Children's Hospital Colorado

Fetal Cardiology

Our fetal cardiologists stand as integral members of Children's Hospital Colorado's Heart Institute and the Colorado Fetal Care Center team. Trained in both pediatric and fetal cardiology they have years of experience in the diagnosis, management and treatment of cardiac anomalies in utero. Even before conception, our fetal cardiologists provide counseling on the risks of fetal cardiac abnormalities and ways to mitigate these risks. Once the mother is pregnant, our fetal cardiologist team partners with the maternal, perinatal and neonatal experts found at Children’s Hospital Colorado and University of Colorado Hospital to develop a compassionate and comprehensive care plan for the remainder of the pregnancy. Our commitment to excellence in the field of fetal cardiology extends beyond outstanding clinical care: we are a national leader in research and educational programs for fetal heart disease. 

FETAL Arrythmia Center of Excellence
TOP Care for Congenital Heart Disease of the Fetus & Neonate

Congenital heart disease (CHD) is the most common congenital defect occurring in approximately one out of every 120 babies and has the highest mortality of any congenital defect within the first year of life. Some conditions can be treated in utero, but for others, treatment is only possible after birth. CHD includes:

  • Structural heart defects ( for example hypoplastic left heart syndrome, hypoplastic right heart syndrome, valve abnormalities, septal defects and transposition of the great arteries) 
  • Abnormal fetal heart rhythms: tachycardia (fast heart rate), bradycardia (slow heart rate) and irregular heart rhythms
  • Heart failure

Once a fetus is identified to have CHD, the maternal, perinatal and neonatal experts at Children’s Hospital Colorado jointly develop a delivery plan to optimize the postnatal outcome. Parents have ample opportunity to have their questions answered by the fetal cardiology team. In addition to medical expertise, family support groups and social services are available to provide emotional support, which is so critical during this time.  If the family is from out of town, our team helps them find affordable housing nearby. Our goal is not only the full term delivery of a healthy infant in the best possible condition to thrive after surgery, but a family who feels supported from the time of diagnosis until their baby goes home.

After delivery, a highly trained team of specialists in pediatric cardiac critical care and pediatric cardiothoracic surgery continue the state-of-the-art care begun by the fetal cardiology team. The pediatric critical care and cardiothoracic surgery teams have some of the best patient outcomes in the nation and experience with even the most complex cardiac defects.

  • Our team of surgeons perform more than 500 heart surgeries per year
  • In 2014, over 50% of surgeries were on patients <1 year old
  • Our results are consistently better than the national average and better in all categories of surgical risk, compared to outcome data analyzed by the Society of Thoracic Surgery.
  • Our neonatal mortality is less than half of expected, based on the Society of Thoracic Surgery average.
  • Our post-operative length of stay is consistently lower than the Society of Thoracic Surgery average.

Depending on your child's specific heart problem, the experts at Children's Hospital Colorado will tailor a treatment plan and follow-up care specific to your family's needs. Because no two heart problems are the same, children with the same diagnosis might undergo different treatment. 

The following is a general explanation of the types of treatment we provide to care for your child's heart.

Adult Congenital Heart Disease Program

The Adult Congenital Heart Disease Program provides the best possible care for adolescent and adult patients with congenital heart disease. 

Arrhythmia Center

The Arrhythmia Center is an internationally recognized program for the treatment of abnormal heart rhythms, known as cardiac arrhythmia. Our patients range in age from the fetus to the young adult. 

Cardiac Anesthesia

Our pediatric cardiac anesthesiologists are on call 24/7 and dedicated to patients within the Heart Institute. These specially trained doctors help keep kids comfortable during surgery or when they need to stay very still for certain heart tests. 

Cardiac Catheterization

The Cardiac Catheterization Lab is a state-of-the-art facility used to diagnose and treat heart problems. We perform more than 800 heart catheterizations each year, and many defects that once required open-heart surgery can now be corrected in the cath lab.

Cardiac Intensive Care Unit (CICU)

The Cardiac Intensive Care Unit (CICU) is dedicated to acutely ill heart patients and those recovering from heart surgery. Ours is the only pediatric CICU in the seven-state region. 

