Scientists at Texas Children’s Hospital, Rice University and Baylor College of Medicine have won a prestigious National Institutes of Health grant to study the dynamic processes and cellular players linked to discrete subaortic stenosis (DSS), a congenital heart disease.
The $2.2 million, four-year R01 grant administered by the National Heart, Lung and Blood Institute will allow a team led by Dr. Sundeep Keswani and Jane Grande-Allen to develop computer and tissue-engineered models to predict the recurrence of DSS lesions of the left ventricular outflow tract (LVOT).
Keswani is a surgeon and director of surgical research at Texas Children’s and an associate professor in the Michael E. DeBakey Department of Surgery at Baylor. Grande-Allen is Rice’s Isabel C. Cameron Professor of Bioengineering and chair of the university’s Department of Bioengineering.
In normal hearts, blood passes through the tract from the left ventricle to the aorta. In patients with DSS, a fibrous tissue membrane forms and prevents blood flow from leaving the heart. Heart surgery is the only current option to manage the disease, but up to 30 percent of patients have an aggressive form of DSS in which the membrane recurs, and these patients may have to undergo further cardiothoracic surgery. The researchers believe a better understanding of how the fibrous membranes form will help doctors manage the disease.
“We have found some striking differences between patients who have the aggressive form of the disease and those who do not,” Keswani said. “These findings will give insight into the mechanism of how this membrane forms and perhaps why some humans have a more pro-fibrotic phenotype.
“This project is the just the beginning of understanding how different kinds of biomechanical forces interact with cells in the LVOT to produce fibrosis,” he said.
Working with co-investigator Philippe Sucosky of Wright State University, the research team has developed preliminary computational fluid dynamic models that mimic the complex shear forces and the altered geometry of the tract observed in DSS. The models will help the researchers develop a physical bioreactor to investigate interactions between the major cellular players in DSS: the endocardial endothelial cells that are exposed to shear forces, the cardiac fibroblasts that facilitate fibrosis and the circulating immune cells.
Preliminary computer model data suggested that altered internal geometries in children’s hearts generate turbulence in the flow of blood. That affects the shear forces in the LVOT that in turn trigger an inflammatory response by endothelial cells and encourage the formation of fibrous tissue.
In the future, Grande-Allen and Keswani expect their work will help prevent fibrotic lesions by identifying targets in advance. That ability could also help treat other fibrotic cardiovascular diseases associated with altered flow.
Keswani is the principal investigator for Texas Children’s Laboratory for Regenerative Tissue Repair and a pediatric and fetal surgeon. His laboratory investigates the interaction of inflammation and the extracellular matrix that drives fibrosis with the goal of developing anti-fibrotic, regenerative therapies. Grande-Allen’s Integrative Matrix Mechanics Laboratory specializes in studying the composition and behavior of biological tissues, with a particular interest in heart valves.
The project also received support from the Virginia and L.E. Simmons Family Foundation Mini-Collaborative Research Fund and a gift from Lew and Laura Moorman.
Texas Children’s Hospital has once again been named as a national leader among pediatric institutions by U.S. News & World Report in their recently published 2018-19 edition of Best Children’s Hospitals.
Ranked fourth among all children’s hospitals nationally and one of only 10 hospitals to achieve the Honor Roll designation for the tenth straight year, Texas Children’s is the only hospital in Texas – and the entire Southern region of the U.S. – awarded this coveted distinction.
In addition to ranking children’s hospitals overall, U.S. News & World Report also ranks the top 50 pediatric hospitals in 10 major sub-specialty areas. To be considered for the honor roll distinction, a hospital must have high rankings in at least three sub-specialties. For the second straight year, Texas Children’s Heart Center ranks No. 1 in the nation for pediatric cardiology and heart surgery. Texas Children’s Pulmonology ranks as the best program in the country for children with lung diseases.
Cardiology and Congenital Heart Surgery is again no. 1 in the nation and received the top score in externally reported risk-adjusted operative mortality for congenital heart surgery.
Pulmonology, which first debuted in the top spot in the 2016 rankings, is now again ranked no. 1 in the nation. We received the top score in several asthma outcomes and structure metrics, such as mean LOS for asthma patients.
Neurology and Neurosurgery moved from no. 4 to no. 3, receiving the top score in several outcomes metrics, such as 30-day readmissions for craniotomy and Chiari decompression and complication rate for epilepsy surgical procedures.
Nephrology also moved from no. 4 to no. 3, with the top score in one-year kidney transplant graft survival and hemodialysis catheter-associated bloodstream infections.
Urology moved from no. 6 to no. 4, propelled by the top score in unplanned hospital admission for urologic issues within 30 days of surgery, as well as significant improvements in hypospadias and revision surgeries.
This year’s rankings are the results of a methodology that weighs a combination of outcome and care-related measures such as nursing care, advanced technology, credentialing, outcomes, best practices, infection prevention and reputation, among others.
Our results continue to reflect the diligent efforts of a solid structure focused on the U.S. News survey. The process of compiling and refining our data is an ongoing challenge, which will continue to improve under the excellent leadership of Trudy Leidich, Elizabeth Pham and the entire USNWR team.
The 2018-19 edition of Best Children’s Hospitals is available online at www.usnews.com/childrenshospitals.
Staff with Texas Children’s Heart Center and Texas Children’s Pulmonology celebrated Tuesday after learning they were ranked No. 1 by U.S. News & World Report in their respective specialties.
Heart Center staff gathered in a conference room on the fourth floor of Texas Children’s Pavilion for Women to learn their ranking and cheered in delight when they found out they remained No. 1 in the nation in cardiology and congenital heart surgery.
