Inaugural CHOC Conference on Fetal Heart Disease Detection and Management, April 28-29

Early fetal detection, obstructive left heart lesions, variants of Tetralogy of Fallot, and Heterotaxy syndrome are just some of the topics featured at the upcoming CHOC Children’s conference, Pacific Coast Fetal Cardiology 2017: An Interactive and Case-Based Educational Symposium, held on April 28-29, 2017 at the Newport Beach Marriott Hotel and Spa.

“Our conference will focus on the use of cases to convey important points on fetal heart disease detection and management,” says conference co-chair Dr. Wyman Lai, medical director, echochardiography, and co-medical director, CHOC Heart Institute.

Open to obstetricians, radiologists, maternal fetal medicine specialists, pediatric cardiologists and sonographers, the anticipated event will cover how to detect serious heart defects during pregnancy, and how to discern when to refer to a fetal cardiology specialist. Keynote speakers, Dr. Wayne Tworetzky from Boston Children’s and Dr. Lynn Simpson from Columbia University Medical Center, will be among the nationally recognized experts attending.

The conference is sponsored in part by the UCSF Benioff Children’s Hospitals and several ultrasound companies. Additionally, two parent support groups will be present as exhibitors. The groups have a mission to improve early fetal cardiac detection, which allows for 1) time for appropriate family counseling, 2) better planning of care for delivery location and method, and 3) better coordination of care between the multiple subspecialties involved.

“Studies have shown improved outcomes for cardiac patients who are diagnosed before birth compared to those diagnosed after birth. This highlights the importance of improving the fetal detection rate for congenital heart disease in our communities,” Dr. Lai adds.

After the conference participants will be able to:

  • Use suggested best practices for fetal cardiology screening
  • Apply the current International Society for Ultrasound in Obstetrics and Gynecology (ISUOG) and American Society of Echocardiography (ASE) guidelines to improve screening efficacy.
  • Rule out or assess for selected complex anomalies during fetal cardiology screening.
  • Diagnose obstructive left heart lesions and counsel families on treatment options and prognoses.
  • Use key featured reviewed to diagnose Heterotaxy syndrome.
  • Counsel patients on the benefits and limitations of early fetal echocardiography.
  • Diagnose Tetralogy of Fallot, its variants and refer for treatment.

Participants are invited to submit an interesting case, by March 14 at https://fetalcardiology.eventgrid.com/, in one or more of the following clinical areas:

  • Obstructive left heart lesions
  • Heterotaxy syndrome
  • Early fetal echochardiography
  • Variants of Tetralogy of Fallot

To register for Pacific Coast Fetal Cardiology 2017: An Interactive and Case-Based Educational Symposium, visit CHOC’s website.

In the Spotlight: Wyman Lai, M.D.

A nationally-recognized pediatric cardiologist with expertise in fetal cardiology and non-invasive imaging for heart disease in fetuses and children has joined CHOC Children’s. Dr. Wyman Lai is the new medical director of echocardiography at CHOC; co-medical director of the CHOC Heart Institute, and assistant division chief of cardiology with CHOC Children’s Specialists.

“CHOC has a fabulous mix of state-of-the-art care, community presence, and academic achievement. I thoroughly enjoy working with my colleagues, who strive to provide the very best care available. The administrative staff at CHOC has also been extremely supportive. Together we are building a pediatric service that rivals any in the region, and we have our sights on even higher goals,” Dr. Lai says.

Dr. Lai’s passion for helping others inspired him to become a doctor. His original plan was to go into academic primary care pediatrics, and he majored in maternal and child health for his Master of Public Health degree. Early in his training, he switched to pediatric cardiology after becoming fascinated with what the pediatric cardiologists were doing.

“In pediatric cardiology, we are able to make a profound difference in the lives of our patients. With our surgical colleagues, we have made incredible advances in life-saving therapies over the past five decades,” Dr. Lai says. “The heart is an amazingly complex organ; it starts off as a simple tube, and it’s a wonder that it ever develops normally into a four-chambered pumping organ that delivers oxygen efficiently throughout our body.”

Dr. Lai attended medical school at the Alpert Medical School of Brown University. He completed his residency at UCLA Ronald Reagan Medical Center, followed by a pediatric cardiology fellowship at UCLA Medical Center, and later, a pediatric cardiology MRI fellowship at Boston Children’s Hospital.

Since joining CHOC, Dr. Lai has been treating patients with complex congenital heart disease. He is also treating patients with the full spectrum of heart conditions, from heart murmurs to chest pain and syncope.

Dr. Lai’s approach towards his patients and their families is to treat them like family members.