Cardiology Clinic

The Cardiology Clinic is usually a patient's first stop at the Heart Institute after a referral from a primary care doctor. Our board-certified pediatric cardiologists will meet with your family, assess your child's heart, and coordinate a care plan based on your child's diagnosis. 

Cardiomyopathy Program

The Cardiomyopathy Program provides care for kids whose heart muscle doesn't work as well as it should  a condition known as cardiomyopathy, which can lead to heart failure. 

Cardiopulmonary Exercise Laboratory

Our Cardiopulmonary Exercise Laboratory is used to test the heart and lungs of children and young adults during physical activity. Because most other tests are done while a child is still or at rest, an exercise test lets a doctor see how the body responds to exercise. 

Complex Congenital Heart Disease and Development Clinic

The Complex Congenital Heart Disease and Development Clinic is a specialized follow-up clinic for babies born with complex congenital heart disease who need a series of surgeries to improve cardiac circulation and help them thrive and grow.

Cardiovascular Surgery

Doctors in the Department of Cardiovascular Surgery specialize in treating congenital heart defects present at, or before, birth. By performing more surgeries than any other center in the region, our surgeons have experience and patient survival statistics as good as  or better  than most centers in the country.

ECMO Program

The ECMO Program (extracorporeal membrane oxygenation) provides cardiac and respiratory support to patients whose heart and lungs are so severely diseased or damaged that they can no longer work on their own. 

Fetal Cardiology Program

The Fetal Cardiology Program offers advanced services to families who are expecting a baby diagnosed with a heart disease before birth. Our doctors can examine the fetal heart as early as 14 weeks gestation, and then care for that child into adulthood.

Heart Transplant Program

The Heart Transplant Program at Children's Hospital Colorado is one of the leaders in pediatric heart transplantation. Our patient survival rates and total procedures performed rank us among the top few programs in the country. 

Lipid Clinic

The Lipid Clinic is a preventative cardiology program that serves kids and teens at risk for heart diseases by helping them identify and manage high cholesterol and high triglycerides.

Marfan Syndrome Clinic

The Marfan Syndrome Clinic was deemed the regional referral center for the Rocky Mountain region by the National Marfan Foundation. The clinic, located within the Heart Institute, focuses on the cardiac needs of patients with the connective tissue disorder. 

Pediatric Heart Lung Center

The Pediatric Heart Lung Center is a multidisciplinary program that provides patient care, education, research and training in childhood heart and lung disease. 

Pulmonary Hypertension Program

The Pulmonary Hypertension Program is one of the premier programs in the world for patients with pulmonary hypertension and other heart and lung diseases. Our program offers state-of-the-art diagnosis, consultation and long term follow-up care for kids and their families. 

Regional Cardiology Outreach Program

The Regional Cardiology Outreach Program brings Children's Hospital Colorado's renowned heart experts to cities throughout the Rocky Mountain region. Our pediatric cardiologists visit cities at the request of local primary care doctors and the community.

Transcatheter Pulmonary Valve Program

The Transcatheter Pulmonary Valve Program is a breakthrough procedure for kids and adults who have a failing, surgically placed pulmonary valve. Children's Hospital Colorado is one of only a small number of programs in the country to offer this alternative to open-heart surgery. 

Ventricular Assist Device (VAD) Program

The Ventricular Assist Device (VAD) Program uses state-of-the-art technology to extend the life of children awaiting heart transplantation. By helping the heart's pumping chambers, a VAD is a longer-term option for patients in heart failure.

For many patients who live in rural area and have need for specialized medical care, receiving regular and timely visits with a specialist can be an extraordinary and expensive burden. One potential solution to this issue is the use of telemedicine, allowing medical information to be exchanged between medical sites via electronic communications in order to improve a patient’s clinical health status. This innovative approach to medical care began expanding at Children’s Hospital Colorado approximately 4 years ago, with an increasing number of specialties now offering telemedicine care options.

