Collaboration will address care for congenital heart disease in adults

Monday, July 09, 2007

PHOENIX, Ariz. - Congenital Heart Disease (CHD) is one of the most common birth defects, occurring in nearly 1 percent of the general population. With improved recognition, diagnosis and treatment, 85 percent of infants born with a heart defect survive to adulthood.

"This success rate has created a large and growing population of young adults who require lifelong cardiac care. The care of these patients requires a multidisciplinary approach," says Dr. Craig Cohen, an adult congenital heart specialist with Arizona Pediatric Cardiology Consultants (APCC), an affiliate of Cardiology Specialists Pediatrix and Phoenix Children's Hospital (PCH).

Importantly, as they reach adulthood, these patients need a continuity of care.

Such a team approach, involving a unique collaboration of discrete partners, is now a reality in the Valley and embraces the combined expertise of PCH, APCC and Mayo Clinic. In this team approach, Mayo will collaborate with PCH and APCC to provide care to adult patients with congenital heart disease. Patients will have surgery - or be medically treated - on Mayo's Phoenix campus, where the practice will be housed.

"As pediatric patients grow older, they need access to physicians who understand the needs of adults with congenital heart disease and who can offer them that specialized care," says Dr. Michael Teodori, section chief of cardiothoracic surgery at PCH. "They need someone who understands their case from a life-long perspective."

Optimal care for such patients requires the combined skill sets of specialized pediatric and adult cardiology physicians/cardiac surgeons, and, according to Dr. Francisco Arabia, chair of Cardiothoracic Surgery at Mayo Clinic, the collaboration with PCH and Arizona Pediatric Cardiology Consultants has the potential to meet that need.

Dr. Jamil Tajik, internationally renowned adult congenital cardiologist at Mayo Clinic, will work along with APCC in the initial evaluation of these patients. Dr. Tajik pioneered the adult congenital disease practice at Mayo Clinic in Rochester, Minn., and developed a specialized center for treatment of these patients. "Now we are in a position to launch a multi-specialty practice here with outstanding collaborative partners, and not just from a practice standpoint, but intertwined with research and education. This holds great possibilities for patients in the Valley and the greater Southwest. Three different institutions come together to focus on the patient, transitioning them from childhood to adulthood."

The first patient to benefit from this new collaboration underwent successful pulmonic valve replacement surgery earlier this year at Mayo Clinic. (The pulmonic valve lies between the right ventricle and the pulmonary artery in the heart). True to the goal of the collaboration, the surgery was performed jointly by Teodori and Arabia at Mayo Clinic Hospital.

The patient, a 63-year old man with congenital pulmonary valve stenosis, is illustrative of the benefit of a multidisciplinary approach and a continuum of care from infancy to adulthood. He has been the subject of medical journal articles, calling himself a "reluctant celebrity" because of his decades-earlier label, "blue baby."

At age 8, in 1953, he underwent surgery at a Colorado hospital. His radical treatment involved induction of hypothermia, whereby he was immersed in ice water to undergo the surgery. That early treatment mode is chronicled in an exhibition at the Smithsonian Institution. The patient had a difficult young childhood because of medical complications and then, into adulthood, functioned quite well, excelling in gymnastics and running a furniture upholstery business for 30 years.

Five years ago, the patient began experiencing breathing problems while still living in Denver. He moved to the Valley in 2003 and sought out Dr. Craig Cohen for consultation because of his experience with congenital heart disease.

A number of other patients with congenital heart disease have been treated by the new collaborative team, but the formal opening of the practice is July 10, 2007.

Mayo Clinic is the first and largest integrated, not-for-profit group practice in the world. As a leading academic medical center in the Southwest, Mayo Clinic focuses on providing specialty and surgical care in more than 65 disciplines at its outpatient facility in north Scottsdale and at Mayo Clinic Hospital. The 208-licensed bed hospital is located at 56th Street and Mayo Boulevard (north of Bell Road) in northeast Phoenix, and provides inpatient care to support the medical and surgical specialties of the clinic, which is located at 134th Street and Shea Boulevard in Scottsdale.

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