I seek to find the best treatment option for every patient, taking into account the unique anatomic, physiologic, social and emotional considerations that apply to each individual case.


Undergraduate Degree

  • Columbia College , 1978 , New York , NY

Medical School

  • Harvard Medical School , 1982 , Boston , MA


  • Albert Einstein College of Medicine , 1983 , Bronx , NY


  • Albert Einstein College of Medicine , 1986 , Bronx , NY

Graduate Degree

  • Columbia-Presbyterian Medical Center , 1989 , New York , NY

Philosophy of Care

I love interacting with children and I love physiology. I seek to find the best treatment option for every patient, taking into account the unique anatomic, physiologic, social and emotional considerations that apply to each individual case.


During my pediatric cardiology fellowship at Columbia-Presbyterian Medical Center, I first became interested in the impact of congenital heart disease on a child’s ability to exercise. After completing my fellowship I worked for two years as a staff pediatric cardiologist at Downstate Medical Center in Brooklyn NY. I then joined the faculty at Tufts Medical Center and started an exercise physiology program there. I ultimately became the chief of Pediatric cardiology and served in that role until November 2002, when I joined Boston Children’s Hospital’s Pediatric Cardiology Department and became Director of the Exercise Physiology Laboratory. In addition to caring for patients with cardiovascular disease, I have engaged in extensive clinical research focusing upon the effect of congenital heart disease on a patient’s exercise function, the benefits of exercise in this population and the insights that exercise physiology testing can provide about the health of these patients. I have also studied novel ways of assessing a patient’s heart function and explored novel treatment approaches for patients with muscular dystrophy and patients with Fontan physiology.


