We know that caring for a child with congenital heart disease—whether it’s an easily correctible defect or a complex, advanced condition that requires delicate heart surgery—can create great anxiety and concern for parents. The Heart Center at Medical City Children’s Hospital provides peace of mind by offering advanced treatment options for neonates, infants, children, adolescents and adults with all forms of congenital and acquired heart disease. As the only hospital in North Texas with both a full-service children’s hospital and an adult hospital in the same location, our world-renowned specialists are able to provide patients of all ages who have congenital heart defects with compassionate, comprehensive care.
Medical City Children's Heart Center staff
Heart conditions we treat
Specialists at The Heart Center treat the full range of heart conditions in patients of all ages, including:
Congenital heart disease
- Aortic valve stenosis (AVS)
- Atrial septal defect (ASD)
- Coarctation of the aorta (CoA)
- Complete atrioventricular canal defect (CAVC)
- Transposition of the great arteries
(dextro-transposition of the great arteries, d-TGA)
- Ebstein’s anomaly
- Hypoplastic left heart syndrome (HLHS)
- I-transposition of the great arteries
- Patent ductus arteriosus (PDA)
- Pulmonary atresia
- Pulmonary valve stenosis
- Single ventricle defects
- Tetralogy of Fallot
- Total anomalous pulmonary venous
- Tricuspid atresia
- Truncus arteriosus
- Ventricular septal defect (VSD)
Acquired heart disease
- Aortic aneurysm
- Atrial fibrillation
- Heart failure
- Heart murmurs
- Heart valve problems and disease
- Kawasaki disease
- Peripheral artery disease (PAD)
- Venous thromboembolism
Our specialized physicians and services
The multidisciplinary pediatric heart team at Medical City Children's consists of a wide range of specialists to ensure your little one receives the most advanced, comprehensive care possible. Just a few of the specialists who may be part of your child’s care team include:
Congenital heart surgery
Medical City Children’s Hospital is proud to be at the leading edge of prenatal diagnosis. Early detection of a congenital (present at birth) heart defect allows careful planning of future care. With a fetal echocardiogram (an ultrasound of the heart), some heart problems can be identified as early as 12 weeks into a pregnancy. Using fetal detection to find potential problems in utero gives specialists the ability to provide early intervention and customized treatment that is best suited to each patient, helping to ensure an optimal outcome.
If your unborn child is diagnosed with a congenital heart defect, the heart surgeon will meet with you to answer any questions you may have and review treatment options. Congenital heart surgery is always a delicate operation, so Medical City Children’s Hospital has assembled a team pf specialists with expertise in all areas to help provide the high-quality, compassionate care needed for complex procedures.
Cardiac Intensive Care Unit (CICU)
The CICU is a specialty unit that is intensely focused on caring for children with heart defects. Following delivery and surgery, your baby will be cared for in the CICU by a multidisciplinary team of healthcare experts in congenital heart disease.
This specially trained team consists of congenital heart surgeons, pediatric cardiac intensivists, pediatric heart nurses and pediatric perfusionists who run the heart/lung bypass machine.
Patient-centered care in our CICU means that our specialists work with you—the one who knows your child best—to help your child recover swiftly and safely from heart surgery, catheter procedures, complex treatments or complications from heart conditions. With specialty training in fields including pediatric critical care, cardiology and cardiac anesthesia—combined with leading-edge monitoring and support technology—our experts are able to recognize and respond to problems quickly and effectively.
The CICU at Medical City Children’s Hospital is one of the few cardiac units of its kind in the nation, allowing each child to stay in the same private room from admission to discharge. The high-tech rooms adapt to the level of care the patient may need, which eliminates the need to transfer the patient to other units in the hospital. Our rooms provide all of the family amenities of a regular acute care patient room with the addition of technology designed specifically for intensive care. Throughout their hospital stay, our cardiac patients are treated by one dedicated healthcare team. This unique model of care provides continuity that greatly improves patient safety, as well as patient and family comfort and satisfaction, research shows.
With more than 50 years of combined experience, our CICU physicians have the following qualifications:
- Board certifications in Pediatrics
- Additional board certifications in either Pediatric Cardiology and/or Pediatric Critical Care Medicine
- Advanced fellowships in Pediatric Cardiac Critical Care
You can rest assured that your child will always receive prompt, expert medical attention by one of our board-certified physicians—and never by a physician in training or a medical student. Cardiac intensive care attending physicians are available in the CICU 24 hours a day, 7 days a week.
