HeArT (High Acuity Transition) Program

The HeArT (High Acuity Transition) Program provides intense outpatient follow-up care for cardiac patients who are at the greatest risk of heart failure, growth problems and neurodevelopmental impairments.

Infants with congenital heart defects (CHD), especially single ventricle physiology and hypoplastic left heart syndrome, need frequent and extensive follow-up care in their early infancy. Patients with single ventricle heart defects typically undergo three cardiac surgical procedures during the first few years of life. During the gaps between the first and second operation, these children are at risk for various cardiac problems, as well as feeding issues and poor weight gain. Such patients warrant frequent cardiology clinic visits and occasionally need to be readmitted to the hospital in between procedures.

Led by, John Costello , MD, our HeArT Clinic is designed to provide highly individualized outpatient care to the most fragile children with heart disease. The HeArT Clinic Team consists of a dedicated pediatric nurse practitioner and cardiologists from Lurie Children’s Single Ventricle Center of Excellence with special expertise in the care of children with complex congenital heart disease. The HeArt Program’s clinical staff are dedicated to assisting neonates and infants with single ventricle to stay as healthy as possible, with careful monitoring.

Common congenital heart conditions seen by the team include:

  • Hypoplastic left heart syndrome (HLHS)
  • Hypoplastic right heart syndrome
  • Tricuspid atresia
  • Double inlet left ventricle (DILV)
  • Double outlet right ventricle (DORV)
  • Complex single ventricle
  • Unbalanced atrioventricular septal defect (AVSD)
  • Heterotaxy
  • Certain patients with tetralogy of Fallot or complex transposition of the great arteries

These children are also enrolled in our Home Monitoring Program (HMP). These patients are sent home with special medical equipment, such as a pulse oximeter and baby scale, to help monitor their progress at home and detect subtle changes that warrant further evaluation. The program is led by a dedicated nurse practitioner who meets families prenatally and will work in weekly collaboration with the family, pediatrician, and local referring cardiology team to ensure the best possible outcome. Our team will help carefully monitor each patient’s oxygen saturations, growth and nutrition in addition to coordinating follow-up with our neurodevelopmental clinic. Later on, the program helps patients with complex heart disease transition back to their primary cardiologist or seek continued care in our Single Ventricle Center of Excellence.

What to Expect

An initial appointment will be scheduled when your child is discharged from the hospital. After the first appointment, any other appointments will be scheduled on an as-needed basis, depending on the child’s condition.

While your child is in our care, we will communicate regularly with your cardiologist and pediatrician to keep them informed of the child’s status. HeArT clinicians will facilitate all aspect of cardiac care as well as coordinate complex non-cardiac care. The transition back to your child’s primary cardiologist will be coordinated to accommodate the needs of the both the primary cardiologist and the child. Our team is also available on a consultative basis.

Specialists

Our multidisciplinary approach to treating children with CHD involves a dedicated team of specialists to make sure all of our patients’ needs are met. The team includes the following:

The HeArT Clinic team is fully integrated into our Single Ventricle Center of Excellence.

Questions & Concerns

If you have any questions or concerns after your child is discharged, our team is available to take your call.

Mondays through Fridays, 8 a.m.-4 p.m., call the single ventricle nurse practitioner at 312.227.4000 and ask for Michelle Steltzer, CPNP-AC/PC.

Mondays through Fridays after 4 p.m. and on weekends, call the hospital operator at 312.227.4000 and ask for the cardiology fellow on call.

If the following symptoms occur, call the numbers above:

  • Temperature over 100.5 degrees
  • Increase in difficulty breathing/turning blue
  • Problems with feeding
  • Persistent cough
  • More than two episodes of vomiting/diarrhea within two hours
  • Saturations less than 75%, unless otherwise specified
  • Weight loss of more than 30 grams in one day
  • Failure to gain 20 grams of weight over the course of 72 hours

Make a Referral

Our Single Ventricle Center team and HeArT Clinic can be reached by calling Kara Barto at 312.227.4403.

Our HeArT program outpatient clinic is typically held on Monday mornings and Thursday afternoons.

The Heart Center at Lurie Children’s Hospital is an active participant in the National Pediatric Cardiac Quality Improvement Collaborative (NPC-QIC).

The Division of Cardiology is committed to excellence in the care of young patients with congenital and acquired heart disease — from the fetus to the adult. Our mission is to foster a collaborative environment in which expertise in cardiac issues is cultivated through the promotion of research, education, and prevention.