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


Publications powered by Harvard Catalyst Profiles

  1. Cardiac resynchronization therapy improves the ventricular function of patients with Fontan physiology. Am Heart J. 2020 12; 230:82-92. View abstract
  2. Exercise Capacity and Predictors of Performance After Fontan: Results from the Pediatric Heart Network Fontan 3 Study. Pediatr Cardiol. 2021 Jan; 42(1):158-168. View abstract
  3. The Adaptation of Pediatric Exercise Testing Programs to the Coronavirus/COVID-19 Pandemic. World J Pediatr Congenit Heart Surg. 2021 01; 12(1):43-47. View abstract
  4. Letter by Opotowsky et al Regarding Article, "Results of the FUEL Trial". Circulation. 2020 Jul 28; 142(4):e38-e39. View abstract
  5. Establishing a Comprehensive Pediatric Cardiac Fitness and Rehabilitation Program for Congenital Heart Disease. Pediatr Cardiol. 2020 Dec; 41(8):1569-1579. View abstract
  6. Results of the FUEL Trial. Circulation. 2020 02 25; 141(8):641-651. View abstract
  7. A prospective 5-year study of exercise performance following Melody valve implant. Am Heart J. 2019 03; 209:47-53. View abstract
  8. Exercise testing and spirometry as predictors of mortality in congenital heart disease: Contrasting Fontan physiology with repaired tetralogy of Fallot. Congenit Heart Dis. 2018 Nov; 13(6):903-910. View abstract
  9. Rationale and design of Long-term Outcomes and Vascular Evaluation after Successful Coarctation of the Aorta Treatment study. Ann Pediatr Cardiol. 2018 Sep-Dec; 11(3):282-296. View abstract
  10. A Pilot Study of Inspiratory Muscle Training to Improve Exercise Capacity in Patients with Fontan Physiology. Semin Thorac Cardiovasc Surg. 2018 Winter; 30(4):462-469. View abstract
  11. Incidence and Predictors of Clinically Important and Dangerous Arrhythmias During Exercise Tests in Pediatric and Congenital Heart Disease Patients. JACC Clin Electrophysiol. 2018 10; 4(10):1319-1327. View abstract
  12. Impact of the cone operation on left ventricular size, function, and dyssynchrony in Ebstein anomaly: a cardiovascular magnetic resonance study. J Cardiovasc Magn Reson. 2018 05 21; 20(1):32. View abstract
  13. Design and rationale of the Fontan Udenafil Exercise Longitudinal (FUEL) trial. Am Heart J. 2018 07; 201:1-8. View abstract
  14. A Randomized Trial Comparing Cardiac Rehabilitation to Standard of Care for Adults With Congenital Heart Disease. World J Pediatr Congenit Heart Surg. 2018 03; 9(2):185-193. View abstract
  15. Pseudoaneurysm complicating right ventricle-to-pulmonary artery conduit surgery: Incidence and risk factors. J Thorac Cardiovasc Surg. 2017 12; 154(6):2046-2049. View abstract
  16. Decline in peak oxygen consumption over time predicts death or transplantation in adults with a Fontan circulation. Am Heart J. 2017 Jul; 189:184-192. View abstract
  17. Feasibility of exercise stress echocardiography and myocardial response in patients with repaired congenital heart disease. Am Heart J. 2017 Jun; 188:1-10. View abstract
  18. Poster 26 A Randomized Trial of Cardiac Rehabilitation for Adolescents and Adults with Congenital Heart Disease. PM R. 2016 Sep; 8(9S):S169. View abstract
  19. Noninvasive Cardiac Output Estimation by Inert Gas Rebreathing in Mechanically Ventilated Pediatric Patients. J Pediatr. 2016 10; 177:184-190.e3. View abstract
  20. A prospective 5-year study of the frequency of arrhythmias during serial exercise testing and clinical follow-up after Melody valve implant. Heart Rhythm. 2016 11; 13(11):2135-2141. View abstract
  21. Noninvasive cardiac output estimation by inert gas rebreathing in pediatric and congenital heart disease. Am Heart J. 2016 Apr; 174:80-8. View abstract
  22. Exercise Performance in Patients with D-Loop Transposition of the Great Arteries After Arterial Switch Operation: Long-Term Outcomes and Longitudinal Assessment. Pediatr Cardiol. 2016 Feb; 37(2):283-9. View abstract
  23. Fontan physiology revisited. Anesth Analg. 2015 Jul; 121(1):172-82. View abstract
  24. Relationship between Exercise Parameters and Noninvasive Indices of Right Ventricular Function in Patients with Biventricular Circulation and Systemic Right Ventricle. Congenit Heart Dis. 2015 Sep-Oct; 10(5):457-65. View abstract
  25. Exercise oscillatory ventilation in patients with Fontan physiology. Circ Heart Fail. 2015 Mar; 8(2):304-11. View abstract
  26. Prevalence of arrhythmias during exercise stress testing in patients with congenital heart disease and severe right ventricular conduit dysfunction. Am J Cardiol. 2014 Aug 01; 114(3):468-72. View abstract
