Tag Archive for: prenatal cardiology

Optimized congenital heart care ‘from twinkle to wrinkle’: Q&A with Wayne Franklin

Wayne J. Franklin, M.D., F.A.C.C., recently joined Children’s National Hospital as senior vice president of the Children’s National Heart Center. In that role, he oversees the full spectrum of heart care services which includes comprehensive care, as he puts it, from twinkle — when a child is barely more than a twinkle in their mother’s eye — to wrinkles — or throughout the lifespan.

During his first week, Dr. Franklin answered questions about his vision for the Children’s National Heart Center and told the team more about his clinical and research priorities.

Q: Why did you choose Children’s National?

A: Children’s National has such a long history of caring for the children and families in the community — over 150 years. This is a hospital taking fantastic care of patients now, but also planning for the future and the future of healthcare specifically. And I wanted to be part of that team. We know health care is ever changing and I want to be ahead of that, really providing the best care possible for today’s patients and about how to plan the ideal care for tomorrow’s patients.

I’m also excited to work with Children’s National President and CEO Michelle Riley-Brown. When I worked with her previously, I found out she’s a fantastic leader. I know she’s already started to do amazing things for Children’s National and the community.

Q: What is your vision for Children’s National Heart Center?

A: My vision for the heart center is to organize, coordinate and optimize all the different aspects of caring for children with heart problems.

It’s a complicated process. There’s intensive care in the hospital, ambulatory care in the clinic, acute care and emergency care. One of my roles is to coalesce all of those facets to provide total care for people from the prenatal period through birth and beyond into the teenage years, adulthood and even parenthood and grandparenthood.

I think we’re well-equipped to do that here at Children’s National.

As part of our commitment to providing the best care for patients and their families, we also plan to rely on our patient-family advisory council and our family-centered care approach. We take patient and family concerns to heart and want to continue bringing that information together with our world-class clinical care. That’s how we’ll be sure to provide great outcomes now and down the road.

Q: How is research a part of your vision for the Heart Center?

A: Research is critical to cardiac disease in children, especially in Washington, D.C. I think we’re very fortunate because people here at Children’s National are doing groundbreaking research and we work close to truly great scientific organizations like the George Washington University and the National Institutes of Health. Some of our heart center faculty actually work at the NIH too.

The top centers in the country, including Children’s National, are involved with cutting-edge innovation and research alongside clinical care and a big part of my job is to support these efforts to translate this science and help improve health outcomes for our patients.

Q: Why did you choose to work in the field of pediatric cardiology?  

A: While children with heart problems can become very sick, our advances in cardiac surgery, catheter interventions, cardiac intensive care and anesthesia allow us to work together to make them better reasonably quickly. To be able to provide them that care is really rewarding. Our team can really impact their health for a lifetime.

Q: What research are you, personally, interested in?

A: The research that I’m particularly interested in involves the full gamut of cardiac disease, from single ventricle physiology to pulmonary hypertension to fetal cardiology to women with heart disease. Fortunately, here at Children’s National there is a strong research infrastructure and some fantastic physician scientists.

Q: How did your interest in pediatric cardiology evolve into a specialty in adult congenital heart disease?  

A: When these kids grow up, they become adults with heart disease that is caused by their congenital heart lesions. It’s a different type of heart disease than an age-related heart attack, high cholesterol or stroke. I focused on this area many years ago because there are now more adults with congenital heart disease than children.

Currently, there is a need for more adult congenital heart disease specialists and there will continue to be need for even more in the future. I’m fortunate to join one of the best adult congenital heart programs in the country by coming to Children’s National.

Q: How do you spend your free time when you aren’t here at the hospital?

A: I work a lot but when I get time away from work, I love to spend my it with my family and I’m lucky to have a truly spectacular wife. In December, we’ll celebrate our 20th wedding anniversary and it’s been an extraordinary and exciting ride. We have two wonderful kids, both teenagers. Being a father myself has given me a different perspective about taking care of children throughout their lifetimes.

Q: What’s your favorite Washington, D.C., monument?

A: I always have to go back to the Lincoln Memorial. It was the first monument I saw on an 8th grade trip. I still remember the moment when I first walked up there…you see him. Incredible. He is literally larger than life, it’s just breathtaking. I think I’ll always remember that feeling.

Mary Donofrio, M.D., FAAP, FACC, FASE, named as The Van Metre Companies Professor of Fetal Cardiology

Mary Donofrio

Children’s National Hospital named Mary Donofrio, M.D., FAAP, FACC, FASE, as The Van Metre Companies Professor of Fetal Cardiology at Children’s National Hospital.

Children’s National Hospital named Mary Donofrio, M.D., FAAP, FACC, FASE, as The Van Metre Companies Professor of Fetal Cardiology at Children’s National Hospital.

