Heart to Heart with Anna

Pediatric Cardiologist, Researcher, Mentor & Podcaster!

April 02, 2019 Dr. Robert Pass Season 13 Episode 14
Heart to Heart with Anna
Pediatric Cardiologist, Researcher, Mentor & Podcaster!
Heart to Heart with Anna
Pediatric Cardiologist, Researcher, Mentor & Podcaster!
Apr 02, 2019 Season 13 Episode 14
Dr. Robert Pass

Dr. Robert Pass is the Chief of Pediatric Cardiology and the co-director of the Pediatric Heart Center at The Icahn School of Medicine at Mount Sinai in NYC. He is also the director of pediatric electrophysiology at the same institution. His career goals are to develop and perform cardiac procedures to help the cardiac health of children and adults with congenital heart disease.

He has started a Pediatric Cardiology Podcast that reviews some of the latest literature in the field of pediatric cardiovascular medicine and he also interviews thought leaders in the field. The program, ‘Pediheart: Pediatric Cardiology Today,’ is available on iTunes, Spotify, and Stitcher. Today he talks with Anna about how he entered the field of pediatric cardiology, what he does as a pediatric cardiologist and how he came to add “podcaster” to his resume.

Support the show (https://www.patreon.com/HearttoHeart)

Show Notes Transcript

Dr. Robert Pass is the Chief of Pediatric Cardiology and the co-director of the Pediatric Heart Center at The Icahn School of Medicine at Mount Sinai in NYC. He is also the director of pediatric electrophysiology at the same institution. His career goals are to develop and perform cardiac procedures to help the cardiac health of children and adults with congenital heart disease.

He has started a Pediatric Cardiology Podcast that reviews some of the latest literature in the field of pediatric cardiovascular medicine and he also interviews thought leaders in the field. The program, ‘Pediheart: Pediatric Cardiology Today,’ is available on iTunes, Spotify, and Stitcher. Today he talks with Anna about how he entered the field of pediatric cardiology, what he does as a pediatric cardiologist and how he came to add “podcaster” to his resume.

Support the show (https://www.patreon.com/HearttoHeart)

spk_0:   0:00
most people who become pediatric cardiologists enjoy the physiology of cardiology. It's one of those fields that makes sense, and it's always expanding field tons of innovations.

spk_2:   0:22
Welcome to heart to heart with Anna, I Am an Edge, or C and a host of your program. Today's episode is called Pediatric Cardiologists. Researcher, mentor and podcaster. Dr. Robert Pass is the chief of pediatric cardiology and the co director of the Pediatric Heart Center at the Icon School of Medicine at Mount Sinai in New York City. He is also the director of pediatric electrophysiology at the same institution. His career goals are to develop and perform cardiac procedures to help the cardiac health of Children and adults with congenital heart disease. Doctor Passes the author of over 85 papers in peer review journals, most as the first or senior author. He has also frequently asked to speak at international meetings about various areas of pediatric electrophysiology. He has also mentored roughly 25 cardiology fellows. Doctor Pass is honored to do what he does with his life. Caring

spk_3:   1:14
for patients, their families, another cardiac professionals. He has started a pediatric cardiology podcast that reviews some of the latest literature in the field of pediatric cardiovascular medicine. And he also interviews Thought Leaders in the Field. The program Petey Heart. Pediatric Cardiology Today is available on iTunes, Spotify and stitcher. Segment one. We're going to touch it After pass about becoming a pediatric cardiologist. Segment two will focus on why he started a podcast and in a final segment will discuss some of his favorite topics and guests, as well as future topics he hopes to discuss. Welcome to heart to heart with Anna. Doctor Pass

spk_0:   1:50
high. Ana, thank you so much for having me on the podcast. It's a great honor to be here.

spk_3:   1:54
Ah, well, it is an honor for me to have you on the show. I've had so much fun listening to some of your podcasts.

spk_0:   2:00
Thank you very much. That means a lot to me from such a established an excellent podcaster as yourself.

spk_3:   2:06
Thank you. That feels really good to hear. Well, let's get started by talking about why you decided to become a pediatric cardiologist.

