Saturday, August 5, 2017

Pediatric heart surgery has resumed at UK, in partnership with Cincinnati Children's Hospital

Magdalen Wilson, one of the first
UK pediatric heart surgery patients
since it re-opened, with parents Thom
and Lauren Wilson of Nicholasville
By Melissa Patrick
Kentucky Health News

After a five-year hiatus, Kentucky Children's Hospital is performing pediatric heart surgeries again, this time in partnership with Cincinnati Children's Hospital Medical Center – and it has already performed more than 12 since it opened in May.

"It is an important day here at the University of Kentucky and UK HealthCare to acknowledge that we've resumed the pediatric congenital heart program," said Bo Cofield, the hospital's chief clinical operations officer. "While we've got a fantastic pediatric cardiology program, we paused our surgical program a couple of years ago because it wasn't what we wanted it to be – a world class program – and we really believe that we've got that now through this partnership."

UK voluntarily suspended heart surgeries on children in 2012 after five died in 11 months. The program's chief surgeon, Dr. Mark Plunkett, left the program in 2013 with a $1 million settlement and an agreement to not talk to the news media. The letter of intent to partner with Cincinnati Children's was signed in 2015 and finalized in January 2016.

An internal review of the program didn't say why it was suspended. UK refused to release the program's death rates, but did so after the state attorney general ruled that it had to and CNN reported on the problem. The annual mortality rates averaged 5.8 percent, ranging from 5.2 percent in 2010 to 7.1 percent in 2012. The national average for a program of similar size was 5.3 percent.

The new program is a "one program, two sites" model that benefits both facilities, said Dr. Andrew Redington of Cincinnati Children's. He said the partnership allows UK's program "to provide the same level of care as we provide in Cincinnati" and Cincinnati's program to focus on "that high level of surgery that perhaps UK doesn't do," such as transplants.

Asked what specific changes they made to re-open, Cofield said, "We think there was some requirement for investment in certain things – more people, more training for the people that we brought in and clearly a focus on ensuring that we have the clinical infrastructure necessary to safely care for patients," including a "tele-video-conferencing" system that allows for seamless communication between the locations.

"What we want to do is provide the best level of care to as many children as possible, as close to home as possible," said Redington. "For patients and children who travel maybe a hundred or two or three hundred miles to get to Cincinnati, that's a burden and we recognize that."

Choosing care close to home was important to a Nicholasville family, whose infant is one of the first pediatric patients to undergo surgery in the new program.

Five-month-old Magdalen Wilson, who was born with several congenital heart defects, underwent open-heart surgery July 5 at Kentucky Children's Hospital and is doing well, said Thom and Lauren Wilson, her parents.

After learning about Magdalen's heart defect when Lauren was about seven and a half months pregnant, the Wilsons traveled between Nicholasville and Louisville twice a week to see specialist during the pregnancy. The Wilsons have three other children.

Magdalen was able to go home after she was born, but at about three months, she quit eating and her parents took her to UK's pediatric emergency center where she was admitted and assessed by the pediatric heart team. They learned about UK's new pediatric heart surgery program.

"We made the decision at that point to transfer our care to UK because it was close to home and the doctors and cardiologists we encountered in the pediatric intensive care unit were attentive and showed great concern for Magdalen's well-being," Lauren Wilson said in the news release.

Thom Wilson thanked all of their caregivers at UK and said they had received "excellent care." He later added that they appreciated that UK's pediatric heart surgery program was part of "a very well-known established program."

Magdalen's surgery was performed by Dr. James Quintessenza, who Cofield described as a "world-class pediatric cardiothoracic surgeon" and Redington called "one of the best surgeons on the planet." Quintessenza described the new program as a fine-tuned "orchestra." He added, "We are off to a great start."

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