specialists at Maria Fareri Children's Hospital (MFCH) at Westchester Medical Center are dedicated to providing an uncompromised level of care for each and every patient. What's best is that these patients and their families can stay close to home and receive treatment for their cardiac condition and continuing follow-up.
Our fetal cardiology experts, each of whom has more than 20 years of experience in the field, use non-invasive technologies and techniques such as echocardiography to diagnose conditions as early as 14 weeks, such as arrhythmias, myocardial dysfunctions and other heart conditions. Having the ability to diagnose conditions at such an early stage, allows the cardiologists at Maria Fareri Children's Hospital (MFCH) to work with perinatologists at Westchester Medical Center, to optimize pregnancy management and address patient heart issues as soon as possible, in order to secure the best outcomes. Sometimes, treating the mother is a tecnique we use with crucial impact for the developing baby.
If there is a issue with the electrical current in a home, the homeowner calls an electrician to diagnose and fix the problem. A child's heart has a highly specialized electrical system as well, and the dedicated pediatric electrophysiology specialists at Maria Fareri Children's Hospital (MFCH) at Westchester Medical Center can accurately diagnose and treat problems with the child's cardiac electrical system, which controls the rhythmic contractions that pump blodd throughout a child's body.
Our doctors are specially trained to determine the cause of an abnormal heart rhythm, locating its origin and tailoring pecific treatment. The electrophysiology services offered at Maria Fareri Children's Hospital (MFCH) at Westchester Medical Center include routine electrocardiography, ambulatory (Holter) monitoring, event (transtelephonic) monitoring, exercise stress testing, intracardiac electrophysiology study, radiofrequency ablation, cryoablation, temporary and permanent pacemaker placement, and implantable defibrillators. Successful therapy is standard for supraventricular tachycardia, complete heart block, sinus node dysfunction, long QT Syndrome, ventricular tachycardia and Wolff-Parkinson-White Syndrome among other conditions which affect the heart's wiring system.
A picture is worth a thousand words. Just ask our outstanding pediatric cardiologists who use ultrasound and other cardiac imaging techniques to answer difficult clinical questions while caring for our patients.
High resolution echocardiography often eliminates the need for riskier, invasive and more complicated testing. Echocardiograms use high-frequency sound waves to create real time images along with Doppler derived physiologic data. Since the procedure is non invasive and painless, it can be performed in almost any venue (e.g. outpatient, bedside or operating room) to clearly define ventricular function, anatomic defects and hemodynamics. Our studies are digitally acquired into a central computer archive, making review and analysis easier and more precise, while allowing Web transfer. Each imaging suite in our network of centers is child friendly with a television and VCR / DVD players to comfort patients during the procedure.
Our newest cutting edge technology incudes real time three dimensional imaging. These acquired volume sets can be manipulated on or off line to allow evaluation in all views and planes. This tecnique allows doctors to "peel away" an outer layer of heart and look inside from any vantag to evaluate valve function, wall defects and other problems. Three dimensional images facilitate precise surgical planning since our non invasively acquired images now represent what the surgeon actually sees.
The dictionary defines an intervention as an action that alters a devlopment. At Maria Fareri Children's Hospital (MFCH) at Westchester Medical Center, our interventional cardiologists alter children's lives by joining years of experience with today's latest technologies to diagnose and treat different forms of congenital heart disease and vascular conditions, often finding alternatives to open-heart surgery.
Interventional cardiology takes the form of a cardiac catheterization, which is performed in our specially designed pediatric catheterization laboratory. The procedure is done under general or local anesthesia, resulting in little or no discomfort for the child. This procedure helps our doctors identify pediatric heart conditions, measure their impact on the body, determine their severity, and plan ttreatment. Often, conditions are treated right at the time of catheterization, eliminating the need for an overnight stay.
If surgery is required, Maria Fareri Children's Hospital (MFCH) at Westchester Medical Center provides one of New York State's top pediatric heart surgeons, along with a comprehensive team of specialists, focused on providiing excellent cardiovascular surgical care for patients, ranging from premature babies to young adults.
The cardiovascular surgery team also embraces the family centered care approach offered throughout the hospital and works closely with each family to determine the best treatment options for each patient.
An anesthesiologist must work hand in hand with a surgeon or catheterization specialist, and the children that undergo heart procedures at Maria Fareri Children's Hospital (MFCH) at Westchester Medical Center are monitored by a skilled cardiovascular anesthesiology team before, during and after surgery.
Our cardiovascular anesthesiologists are pediatric congenital heart disease specialists that work with children full time, so they understand the complexities of pediatric cardiovascular problems. They are skilled at getting children safely sedated quickly in order to reduce anxiety and ensure pain free procedures. This care continues to the pediatric intensive care unit where our intensivists are skilled at dealing with postoperative issues. Thus, a continuum of care is provided for your child, allowing for the most optimal result.
The cardiovascular anesthesia team at Maria Fareri Children's Hospital (MFCH) at Westchester Medical Center provides care for all children's heart surgery and related cardiovascular procedures. The age and size of patients we treat range from athletic teenagers and young adults, to the smallest of infants, including premature babies.
In addition to being outstanding practiotioners of their clinical craft, pediatric cardiology specialists at Maria Fareri Children's Hospital (MFCH) at Westchester Medical Center also develop and participate in cutting edge research. They conduct this research through the Children's Hospital affiliation with New York Medical College, which shares its campus with Westchester Medical Center, and with other major academic centers nearby and around the world.