spk_0:   2:14
Well, I always knew that I enjoyed working with Children when I was a young person. 16 or 17 years old. I worked as a summer camp counselor in a nursery school for Children and had a really wonderful time. And I realized at that time that I enjoyed working with Children, and when I went to medical school, it seemed to me that nothing felt more urgent or desired for me than working with kids. I ultimately made the decision that if I was going to be woken up in the middle of the night, probably I would be the least bothered by being called by a mother a child. And that's sort of how I ended up going into pediatrics. In regards to cardiology, I think most people who become pediatric cardiologists enjoy the physiology of cardiology. It's sort of one of those fields that for lack of a better term, you'd say it makes sense, and it's always expanding field tons of new innovations in it. For people who like to do procedures, it's a nice field because basically almost every area within cardiology today has technical challenges. It's a wonderful combination of being able to longitudinal e follow patients and families for many, many years. I have some patients over 20 years, but also to do invasive procedures, so it's really for me is a good combination of multiple things that I enjoy doing

spk_3:   3:29
right. It's a little bit of everything. I'm amazed it all the different things that pediatric cardiologists do. My since 24. So I've been looking at the field of pediatric cardiology for 24 years, and it's been amazing to me how doctors pediatric cardiologists specifically have really immersed themselves not on Lee in the diagnostic hair and the maintenance care of people with congenital heart defects, but also going to the cath lab and do invasive procedures. I mean, you really get to do a little bit of everything. Yeah, I

spk_0:   4:03
would agree with that statement and certainly is one of the main reasons that I so enjoy my work.

spk_3:   4:08
So electrophysiology is a specialization inside of pediatric cardiology itself. Why the electrical system?

spk_0:   4:15
Well, to be honest, when I first got interested in pediatric cardiology, I was, interestingly enough, a visiting medical students at Mount Sinai, where I now work. At that time, I was a student at Boston University School of Medicine, and I was doing an away elective at Mount Sinai, and while there, Dr Toni Rossi, who's a great friend and mentor of mine was taking care of a child who had postoperative junction A ll ectopic tachycardia or what if sometimes refer to its jet. And one of the main tenets of that treatment is to cool a patient because lower body temperature will sometimes extinguish that arrhythmia. And what I recall being so interested by was that he literally took ice and poured it around the patient's body with an open chest. And I thought, This is the most amazing thing I've ever seen And it actually worked out today we wouldn't use ice, nor would Dr Rossi. But this was in the early days of even understanding how to manage this arrhythmia. But I just thought it was such a remarkable thing that such a simple solution fix this child's heart rhythm. And you have to understand that before it was recognized that cooling was an important part of treating this arrhythmia, Children would die from the same with me. And so I was very, very impressed by this. And then later in my career, when I was a cardiology fellow, I had the very good fortune of having the opportunity to work with what is probably the finest pediatric Electrophysiology Group in the World at Boston Children's Hospital, which is led by Dr Edward Walsh, was also a very dear friend and mentor. And I think that those two opportunities pretty much solidified in my mind an interest in electrophysiology

spk_3:   5:50
Wow, Yes, I've had the pleasure of meeting Dr Walsh at some parent conferences where he has attended and presented. He is quite remarkable. Well, I think with the electrical system one of the other things that, to me, is the most amazing thing is how devices have changed over the last 24 years that I've been watching it. I mean, we've gone from pacemakers to I c d S t A D s. It's amazing to me all the different devices and they keep getting tinier and tinier.

spk_0:   6:20
Yeah, it really is a miracle of innovation, how small the devices have become, and also importantly how the batteries on these devices have improved so tremendously. There was a time when if we got five years out of a pacemaker, would be thrilled. Today. If a pacemakers wires are working properly, it's a vice. In the last 12 or 13 years, I would agree with you that there's been tremendous innovation and improvements in that.

spk_3:   6:45
Well, what do you think about the new technology where there will be lead lis devices?

spk_0:   6:51
Well, I think it's quite a remarkable achievement. The idea that you don't have to have an incision on your chest or in your skin is certainly very impressive at the present time. It hasn't really been used very many times in Children. My colleague at Mount Sinai, Barry Love, is one of the few pediatric cardiologists who have been planted one in a young person. I think we're not yet sure what the role is gonna be for Children. Because remember that although these devices have wonderful capabilities and a very long battery, we're talking in young people of, you know. Whereas I often choke, we're not playing for five or 10 years here. If you have a 20 year old patient, you've hoping you have another 80 years ahead of you. And so the issue in my mind at least that the present time is what are we going to do when these batteries wear out? How easy is it going to be to remove them and replace them? I do think though there's already a developing literature on removal of these devices, and it does not appear from what my reading of the literature is if they're very difficult to remove. So I actually think that there is a real future for this, but at the present time, I think it would still be in the investigational category for Children.

