- Goals and objectives
The purpose of the training program in interventional pediatric cardiology is to provide pediatric cardiologists (after or during the third year of their formal pediatric cardiology training) with theoretical background and practical experience necessary to undertake interventional pediatric cardiology procedures independently.An understanding of pathology, patho-physiology, clinical presentation, non-invasive, catheterization and angiographic features and natural history of the cardiovascular defects/abnormalities that are likely to benefit by transcatheter interventions will be inculcated. Indications and contraindications for undertaking transcatheter interventions and complications associated with such procedures will also be stressed. Practical issues related to methods of balloon/blade atrial septostomy, balloon valvuloplasty/angioplasty, coil embolization, stent implantation, transcatheter cardiac septal defect occlusion and transcatheter retrieval of intravascular/cardiac foreign bodies will also be taught.
- Didactic Curriculum
- Reading material:
The trainee will be provided with a list of books, monographs, reviews and original papers related to interventional pediatric cardiology. Trainees are required to complete review of these materials as well as current literature, as applicable to interventional pediatric cardiology, during their program.
Lectures by the faculty of the Division of Pediatric Cardiology with expertise in interventional pediatric cardiology on a weekly basis.
- Conferences: Attend/participate in the combined cardiac catherization and cardiac surgical conference in which theoretical and practical issues related interventional cases are discussed by both pediatric cardiology and cardiac surgical faculty.
- Curriculum: Didactic and clinical curriculum is arbitrarily divided into several groups:
- Balloon angioplasty/valvuloplasty,
- Placement of intravascular stents,
- Transcatheter occlusion of cardiac septal defects,
- Balloon and blade atrial septostomy,
- Embolization of superfluous blood vessels,
- Transcatheter removal of intracardiac/intravascular foreign bodies, and
- Miscellaneous interventional procedures.
- Reading material:
- Clinical Curriculum:
The clinical curriculum rotates around items described above, giving adequate hands-on training in these areas. Experience in the catheterization laboratory and providing opportunity to evaluate patients requiring interventions prior to the procedure and at follow-up in the out-patient clinic, including echo-Doppler evaluation provide a comprehensive training.Selection of fellows for the fellowship program is based on merit from among the applicants. The program is nationally advertised, particularly through the ACGME approved Pediatric Cardiology Fellowship Program Directors.
- Didactic Curriculum
- Prerequisites for entry in the program
- Pediatric Cardiology Board Certification or eligibility or its equivalent for Pediatric Cardiologists who have completed their formal training, or
- Two or more years of formal pediatric cardiology fellowship training.
- Duties and responsibilities
The fellow’s responsibilities include evaluation of patients and performance of cardiac catheterization and interventional procedures under supervision of faculty in the Pediatric Cardiology Division. They are also responsible for presentation of cases in the combined cardiac catheterization/cardiac surgery conference. The fellows will also participate in teaching the pediatric residents and to supervise the residents and medical students assigned to provide care for interventional cardiology patients on the wards. They will also participate in research related to interventional cardiology.
- Supervision of fellows
The fellows will be supervised by faculty members of the Division of Pediatric Cardiology. During the interventional pediatric cardiology procedures in the cardiac catheterization laboratory, one of the faculty members will always scrub with the fellow and provide close supervision in performing the procedure. Pre- and post-procedural evaluation on the patients by the fellow will also be supervised. Progressively increasing responsibility in studying the patients and in performing the procedures will be given, depending upon the ability of the fellow to take such responsibility, but still under the direction of the faculty.
- Evaluation of fellows
A mechanism has been developed to evaluate the following areas: a) degree of attainment of program objectives; b) assessment of fellow performance and c) assessment of staff performance. The evaluations will be used to provide a feedback to correct existing deficiencies.Faculty from the Division of Pediatric Cardiology who are involved in the fellow’s training will participate in evaluating the fellows on a quarterly basis. A standardized evaluation instrument will be used to assess progress in acquisition of knowledge, skills and attitudes.The fellow will evaluate the experiences and training received. He/she will evaluate teaching skills of faculty in assisting fellow’s acquisition of knowledge, attitude, and skills.
Ordinarily, the candidates admitted for this program would have completed ACGME requirement for board certification in Pediatrics and Pediatric Cardiology. Currently, ACGME approval process for subspecialty of Pediatric Interventional Cardiology does not exist. But, most pediatric cardiology programs require “formal” training in interventional pediatric cardiology prior to accepting candidates on faculty (or staff) in their programs. The candidates trained in this program will be eligible for such credit.
- Other Items
- Location of training: University of Texas-Houston Health Sciences Center
- Number of fellows proposed: One
- Length of training: One year
- Person to contact
For further information, you may contact:
John P. Breinholt III, MD
Associate Professor of Pediatrics and Medicine
Director, Division of Pediatric Cardiology
University of Texas-Houston Medical School
6410 Fannin Street, UTPB, Suite 425
Houston, TX 77030