Maria Fareri Children's Hospital (MFCH) at Westchester Medical Center is part of an academic health center which fosters a research environment; several intersting cardiovascular research projects are currently underway. One is in the area of pulmonary arterial hypertension, a serious and debilitating condition that often complicates childhood heart and lung problems. Research is being conducted to understand the cellular and molecular changes that occur before the condition becomes clinically apparent. In addition, testing of new strategies for treatment in children thought previously to have no hope of improvement is underway with promising initial results.
Another research program with pediatric cardiology scientists and physicians working together focuses on orthostatic intolerance, where changes in heart rate lead some children to faint or to exhibit symptoms such as lighteheadedness, fatigue, anxiety and visual disturbances. This work is sponsored by the National Institue of Health.
Sponsored by a variety of resources including the Maria Fareri Children's Hospital Children's Hospital Foundation, family foundation grants and healthcare industry research partnerships, research projects are also being conducted on fetal cardiac disorders and in other areas of pediatric cardiovascular medicine.
The pediatric Cardiology group at Maria Fareri Children's Hospital (MFCH) at Westchester Medical Center offers a specialized approach to prevention for children with risk factors for accelerated cardiovascular disease such as abnormal cholesterol levels, high blood pressure, obesity and diabetes. Once a risk factor is identified, our preventive cardiology team partners with nutritionists, metabolic experts and other specialists to construct a specialized program that will help reduce the risk of a heart attack, stroke, and other complications as a child grows into adulthood. This includes analysis of the full biochemical profile, necessary genetics assessment and referral to associated pediatric specialists when co-morbities such as obstructive sleep apnea, asthma, fatty liver, gastroesophogeal reflux, polycystic ovaries, and orthopedic problems are found. Preventive cardiology specialists are skilled at assessing the need for medical therapy and in its use, and alos in determining when medicine may not be the answer for a particular child.
Exercise is important to everday health, and it is also an important tool in the treatment of pediatric patients. Exercise testing is helpful in the evaluation of cardiac conditions, plus it provides evidence as to how the heart is interacting with the lungs and muscles.
The exercise laboratory has equipment designed for pediatric evaluation of how physical exertion impacts a child's cardiovascular syatem and also what the tolerance for exercise is in any patient. In addition to patients with known cardiac problems and post surgery evaluation, patients come to our laboratory to learn why a child suffers from exercise induced conditions such as shortness of breath or palpitations. We evaluate backyard game players as well as elite athletes who seek the counsel of our cardiac experts. In many circumstances, our exercise laboratory staff provides children with the confidence they need to enjoy childhood games and organized sports, while giving parents the peace of mind that their kids can participate in activities safely. In other situations, a specially designed program can be developed to help children improve exercise tolerance and avoid risk prone activities.
Congenital heart disease (CHD) is a broad term that can describe a number of different problems with the heart's structure and function due to abnormal heart development before birth. According to the American Heart Association, approximately 35,000 babies are born each year with some type of congenital heart defect.
Congenital means present at birth, but in some cases, the symptoms are not immediately obvious. In fact, some defects may not cause problems for many years. Other problems, such as a small ventricular septal defect (VSD), may never cause any problems and some people with a VSD have normal physical activity and a normal life span.
Some heart defects heal over time, while others require treatment ranging from medication alone to one or more surgeries. The risk of death from congenital heart disease surgery has dropped dramatically from the national average in the 1970s of approximately 30%. Our program had a 97% survival rate in 2006, which is above the New York State average.
Congenital heart disease is often divided into 2 types:
1. Cyanotic (blue discoloration caused by a relative lack of oxygen)
2. Non-cyanotic
The following lists cover the most common of the congenital heart diseases:
Our program treats all congenital heart diseases, ranging from the simple, such as atrial septal defect and ventricular septal defect, to the more complex, such as transposition of the great vessels and hypoplastic left heart syndrome.
Dr. Sett has performed over 1000 operations in children and adults with congenital heart conditions. These include:
Repair of atrial septal defects including secundum sinus venosus and ostium primum defects, repair of Scimitar syndrome, repair of LSVC to roof of left atrium and others.
Repair of ventricular septal defects
Repair of double chambered right ventricle
Repair of atrioventricular septal defects
Repair of tetralogy of Fallot
Repair of double outlet right ventricle
Repair tetralogy of Fallot with atrioventricular septal defect or double outlet right ventricle
Repair of pulmonary atresia and ventricular septal defect with and without aortopulmonary collateral arteries (MAPCA's) including unifocalization
Repair of congenitally corrected transposition of the great arteries
Repair of anomalous left coronary artery from the pulmonary artery
Repair of cor triatriatum
Ligation of patent ductus arteriosus
Blalock-Taussig shunts
Repair of coarctation of aorta
Pulmonary artery banding
Arterial switch operation
Norwood procedure
Hybrid procedure
Repair of total anomalous pulmonary venous drainage
Repair of pulmonary atresia and intact ventricular septum
Repair of interrupted aortic arch
Repair of truncus arteriosus
Repair of hemitruncus
Ross procedure
Enlargement of hypoplastic aortic arch
Repair of coronary artery fistula
Bidirectional Glenn operation
One and a half ventricle repair
Kawashima operation
Fontan operation
Intraoperative stenting of pulmonary arteries
Aortic valvotomy
Valve replacement
Resection of subaortic stenosis
Konno operation
Manougouin / Nicks procedure
Modified konno operation
Aortic root replacement
Mitral valve repair following repair of atrioventricular septal defects and for isolated cleft mitral valve
Extracorporeal membrane oxygenation is a type of portable heart-lung machine. It is sometimes used to support the heart and lungs before and after complex cardiac surgery. Support on the portable heart-lung machine allows the heart to recover following repair of complex heart diseases. ECMO has been successfully used in children undergoing repair of congenital heart defects at the Maria Fareri Children's Hospital.
