Arrhythmias are a common problem in adults with congenital heart disease. The Cardiac Electrophysiology Service is directed by Dr. Hasan Garan, a world-renowned expert in the management of complex atrial and ventricular arrhythmias. Our electrophysiology laboratories are equipped with state of the art mapping and ablation systems, including CARTO and non-contact mapping, stereotaxis, radiofrequency and cryoablation. Our pacemaker/ICD Program has extensive experience with the use of the implantable defibrillator in congenital heart disease patients. Patients requiring both surgical repair and arrhythmia management are often candidates for combined congenital heart and arrhythmia surgery.
The cardiac surgical program at Columbia's Schneeweiss Adult Congenital Heart Center is one of the finest in the world and is an integral part of the cardiac surgical program at the New York Presbyterian Hospital. Our congenital heart surgeons, Dr. Jan Quaegebeur, Dr. Emile Bacha, and Dr. Jonathan Chen practice exclusively congenital heart disease surgery in both children and adults. Our surgeons have done pioneering work in the surgical treatment of d-transposition of the great arteries, Ebstein's anomaly, the Ross operation, and pulmonary valve replacement with right ventricular reconstruction. Our cardiac transplantation program is the largest in the United States and one of the most experienced Centers for transplantation in patients with complex congenital heart disease.
Diagnostic imaging studies are essential to the management of adults with congenital heart disease. Proper use of available imaging modalities including echocardiography, cardiac MRI, CT angiography, and cardiac catheterization ensures precise anatomic and functional diagnosis. At the Schneeweiss Center, echocardiography, cardiac MRI, and cardiac catheterization are performed in laboratories dedicated to congenital heart disease.
Interventional cardiac catheterization is an essential part of the current management of adults with congenital heart disease. Our team of interventional cardiologists have extensive expertise in the use of the ASD closure device, stents for pulmonary artery stenosis and coarctation of the aorta, balloon valvuloplasty, and coil embolization of pulmonary AV fistula, aortic collaterals and patent ductus arteriosus.
With the growth of the adult congenital heart population, the need for expert guidance regarding family planning, pregnancy and genetic counseling has increased. This requires an understanding of the specific cardiac defect and related issues such as status of repair, heart muscle function, pulmonary hypertension, presence of arrhythmias, and the need for medications. For many patients who have a satisfactory repair, an examination, electrocardiogram and echocardiogram may suffice. In others with more complex congenital heart disease, such as a Fontan or Mustard repair, or the presence of residual coarctation or pulmonary hypertension, a more formal assessment of functional capacity and anatomy might be indicated.
From the simple to the complex, the Schneeweiss Adult Congenital Heart Center offers patients the expertise of a team of renowned specialists in adult congenital heart disease, maternal fetal medicine, fetal echocardiography, pulmonary hypertension, genetics, and obstetric anesthesiology.
Columbia has been a national leader in the use of the Transcatheter Pulmonary Valve. The procedure is performed during a cardiac catheterization in patients with significant narrowing or regurgitation of a previously implanted pulmonary valve or conduit who would otherwise require another cardiac operation.
We were one of three Centers in the United States that participated in the Medtronic Transcatheter Pulmonary Valve (TPV) trial. To date, more than 50 Melody valves have been implanted at our institution. In January 2010, the FDA approved the use of the Medtronic Melody Transcatheter Pulmonary Valve for patients with poorly functioning pulmonary valve conduits.
In addition, we are now studying the use of another form of Transcatheter Pulmonary Valve known as the Edwards Sapien TM transcatheter heart valve (THV). This will allow us to choose which percutaneous pulmonary valve is best for each individual patient.
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