Photos by Keith Weller

(In the photo above, from left to right: Pediatric critical care physician Jamie McElrath Schwartz, pediatric cardiac surgeon Bret Mettler and Shelby Kutty, a pediatric cardiologist, 共同指导Blalock-Taussig-Thomas儿科和先天性心脏中心.)

约翰霍普金斯儿童中心的一个新中心致力于婴儿管理, 患有各种形式心脏病的儿童和年轻人建立在儿童心脏手术的悠久历史上，可以追溯到大约75年.

In November 1944, 约翰霍普金斯大学的外科医生为一名所谓的“蓝色婴儿”进行了第一次具有里程碑意义的手术, 心脏不能将血液泵入肺部以为身体提供足够氧气的婴儿. A surgical team led by Alfred Blalock, with his longtime technician Vivien Thomas guiding him, implanted a shunt, or tube, to increase blood flow to the lungs. Pediatric cardiologist Helen Taussig worked with Blalock to develop the shunt. 这一手术被认为挽救了成千上万儿童的生命，开创了现代心脏外科领域. It also enhanced Johns Hopkins’ reputation worldwide.

In January 2020, 约翰霍普金斯医学院将儿科和先天性心脏病(CHD)方面的多位专家引入了新的Blalock-Taussig-Thomas儿科和先天性心脏病中心, located in The Charlotte R. Bloomberg Children’s Center building. A collaboration among the divisions of pediatric cardiology, pediatric cardiac surgery, and pediatric anesthesiology and critical care medicine, the center offers lifelong care for patients born with CHD.

约翰霍普金斯大学是先天性心脏病手术干预的发源地 Jamie McElrath Schwartz他是新中心的联合主任，也是儿科重症医学的部门主任. “We picked the name specifically to include these three pioneers, as we are building on that past and creating a new future.”

虽然来自不同学科的专家在过去合作照顾冠心病患者, Schwartz says this reorganization establishes a fully integrated, multidisciplinary approach at Johns Hopkins Medicine.

“We have the ability to create dedicated services like operative teams, pediatric perfusion teams, a cardiac intensive care unit and nursing,” she says. “That’s exciting, because these are people who want to narrow their practice to CHD, to work with these families long term and provide them excellent care.”

Center co-director Shelby Kutty, who also serves as director of pediatric and congenital cardiology, 该中心的结构最大限度地利用了约翰霍普金斯医学院的专业知识, 对患者家属有利，并使该机构在招募顶级专家方面具有竞争优势, improving rankings, and garnering philanthropy and research dollars.

CHD patients are very complex, he says, 通常需要一系列的服务:“这是一个非常注重结果的专业, and the key to having good outcomes is a dedicated team and teamwork.”

Bret Mettler, director of pediatric cardiac surgery, is also a co-director of the center. 他最近从范德比尔特大学医学中心来到约翰霍普金斯医学院, 他是儿科心脏移植和机械支持的主任. Pediatric and congenital cardiac surgeon Danielle Gottlieb-Sen joined the team in April. With expertise in the genetics and prenatal diagnosis of CHD, 她将在指导心脏中心儿童心脏研究的同时进行临床实践.

“Our goal is to provide a service line of care, 推荐十大正规网赌平台和他们的家人只要拨打一个电话号码就可以获得门诊服务, surgeries, postoperative care and research studies,” Mettler explains. “We plan to develop the heart center into an elite destination.”

Partnering with Maternal-Fetal Experts

约翰霍普金斯大学的母胎医学和产科专家近在咫尺, 新的心脏中心将有助于为母亲和她们的婴儿提供全方位的护理. In addition, when issues are discovered early in pregnancy, 胎儿治疗干预可以为婴儿提供最好的生命开端. Within minutes to hours of being born, 婴儿可以在专门的儿科心脏重症监护病房照顾或准备手术.

在妇产科，胎儿治疗中心的专家，由 Ahmet Baschat, and fetal imaging, led by Jeanne Sheffield and Janice Henderson, 已经能够识别绝大多数的胎儿新生儿先天性异常，包括冠心病. 通过这样做，这些团队然后与儿童中心的胎儿项目合作，由 Eric Jelin, 以及儿科心脏病学团队，以实现从产前治疗到产后护理的平稳过渡.

Caring for Adults with CHD

Thanks to advances in pediatric cardiac care, over 95% of children born with CHD now live into adulthood. 因此，新中心纳入了由心脏病专家指导的成人冠心病项目 Ari Cedars, to care for older teens and young adults. 它允许他们继续管理他们的冠心病需求，以及任何成人发作的心脏疾病，如冠状动脉疾病和心律失常.

“当你从儿科年龄组过渡到成人年龄组时，你不会停止患有冠心病, 所以成人冠心病患者最好通过儿科和成人心脏护理服务的联合治疗,” says Cedars, 约翰霍普金斯医院是为数不多的为这些患者提供儿科和成人心脏护理的主要医疗中心之一. 他说，多学科中心将采用以推荐十大正规网赌平台为中心的护理方法. “We actively track patient experiences between visits, using patient-reported outcomes, metrics and mobile health technologies to help inform our care,” Cedars says.

Advancing CHD Research

Because CHD affects a relatively small patient population, 梅特勒希望与其他冠心病项目建立临床和研究伙伴关系. 库蒂说，该项目还希望扩大其服务范围，包括儿科医生, 整个地区的社区心脏病专家、母胎医学医生和产科医生.

Additionally, 心脏中心已经启动了心血管分析智能计划, directed by Cedric Manlhiot, 哪家公司使用人工智能和机器学习工具，将实时临床数据转化为有助于预测患者预后的模型. “我们的目标是找到更好的方法来利用数据和设计重要临床问题的解决方案, which in turn are directly evaluated at the physician and patient level,” Kutty says.

其他研究工作将集中在预测分析技术的新方法上，以帮助解决各种心血管问题, 以及评估儿童和成人冠心病患者心功能和预后的创新方法.