Our nurse practitioners are similarly qualified, with
- Certifications in Pediatric Critical Care and Pediatric Primary Care
Bringing the highest level of knowledge and expertise to each patient, our team of pediatric cardiac intensivists works closely with the Heart Center's anesthesiologists, cardiologists, neonatologists, surgeons, cardiac advanced nurse practitioners and cardiac nurses. To make sure your child receives the most comprehensive care possible, the team also works with experts from different healthcare specialties. This multidisciplinary team meets daily to discuss and personalize each patients’ care plan, which means your child has the benefit of having multiple doctors weigh in on different treatment options.
We understand how important family is to the healing process. In addition to offering private rooms, the CICU features:
- Dedicated beds for newborns to toddlers as well as for children and young adults.
- Connection to Medical City Women’s Hospital, the only birthing center in the region where moms and babies are cared for under the same roof. This lets us provide immediate care for newborns who need urgent cardiac treatment, while keeping them close to their mothers as they recover from delivery.
- Family space in rooms so that one parent can stay at their child’s bedside 24/7.
- Private consultation rooms for parent-physician conversations.
- Dedicated waiting room for families of CICU patients only in immediate proximity to the CICU.
- Families are encouraged to participate and ask questions on daily multidisciplinary rounds in the CICU.
- Dedicated Child Life Services, a department at Medical City Children's Hospital that provides invaluable resources for helping your child cope with surgery and other medical procedures. The specialists use play therapy, videos, games, music and more, to help explain things in ways children can understand. The aim is to help relieve stress, provide distraction and make the experience less scary.
- Families who have a child diagnosed with a congenital heart abnormality can benefit from connecting with people who have had or are having similar experiences. That's why parents of former Medical City Children's Hospital patients lead a congenital heart support group called Amazing Little Hearts. The mission of Amazing Little Hearts is to provide families affected by congenital heart disease with compassionate care and support. Families meet monthly to share experiences, encouragement and advice.
Specialized, ongoing care
Once your child’s hospitalization is completed, we encourage parents to let their child get back to being a kid. Children have amazing recovery abilities and intuitively understand to stop playing if they overexert themselves. All of our patients receive ongoing care from their cardiologists, and their congenital heart surgeon personally follows up with their obstetrician and pediatrician. Our board-certified physicians also specialize in advanced minimally invasive procedures. With Medical City Dallas on the same campus as Medical City Children’s Hospital, your child can receive expert, ongoing heart care into adulthood.
Some babies who are born with a single ventricle defect, such as hypoplastic left heart syndrome, are fragile when they are discharged from the hospital. While we know that the time spent at home with family is important, parents should also be aware that there is an increased risk of potentially life-threatening medical complications that can occur between your child’s birth and their second major operation, usually performed when they are around six months of age. To help these fragile infants stay as safe as possible during this high-risk period, we use the Hearts at Home Monitoring Program. This technology allows home monitoring of key health measures and provides early recognition of warning symptoms.
The unique program at Medical City Children’s has taken this monitoring one step further to include weekly scheduled video visits with the patient and family in their home, along with daily remote patient monitoring via an iPad that is sent home with the family. In addition to being monitored by your cardiologist, your baby will be followed daily by an advanced nurse practitioner in the CICU who will be alerted to any changes that may warrant you visiting your pediatrician or cardiologist.
When your baby is discharged from the hospital, you will receive:
- A pulse oximeter, which is a painless sensor device for measuring oxygen levels in the blood
- A baby digital scale
- An iPad that will be specially configured so that you can:
- Record your child’s vital signs and share them with the care team
- Record and share other important data about your child’s condition
- Attend video calls with the care team
- A binder featuring a one-page healthcare dashboard, allowing you to quickly and accurately share important medical information with any healthcare team that treats your child
When it comes to your child’s healthcare needs throughout their life, our pediatric cardiologists on the medical staff have the answers and treatment options you’re looking for, whether they’ve just been diagnosed with a heart condition or you’ve been managing it for years. Team members are specially trained to treat congenital and acquired heart conditions in patients of all ages, from before birth through adulthood. Partnering with specialists from our Maternal Fetal Institute provides unborn babies and infants with comprehensive, multidisciplinary care.
Pediatric electrophysiologists diagnose and treat heart arrhythmias (abnormal and dangerous heart rhythms) in children. Arrhythmias can often go undetected, especially since they may not cause symptoms all of the time.
Signs that your child may have an irregular heart rhythm can include:
- Heart palpitations (fluttering or skipping beats)
- Unexplained dizziness or fainting
- Family history of sudden cardiac death
If you child has a suspected arrhythmia, our specialists may conduct an electrophysiology study to identify problems with the heart’s electrical system. The electrophysiology study is performed using cardiac catheterization—a highly specialized procedure that can be used to both diagnose and treat a variety of heart conditions.