  27. Abnormal spirometry after the Fontan procedure is common and associated with impaired aerobic capacity. . 2014 Jul 01; 307(1):H110-7. View abstract
  28. Effects of transcatheter pulmonary valve replacement on the hemodynamic and ventricular response to exercise in patients with obstructed right ventricle-to-pulmonary artery conduits. JACC Cardiovasc Interv. 2014 May; 7(5):530-42. View abstract
  29. Exercise physiology and testing in adult patients with congenital heart disease. Heart Fail Clin. 2014 Jan; 10(1):23-33. View abstract
  30. Physical activity is associated with improved aerobic exercise capacity over time in adults with congenital heart disease. Int J Cardiol. 2013 Oct 12; 168(5):4685-91. View abstract
  31. Exercise standards for testing and training: a scientific statement from the American Heart Association. Circulation. 2013 Aug 20; 128(8):873-934. View abstract
  32. Prognostic value of exercise testing during heart transplant evaluation in children. Circ Heart Fail. 2013 Jul; 6(4):792-9. View abstract
  33. 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
  34. Long-term functional health status and exercise test variables for patients with pulmonary atresia with intact ventricular septum: a Congenital Heart Surgeons Society study. J Thorac Cardiovasc Surg. 2013 Apr; 145(4):1018-1027.e3. View abstract
  35. Correlation of exercise response in repaired coarctation of the aorta to left ventricular mass and geometry. Am J Cardiol. 2013 Feb 01; 111(3):406-11. View abstract
  36. Left ventricular diastolic function in children and young adults with congenital aortic valve disease. Am J Cardiol. 2013 Jan 15; 111(2):243-9. View abstract
  37. Exercise stress echocardiographic assessment of outflow tract and ventricular function in patients with an obstructed right ventricular-to-pulmonary artery conduit after repair of conotruncal heart defects. Am J Cardiol. 2012 Nov 15; 110(10):1527-33. View abstract
  38. Natural history of exercise function in patients with Ebstein anomaly: A serial study. Am Heart J. 2012 Mar; 163(3):486-91. View abstract
  39. Cardiopulmonary exercise function among patients undergoing transcatheter pulmonary valve implantation in the US Melody valve investigational trial. Am Heart J. 2012 Feb; 163(2):280-7. View abstract
  40. Paediatric cardiac rehabilitation in congenital heart disease: a systematic review. Cardiol Young. 2012 Jun; 22(3):241-50. View abstract
  41. Cardiopulmonary exercise testing in adults with congenital heart disease: can we prognosticate and improve prognosis? Circulation. 2012 Jan 17; 125(2):210-1. View abstract
  42. Non-geometric echocardiographic indices of ventricular function in patients with a Fontan circulation. J Am Soc Echocardiogr. 2011 Nov; 24(11):1213-9. View abstract
  43. Longitudinal exercise capacity of patients with repaired tetralogy of fallot. Am J Cardiol. 2011 Jul 01; 108(1):99-105. View abstract
  44. Recovery of oxygen consumption after maximal exercise in children. Med Sci Sports Exerc. 2011 Apr; 43(4):555-9. View abstract
  45. Exercise testing identifies patients at increased risk for morbidity and mortality following Fontan surgery. Congenit Heart Dis. 2011 Jul-Aug; 6(4):294-303. View abstract
  46. Exercise testing and training in children with congenital heart disease. Circulation. 2010 Nov 09; 122(19):1957-67. View abstract
  47. Randomized trial of pulmonary valve replacement with and without right ventricular remodeling surgery. Circulation. 2010 Sep 14; 122(11 Suppl):S201-8. View abstract
  48. Long-term pulmonary regurgitation following balloon valvuloplasty for pulmonary stenosis risk factors and relationship to exercise capacity and ventricular volume and function. J Am Coll Cardiol. 2010 Mar 09; 55(10):1041-7. View abstract
  49. Serial cardiopulmonary exercise testing in patients with previous Fontan surgery. Pediatr Cardiol. 2010 Feb; 31(2):175-80. View abstract
  50. Effect of transcatheter occlusion of a pulmonary arteriovenous fistula on the cardiopulmonary response to exercise. Pediatr Cardiol. 2010 Jan; 31(1):142-3. View abstract
  51. Exercise function of children with congenital aortic stenosis following aortic valvuloplasty during early infancy. Congenit Heart Dis. 2009 Jul-Aug; 4(4):258-64. View abstract
  52. A cross-sectional study of exercise performance during the first 2 decades of life after the Fontan operation. J Am Coll Cardiol. 2008 Jul 08; 52(2):99-107. View abstract
  53. Fontan fenestration closure has no acute effect on exercise capacity but improves ventilatory response to exercise. J Am Coll Cardiol. 2008 Jul 08; 52(2):108-13. View abstract
  54. Different worlds (Vive la différence!). Acta Paediatr. 2008 Apr; 97(4):400-1. View abstract