spk_3:   7:56
That all makes perfect sense. Tell me what the most meaningful thing about passing on your knowledge to the next generation ISS.

spk_0:   8:03
Well, I think in general it's very important to help our young colleague eggs going forward. My father, who was also a physician, he was an ophthalmologist. He used to say that it was very important when you get older, to sort of step aside to some degree and allow the new young people toe have their day in the sun. And I think that I have enjoyed teaching and mentoring fellows throughout the entire course of my career thus far, and anybody who does a lot of that probably knows what I'm about to say, which is that we certainly gain at least as much, if not more, from mentoring and teaching young people as they do from us, because they often are. The night is for various different projects that we come up with due to questions that they have and their energy energizes you. So despite being 51 years old, I feel as if I'm 26 when I'm around them. And that's always a good feeling, Of course,

spk_4:   8:59
takes this hot industry. We're offering us a mechanical hot, and he said, now that I've had enough to give it to someone who's worthy. My father promised me a golden dressed twirled it, held my hand and asked me where I wanted to go. Whatever strive for conflict that we experienced in our long career together was always healed by humor.

spk_5:   9:20
Heart to heart With Michael Please join us every Thursday at noon, Eastern as we talked with people from around the world who have experienced those most difficult moments

spk_2:   9:35
forever by the Baby Blue Sound collective. I think what I love so much about this CD is that some of the songs were inspired by the patient's many listeners will understand many of the different songs and what they've been inspired. Our new album will be available on iTunes amazon dot com Spotify. I love the fact that the proceeds from this CD are actually going to help those with congenital heart defects Enjoy music home tonight forever. Look,

spk_1:   10:13
you are listening to heart to heart with Anna. If you have a question or comment that you would like to address the show, please send an email to Anna Dworsky at Anna at heart to heart with anna dot com. That's Anna at heart to heart with anna dot com Now back to heart to heart with them.

spk_3:   10:32
Before we went to break Doctor Pass, you were telling me about the importance of mentoring and passing that knowledge on to the next generation. I've got to believe that has something to do with you started this podcast. How did you come up with the idea of creating a podcast? The

spk_0:   10:48
truth is, in the last couple of years, as you well know, podcasts become increasingly popular. I think it would be fair to say I became aware of them maybe two or three years ago, and what I love about it is that they're really podcasts on virtually any topic one would might be interested in. And I started listening to different podcasts and the sum of the podcast that I was most interested in, where they're a couple from The New York Times that are very interesting. And then also as I'm getting older, I'm naturally thinking about personal finance and retirements and things like this, although I'm not that close to retirement now. And I started to listen to a number of podcasts on that topic, and I came to realize that this was really a wonderful medium to disseminate information. And so I looked to see if there was anything in my field of medicine, pediatric cardiology and cardiac surgery. And there really is virtually nothing. There are one or two episodes on other podcasts that may touch on our field, but ultimately, what I really did. Big search. I didn't find anything on the topic, and I thought this might be a nice opportunity to review the literature and for my spell to keep up on literature so often in pediatric cardiology or cardiac surgery. We remain in these little silos where we are interested only in the area of cardiology that we personally are dealing with on a daily basis. By having a podcast like this in order to keep it interesting to the largest number of people in the field. I make a strong effort to change the area of interest of each episode so that everybody who listens to the podcast will at least find their area of interest every couple of weeks. And that's been wonderful for me. It allows me to keep up with the literature a little better than I Waas, and it also has allowed me a wonderful opportunity to speak with various different experts. Some of them I know, before the podcast started. But many of them I'm meeting for the first time, and it's really been a wonderful opportunity to meet a lot of very nice investigators throughout the world.

spk_3:   12:41
Well, I think it's interesting how small the whole field of pediatric cardiology is. It seems like everybody is only seven generations away from you just heard.

spk_0:   12:52
That's certainly true.