Our pediatric interventional cardiologists are experts at delivering minimally invasive care so that some congenital heart defects can be repaired without surgery. Using diagnostic catheterization and cardiac catheterization procedures, they can diagnose and treat a variety of common and less common, highly complex heart conditions.
Catheterization involves the insertion of catheters—long, thin tubes that resemble straws—into the heart using the large arteries and veins as pathways. Diagnostic catheterization can provide your child’s physician with valuable information, including:
- The presence of congenital heart defects
- The location of blocked or narrowed blood vessels
- Pressure and oxygen level measurements
- How well the heart is pumping
- Problems with the heart valves
- Tissue samples (biopsy)
Cardiac catheterization procedures may be part of your child’s treatment plan and may be used for:
- Ablation for treating heart arrhythmias (abnormal heart rhythms)
- Angioplasty for widening a narrowed artery, with or without placing a stent
- Fixing congenital heart defects, such as closing holes
- Replacing or repairing heart valves, such as opening narrow heart valves (balloon valvuloplasty)
- Preventing blood clots by closing off part of the heart
It can be concerning any time your child has to go under anesthesia—and even more so when they are being treated for a heart condition. The unwavering goal of our pediatric cardiac anesthesiologists is to make sure your child is comfortable, safe and receives the personalized care that he or she deserves. Our comprehensive anesthesia care includes board-certified pediatric cardiac anesthesiologists who work in tandem with heart surgeons and other cardiac specialists to ensure the best possible outcome for your child.
Advanced cardiac imaging and MRI
The pediatric cardiac imaging lab team at Medical City Children’s Hospital utilizes the full array of innovative diagnostic techniques to determine the best treatment options for your child. Combined with compassionate care that helps to put children at ease and ensure their safety, our specialists are skilled at getting the best possible images of your child’s heart.
Imaging tests available include:
- Angiography—X-ray imaging of the heart’s blood vessels)
- Computed tomography (CT) scan—a combination of X-rays and computer technology that provides a detailed look at the heart
- Fetal echocardiogram—a non-invasive ultrasound image of the heart muscle performed while the baby is still in its mother’s womb (in utero)
- Intracardiac echocardiogram—a catheter-based procedure for gathering ultrasound images within the heart
- Magnetic resonance image (MRI)—a non-invasive procedure using radiofrequency to produce detailed 3-D images
- Stress echocardiogram—a test that measures how well the heart and blood vessels are working when heart rate is elevated
- Transesophageal echocardiogram (TEE)—a catheter-based procedure using the esophagus as a pathway to examining the heart without the ribs or lungs blocking the view
- Transthoracic echocardiogram (TTE)—the most common, non-invasive echocardiogram for creating a moving picture of the heart through the chest wall
The cardiac specialists at Medical City Children’s Hospital are equipped to treat the most medically fragile infants. Our advanced treatments include extracorporeal membrane oxygenation (ECMO), a heart-lung support system often used for babies with congenital heart defects who are awaiting a heart transplant. The goal of ECMO is to provide the oxygen that a baby’s body needs and can’t yet make on its own. ECMO may also be used after surgery to help the healing process.
ECMO therapy requires a large team of experienced caregivers. Our dedicated specialists care deeply about the health and safety of every child and use all of their skills and expertise to ensure the best possible outcomes.
Kristine J Guleserian, MD is Chief of Congenital Heart Surgery at Medical City Dallas. Board-certified in general surgery, thoracic surgery and congenital heart surgery, Dr. Guleserian is the first woman to lead a Congenital Heart Program in the United States.
Heart conditions: frequently asked questions
At the Heart Center at Medical City Children’s Hospital, our goal is to work one-on-one with patients and parents, always keeping you informed and answering any questions you may have. Here are some of our parents’ most-asked questions about congenital heart defects.
Congenital heart defects are more common than people think. Approximately 40,000 babies a year — nearly one out of every 100 — is born with one. However, not all heart defects require surgery. Some may resolve on their own over time, while others may be insignificant enough that surgery isn’t needed. For instance, there are some valve abnormalities or holes in the heart that don’t require surgical attention.
Congenital heart conditions affect the body in a multitude of ways. In the most general terms, if the heart is defective, it is not functioning at its optimal level, so other organs aren’t receiving the full benefit of its actions as they would with a normal and healthy heart.
Babies with congenital heart defects frequently fail to grow well, or thrive. This is because the two hardest things their bodies do all day is breathe and eat. A heart defect frequently results in excess blood flow to the lungs, which causes them to become congested and the baby to breathe fast, trying to get oxygen. When a baby breathes fast, it burns more calories and has less energy left over to eat. As a result, the baby doesn’t gain weight.
However, there are medications that can help control the congestion in the lungs. This allows the baby to go home and gain weight for a few months before coming back to the hospital to undergo surgery for the heart defect.