Telemedicine has the potential to save patients time and money, and to decrease the amount of time missed from work to attend screening interventions. Children's Hospital Colorado currently conducts a fetal echocardiography telemedicine clinic in collaboration with St. Mary's Medical Center in Grand Junction, CO. This service provides critical access to fetal cardiac care and overcomes geographic separation between patients and university-based tertiary centers. Pregnant mothers from the western slope are referred to the fetal echocardiography telemedicine clinic at St. Mary's when concern arises that their unborn baby may have congenital heart disease. Prenatal diagnosis of congenital heart disease can increase survival as newborns with congenital heart defects may be clinically unstable at birth. Prior to telemedicine, families had to travel over the mountains to Denver for this service and timely diagnostic information.

We feel certain that our telemedicine program benefits not only patients and their babies, but also Children’s Hospital Colorado and its partnerships with referring communities. We currently have a research study examining whether tertiary-level diagnosis can be made through 1) telemedicine; 2) patient satisfaction with the service; 3) referring physician satisfaction; 4) impact of use of telemedicine regarding transfers avoided; 4) cost and time savings comparison for patient's regarding time and travel savings.

We hope that our collaboration with St. Mary’s will inform us about how to better serve mothers who need this screening. The effort has the capacity to be scaled to other interventions that might increase access to care lower costs of care, improved quality of care and improve patient outcomes.

We are transforming fetal cardiology through education

Recognizing CHD before birth can improve both prenatal and postnatal outcomes. Certain pregnancies are known to be at high risk for CHD, yet most cardiac defects occur in low risk pregnancies. Thus, one way to improve the outcome of fetal CHD is to improve prenatal detection of CHD in both high and low-risk pregnancies.

At Children’s Hospital Colorado, we offer a unique fetal echocardiography preceptorship program which is a 2-day apprenticeship created for health care providers interested in improving their skills in the diagnosis, treatment and understanding of fetal CHD. The program is given twice a year and is taught by our fetal cardiology sonographers and physicians from Children’s Hospital Colorado and The University of Colorado. The class is limited to 20 students to encourage group interaction. The overreaching goal of the program is for obstetrical sonographers and physicians to detect more fetal CHD earlier in pregnancy, so affected babies can deliver at a cardiac center of excellence and receive the necessary critical care. We appreciate that learning is a lifelong process! We are happy to give a second opinion or help our students with perplexing cases. For more information about the preceptorship, contact Shari Borcherding at shari.borcherding@childrenscolorado.org or call 720-777-2944.

We are transforming Fetal Cardiology through innovative research

Our fetal cardiology team together with the maternal, perinatal and neonatal experts at Children’s Hospital Colorado continually strives to improve patient outcomes and advance the science of fetal cardiology. Our research includes primary fetal cardiac issues as well as non-cardiac anomalies that impact the fetal cardiovascular system. We are the leader in several national and international multicenter studies, and a participating center in several others. Through our research program, we are gaining insight into the causes of fetal cardiac conditions and developing strategies for novel treatments. A complete list of current studies may be found below.

Research Projects on Primary Fetal Cardiac Anomalies           

  • Pregnancy and Long QT Syndrome
  • Heart Sounds at Home: Prospective Maternal Surveillance of SSA Positive Pregnancies Using a Hand-Held Fetal Heart Rate Monitor
  • Outcomes of Pulmonary Atresia and Intact Ventricular Septum
  • Effect of dexamethasone on outcome of fetus with immune-mediated AV block
  • Treatment of Fetal Atrial flutter & Supraventricular Tachycardia (FAST Therapy Trial)
  • Healing from a distance: results of a rural Fetal Cardiology Telemedicine program
  • Database of Normal Values of Cardiac Anatomy and Function, Cardiac Rhythm, and Cardiac Mechanics in Fetuses by Echocardiogram.
  • International Fetal Cardiac Intervention Registry

 

Research Projects on Secondary Fetal Cardiac Anomalies

  • Left ventricular sphericity index in fetuses with congenital diaphragmatic hernia
  • Assessment of fetal cardiac function in Twin-Twin Transfusion Syndrome
  • Effect of indomethacin and anesthetic regimen on the fetal heart during open myelomeningocele repair
  • Bladder outlet obstruction and cardiac function
  • Evaluation of heart function in the fetus at risk for heart failure using Velocity Vector Imaging (VVI)

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