spk_3:   12:53
One of the things that has really impressed me with one of the conferences that I went to that doctor Gil Warren off ski was in charge of was the innovation that occurs from you collaborating with people who are specialists in the different areas of pediatric cardiology. So I imagine doing this review of literature that's even Ah, little bit outside of what you do on a regular basis might give you some ideas of ways that you can improve your own practice.

spk_0:   13:20
There's certainly a truth in what you're saying, absolutely. And I think the other thing that's becoming increasingly clear is that now that technology has advanced so far, it's so easy to communicate with our colleagues in other parts of the world. It really is starting to become less and less common that you see single center studies on topics. Pediatric cardiology is rife with papers that described the experience of a single center. Now these are very valuable because often times their studies about novel approaches, and when you're starting anything new, you're not gonna get a lot of centers to buy in on that immediately. But what's wonderful? For example, a few weeks ago, I reviewed a paper from the pediatric Cardiomyopathy Registry. This is a group of doctors over like 15 or 20 different centers who contribute their information Well, as you would imagine, if we have data on over 1000 patients who have a certain disease, the importance and the value of this study is going to be much greater then if a single center reports on 15 patients with with the same disease. And so the numbers of collaborative, large studies with large numbers of patients, which give us much more powerful information about our patients in order to improve our care of the patients is growing exponentially. And that's a wonderful thing for our patients.

spk_3:   14:38
It is. And I think it is fascinating how doctors from all over the world you wouldn't know each other you go to the conference is together. You do telemedicine together. I just absolutely amazed at that. So you are interviewing people all over the world? Do you have a whole team of people helping you with your podcast?

spk_0:   14:58
Well, I must have if it's here that this is a one man job. I am the producer, the designer. I'm everything. The advertiser. There is no one else on this podcast other than me, and it's been a little bit rough at times, but I've enjoyed it very much. And as you and I were talking off air, I'm usually able to do most of the work of the podcast in under four hours a week. And so It's a bit of a time commitment, but it isn't a crazy or super long one. And truthfully, I enjoy it. So it's almost like a hobby for me.

spk_3:   15:28
Wow, that really amazes me because I see you've done a fabulous job with promoting the podcasts. I've seen it all over LinkedIn. I've seen it on Twitter. We've put it on Facebook. I don't know if you're on Facebook, but we've carried it over to Facebook for you promoted on Facebook. How do you publicize your podcast?

spk_0:   15:48
Well, basically can make up these little placards describing the various episodes. It takes literally five or 10 minutes at most. And as you know, putting things up on social media is 30 seconds. Click. It's not very difficult thing, and one of the nice things about Social Media's It's free, so I don't really have to pay for any advertising. I don't have any sponsors or support of the podcast, so the budget is very low, which is zero. It ends up being just fine and really, as I said, other than writing an email to the P D heart link, since which is a very large net server of pediatric cardiac cancer specialists. I write to emails a week to that that go out most people who practice pediatric cardiology or pediatric heart of answer medicine, and that's about it. The advertising, although I do try to put a number of things out on this different sites that you described, it really is not a very long process takes only a few minutes.

spk_3:   16:42
I wonder how many of your listeners or parents like me who found you and said Yes, it's about time. There's more information that's available to the common person. But, man, I went out and listen to some of your shows Dr Pass and they are quite cerebral. They have certainly gone way above my head.

spk_0:   17:00
I hope that's true, but that's kind of you to say

spk_3:   17:03
now. But I think it's great that you have this media so that hey, if you're working in Washington, D. C or New York City and you ride the subway to work or you ride on the train, you just pop your ear buds in and get a mini lesson. Whatever topic it is that they plug into that week,

spk_0:   17:22
well, it's interesting because what you just described is what I hear most often, which is people listen to the podcast as they're driving or going toe work. And what I found most extraordinary is how people are listening to it throughout the world. Over 80% of the listeners are in the US, as you would imagine, but fully 15 to 20% are outside the U. S. And I have had listeners in Korea, China, India, Israel, Saudi Arabia, South Africa, various different parts of South America, pretty much everywhere in the world. I have have listeners, So it's really quite an extraordinary thing that from my little office in my apartment on the Upper West Side of Manhattan, people are listening to the podcast all over the world that I'm very appreciative of all the listeners.

