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Pediatric cardiology: A revitalized division beats strongly

07/01/2010

Bigger isn’t necessarily better. Just ask Michael de Moor, MD, FACC, FSCAI, who became Chief of Pediatric Cardiology at Floating Hospital for Children at Tufts Medical Center in 2010 after 12 years in a similar post at Massachusetts General Hospital.

“The fact that Floating is a relatively small, dedicated children’s hospital confers huge benefits,” he says. “It means our focus is squarely on the patient and family. All our patients are primarily looked after by an attending physician, not residents or fellows. And we provide very attentive, personal service.

“The way we practice here is the way I trained to be a physician for my patients, and a teacher to my students,” he adds. “It’s what attracted me to this organization. Our division will remain moderate in size, specifically so we can provide this level of patient- and family-centered care. ”

But while Floating Hospital’s pediatric cardiology division may remain relatively small in size, its scope is decidedly full service.

“Ours is one of only a handful of full-service pediatric cardiology programs in New England,” says John Schreiber, MD, Chief Administrative Officer and Pediatrician-in-Chief at Floating Hospital. “And with Mike de Moor at the helm, it’s growing even stronger.”

De Moor describes some of the program’s existing clinical strengths, and areas in which the program is being revitalized:

“We’ve long had a well-established and respected pediatric cardiac surgery program headed by Dr. Ken Warner,” de Moor says, noting that the program cares for infants and children with congenital and acquired cardiac abnormalities. “We have an excellent pediatric ICU, which is equipped and staffed to transport and care for critically ill infants and children with heart disease.”

De Moor himself is a nationally known interventional cardiologist, skilled in the minimally invasive correction of intra-cardiac defects, and serves as Director of Floating’s Pediatric Catheterization Lab. He also serves as Co-Director of the Adult Congenital Heart Program at Tufts Medical Center, providing exceptional continuity of care for patients with congenital heart disease.

“There has been so much progress in both therapeutic and diagnostic technology over the past 20 years,” de Moor continues. “What we can diagnose with echocardiography, CT and cardiac MRI is dramatic. On the treatment side, we can often use catheter techniques to correct intra-cardiac defects and rhythm disturbances, making open surgery unnecessary. We can put in implantable defibrillators for kids prone to sudden cardiac death, and pacemakers for kids with heart block.”

To further strengthen the pediatric cardiology team, de Moor has recruited three new specialists who come on board July 1.

“Dr. Alisa Niksch is a pediatric electrophysiologist who deals with the spectrum of heart rhythm disorders in children,” he notes. “Dr. Mark Zilberman, an expert in fetal cardiology, will be our Director of Pediatric Echocardiography and will work closely with the extensive Maternal-Fetal Medicine program at Tufts Medical Center.”

“And Dr. Liwen Tang is a general pediatric cardiologist and echocardiologist. She is also specializing in fetal echo,” he continues. “A Chinese-American who speaks fluent Mandarin and other Chinese dialects, she will be an important resource to the many Chinese-American patients we serve due to our proximity to Boston’s Chinatown.”

“We have an outstanding sedation service,” de Moor points out. “Anxious young patients can be sedated by intensivists so that we can get the images we need. It’s a valuable service for children and their parents,” he adds, noting that a recent gift from the Ronald McDonald House® Charities to establish the Boston area’s first Comfort Corner sedation suite will further enhance Floating’s ability to tailor pain management and sedation to the individual needs of each child.

Because Floating Hospital is literally attached to Tufts Medical Center, it enables seamless collaboration with the Adult Cardiovascular Center (and its special expertise in cardiomyopathy, electrophysiology, heart failure and heart transplantation). In addition, the pediatric cardiology program works closely with the Medical Center’s renowned perinatal and genetics services as well as Floating’s neonatal service and 45-bed Level III neonatal intensive care unit (NICU) – ensuring that the littlest of cardiac patients get the level of care they require.

“The depth of expertise at this institution is incredible,” says de Moor.

New clinical program development also is underway, including a pediatric extracorporeal membrane oxygenation (ECMO) program that will provide an essential backup resource for children undergoing cardiac surgery as well as those with congenital diaphragmatic hernias, or who have acute severe respiratory insufficiency. Slated to launch in 2010, it is being developed in collaboration with Floating’s pediatric critical care, pediatric surgery and neonatology services. In addition, a new cardiac cath lab is slated to open next year.

“The beauty of our program is that everything is in one place,” de Moor says. “The clinic, physicians’ offices, the echocardiography service and the cardiac cath lab are all in one co-located area. It’s unique and extremely efficient – another advantage of being in a smaller, dedicated children’s hospital. And for patients and families who must travel into Boston for care, it’s extremely convenient.”

Equally convenient is the way in which Floating Hospital brings its tertiary-level expertise to the community. Through partnerships with four local hospitals (Signature Healthcare Brockton Hospital, St. Anne’s Hospital in Fall River, Lawrence General Hospital and Lowell General Hospital) as well as freestanding specialty clinics in Woburn and Taunton, de Moor and members of his division see patients at Pediatric Cardiology satellite clinics serving these communities. Later this summer, similar partnerships at MetroWest Medical Center and Morton Hospital in Taunton will become operational. Farther away, monthly satellite clinics are being staffed in Worcester and Leominister.

“It gives patients access to our subspecialists’ care in a familiar and close-to-home setting, without the expense and hassle of traveling into Boston,” de Moor says. “We’re enthusiastic about providing service to these areas as well as other community hospitals we may partner with in the future.”

A big part of this service is collaboration with the community-based pediatricians who refer their patients to de Moor and his team.

“We work very closely with our referring physicians,” he says. “We often discuss cases by phone, especially the complex ones that require frequent communication. And in simpler cases, the referring physician will always get a letter from us.”

“We have a very close bond with our community pediatricians,” de Moor adds. “We’re gratified to have a very loyal referral base; it’s a big part of why Floating Hospital has done so well over the years. We’re dedicated to maintaining this connection.”