Medicine challenges me to understand how to modify complex diseases processes with a goal of improving patient outcomes and quality of life.

EDUCATION

Undergraduate Degree

Biochemical Sciences
  • Harvard University , 2000 , Boston , MA

Medical School

  • Columbia University College of Physicians & Surgeons , 2004 , New York , NY

Internship

  • Children’s Hospital at Montefiore , 2005 , Bronx , NY

Residency

Pediatrics
  • Children’s Hospital at Montefiore , 2007 , Bronx , NY

Fellowship

Pediatric Cardiology
  • Boston Children's Hospital , 2009 , Boston , MA

Fellowship

Chief Fellow, Pediatric Cardiology
  • Boston Children's Hospital , 2010 , Boston , MA

Fellowship

Pediatric Cardiology; Heart Failure; Transplantation Senior Fellow
  • Boston Children's Hospital , 2011 , Boston , MA

Philosophy of Care

Having a sick child can leave parents feeling scared and powerless. My goal is to help children and parents understand their illness so that they can regain some amount of control. Educating children, families, and other medical providers about heart failure is a key component of that process. We can then discuss treatment options and make the best decision for each individual child and family.

Medicine is a calling. I became a doctor because I wanted to be able to help, protect and heal. Since I was a child, I been fascinated with how things work and how we can make them work better. Medicine challenges me to understand how to modify complex diseases processes with a goal of improving patient outcomes and quality of life.

PROFESSIONAL HISTORY

I am a pediatric cardiologist at Boston Children’s Hospital specializing in Heart Failure & Transplantation. My clinical work is focused on the evaluation and management of children with advanced heart failure and those requiring mechanical circulatory support and/or heart transplantation. I am also a translational researcher focused on the development of biomarkers and novel imaging technologies which will allow for non-invasive diagnosis of cardiac allograft vasculopathy (CAV).

 
I am a clinical expert in the diagnosis and management of the highly sensitized pediatric heart transplant patient and those who develop antibody mediated rejection. I have published our center’s experience with peri-operative desensitization for crossmatch positive heart transplantation and utilized eculizumab (a terminal complement inhibitor) and bortezomib (a proteasome inhibitor) for the treatment of antibody mediated rejection. I am the only transplant physician in our group to perform intracardiac hemodynamics, endomyocardial biopsies, and coronary angiography in transplant patients and have expertise in the diagnosis of CAV.

I have demonstrated that VEGF-A can be used to stratify risk for development CAV in children after heart transplantation. We are planning a prospective study to determine if VEGF-A testing can safely reduce the frequency of invasive coronary angiography procedures in pediatric heart transplant recipients. In addition, I am leading a multi-center collaboration to design and perform the first randomized control trial of maintenance immunosuppression in pediatric heart transplantation. We expect this trial will support the first FDA approved indication for maintenance immunosuppression in pediatric heart transplantation.

CERTIFICATIONS

  • American Board of Pediatrics, General Pediatrics
  • American Board of Pediatrics, Pediatric Cardiology