  55. Determinants of heart rate recovery following exercise in children. Med Sci Sports Exerc. 2008 Apr; 40(4):601-5. View abstract
  56. Transient monocular vision loss from acute rheumatic fever. Pediatr Cardiol. 2008 Sep; 29(5):966-8. View abstract
  57. Longitudinal changes in heart rate recovery after maximal exercise in pediatric heart transplant recipients: evidence of autonomic re-innervation? J Heart Lung Transplant. 2007 Dec; 26(12):1306-12. View abstract
  58. Effect of pulmonary artery angioplasty on exercise function after repair of tetralogy of Fallot. Am Heart J. 2008 Jan; 155(1):182-6. View abstract
  59. Safety and efficacy of carvedilol therapy for patients with dilated cardiomyopathy secondary to muscular dystrophy. Pediatr Cardiol. 2008 Mar; 29(2):343-51. View abstract
  60. Cardiac magnetic resonance imaging correlates of exercise capacity in patients with surgically repaired tetralogy of Fallot. Am J Cardiol. 2007 Nov 01; 100(9):1446-50. View abstract
  61. Cardiac rehabilitation improves heart rate recovery following peak exercise in children with repaired congenital heart disease. Pediatr Cardiol. 2007 Jul-Aug; 28(4):276-9. View abstract
  62. Sustained effects of cardiac rehabilitation in children with serious congenital heart disease. Pediatrics. 2006 Sep; 118(3):e586-93. View abstract
  63. Coexistence of three rare congenital heart defects in a single patient: a unique case with important embryologic implications. Pediatr Cardiol. 2006 Jul-Aug; 27(4):503-7. View abstract
  64. Determinants of exercise function following univentricular versus biventricular repair for pulmonary atresia/intact ventricular septum. Am J Cardiol. 2006 Jun 01; 97(11):1638-43. View abstract
  65. Clinical stress testing in the pediatric age group: a statement from the American Heart Association Council on Cardiovascular Disease in the Young, Committee on Atherosclerosis, Hypertension, and Obesity in Youth. Circulation. 2006 Apr 18; 113(15):1905-20. View abstract
  66. Impact of cardiac rehabilitation on the exercise function of children with serious congenital heart disease. Pediatrics. 2005 Dec; 116(6):1339-45. View abstract
  67. Effect of systemic corticosteroid therapy on risk for intra-abdominal or pelvic abscess in non-operated Crohn's disease. Clin Gastroenterol Hepatol. 2005 Dec; 3(12):1215-20. View abstract
  68. Expanding the indications for pulmonary valve replacement after repair of tetralogy of fallot. Ann Thorac Surg. 2003 Oct; 76(4):1066-71; discussion 1071-2. View abstract
  69. Effect of transcatheter closure of atrial septal defect on the cardiopulmonary response to exercise. Am J Cardiol. 2002 Oct 01; 90(7):803-6. View abstract
  70. Choice of device size and results of transcatheter closure of atrial septal defect using the amplatzer septal occluder. J Interv Cardiol. 2002 Aug; 15(4):287-92. View abstract
  71. Transcatheter closure of patent foramen ovale in patients with paradoxical embolism: intermediate-term risk of recurrent neurological events. Catheter Cardiovasc Interv. 2002 Feb; 55(2):189-94. View abstract
  72. Immediate and six-month results of the profile of the Amplatzer septal occluder as assessed by transesophageal echocardiography. Am J Cardiol. 2001 Oct 01; 88(7):754-9. View abstract
  73. Echocardiographic assessment of the right ventricular response to exercise. Pediatr Cardiol. 2001 Mar-Apr; 22(2):107-9. View abstract
  74. Early ECG abnormalities associated with transcatheter closure of atrial septal defects using the Amplatzer septal occluder. J Interv Card Electrophysiol. 2000 Oct; 4(3):469-74. View abstract
  75. Palliative balloon pulmonary valvuloplasty in tetralogy of fallot: echocardiographic predictors of successful outcome. J Invasive Cardiol. 2000 Sep; 12(9):448-51. View abstract
  76. Measurement of atrial septal defect size: a comparative study between three-dimensional transesophageal echocardiography and the standard balloon sizing methods. Pediatr Cardiol. 2000 Sep-Oct; 21(5):465-9. View abstract
  77. Factors affecting the exercise capacity of pediatric patients with aortic regurgitation. Pediatr Cardiol. 2000 Jul-Aug; 21(4):328-33. View abstract
  78. Transesophageal echocardiographic results of catheter closure of atrial septal defect in children and adults using the Amplatzer device. Am J Cardiol. 2000 Jun 01; 85(11):1387-90. View abstract
  79. Aortic-origin reconstruction of the great vessels: risk factors of early and late complications. J Vasc Surg. 2000 Feb; 31(2):260-9. View abstract
  80. The benefits of secondary interventions in patients with failing or failed pedal bypass grafts. Am J Surg. 1999 Aug; 178(2):151-5. View abstract