Dr. Donofrio serves as Medical Director of the Prenatal Cardiology Program and Critical Care Delivery Program, Director of the Advanced Cardiac Imaging Fellowship and Co-Director of the Cardiac Neurodevelopmental Outcome Program at Children’s National. She is a Professor of Pediatrics at George Washington University and is the founding and current President of the Fetal Heart Society, a non-profit organization created to advance the field of fetal cardiovascular care and science through collaborative research, education and mentorship.

About the award

Dr. Donofrio joins a distinguished group of 42 Children’s National physicians and scientists who hold an endowed chair. Professorships at Children’s National support groundbreaking work on behalf of children and their families and foster new discoveries and innovations in pediatric medicine. These appointments carry prestige and honor that reflect the recipient’s achievements and donor’s forethought to advance and sustain knowledge.

Dr. Donofrio is an international expert in fetal cardiology. She specializes in the fetal diagnosis and assessment of cardiovascular disease and the in-utero and delivery room management of newborns with complex congenital heart disease (CHD). Dr. Donofrio created an evidenced-based risk-assessment protocol for delivery room management which is now the standard of care for newborns with CHD. Dr. Donofrio has been a co-investigator on several NIH sponsored studies assessing in utero factors that influence neurodevelopmental outcome in children with CHD and more recently a study designed to minimize brain injury during heart surgery using cardiopulmonary bypass. She has published more than 130 papers, including the American Heart Association Scientific Statement on the Diagnosis and Treatment of Fetal Cardiac Disease.

The Van Metre Companies, through their vision and generosity, are ensuring that Dr. Donofrio and future holders of this professorship will launch bold, new initiatives to rapidly advance the field of fetal cardiology, elevate our leadership and improve the lifetimes of children with special hearts.

About the donors

For the past 65 years, Van Metre Companies has remained one of the Greater Washington D.C. area’s most successful, private, multi-faceted real estate developers. Albert G. Van Metre, the founder of Van Metre Companies, established a tradition of philanthropy focused on local charities. As a homegrown business, perpetuating that legacy of local giving is both a responsibility and a source of pride. The Van Metre Companies Professor of Fetal Cardiology honors Albert G. Van Metre’s memory by continuing this tradition of commitment to the community they call home.

The Van Metre Companies hosts the Annual Van Metre 5K Run in support of Children’s National, a longstanding tradition that has raised nearly $3 million in the past 30 years. In 2010, Children’s National dedicated the Van Metre Companies Cardiovascular Surgery Operating Room, a state-of-the-art cardiovascular surgery suite which was funded through the Annual Van Metre 5K Run. They also established The Van Metre Companies Professorship in Cardiology held by Charles Berul, M.D., Chief of Cardiology and Co-director of Children’s National Heart Institute.

 

Innovative phase 1 trial to protect brains of infants with CHD during and after surgery

A novel phase 1 trial looking at how best to optimize brain development of babies with congenital heart disease (CHD) is currently underway at Children’s National Hospital.

Children with CHD sometimes demonstrate delay in the development of cognitive and motor skills. This can be a result of multiple factors including altered prenatal oxygen delivery, brain blood flow and genetic factors associated with surgery including exposure to cardiopulmonary bypass, also known as the heart lung machine.

This phase 1 trial is the first to deliver mesenchymal stromal cells from bone marrow manufactured in a lab (BM-MSC) into infants already undergoing cardiac surgery via cardiopulmonary bypass. The hypothesis is that by directly infusing the MSCs into the blood flow to the brain, more MSCs quickly and efficiently reach the subventricular zone and other areas of the brain that are prone to inflammation. The trial is open to eligible patients ages newborn to six months of age.


Learn more in this overview video.

The trial is part of a $2.5 million, three-year grant from the National Institutes of Health (NIH) led by Richard Jonas, M.D., Catherine Bollard, M.B.Ch.B., M.D., and Nobuyuki Ishibashi, M.D.. The project involves collaboration between the Prenatal Cardiology program of Children’s National Heart Institute, the Center for Cancer and Immunology Research, the Center for Neuroscience Research and the Sheikh Zayed Institute for Pediatric Surgical Innovation.

“NIH supported studies in our laboratory have shown that MSC therapy may be extremely helpful in improving brain development in animal models after cardiac surgery,” says Dr. Ishibashi. “MSC infusion can help reduce inflammation including prolonged microglia activation that can occur during surgery that involves the heart lung machine.”

Staff from the Cellular Therapy Laboratory, led by director Patrick Hanley, Ph.D., manufactured the BM-MSC at the Center for Cancer and Immunology Research, led by Dr. Bollard.

The phase 1 safety study will set the stage for a phase 2 effectiveness trial of this highly innovative MSC treatment aimed at reducing brain damage, minimizing neurodevelopmental disabilities and improving the postoperative course in children with CHD. The resulting improvement in developmental outcome and lessened behavioral impairment will be of enormous benefit to individuals with CHD.

For more information about this new treatment, contact the clinical research team: Gil Wernovsky, M.D., Shriprasad Deshpande, M.D., Maria Fortiz.