“As with all families, however, not everyone is the same,” he explains. “Some patients and parents want more medical information and some less. Some want to be very involved in the decision-making process and some not so much. My practice is to provide them with enough information and support, so they feel comfortable with the decisions they are making.”

Along with Drs. Nita Doshi and Pierangelo Renella, Dr. Lai is helping to build a great program in fetal cardiology at CHOC. He is also working with Dr. Renella to grow the congenital cardiac MRI program, including the use in non-invasive imaging for creating 3D heart models.

“We recently used a 3D cardiac MRI dataset to print several heart models that were used to assist in the planning of care for a child with complex congenital heart disease. Another area of innovation is our purchase of new patient monitoring software in the cardiovascular ICU that will help us to identify patients at risk for acute deterioration before it happens,” Dr. Lai says.

In April, Dr. Lai will serve as co-program director for an inaugural conference hosted by CHOC, Pacific Coast Fetal Cardiology 2017: An Interactive and Case-Based Educational Symposium, in Newport Beach. The conference supports CHOC’s efforts to improve the success of fetal cardiac screening in the region, he says.

Dr. Lai is a prolific author who has published numerous journal articles and chapters, and has contributed to several high-level textbooks utilized throughout the country. He has lectured extensively in the United States and internationally. Dr. Lai is a member of the American College of Cardiology, American Society of Echocardiography, and American Academy of Pediatrics, among other professional organizations. In addition, he sits on the National Board of Echocardiography Board of Directors.

His ongoing academic interests include creating a reliable set of normal values for cardiovascular structures in newborns and children, developing pediatric cardiac MRI guidelines, and testing new cardiac MRI sequences.

In his spare time, Dr. Lai loves spending time with his family. He also enjoys swimming, biking and running. He hopes to run in this year’s Boston and New York marathons, which he has participated in the past. He is also attending classes for a health care executive MBA at UC Irvine.

For cardiology referral guidelines, click here. To refer a patient, call 888-770-2462. 

To contact Dr. Lai, please call 714-509-3939.

CHOC Children’s Expands Fetal Cardiology Program

Approximately 1 percent, or 40,000, babies in the United States are born with a congenital heart disease each year. That’s almost 5,000 babies in California alone. In order to catch problems as early as possible, fetal cardiology specialists at the CHOC Children’s Heart Institute work with pregnant women to evaluate, diagnose and manage babies in utero who may be at risk for congenital heart defects, heart failure or rhythm disturbances.

CHOC offers the only comprehensive fetal cardiology services in Orange County, and our team has advanced training in fetal echocardiography, fetal magnetic resonance imaging, electrophysiology and genetics.

“Fetal echocardiography is a powerful tool that helps identify significant abnormalities and allows for family, delivery and interventional planning as necessary,” says Wyman Lai, MD, who recently joined CHOC from Columbia University in New York to lead CHOC’s non-invasive cardiac imaging program.

Fetal cardiac imaging is performed using ultrasound machines with the highest resolution imaging available, including 2D and Doppler analysis, as well as 3D technology. This allows us to perform first trimester screening so that patients can be referred at the earliest stages of pregnancy.

CHOC board-certified cardiologists perform fetal echocardiograms in their offices to help detect heart abnormalities before birth. At the time of appointment, patients receive a comprehensive diagnosis and care plan. Depending on the child’s condition, referrals to other experts, such as cardiac interventionalistscardiac electrophysiologistscardiac surgeons and heart failure specialists will be provided as needed. Early intervention improves the chance of survival after delivery for babies with severe defects.

Who Should Have a Fetal Echocardiogram

Pregnancies may be at risk for congenital heart disease for a variety of reasons.

Fetal risk factors include:

  • An abnormal appearing heart
  • Abnormal heart rate or arrhythmia on routine screening ultrasound
  • Aneuploidy (chromosomal abnormality)
  • Increased nuchal translucency thickness at first trimester evaluation
  • Noncardiac fetal structural abnormalities
  • A two-vessel umbilical cord
  • Identical twins
  • Fluid accumulation in the fetus.

Maternal risk factors include:

  • Maternal diabetes, lupus or other systemic disease that involves the heart
  • First-trimester use of known teratogens
  • Assisted reproduction technology
  • Maternal congenital heart disease.

Familial risk factors include:

  • A history of a previous child being born with a heart defect
  • The father being born with a heart defect
  • Other close relatives being born with heart defects or syndromes known to involve the heart.

Fetal Cardiology Referrals

If a pregnant woman is at high risk for delivering a child with congenital heart disease, our fetal cardiology specialists are available for consultation and referral. They can be reached at 714-509-3939, or you can find a fetal cardiologist here in our directory.