by Cindy A. Abole, Public Relations

MUSC's new director of pediatric cardiology is taking the quality cardiac care and research he directs here to children throughout South Carolina.

J. Philip Saul, M.D., who came to MUSC in 1998 from Harvard Medical School, has already helped create the Children's Heart Program of South Carolina, a collaborative consortium of 17 pediatric cardiologists in South Carolina which will ultimately coordinate a network of heart specialists and outreach opportunities throughout the state.

“In the area of pediatric cardiology, it would be ideal if pediatric cardiac services could be regionalized like this throughout the country, so that frontier care could be provided at each of a limited number of centers,” said Saul. “Studies show that as medical centers compete for congenital heart patients, in the long run it is the patients who lose out to fragmented care.”

Through the Children's Heart Program, the state is divided into four geographical regions: the Upstate—centered at Greenville Hospital Systems, Greenville; the Midlands—USC/Richland Memorial Hospital, Columbia; the Piedmont—McLeod Hospital, Florence and the Lowcountry—centered at MUSC, Charleston.

Saul wants to focus on frontier interventional techniques and clinical services in all areas of pediatric cardiology— surgery, catheterization, electrophysiology, echocardiography and intensive care.

Hospitals in the four areas provide patient education, primary cardiac evaluations, surgical follow-up, telemedicine and teleconferencing and coordinates subspecialty clinics throughout the state. Most tertiary services and all catheterization and surgery will take place at MUSC.

“This is a wonderful opportunity for South Carolina and all its pediatric patients seeking cardiac care," Saul said. “It's a chance for the pediatric cardiac specialists in this state to create a model national program which will deliver coordinated state-of-the-art cardiac care and services within a rural medium-sized state. Right now, such a model doesn't exist.”

Through the Children's Heart Program, primary cardiology and follow-up services will be provided at each center and in outreach practices located in Anderson, Beaufort, Greenwood, Hilton Head, Lancaster, Murrells Inlet, Myrtle Beach, Spartanburg and Sumter. Together, the program will provide local pediatric cardiology services to all of the state population centers except Aiken and Rock Hill. However, the program plans to market its excellence in patient care to these remaining areas within South Carolina and to patients in bordering regions of North Carolina and Georgia.

Over time, MUSC will reduce or end its primary care cardiology presence in the Columbia, Greenville and Florence areas. Instead, MUSC will continue its work by providing care through subspecialty clinics —electrophysiology, adult congenital heart disease, fetal echocardiography, etc.

“We want to create a unified program that can bind geographically disparate cardiologists to a strong surgical and interventional program with excellent outcomes,” Saul said. He believes that providing information and data will help to promote the program's credibility. He's comfortable publishing mortality and success rate outcomes through the program's Internet website.

“Every parent has the right to know the quality of care their child experiences,” Saul said. “That includes MUSC and every other medical center.”

Among the program's initiatives is to seek government legislation of the regional healthcare system and approach Medicaid and the state's insurers in establishing guidelines and support for the program's goals. The group also wants to incorporate a pediatric cardiology subchapter within the American Academy of Pediatrics Chapter of South Carolina.

Peds Cardiology director’s talent far reaching

by Cindy A. Abole, Public Relations

Working with his hands and machinery have been constant themes throughout the life of J. Philip Saul, M.D. Whether he tinkered with a car engine or laid down pipe as a master plumber, Saul never lost his attraction for mechanics or his gentle touch as he merged his talents into the world of hope and healing.

As new director of Pediatric Cardiology, Saul has brought his own skills in interventional electrophysiology, and he has recruited a staff of 12 pediatric specialists.

In addition to his leadership in pediatric cardiology clinical services, Saul’s experience in research activities are impressive. He and D. Woodrow Benson, M.D., the new director of cardiovascular genetics, are working with the Cardiac Developmental Biology Center, run by Roger Markwald, Ph.D., chairman, Department of Cell Biology and Anatomy to understand the genetic and developmental bases of congenital heart disease. They plan to eventually identify all South Carolina families with more than one affected family member for genetic studies. These efforts should lead to the ability to screen for genetic causes relating to congenital heart lesions.

In another study NIH-funded study, Saul is studying blood pressure regulation in patients suffering from chronic fatigue syndrome. Initial research efforts have concluded that affected youngsters suffer from brain blood flow abnormalities similar to those seen in patients with typical fainting spells due to low blood pressure. Saul hopes to discover why blood flow to the brain might be reduced in fatigue patients, even though their blood pressure is in the normal range.

An Atlanta, Ga., native, Saul graduated with a degree in physics from Duke University. He went on to receive his M.D. from Duke, opening opportunities for residencies and fellowships in New England and elsewhere. He completed his residency at the Children’s Hospital, Boston and finished clinical and research fellowships in cardiology and electrophysiology at Children’s in Boston and Children’s Memorial Hospital in Chicago.

As part of his post-doctoral research, Saul was a visiting scientist and researcher in medical physics at the Massachusetts Institute of Technology (MIT) from 1985 to 1987.

After serving as an instructor and assistant professor from 1987 to 1994, he was named associate professor of pediatrics at Harvard Medical School. He also held faculty positions at Harvard-MIT Division of Health Sciences and Boston University’s Biomedical Engineering Department. Saul is currently a member of the American Heart Association, American College of Cardiology, Society for Pediatric Research, Institute of Electrical and Electronic Engineers, Society for Pediatric Research and the Charleston County Medical Society.

His expertise and technical background have helped him in the discovery and design of several devices and patents used in the latest cardiology procedures. Among these discoveries are the use of low temperature heat mapping with radio frequency energy to minimize damage done in catheter ablation procedures, and a fluid cooled and perfused catheter tip for enhancing the lesions produced by ablation techniques when the proper location is identified with the low temperature mapping procedure.