Expanding the high level of expertise in caring for children with structural or electrical heart disease is the goal of J. Philip Saul, M.D., the newly appointed director of MUSC’s Pediatric Cardiology Services.

Saul, appointed in December 1997, is enthusiastic about the strengths of his team of doctors. “Our goal is to continue to have first-class, state of the art services in every main area of pediatric cardiology-surgery, catheterization, electrophysiology, echo-cardiography and intensive care,” Saul said. “The three areas where we will clearly differentiate ourselves from the rest of the Southeast are in surgery, interventional catheterization and electrophysiology.”

Saul’s interest and expertise is in electrophysiology. Some patients requiring management of rhythm disorders were born with a problem. Others develop rhythm disorders because of scarring in the heart after surgery. Before coming to MUSC, Saul and his colleagues at Children’s Hospital in Boston were the first to perform a radiofrequency catheter ablation procedure in a child with Wolff-Parkinson-White syndrome. This technique is now used more than 100,000 times a year worldwide to treat patients with a wide variety of tachyarrhythmia disorders.

The Team

Scott M. Bradley, M.D., of MUSC’s Department of Surgery works closely with Saul’s team.

“Scott Bradley is one of the top pediatric cardiac surgeons in the country,” Saul said. Bradley’s mortality rate is about 2 percent, “and he operates on the most difficult and complicated cases, including newborns and even premature newborns. He is almost certainly the best pediatric cardiovascular surgeon in the Southeast.”

The area’s interventional catheterization services are directed by Wolfgang A.K. Radtke, M.D.

“Dr. Radtke’s skills are at the highest level of interventional catheterization throughout the world,” Saul said. Radtke is among only a few doctors in the country using the latest catheter treatments for atrial septal defect closures, completely avoiding open heart surgery.”

Seshadri Balaji, M.D., works with Saul in electrophysiology, and also has interests in pacemakers and syncope in children. Henry B. Wiles, M.D., works with heart transplantation and noninvasive imaging. In addition to cardiac development research, Tim C. McQuinn, M.D., specializes in intensive care medicine.

In three to four years, more than half of the patients with some forms of congenital heart disease will be adults. Ashby B. Taylor III, M.D., with his more than 25 years experience, heads the adults with congenital heart disease program, which will bring together adult and pediatric specialists to provide services to congenital heart disease patients who are now reaching adulthood.

D. Woodrow Benson, M.D., Ph.D., is working on a research program to identify the genetic and functional basis of familial congenital heart disease. Benson wants to identify all the families in the state that have more than one member with congenital heart disease. Working with faculty members from MUSC’s Department of Cell Biology and Anatomy to identify the function of genes, and with the Greenwood Genetics Center, Benson and his colleagues will then screen for the genetic cause of disease.

Benefits to families could include prenatal diagnosis—identifying their risk of passing on the gene to children and identifying unsuspected disease in any family member.

The long-term goal is to develop a therapeutic intervention, either genetic therapy or prenatal therapy, to combat the problem.

Logging on

Currently in the planning stages, telemedicine is another project on the horizon in pediatric cardiology. Referring physicians will be able to use telemedicine to send images for another opinion or interpretation. It also will be used to help screen patients and determine whether they need to come in for further services.

Another use for telemedicine will be to help keep referring physicians involved in their patients’ care without having to be at the Medical Center. For example, images of a patient’s procedure can be sent confidentially over the Internet to his physician’s office, where the physician can view the treatment, be available for consultation and get immediate updates.

Editor's note: The article is reprinted from MDialogue newsletter, a physician liaison program publication.