This week we speak with Dr. John Brown who is the Harris B. Schumacker Professor Emeritus of Surgery at the University of Indiana. A congenital heart surgeon for over 45 years, Dr. Brown has performed more than 15,000 pediatric heart operations at Riley Hospital for Children and another 5000 heart operations in adults at IU and Methodist Hospitals. He performed the first pediatric heart transplant in Indiana and developed the first clinical use of the bovine jugular vein and valve for a pulmonary valve replacment in children. He also performed the only known twin to twin newborn heart transplant in the world. He has done and seen it all and has a unique perspective. How did he achieve so much and still have a succesful 56 year marriage to his wife Carol Ann? What is Dr. Brown most proud of in a career that is as prolific as his? What advice would he have have for the next generation? Prepare to be inspired by this master surgeon and friend and colleague of many in our field.

This week we review a fascinating very long-term surgical follow-up study from the team at Royal Children's Hospital in Melbourne reviewing over 30 year follow-up following the arterial switch operation for the treatment of transposition of the great vessels. What percentage of patients need reintervention by 30 years post neonatal repair? What anatomical sub-types are more likely to be associated with a need for reintervention and why? When intervention is required for neo-aortic or aortic root problems, can these usually be repaired or do they require replacement? Professor Igor Konstantinov from Melbourne shares his deep insights into this complex patient group. 

• DOI: 10.1016/j.jtcvs.2025.09.008

Why are compassion, kindness and humility critical to the care of patients in 2026? How can practitioners be taught these approaches and how does this 'triple gift' not only improve patient care but also professional interactions? Can this be taught? If so, what are the best ways? Professor Colin McMahon of Children's Health Ireland at Crumlin shares his deep insights into this important and oft-neglected aspect of being a caregiver. 

• DOI: 10.1007/s00246-026-04161-y

Following today's interview we also briefly speak with Professor Jack Rychik of Children's Hospital of Philadelphia about the upcoming CHOP 2026 meeting entitled "Cardiology 2026 - Together!". For those interested in possibly attending this meeting which begins on 2.28.26, take a look at the website below for more information:

https://www.chop.edu/events/cardiology-2026

This week we replay an episode from nearly 2 years ago about an editorial commentary from multiple congenital heart surgical leaders in the US. The topic of their expert opinion piece is the concept of public reporting of results and their 'amplification' through organizations such as US News and World Report, to name one. How has the use of the database from STS been sometimes misinterpreted through public reporting or ranking systems? What was the initial intent of the STS database and how does the present usage of these data differ from the initial intent? Do STS risk adjustment models capture all aspects of risk for patients undergoing surgery and how do deficiencies in this result in unfair 'rankings' of programs? Can we 'take control' of our data and interpret it more clearly and accurately for the public and reduce misusage or misinterpretation of the data? How can public reporting result in improved outcomes? How can 'gaming' of the system be reduced? Dr. Emile Bacha, Professor of Surgery at Columbia University shares his deep insights into a complex and challenging topic.

• DOI: 10.1016/j.jtcvs.2023.03.022

This week we review a recent work on fetal atrial septal interventions in the patient with hypoplastic left ventricle or double outlet right ventricle with mitral valve atresia/dysplasia and a restrictive or intact atrial septum. How often was this procedure technically feasible and successful? What are the criteria to be considered for such an intervention? Why does use of a laser improve the crossing of the atrial septum in this procedure? Should prenatal intervention be used instead of postnatal intervention in this setting? Associate Professor of Pediatrics at Baylor College of Medicine, Dr. Betul Yilmaz shares her insights into this fascinating topic.

https://doi.org/10.1161/CIRCINTERVENTIONS.125.015209

This week we replay an important episode from 2 years ago in which we delved into the world of antibiotic prophylaxis for dental procedures. What are the data to support its use in the congenital heart patient? Why has this been such a difficult topic to study? What do we now know about this topic and what still remains unanswered? Given the low prevalence but dire consequences of this disease, how can investigators consider studying this topic in the future? Is there adequate equipoise to proceed with a randomized controlled trial? We speak with Advanced Imaging Fellow at Boston Children's Hospital, Dr. Francesca Sperotto of Harvard University about her recent multicenter meta-analysis of 30 studies including over one million cases of endocarditis. 

• DOI: 10.1001/jamacardio.2024.0873

This week we review a follow-up work from the team at USC and Children's LA led by Dr. Yaniv Bar-Cohen on a novel micropacemaker. How has the device changed and improved over the past 3-5 years since his last visit to Pediheart? What are some of the difficulties of designing a device that is both stable on the epicardium but not inclined to develop inflammation? Why did the team move from a screw in eletrode model to a different design? What applications could this device have both for infants but also adults? Dr. Bar-Cohen shares his deep knowledge of both electrophysiology and device design this week.

• DOI: 10.1016/j.hrthm.2025.01.036

For those interested in stepping back in time to hear Dr. Bar-Cohen's first description of an earlier version of this novel pacemaker, here is the link from 2018:

https://podcasts.apple.com/us/podcast/pediheart-podcast-26-novel-means-of-epicardial/id1341472214?i=1000498801107

This week we review a recent large scale PHIS database study on pericardial effusion following congenital heart surgery. Which operations other than ASD are most highly associated with the development of an effusion? What might be some approaches both surgically and medically to reduce the chances of these developing or requiring intervention? What are the implications of a pericardial effusion after surgery? How many require readmission for this complication? Dr. Mario O'Connor, who is a congenital heart surgical research fellow at UT Austin, shares his insights into his recent publication. 

• DOI: 10.1177/21501351251322876

This week we review a recent report on LV strain following the Ross operation. Can this sort of functional analysis help predict remodeling after aortic valve replacement? How can the type of Ross potentially affect heart function after the operation? Why might some parameters of LV strain improve but others not following surgery? Can preoperative strain measurements predict perioperative course? How does the addition of a Konno to a Ross change the outcomes of function? We speak with Chief of Cardiovascular Surgery at Primary Children's Hospital in Utah, Dr. S. Adil Husain and 3rd year integrated cardiac surgical resident Michal Schaffer of the University of Utah about these and other topics related to LV function following the Ross operation in children. 

·         DOI: 10.1007/s00246-025-04124-9

This week we end 2025 with a Pediheart tradition - an episode on personal finance for medical professionals with noted authority on index investing and personal finance, Mr. Paul Merriman. Paul is a retired investment advisor who now has a popular podcast "Sound Investing" and website in which he offers advice on investing for 'do it yourself' investors. In this week's episode, the 5th of his visits to Pediheart, Mr. Merriman discusses 'factor investing' via index-like ETF's and funds. He also reviews who he believes might benefit from a financial advisor, what sort of advisor most should seek out and why he believes that many do not need one if they can 'stay the course'. Resources mentioned in today's podcast are below. Wishing all a happy and healthy new year in 2026. 

Paul's website:
https://www.paulmerriman.com/#gsc.tab=0
'Best In Class' ETF's:
https://www.paulmerriman.com/Best-in-Class-ETF-Recommendations2025#gsc.tab=0
Sound Investing 'Quilt Charts':
https://irp.cdn-website.com/6b78c197/files/uploaded/(K)_Quilt_Charts_(1928-2024)_-_2024_Returns_(1).pdf
DFA 'Turn Out The Noise':
https://www.dimensional.com/film

As a reminder, all of the information provided in this week's episode should be considered entertainment and all financial decisions should be vetted with professionals or knowledgeable and trusted friends/family.