In a conference room on the 10th floor of Wallace Tower, the Pulmonology team gathered to laud their well-deserved milestone. Pulmonology, which first debuted in the top spot in the 2016 rankings, is now once again ranked No. 1 in the nation.
Click here for more information about the Heart Center and here to learn more about our pulmonology program.
On June 22 one of Texas Children’s three therapy dogs, Bailey, celebrated her second birthday. Bailey’s handler, Adair Galanski, and the Child Life department threw a party for her and invited several patients and their families to join the fun.
The celebration was held in the Kid’s Zone, an area on the sixteenth floor of West Tower that provides a fun, safe and procedure-free environment for Texas Children’s inpatient population and their families. Bailey was donated to Texas Children’s Hospital from our President and CEO Mark Wallace and his wife as a gift earlier this year, to offer a distraction and motivation to patients undergoing certain medical procedures.
As soon as patients checked in and walked through the door, Bailey and Galanski were directly across the room for them to pet her, play, and wish her a happy birthday. Bailey was prepped and ready to take pictures in her pink tutu and pink crown with a number two right in the middle.
On top of plenty colorful decorations, there were several areas available for patients to play and engage with each other. There was a station with paper and color pencils so patients could create personalized birthday cards for Bailey, an area where they could paint ceramic dogs to take with them, and a board with baby pictures of all of the therapy dogs so that patients could play a game of guess who is who. With dozens of people coming and going, one of the busiest portions of the party was the doggy corner, where Bailey’s siblings Elsa and Pinto were hanging out and cuddling with patients.
The relationship that Bailey has with patients was extremely evident as they brought gifts of their own to celebrate the occasion. One patient presented her with a hand painted name badge that said “#1 couch potato,” because she calls Bailey her small fry. Another patient also brought her a teddy bear, but what is most important is all the love that was brought to Bailey from all of the children.
Another patient ran straight to Bailey in her crown and beautiful pink dress as she was eager to tell her that she was celebrating her birthday as well.
Parties like these are thrown every year to celebrate the therapy dogs because it is another event that provides normalization.
Marial Biard, Music Therapist, Child Life Department. I have had the privilege of working at Texas Children’s Hospital since February, 29 (Leap year) 2016.
What month are you Super Star for?
My assistant director summoned me in for a “brief in-person meeting” in her office. Turns out I was instead being awarded, a pleasant surprise. I later got to celebrate with my department, family and the Texans. It was a whirlwind day.
It means the world to me! It also means that Texas Children’s is now understanding and appreciating creative arts as a means to help in the healing of the “whole child.” Children need more than medicine to get better. I will always be grateful to Texas Children’s for giving me the opportunity to provide and promote music therapy services. Music Therapy enhances our patient’s opportunities to learn, express, and play while they heal and rehabilitate. It positively impacts the way both parents and patients view their hospitalization experience. By letting me explore and create alongside of my patients this organization has helped me learn not just to hear but to listen, not just to see but to have vision, and not just to speak up but to sing proud.
In my opinion you are a Texas Children’s super star when the people you serve and work alongside of no longer see you as an individual, instead they see the actions and services that embody our core values to embrace freedom, lead tirelessly, live compassionately, and amplify unity. It seems I am now an embodiment of patient’s stories; when I walk into a room I hope people see service that has deeply impacted a patient’s admission or coworker’s career. Instead of seeing me, I hope they remember sessions that have brought great joy or great comfort to a time in someone’s life when it was most needed.
The children I serve; the opportunity to be the favorite part of someone’s day. I think it is so cool and humbling that I get to help be a light in a child and/or family’s darkest time – to help them continue to make happy memories, celebrate milestones, and show them that every facet of their child’s care is being taken into the deepest consideration.
The people I work beside every day. Texas Children’s Hospital has knocked it out of the park in bringing in people who are equal parts – head, heart and hands. The brilliance, service, leadership and passion every member of our team exudes is what pushes Texas Children’s to the top of the “dream job” charts. Our team knows what it means to serve the greater good.
My definition of leadership is this: If you are a leader, the true measure of your success is not how far you go, but how far those around you go as well. I believe everyone at Texas Children’s is a leader and therefore it is our responsibility to continually raise one another up, to push each other for the common goal of improving the health and lives of the kiddos and families we serve.
I would like to express gratitude to the people beyond the walls of Texas Children’s who have supported and sustained me through my career. Thank you to my family, husband, fellow music therapists and friends. Your unwavering love has given me the courage, knowledge and freedom to do my best every day.
Do you know someone who exemplifies our values? Then be sure to nominate them today!
Texas Children’s President and CEO Mark Wallace is committed to meeting every employee at Texas Children’s, and one way he does that is during the New Employee Pep Rally. More than 500 new employees were invited to attend the most recent Pep Rally on June 4 and from the moment team members arrived, they shared their excitement to be with Texas Children’s.
New employees, leaders, and assigned “buddies” mixed, mingled, and snapped selfies. To close the event, team captain – Wallace – celebrated what our team had accomplished and what’s ahead as our One Amazing Team keeps growing.
Cancer Center Director Dr. David Poplack was recognized as a Hometown Hero at the June 20 Houston Astros game against the Tampa Bay Rays at Minute Maid Park.
The Astros Hometown Heroes Program recognizes people from the Houston area who have helped their community in extraordinary ways.
Poplack has served as the director of Texas Children’s Cancer and Hematology Centers since 1993. Since his arrival, the Texas Children’s Cancer Center has grown exponentially, from seven faculty members, 42 employees, 4,000 square feet of laboratory space and less than $1 million in annual external grant funding in 1993 to over 180 faculty members, 1,000 employees, 100,000 square feet of lab space and $50 million in annual external grant funding.