HELLO, MY NAME IS JACK RYCHIK.
I'M THE DIRECTOR OF THE
FETAL HEART PROGRAM
OF THE CARDIAC CENTER AT
THE CHILDREN'S HOSPITAL
OF PHILADELPHIA, AND I ALSO
PLAY AN ADDITIONAL ROLE
IN BEING THE DIRECTOR
OF THE SINGLE VENTRICLE
SURVIVORSHIP PROGRAM.
THERE ARE A NUMBER OF VERY
IMPORTANT AND INTERESTING
AND EXCITING NEW
DEVELOPMENTS THAT ARE TAKING
PLACE IN PRENATAL CARE,
CARE BEFORE BIRTH,
FOR FETUSES THAT HAVE
CARDIOVASCULAR DISEASE.
ONE IS THE TECHNOLOGICAL
REVOLUTION THAT EXISTS
IS ALLOWING US TO PERFORM
SCANNING OF THE FETUS
AT EARLIER AND EARLIER
POINTS IN TIME.
WHEREAS, EVEN 10 YEARS AGO
SCANNING OF THE FETUS COULD
TAKE PLACE AT 18 OR
20 WEEK'S GESTATION,
WE CAN NOW LOOK AT MINUTE
DETAILS OF THE FETAL HEART
AS EARLY AS 13 WEEK'S
GESTATION AND OBTAIN
A WEALTH OF INFORMATION ABOUT
THE STATE OF THE CIRCULATION
AND THE CARDIOVASCULAR
SYSTEM.
SECONDLY, WE ARE MOVING FROM
A PERIOD OF TIME IN WHICH WE
ARE FOCUSING ON DIAGNOSTICS
TO NOW TRULY BEGINNING
TO THINK ABOUT AND IMPLEMENT
STRATEGIES FOR INTERVENTION
FOR TREATING
DISEASE BEFORE BIRTH.
THERE ARE CATHETER
TECHNIQUES THAT ARE
AVAILABLE THAT CAN ALLOW US
TO GAIN ACCESS TO THE FETAL
CIRCULATION AND, IN FACT,
PERFORM CATHETER PROCEDURES,
SUCH AS OPENING A NARROWED
VALVE OR PLACING A STENT
IN THE HEART.
OUR GOAL IS TO, BY VIRTUE OF
HAVING SUCH A LARGE CLINICAL
EXPERIENCE, TAKE ON THE
OBLIGATION OF CREATING NEW
INFORMATION AND NEW SCIENCE
AND LEARN NEW THINGS
THAT WE CAN THEN TRANSLATE
INTO CLINICAL CARE.
WE CAN ALSO NOW BEGIN TO
MOVE INTO THINKING ABOUT
UTILIZING MEDICATIONS
OR OTHER THERAPIES,
SUCH AS ADMINISTERING
OXYGEN TO MOTHERS TO HELP
AND MODIFY THE
DEVELOPMENT OF THE FETAL
CARDIOVASCULAR SYSTEM.
THEY HAVE A VERY IMPORTANT
FOCUS NOW ON LOOKING
AT THE IMPACT OF A DIAGNOSIS OF
HEART DISEASE ON THE MOTHER,
ON HER LEVELS OF STRESS
AND HOW THAT INFLUENCES
FAMILY DYNAMICS.
WE THINK NOT ONLY IS THAT
IMPORTANT FOR THE MOTHER,
BUT ALSO THAT CAN INFLUENCE
THE WELL-BEING OF THE FETUS
IN A FEEDBACK LOOP.
SO A LOT OF RESEARCH WORK
UNDERWAY NOW IN MEASURING
MATERNAL STRESS AND LOOKING
AT THE PHYSIOLOGIC INFLUENCE
ON THE FETUS.
I'VE BEEN A MEMBER OF THE
CARDIAC CENTER AND WORKING
HERE AT THE CHILDREN'S
HOSPITAL OF PHILADELPHIA
FOR OVER 20 YEARS.
OUR FIELD OF CONGENITAL
HEART DISEASE IS STILL
A QUITE YOUNG ONE,
AND THERE'S STILL MUCH
THAT WE DON'T UNDERSTAND.
AND OVER THIS RELATIVELY
SHORT SPAN OF 20 YEARS,
WE'VE BEEN ABLE TO TRULY
CHANGE HOW WE APPROACH
PATIENTS AND HOW WE
MANAGE OUR PATIENTS.
IT'S THAT ASPECT OF THIS
PARTICULAR FIELD THAT
I THINK IS INCREDIBLY EXCITING
AND KEEPS ME VERY MUCH
ENGAGED IN THAT ONE CAN
THINK ABOUT INNOVATIONS,
ONE CAN BEGIN TO APPLY THEM
TOWARDS INDIVIDUAL PATIENTS,
AND ONE CAN MAKE A MAJOR
DIFFERENCE IN THE LIVES
OF OUR CHILDREN THROUGH THE
EFFORTS AND THE COLLABORATION
THAT EXISTS WITHIN
THE CARDIAC CENTER
OF THE CHILDREN'S HOSPITAL
OF PHILADELPHIA.
