THIS MONTH’S PROFESSIONALS

Dr. John Breinholt

Dr. John Breinholt

Pediatric Cardiology

Dr. John Breinholt Dr. Breinholt currently serves as Chief of Pediatric Cardiology at Children’s Memorial Hermann Hospital and is the director of the Division of Pediatric Cardiology in the Department of Pediatrics at McGovern Medical School at UTHealth, part of the University of Texas Health Science Center at Houston. He was selected for the Society for Cardiovascular Angiography and Interventions Emerging Leader Mentorship Program (2013-25) and the American Academy of Pediatrics Young Physicians’ Leadership Alliance (2014-2017).

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This Month’s Questions & Answers

  • Bsmall
    Bsmall, SUPPORT NETWORK Member Asks
    Q.

    "My son was recently diagnosed at 12 yrs old with PAPVR. He is scheduled to see a cardiac surgeon soon. Any help with information and connection with parents who have been faced with this would be greatly appreciated. I am scared and I am trying to learn all I can.. in what to expect... If anyone can share their experiences it would mean the world to me."

    A.

    I am unaware of any specific group for this. Most of these patients do very well. It is a relatively straightforward surgery that involves the closure of an atrial septal defect (sinus venosus) and rerouting of the pulmonary vein. The challenges typically involve where the pulmonary vein enters, and complications can involve residual narrowing of the pulmonary vein. Nevertheless, it usually goes well.
    Some centers have begun offering alternative approaches to this surgery that involve a less invasive approach that doesn’t involve a sternotomy (incision in the middle of the chest), but rather in the underarm area. One center is in Sacramento, and the other is the University of Texas HSC at Houston/Children’s Memorial Hermann Hospital where I work. This is a relatively new approach with a better cosmetic result. Thank you, Dr. Breinholt

  • Pfletcher490
    Pfletcher490, SUPPORT NETWORK Member Asks
    Q.

    "What is exactly is congestive heart failure"

    A.

    Congestive heart failure is a broad term that describes the heart's inability to effectively or efficiently handle its function. It might be because the strength of the heart is weakened, or it might be because of a congenital defect that leads to over circulation of blood to the lungs. The definition of CHF is easier to explain depending on the heart being discussed. Thank you, Dr. Breinholt

  • MJH1979
    MJH1979, SUPPORT NETWORK Member Asks
    Q.

    "My daughter is born on 28 th may 2018. on 29 may 2018 she was diagnosed with hypoglycemia. On June 10, 2018 she aspirated twice and admitted in NICU with breathing difficulty. On June 12, 2018 she was diagnosed with two holes in her heart, one asd of 3 mm and PDA of 4 mm. Her pneumonia is still there today on 18 th June 2018 but improving."

    A.

    The hypoglycemia and aspiration are unlikely due to the heart. The ASD is small and may never need intervention. Unless it “grows” as she grows and becomes a size that we would consider closing, it would not be done until she is 3-4 years old at the soonest. The PDA could require intervention. Sometimes the measurements can overestimate, but if she has heart chamber enlargement (on the left side) in addition to the PDA, it may need to be closed. It is also possible that the pneumonia is related, but it would require examining her and having more information to know for sure. I hope she has a cardiologist. That would be the most important next step. Thank you for this question, Dr. John Breinholt

  • parijat
    parijat, SUPPORT NETWORK Member Asks
    Q.

    "My child has Ostium Secundum ASD of 7-8 mm and Large Perimembranous VSD during his first month of age. Now he is 5 months old and the ASD is 5 mm and Moderate VSD. Can you please suggest wheather any surgery will be needed or it will cure itself."

    A.

    Perimembranous VSDs do not frequently close on their own, particularly if they are moderate to large in size. ASDs can get smaller, and even close. If the ASD is only 5mm at 5 months of age, it is possible it will close, or at least not require surgery (or even catheter based closure). The VSD is more difficult to predict. If the child continues to do well clinically, doesn’t require any medical therapy, is growing and thriving, he can wait. We do watch the aortic valve closely because flow through the defect can influence that valve and cause problems. If it does, surgery will be necessary. Sometimes the defect can be partially closed by valve tissue from the tricuspid valve (from the right ventricle). If that happens (or has already happened), sometimes we can close those defects in the catheterization laboratory, without surgery.
    The short answer is the ASD may not need anything or could be closed with a device and without surgery. The VSD is more difficult to predict and hard for me to comment without more information. However, if he is doing well, there is time and surgery may not be necessary.
    Thank you for this question.
    Dr, John Breinholt

  • Annie6556
    Annie6556, SUPPORT NETWORK Member Asks
    Q.

    "I had to list the above option, altho I am not sure it is what I have. What I have is a heart valve defect, since birth, but I only found out about it last year. My lower valve does not completely close, so there is regurgitation, i.e., back-flow in that section of my heart, with every beat. It sounds like a small heart murmur via a stethoscope, but only when I am stressed or troubled. My question is what will happen if I ever have a heart attack? I see physicians at my local university campus. I overheard once that my condition should not pose a problem unless I have a heart attack. What problems would present themselves if I ever do have a heart attack? I work on keeping lower cholesterol, but I inherited it from my Mother, and she always took a statin. I am on one but I know it will make no difference, as I have been on them before. What would happen if I did have a heart attack in relation to my valve deformity?"

    A.

    Annie 6556 due to the nature of your diagnosis and defect since birth is highly recommended that you discuss these questions with your cardiologist because they will have your health records available. Each case is different and I would want for you to receive the correct information and what pertains specifically for you.
    Thank you, Dr. Latonya Law

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