spk_3:   18:06
Well, you do a great job, and like you said, you've really made a point of hitting on all different kinds of topics. When I went through and first found your podcasts, I found you pretty early. So I listened to your first podcast. You didn't even have music in that one. So I've been listening to it evolve over time, which has really been interesting for me. Now, one of the things I've been able to do with my podcast, which has been really exciting, is like you. I have listeners all over the world, and I started to get requests for certain episodes to be in particular languages. So I actually have a show that's been done in French, not me. Speaking French, I found a guest host who was amazing. I have a couple of Spanish shows. I'm getting ready to record a show in or do do you have any plans to do some foreign language shows?

spk_0:   18:53
Well, it's interesting you say that I have one time received a request to put the show in Spanish. I honestly have not figured out exactly how I would do that. And truthfully, given that I have a whole other job part to really imagine where I would find the time to work on that. I really do wish it would be an easy thing to do. But it is challenging, given the time constraints that all of us have. Unfortunately,

spk_4:   19:19
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spk_5:   19:47
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spk_3:   20:29
So before the break, we were talking about your podcast, but now I want to know what has your favorite podcast been so far? I

spk_0:   20:37
assume you're asking about my podcast because I enjoyed many of your episodes and some others that I listen to, but on my podcast, of course, I don't want to single anybody out for fear that I'm going to insult my other guests. But there were a couple that I think we're certainly very well listened to, based on the numbers of downloads and which I particularly enjoy, probably three that I most enjoyed were first. I was speaking with Toni Rossi, who's the director of the cardiac I C. U, or at least the former director. Now the head of the cardiovascular program at Nicholas Children's Hospital in Miami, Dr Rossi actually inspired me to become a pediatric cardiologists, that he spoke for an hour on podcast, about how he evolved in his management of postoperative single ventricle patients like hypoplastic left heart type patients. And he really gave a wonderful It felt as if you were at the bedside and he was teaching. And as I was listening to him even 25 years later, it reminded me of why I was so inspired by him. We also had an episode where I spoke with Dr at Wal Tch, about to travel a Jiff below in the risk for sudden cardiac death and ventricular tachycardia. And Ed is one of my dear friends, and it's certainly one of the people. I often say that after my own parents, there's probably nobody I look up to more than that, Walsh and Tony. It is just a wonderful mentor and one of the most wonderful electro physiologist and physicians I've ever met. He's really the most caring person and always does the right thing. And oftentimes people will say about their mentors. They asked themselves as they're standing in a difficult position, what would so and so do for most people who have been trained by Ed Walsh, we say to ourselves, What would Ed do? Because virtually always, that's the right choice. We had a wonderful episode with a very dear friend of mine, named K. K. Kumar Rama and Krishna Kumar. Dr Kumar has a really inspiring story. It wasn't really so much of medicines discussion, but a discussion of how he left the U. S. Went back to India and started a very large pediatric heart center called the M Rita Institute for Cardiology in southern India, in the city of Cochin and really on a shoestring budget with just five cardiologists they're now doing over 600 surgeries a year and nearly 1000 cardiac catheterizations a year, all with just five doctors with outcomes at Rival, any center in the world, really inspiring story. And then, from a scientific perspective, probably for me as an electro physiologist. One of the most interesting episodes was Dr Robert Hamilton from the University of Toronto Book with Us about a novel biomarker for the identification of patients who have a condition called a rhythm. A jannik, right ventricular dysplasia or cardio myopathy. This is a disease that can cause life threatening a arrhythmias as well as heart dysfunction and at the present time are means of making this diagnosis are very imprecise, and a large percentage of patients who have this disorder are not properly identified because the testing that we have is poor. Dr. Hamilton has come up with a blood tests, an immunological test that, at least in initial reports, appears to be almost 100% sensitive and specific for this disorder, and so

spk_3:   23:42
is his

spk_0:   23:42
initial report proves to be true. This will absolutely be a massive game changer and is likely to save the lives of tens of thousands of people throughout the world. So really quite extraordinary achievement.

spk_3:   23:55
You have had some amazing guests. Do you have a favorite?

