Alexander Opotowsky - Cardiologist, Boston Adult Congenital Heart Program
The BACH service provides 24-hour access to consultation and care. Urgent office visits can be arranged as needed, and routine follow-up appointments are normally on time. Also, we pride ourselves on prompt communication with primary care providers.
Our services range from outpatient to inpatient to intensive care, and include:
- routine or advanced imaging
- cardiac and non-cardiac surgeries
- cardiac anesthesia guidance
- catheter-based diagnostics and interventions
- electrophysiologic diagnostics and interventions
- heart failure management and transplantation evaluation
- vascular medicine diagnostics and therapies
- pulmonary hypertension diagnostics and therapies
- support for young patients transitioning from pediatric and adult care
- contraception and family planning
- women’s health support
- family and patient support and guidance
- career and financial guidance
Clinicians in our outpatient service see BACH patients on a routine basis and during emergencies. We run outpatient clinics at Boston Children's Hospital, Boston Children's Hospital at Waltham and Brigham and Women’s Hospital.
We provide comprehensive diagnostic testing, offer complete therapeutic interventions, and coordinate patient care with specialty services within Boston Children's or at one of our affiliated hospitals: Brigham and Women's Hospital, Beth Israel Deaconess Hospital, the Dana Farber Cancer Center and the Mary Horrigan Connors Center for Women’s Health.
Disty Pearson, PA-C - Physician Asst., Boston Adult Congenital Heart Program
Outpatient Services Include:
- Cardiac Magnetic Resonance Imaging
- Functional Evaluation (Exercise Testing)
- Diagnostic Catheterization
- Catheter Based Interventions
- Cardiovascular Surgery
Our inpatient service treats, consults, and admits patients to three separate hospitals:
- Boston Children's Hospital
- Brigham and Women's Hospital
- Beth Israel Deaconess Medical Center.
The decision regarding which hospital to visit for inpatient care is reevaluated on a regular basis depending on the particular areas of expertise that are needed to best evaluate, diagnose and treat you.
The inpatient team is available 24-hours-a-day, seven days a week and works in conjunction with specialists at each hospital to ensure complete and comprehensive care.
Areas of expertise include:
- aggressive heart failure management
- ongoing care in the cardiac intensive care units
- post-operative care
- cardiac catheterization and innovative interventional cardiology
- diagnosis and treatment of pulmonary hypertension
- peri- and postpartum management in conjunction with high risk obstetricians
Our team collaborates with specialists such as electrophysiologists, cardiac surgeons, oncologists, gastroenterologists, hematologists and nephrologists.
In addition to our medical services, the BACH team provides teaching and education regarding the various congenital heart defects, interventions and management to interns, residents and fellows.
Patients who have had chronic childhood illness can benefit from transitioning into an adult program designed specifically to meet their needs. Programs for adults with congenital heart disease differ from the pediatric model in the following ways:
- Focus on physical aging: Adults are physically aging rather than physically developing. Adults with chronic illness often age at an accelerated rate physically, leading to early development of multiple adult-type co-morbidities. This is addressed in an adult program.
- Focus on adult-type co-morbidities: These co-morbidities are often different than pediatric chronic issues. For example, the management of diabetes, kidney disease, systemic hypertension, liver disease, psychiatric illness and even heart failure and arrhythmias are different in the adult versus the pediatric patient.
- Change in hospital visit dynamics: The dynamics of the visit evolve from a doctor-parent-patient triangle to a simple doctor-adult relationship. This, of course, doesn’t mean that family members shouldn’t be included. It just means that the relationship is patient-focused.
- Focus on problem-solving strategies: As young people develop, they move from using emotional coping strategies to problem-solving strategies. Chronic illness often interferes with this development and has been associated with depression and anxiety. An adult clinic can focus on, and recognize the importance of developing these strategies.
- Focus on patient education: An adult clinic works to promote a patient’s understanding of his cardiovascular issues, including basic anatomy and physiology of his congenital heart disease and surgical repair. An adult clinic also helps patients be aware of potential problems they may face in the future, with an emphasis on the importance of follow-up, adherence to medical and preventive care. This includes:
- knowing which signs and symptoms are important to watch for
- knowing why certain medications are prescribed and the potential side effects
- being informed about major generic health issues like sexual health, substance abuse, exercise and nutrition and insurability