PUBLICATIONS

Publications powered by Harvard Catalyst Profiles

  1. Giant Cell Myocarditis in Children: Elusive Giant Cells Might Not Be the Only Clue. Pediatr Dev Pathol. 2021 Oct 04; 10935266211044952. View abstract
  2. Clinical and hemodynamic characteristics of the pediatric failing Fontan. J Heart Lung Transplant. 2021 Jul 29. View abstract
  3. ISHLT consensus statement for the selection and management of pediatric and congenital heart disease patients on ventricular assist devices Endorsed by the American Heart Association. J Heart Lung Transplant. 2021 08; 40(8):709-732. View abstract
  4. Assessment and Treatment of a Young Adult with Congenital Heart Disease and ADHD. J Dev Behav Pediatr. 2021 05 01; 42(4):340-342. View abstract
  5. Hepatorenal dysfunction assessment with the Model for End-Stage Liver Disease Excluding INR score predicts worse survival after heart transplant in pediatric Fontan patients. J Thorac Cardiovasc Surg. 2021 Feb 18. View abstract
  6. Retrospective Analysis of Clinical Genetic Testing in Pediatric Primary Dilated Cardiomyopathy: Testing Outcomes and the Effects of Variant Reclassification. J Am Heart Assoc. 2020 06 02; 9(11):e016195. View abstract
  7. The ABO-incompatible paradigm shifts only as far as allocation policy allows. J Heart Lung Transplant. 2020 07; 39(7):636-638. View abstract
  8. Brighter Future for Children with Congenital Heart Disease Requiring Heart Transplantation? A UNOS Registry Analysis over the Last Three Decades. J Heart Lung Transplant. 2020 Apr; 39(4S):S206-S207. View abstract
  9. Coagulation Monitoring Correlation with Bivalirudin Dosing in Pediatric Ventricular Assist Device Support. J Heart Lung Transplant. 2020 Apr; 39(4S):S467-S468. View abstract
  10. The TEAMMATE Trial: Study Design and Rationale of the First Pediatric Heart Transplant Randomized Clinical Trial. J Heart Lung Transplant. 2020 Apr; 39(4S):S207-S208. View abstract
  11. Marijuana in pediatric and adult congenital heart disease heart transplant listing: A survey of provider practices and attitudes. Pediatr Transplant. 2020 03; 24(2):e13640. View abstract
  12. Association of Clinical Rejection Versus Rejection on Protocol Biopsy With Cardiac Allograft Vasculopathy in Pediatric Heart Transplant Recipients. Transplantation. 2020 01; 104(1):e31-e37. View abstract
  13. Use of the terminal complement inhibitor eculizumab in paediatric heart transplant recipients. Cardiol Young. 2020 Jan; 30(1):107-113. View abstract
  14. Current evaluation and management of plastic bronchitis in the pediatric population. Int J Pediatr Otorhinolaryngol. 2020 Mar; 130:109799. View abstract
  15. Myocardial Infarct After Marijuana Inhalation in a 16-year-old Adolescent Boy. Pediatr Dev Pathol. 2019 Jan-Feb; 22(1):80-86. View abstract
  16. Heart failure after the Norwood procedure: An analysis of the Single Ventricle Reconstruction Trial. J Heart Lung Transplant. 2018 07; 37(7):879-885. View abstract
  17. Managing risk of surgical procedures in pediatric transplant recipients taking mTOR inhibitors: What is the optimal strategy? Pediatr Transplant. 2018 02; 22(1). View abstract
  18. Clinical practice patterns are relatively uniform between pediatric heart transplant centers: A survey-based assessment. Pediatr Transplant. 2017 Aug; 21(5). View abstract
  19. The Evolution of a Pediatric Ventricular Assist Device Program: The Boston Children's Hospital Experience. Pediatr Cardiol. 2017 Jun; 38(5):1032-1041. View abstract
  20. Development and validation of a major adverse transplant event (MATE) score to predict late graft loss in pediatric heart transplantation. J Heart Lung Transplant. 2018 04; 37(4):441-450. View abstract
  21. Into the hearts of babes: Stem cell therapy for pediatric heart failure. J Heart Lung Transplant. 2017 08; 36(8):830-832. View abstract
  22. Dilated Cardiomyopathy in a 2-Year-Old Infant. Clin Chem. 2017 01; 63(1):433-435. View abstract
  23. Vascular endothelial growth factor A is associated with the subsequent development of moderate or severe cardiac allograft vasculopathy in pediatric heart transplant recipients. J Heart Lung Transplant. 2017 Apr; 36(4):434-442. View abstract
  24. Cholesterol efflux capacity of high-density lipoprotein correlates with survival and allograft vasculopathy in cardiac transplant recipients. J Heart Lung Transplant. 2016 11; 35(11):1295-1302. View abstract
  25. Is Endomyocardial Biopsy a Safe and Useful Procedure in Children with Suspected Cardiomyopathy? Pediatr Cardiol. 2016 Oct; 37(7):1200-10. View abstract
  26. Finding the correct role for heart transplant in the treatment of hypoplastic left heart syndrome. J Heart Lung Transplant. 2016 Mar; 35(3):299-300. View abstract
  27. What Is the Role of Developmental Disability in Patient Selection for Pediatric Solid Organ Transplantation? Am J Transplant. 2016 Mar; 16(3):767-72. View abstract
  28. Use of [18F]FDG Positron Emission Tomography to Monitor the Development of Cardiac Allograft Rejection. Transplantation. 2015 Sep; 99(9):e132-9. View abstract
  29. Multicenter Analysis of Immune Biomarkers and Heart Transplant Outcomes: Results of the Clinical Trials in Organ Transplantation-05 Study. Am J Transplant. 2016 Jan; 16(1):121-36. View abstract
  30. Summary of the 2015 International Paediatric Heart Failure Summit of Johns Hopkins All Children's Heart Institute. Cardiol Young. 2015 Aug; 25 Suppl 2:8-30. View abstract
  31. Emerging science in paediatric heart transplantation: donor allocation, biomarkers, and the quest for evidence-based medicine. Cardiol Young. 2015 Aug; 25 Suppl 2:117-23. View abstract
  32. Translational implications of endothelial cell dysfunction in association with chronic allograft rejection. Pediatr Nephrol. 2016 Jan; 31(1):41-51. View abstract
  33. Circulating donor-derived cell-free DNA: a true biomarker for cardiac allograft rejection? Ann Transl Med. 2015 Mar; 3(4):47. View abstract
  34. Safety and efficacy of radiofrequency wire recanalization of chronic central venous occlusions. J Vasc Access. 2015 Jul-Aug; 16(4):309-14. View abstract
  35. Antibody depletion for the treatment of crossmatch-positive pediatric heart transplant recipients. Pediatr Transplant. 2013 Nov; 17(7):661-9. View abstract
  36. Effect of inhaled iloprost on the exercise function of Fontan patients: a demonstration of concept. Int J Cardiol. 2013 Oct 03; 168(3):2435-40. View abstract
  37. VEGF-C, VEGF-A and related angiogenesis factors as biomarkers of allograft vasculopathy in cardiac transplant recipients. J Heart Lung Transplant. 2013 Jan; 32(1):120-8. View abstract
  38. Key Features of the Intragraft Microenvironment that Determine Long-Term Survival Following Transplantation. Front Immunol. 2012; 3:54. View abstract
  39. Endomyocardial biopsy and selective coronary angiography are low-risk procedures in pediatric heart transplant recipients: results of a multicenter experience. J Heart Lung Transplant. 2012 Apr; 31(4):398-409. View abstract
  40. Sudden death after pediatric heart transplantation: analysis of data from the Pediatric Heart Transplant Study Group. J Heart Lung Transplant. 2011 Dec; 30(12):1395-402. View abstract
  41. Changes in echocardiographic measures of systolic and diastolic function in children 1 year after hematopoietic SCT. Bone Marrow Transplant. 2011 Dec; 46(12):1532-9. View abstract
  42. Variant translocation with a deletion of derivative (9q) in a case of Philadelphia chromosome positive (Ph +) essential thrombocythemia (ET), a variant of chronic myelogenous leukemia (CML) with a poor prognosis. Leuk Lymphoma. 2005 Dec; 46(12):1801-6. View abstract