spk_0:   24:00
Well, I don't think I could say I had a favorite, I think. Certainly, Uh, I would say that three of my best friends would always be my favorite. So they would be Dr Rossi. Dr Walsh, it Dr Kumar? Mostly because I know them. I would say it was a lot of fun. I've had one or two former fellows on the podcast that

spk_3:   24:17
has been

spk_0:   24:17
enjoyable to see people who I knew and helped mentor in the beginning parts of the career who now are superstars themselves in the fields of pediatric cardiology. And I have to say that that has been an unexpected joy of this program for me, which is the opportunity to promote the career of young investigators who are on their way up. Some of them I know myself personally, but many I don't and I'm meeting for the first time in the podcast, and it's been very exciting to talk to people who are going to be the leaders in the future of the field.

spk_3:   24:47
Oh, I just love that I think it's fascinating. I love having doctors on my program, and I love hearing about what they're excited about and how they're helping our community. I'm not a doctor myself. Obviously, I'm just a heart mom, but I find the literature fascinating. And, of course, I tend to really focus in on single ventricle, since my son was diagnosed with hypoplastic left heart syndrome when he was an infant. But now I know a little bit about T G A and T O f and so many of the other heart defects and what you were just saying about the biomarker. What's interesting to me about that is all of the research that's being done in genetics. You can't help but wonder if there's a biomarker. If you might also find a genetic component and impossibly be able to help people when they're pregnant with the child who might have that condition take care of it so that it never develops into something that's worrisome.

spk_0:   25:41
Well, that's a very thoughtful comment. I have to say that one of the great advances about the possibility of Dr Hamilton's biomarkers that it is a demonstration of an inflammatory process and the theory behind his understanding or beliefs about this disorder is that there may be inflammation may actually be a problem in this disorder, and so it is absolutely true what you said, which is that if it turns out that that is, in fact the case, there is actually tremendous hope that once someone is identified, we may be able to offer medication, perhaps in an anti inflammatory manner that may halt the progression of this very lethal disease. So not only is this biomarker potentially a game changer for diagnosis, it has the real potential for perhaps not curing but completely and totally changing the course of people's lives for the better. So it's still very early. He doesn't have a huge number of patients, yet he is working on the largest cohort of patients at the present time. But there's a lot of reason to be very excited by Dr Hamilton's observations and findings.

spk_3:   26:45
Wow, that's impressive. I just find the whole field of pediatric cardiology amazing. I can't imagine being in that field and being required to know as much information about as many diverse areas as a doctor in your field has to. Right now. I mean There are a lot of sub specialties, and we're certainly seeing this with e adult congenital heart population where, for example, my son, he sees an electro physiologist at Texas Children's Hospital because he has had certain arrhythmias. Do you think that that's the wave of the future that the pediatric cardiologists, especially those working with adults, is going to have to specialize even more?

spk_0:   27:23
Yeah, I mean, I think at this time, you know, when I started my career, people were still coming out of training as generalists. But I think the field is moving away from that area. Most people are pretty much deciding that they are interested in one particular area of cardiology and are focusing on it. And so one of the challenges, for example, of my new position as the chief of cardiology at Mount Sinai is figuring out ways to make sure that all of the cardiology specialists are working together and are talking to one another. Because the level of complexity of all these various areas, whether it's noninvasive imaging, interventional cardiology, electrophysiology, adult congenital heart failure and transplantation genetics there are also complex on their own that I think we all have a natural tendency to just be focusing exclusively on that and almost neglecting our colleagues. And so having everybody worked together is a very important issue that we are always working on in our field to make sure that we are communicating with one another and working as a team. And that's one of the things that's so wonderful about the center that I work at, which is that everybody works together so well as teammates, and that really is the key of any excellent center. You explain that you that a Texas Children's Hospital, that is another place that is well known to be a wonderful team. I know all of the electro physiologist, a Texas very well, and they're all wonderful collaborators with their colleagues at the hospital, any good heart center. There must be a wonderful degree of teamwork and working together. It's a very, very important concept in our field.