  81. Long-term outcome of transcatheter coil closure of small to large patent ductus arteriosus. Catheter Cardiovasc Interv. 1999 Aug; 47(4):457-61. View abstract
  82. Echocardiographic characteristics of successful deployment of the Das AngelWings atrial septal defect closure device: initial multicenter experience in the United States. Am J Cardiol. 1999 Apr 15; 83(8):1236-41. View abstract
  83. Three-dimensional echocardiographic analysis of valve anatomy as a determinant of mitral regurgitation after surgery for atrioventricular septal defects. Am J Cardiol. 1999 Mar 01; 83(5):745-9. View abstract
  84. Transoesophageal echocardiography during scoliosis repair: comparison with CVP monitoring. Can J Anaesth. 1998 Oct; 45(10):925-32. View abstract
  85. Concerning the Fontan patient's excessive minute ventilation during exercise. J Am Coll Cardiol. 1998 Oct; 32(4):1132. View abstract
  86. Treatment of pulmonary hypertension with inhaled nitric oxide during hepatic transplantation in an adolescent: reversibility of pulmonary hypertension after transplantation. Clin Pediatr (Phila). 1998 Aug; 37(8):505-9. View abstract
  87. Factors affecting clinical outcome following endoscopic perforator vein ablation. Am J Surg. 1998 Aug; 176(2):162-7. View abstract
  88. Effect of pulmonary artery stenoses on the cardiopulmonary response to exercise following repair of tetralogy of Fallot. Am J Cardiol. 1998 May 15; 81(10):1217-9. View abstract
  89. Electrocardiographic markers of late sudden death risk in postoperative tetralogy of Fallot children. J Cardiovasc Electrophysiol. 1997 Dec; 8(12):1349-56. View abstract
  90. Fate of mitral regurgitation following repair of atrioventricular septal defect. Am J Cardiol. 1997 Nov 01; 80(9):1194-7. View abstract
  91. Excessive anaerobic metabolism during exercise after repair of aortic coarctation. J Pediatr. 1997 Aug; 131(2):210-4. View abstract
  92. Comparison Between the Mean dP/dt During Isovolumetric Contraction and Other Echocardiographic Indexes of Ventricular Systolic Function. Echocardiography. 1997 May; 14(3):215-222. View abstract
  93. Truncus arteriosus with a single left ventricle: case report of a previously unrecognized entity. Am Heart J. 1997 Mar; 133(3):377-80. View abstract
  94. Evaluation of Ventricular dP/dt Before and After Open Heart Surgery Using Transesophageal Echocardiography. Echocardiography. 1997 Jan; 14(1):15-22. View abstract
  95. Aerobic exercise function of patients with persistent coronary artery aneurysms secondary to Kawasaki disease. Pediatr Cardiol. 1996 Jul-Aug; 17(4):226-30. View abstract
  96. Interventional cardiac catheterization therapy for combined coarctation of the aorta and patent ductus arteriosus: successful outcome in two infants. Cathet Cardiovasc Diagn. 1996 May; 38(1):67-70; discussion 71. View abstract
  97. Effect of blood pressure cuffs on neonatal circulation: their potential application to newborns with persistent pulmonary hypertension. Pediatr Cardiol. 1995 Jan-Feb; 16(1):20-3. View abstract
  98. Physiologic significance of chronic coronary aneurysms in patients with Kawasaki disease. J Am Coll Cardiol. 1994 Dec; 24(7):1633-8. View abstract
  99. A new low profile balloon atrial septostomy catheter: initial animal and clinical experience. J Invasive Cardiol. 1994 Jul-Aug; 6(6):209-12. View abstract
  100. A new noninvasive method for the estimation of peak dP/dt. Circulation. 1993 Dec; 88(6):2693-9. View abstract
  101. Effect of hemodialysis on left ventricular contractility in pediatric patients with end-stage renal disease. South Med J. 1993 May; 86(5):545-50. View abstract
  102. Ventilatory work and oxygen consumption during exercise and hyperventilation. J Appl Physiol (1985). 1993 Feb; 74(2):793-8. View abstract
  103. Severe pulmonary hypertension without significant pulmonary parenchymal disease in a pediatric patient with acquired immunodeficiency syndrome. Clin Pediatr (Phila). 1992 Oct; 31(10):629-31. View abstract
  104. Hemodialysis-induced subaortic obstruction in asymmetric septal hypertrophy. Am Heart J. 1992 Mar; 123(3):807-10. View abstract
  105. Hemodynamic correlates of exercise function in patients with primary pulmonary hypertension. J Am Coll Cardiol. 1991 Dec; 18(7):1738-44. View abstract
  106. Effect of right ventricular anatomy on the cardiopulmonary response to exercise. Implications for the Fontan procedure. Circulation. 1990 Jun; 81(6):1811-7. View abstract
  107. Comprehensive spectral analysis of human EEG generators in posterior cerebral regions. Electroencephalogr Clin Neurophysiol. 1966 Mar; 20(3):224-37. View abstract