Some children can grow out of heart abnormalities, but it depends on each child’s specific case. A fetal heart has extra blood vessels as well as holes that exist between the upper chambers of the heart. These pathways are part of the fetal circulation and normally close after birth.
When a heart abnormality is present, sometimes these extra connections in and around the heart don’t spontaneously close as they should. Some holes in both the atrial and ventricular septums may close on their own, and some valve abnormalities are not severe enough to require any intervention. However, more severe types of congenital heart defects won’t get better on their own.
Can congenital heart defects (CHD) be cured?
We’d like to think of surgery as a cure for congenital heart defects, and in many cases, it is. Sometimes tying off extra blood vessels, sewing patches inside the heart to close holes or moving arteries from an improper location to a proper location can restore the heart to a normal state or physiology. Thus the heart has been repaired and is functioning normally though it has still undergone an operation.
With more complex forms of congenital heart defects, in which entire chambers of the heart are missing, surgeries won’t cure the defect but will help the heart function more normally and efficiently. With these more severe heart defects, vast improvements can be made in the heart’s physiology and efficiency but nothing can be done to create a completely normal heart when significant parts are underdeveloped or absent.
How long a repair to a congenital heart defect lasts depends on the situation. Many repairs to congenital heart defects can endure through the child’s lifetime. Babies who are born with more severe defects, such as single ventricle congenital heart disease, will require three surgeries in their first three years of life.
What is the life expectancy of a baby with a congenital heart defect?
The life expectancy of each baby with a congenital heart defect depends on that baby’s specific set of circumstances, including the type and complexity of the defect as well as any other associated birth defects or chromosomal abnormalities. With many of the more straightforward cardiac defects, such as holes in the heart that get repaired early in life, we would expect life expectancy to approach that of a normal, healthy human being who did not have heart surgery.
We have come a long way in the treatment of most heart defects. With modern surgery tools and techniques, medicine and technology, physicians can do a great deal to help normalize the physiology of a heart so that even with severe congenital defects, children can have a good quality of life and survive for decades.
While not a cure, medications can help manage the symptoms of congenital heart disease and can be used to treat babies after they are born or while they are still in the womb. Certain medications can help remove some of the lung congestion that is often present in babies with heart defects, allowing the baby’s body to function more efficiently until surgery fixes the particular condition. We can also safely treat rhythm abnormalities in utero by giving the mother medications that cross the placenta to prevent congestive heart failure in the baby.
That would be extremely rare, but your baby may need the help of a feeding tube until his or her heart is repaired and functioning more efficiently. However, a feeding tube is a very unlikely long-term need.
One of the tools used for diagnosing congenital heart defects is a fetal echocardiogram, or fetal echo. This is an ultrasound—an imaging test using sound waves with no radiation exposure—like the one used for routine pregnancy exams and to find out the sex of your baby. A fetal echo focuses specifically on producing pictures of a baby’s heart while the baby is in the mother’s womb. The optimal time to perform a fetal echo is between 16 and 22 weeks into a pregnancy.
A heart catheterization can provide extra information about the anatomy and physiology of a child’s heart that is helpful as the physician determines the best repair for the congenital heart defect. A heart catheterization allows the physician to see certain areas and make precise measurements that help physicians determine if the baby is a good candidate for surgery. Additionally, there are certain heart defects that can be repaired with the use of trans-catheter techniques, thus avoiding surgery. For example, some holes in certain locations of the heart can be closed by putting a catheter through the hole and deploying a device that plugs up the hole. Similarly, sometimes a valve that is too narrow can be widened with a balloon, also done via catheterization.
Resources and support
You can find helpful information about congenital heart defects and pediatric intensive care from the following sources:
- Adult Congenital Heart Association (ACHA)
- Amazing Little Hearts
- American Academy of Pediatrics
- American Heart Association: Congenital Heart Defects
- Congenital Heart Surgeons’ Society Data Center
- Congenital Portal
- International Society for Heart & Lung Transplantation
- Little Hearts, Inc.
- Mend a Heart Foundation
- Mended Little Hearts
- Pediatric Cardiac Intensive Care Society
- PubMed Health: Congenital Heart Disease
- Saving Little Hearts
- Sisters by Heart
- Society of Thoracic Surgeons
- The Children’s Cardiomyopathy Foundation
- The Children’s Heart Foundation
Camp Brave Heart
Camp Brave Heart is a weekend pediatric cardiac camp that provides a medically safe and fun summer camp experience to children ages 7 to 16 who have congenital heart defects or heart disease and have been or are being treated at Medical City Children's Hospital. The camp is free for current and former pediatric heart patients.
Visit the Camp Brave Heart Facebook page for updates and details.