spk_3:   28:55
Well, it really is absolutely, and I think that's something that was lacking 10 or 20 years ago and maybe because we didn't know the importance of it, but maybe also because there just wasn't a large enough cohort of survivors to point out how important that Waas

spk_0:   29:10
Absolutely. And I think also we're learning now what? Things are important now that we weren't as aware of. You know, 20 years ago we were focused mostly on people staying alive with serious congenital heart disease. Obviously, we're still very focused on that. But we have to get beyond that. And we are now. And so the getting beyond it really is in some regards. Aah! Harder problem. Because keeping our patients healthy throughout their life span, that's, Ah, much more complex issue. And as you know, is the parents of a child with congenital heart disease. Our knowledge of the adult congenital patient is expanding massively, very, very rapidly. And there are things that we are very worried about and concerned about today that we had no idea 20 years ago even were problem at all. And the most interesting or obvious one, for example, is the status of the liver in patients with single ventricle. This is an area that I can tell you 20 years ago. I don't think anybody had any idea that this was a concern. Today it's one of the single most important aspects of caring for a person with single ventricle physiology. That's just one example of how, in such a very short period of time, we are learning so much about our patients and how we need to do things better both when their Children and then again when their annals. So there's a lot of work to be done.

spk_3:   30:26
Yeah, it's interesting that you should choose that one topic that is the number one listen to to Podcast of Heart to Heart With the annex. Was Dr Wu talking about liver involvement in single ventricle Fontane patients? Amazing.

spk_0:   30:40
It's a very serious problem, and I don't think we yet have our handle on exactly how to manage this. But I certainly think that our ability to manage it and prevent it is going to improve over the next 10 to 15 years. I would be shocked if it does not.

spk_3:   30:53
Oh, I think you're absolutely right. Well, what do we have to look forward to in the future with your podcast?

spk_0:   31:00
Well, I think, as they say, more of the same. My plan is to just continue to scour the literature or for topics that I think are going to be interesting. One of the advantages of having had the podcast for years. I can now tell what topics are of the most interest to patients. As we've been discussing, if I put anything on regarding a font and I have an uptick of 20% of the listeners that week s o the Fontanez, probably because it's the single area that if they're digitized, s'more with every single area of cardiology, it definitely is a topic that people are very interested in. And so, I think, probably will see a lot more on the funds. He And one of the things that I'm hoping we're going to be able to get done this year is you may be aware of this organization called the Sad Organization or Sudden Arrhythmia Death Syndrome Organization, which is a wonderful group that works to educate both physicians and patient families about different conditions such as long Q T syndrome or A R V C. And the possibility of prevention of sudden cardiac death. I'm hoping that we're gonna be able to partner with them and every couple of weeks do a double branded podcast on a topic related to channel AAPA thes or a sudden cardiac death arrhythmia conditions with the experts from the sense organization, and so I'm very excited about that possibility.

spk_3:   32:17
Well, I'm going to be curious about that myself, because I had an uncle who died of sudden cardiac death. Is did my grandfather. So I had been wise book on the program oh golly, couple of years ago and that he almost died from sudden cardiac death. Luckily, his wife was right there, and they were able to revive him, but he actually started a nonprofit organization of his own toe identify a particular gene that causes. The problem is, it's amazing all of the information that is out there and how even people like Ben, who is a lawyer. He's not a medical person. But he was able to start a foundation and is paying for people to have their entire genome analysed so they can identify. They can pinpoint where it is that the problem is occurring so these people die of sudden cardiac death. It's amazing to me what can be done nowadays, and anybody who really wants to make a difference can make a difference, and you certainly have made a difference in a lot of people's lives. Thank you so much. for coming on the program today. Dr. Pass.

spk_0:   33:23
Well, it's very kind of you to say that, and it's a wonderful opportunity and honor to be on your show with you. Thank you for everything that you and David do on your show. I think it's such a wonderful service you provide making parents aware that they're not alone, that this is a very, very common problem. And I think your work has been instrumental in increasing the knowledge amongst parents and families, which is something that, honestly, I don't think we do is good enough job as pediatric cardiac specialists. And so I'm glad that you're out there helping spread the word of new therapies and also just sharing experiences, which is obviously sometimes Justus important.

spk_3:   33:59
Well, thank you for that. I appreciate that. That does conclude this episode of Hart Art with Anna. Thanks for listening. Today, my friends find us on iTunes and subscribe. And remember, my friends, you are not alone.

spk_1:   34:13
Thank you again for joining us this week Way Hope you have been inspired on Empowered to become an advocate for the congenital heart defect community Heart to heart with Anna With your hose down, Dworsky can be heard every Tuesday at 12 noon eastern time.