Course Content
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Pediatric Heart Failure: “How to approach the management of Pediatric Heart Failure” Understanding heart failure: the basics in pediatric heart failure and congenital heart diseases. Basics of treatment and decision making in clinic cases
- Introduction. Definition of Heart Failure
- Etiology of Heart Failure in pediatric age
- Pathophysiology of Heart Failure
- Heart Failure in Congenital Heart Disease
- Natriuretic peptid system
- Biomarkers in Heart Failure
- Signs and Symptoms in pediatric age
- Classification of severity in pediatric Heart Failure
- Different forms of cardiomyopathies: “Diagnostic techniques and treatments”
- Dilated Cardiomyopathy
- Myocarditis
- Hypertrophic Cardiomyopathy
- Restrictive Cardiomyopathy
- Non-compaction Cardiomyopathy
- Arrhythmogenic Right Ventricular Dysplasia (ARVD)
- Evaluation Cardiomyopathies and Genetics
- Evaluation Quiz
- Arrhythmias in Pediatric Heart Failure: EKG abnormalities
- Indications ICD in adults and pediatric age
- Clinic Cases. Quiz
- Treatment in chronic pediatric Heart Failure
- New treatment: Sacubitril – Valsartan
- New therapies and Experimental
- Summary Pediatric Heart Failure therapies
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Basic and Advanced Echocardiography in Pediatric Heart Failure Description of basic and advanced echocardiography tools for diagnostic and follow-up of children affected by heart failure
- Journal Club: “Basic and advanced echocardiography in advanced heart failure: an overview”
- LV systolic function
- RV systolic function
- Cardiac Diastolic Function and Diastolic Heart Failure
- Tissue Doppler Imaging (DTI) and diastolic dysfunction
- Summary Echo left diastolic dysfunction
- RV diastolic dysfunction
- Management of pediatric diastolic dysfunction
- Clinic Cases
- dP/dt LV function assessment
- Myocardial Performance Index (Tei Index) Doppler Mitral Flow
- Myocardial Performance Index (Tei Index) DTI
- Basics of Strain and Strain-rate
- Global longitudinal Strain (GLS)
- Cardiac output assessment by Echo
- Advanced Imaging in Pediatric Heart Failure
- Echocardiography: Apps and webs
- Clinic Cases
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Pediatric Heart Transplant (I) Basic in inmunology and rejection. Indications of pediatric heart transplant and contraindications. Mechanical support in pediatric age. Surgery and perioperative treatment.
- Basis of transplant immunology
- Human leucocytes antigen (HLA)
- Blood group antigen (ABO)
- Graft Rejection
- Donor selection & evaluation
- Tissue typing and cross matching
- Ischemic time and the TransMedics® Organ Care System (OCS™)
- Indications and Contraindications of Pediatric Heart Transplant
- Indications of pediatric Mechanical cardiac support (MCS)
- Types of Devices for pediatric MCS
- VAD selection for pediatric MCS
- Surgery of Heart Transplant in pediatric age and in Congenital heart disease
- Principle Challenge in immunosuppressive therapies
- Induction therapy during surgery, postoperative period and denervated heart
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Pediatric Heart Transplant (II) Basic of immunosuppression treatment. Management of rejection and infections in pediatric heart transplant. Information for patients and relatives. Outcomes of heart transplant and indications of retransplantation
- Basis of immunosuppression therapy
- Risk of infection after transplantation
- Complication of chronic immunosuppression
- Basis of Rejection and assessment
- Endomyocardial biopsy and rejection
- Treatment of humoral and cellular rejection
- Chronic rejection: Coronary Artery Vasculopathy (CAV)
- Clinic follow-up in patient transplanted
- Cardiac Rehabilitation in pediatric heart transplant
- Survival and Causes of death in pediatric heart transplant
- Indications of retransplantation and survival
- Home Care after Pediatric Heart Transplant
- Palliative care in Pediatric Heart Failure and Heart Transplantation
- Future perspectives. Summary
- Clinic cases
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Final Quizz Congratulations! You finished the course, check your knowledge with this final test
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Fellow Evaluation Course Evaluation of the cardiac fellows who attended the course in May 2020
Home Care after Pediatric Heart Transplant
Authors: Mohammed AlHaddad and Yaser Alali (Pediatric Heart Failure & Transplant Coordinators at KFSH&RC)
Importance in any program: post Pediatric Heart Transplant Care at home and Family Education.
Objective: Create a comfortable environment for the heart transplant patients and their families and familiarize them with post transplant lifestyle, medications, benefits and risks of the procedure
Principals:
- Inform patients and their families that lifelong follow up medical care is mandatory.
- Commitment to follow up visits, laboratory tests, X-ray, echocardiography and biopsy is essential.
- Compliance to timely medications intake and adherence to the prescribed dosage.
Our supporting team at KFSH&RC is available for support 24 /7 (2 coordinators for pediatric HTx follow-up)Information
Provided to Patients and Families:
Educational material is provided to the family on discharge day, clarifying all above information in Arabic with the contact number of the coordinator to call for any queries.
- Follow up and medial care ( stay in Riyadh for the first 2 -3 months, appointments, Cardiac cath, lab tests….)
- Medication: Immunosuppressants and regular medications.
- Exercises
- Diet
- Hygiene and PPEs
- School attendance
- Animal and pets
- Religious aspect (fasting Ramadan , Umrah or Hajj)
Frequently asked questions
- What to do in case the patient vomits after taking the medication ?
- Why is the patient gaining weight and eating more than before?
- Is the patient allowed to go to crowded places ?
- Is the patient allowed to share the personal items with others ?
- What will happen if a dose of medication is skipped?
- How to stay safe if one of the family members got sick or has flu symptoms?
Risks and Complications:
- Transplant rejection and infections are the most common risks during the first year.
- Fever, Tachycardia, Dyspnea, Fatigue are the most common symptoms of complications. The family is instructed to contact us if any of these signs appear.
In case of emergency the patients should be transported to KFSH, if possible or to the nearest hospital