The Fetal Cardiac Program at Morgan Stanley Children’s Hospital of NewYork Presbyterian Hospital and Columbia University Irving Medical Center is one of the largest of its kind in the United States. As pediatric cardiologists with expertise in fetal cardiology, we work closely with maternal-fetal medicine, genetics, cardiothoracic surgery, and other sub-specialists in the Carmen and John Thain Center for Prenatal Pediatrics to provide the most comprehensive and compassionate care for children diagnosed with congenital heart disease before birth. Our center provides care for both mother and baby from the time of prenatal diagnosis through birth and beyond.
Each year, our fetal cardiac team performs nearly 2,000 fetal echocardiograms and cares for nearly 1,000 children with congenital heart disease, from minor defects to the most complex lesions. We are known both regionally and nationally for our expertise in diagnosing and treating the most complicated fetal heart conditions, and we have extensive experience with the newest and most advanced treatments options. Our team’s care has led to remarkable outcomes for babies who would not have survived their heart condition just a decade or two in the past.
In addition to our primary location on the campus of Columbia University Irving Medical Center in uptown Manhattan, we also offer services in midtown Manahattan at 51 West 51st Street practice.
Conditions We Care For
We care for all fetal heart conditions, including congenital heart defects, abnormal heart rhythms, or issues arising from other processes such as complicated identical twin pregnancies or other fetal anomalies.
Typically, a fetal echocardiogram, which is a safe, non-invasive ultrasound, is performed in the middle of the pregnancy in the second trimester at 18-22 weeks. The baby’s heart is visualized through the mother’s abdomen. For certain high-risk situations, including a family history of major congenital heart disease or a known anomaly or genetic/chromosomal abnormality, we offer early fetal echocardiography. This screening may be performed in the first trimester as early as 11-14 weeks, either through the mother’s abdomen and/or transvaginally.
Some of the fetal heart conditions we treat include:
- Atrioventricular Septal Defect
- Ebstein's Anomaly
- Hypoplastic Left Heart Syndrome (HLHS)
- Tetralogy of Fallot
- Transposition of the Great Arteries
- Truncus Arteriosus
- Ventricular Septal Defect
What to Expect
There are several reasons why you may be referred to our program:
- An ultrasound has revealed an issue with your baby’s heart
- Your baby has a known or suspected genetic/chromosomal abnormality
- You have a multiple pregnancy
- You have a family history of congenital heart disease
- You have a health condition, such as diabetes, that may influence your baby’s heart
- You have undergone assisted reproduction
Your first appointment with us will include a detailed history and fetal echocardiogram to assess the structure and function of your baby’s heart. You will meet with a pediatric cardiologist who has special expertise in fetal heart care. The doctor will describe the findings to you, and our dedicated fetal nurse coordinator will help you navigate the process.
If a genetic or chromosomal abnormality is suspected, you will be referred to our genetic counselors for more information. If neonatal surgery and/or a stay in our Infant Care Care Unit is anticipated, then you will be referred to meet with one of our cardiothoracic surgeons and one of our neonatologists with expertise in newborn heart care. You will also have the opportunity to visit the unit at that time. Based on your baby’s specific heart condition, your cardiologist will work with a maternal-fetal medicine specialist to develop a plan for the remainder of your pregnancy and delivery. For select patients, care may involve medical therapy and/or catheter-based intervention during pregnancy.
Every baby is different, and your plan will address you and your baby’s particular situation. Your baby’s heart team will remain with you through your baby’s birth at NewYork-Presbyterian Morgan Stanley Children’s Hospital, a top-ranked hospital in the country for pediatric heart surgery and care, and beyond.
Fetal Cardiac Therapy
There are many different types of congenital heart defects, and most of the time, treatment is initiated upon the baby’s birth or shortly afterward. However, advances in our understanding of congenital heart disease before birth, as well as improvements in technology, have made it possible to treat some patients before they are born. For example, arrhythmias, specific types of heart tumors, and severe cases of Ebstein's anomaly (a rare abnormality of the tricuspid valve) may be treated by giving the mother medication that crosses the placenta to help the baby prior to birth.
We have recently begun a program to offer catheter-based therapies that allow us to modify the baby’s heart disease in utero with the goal of minimizing invasive interventions after birth. We offer procedures for babies with severe aortic stenosis and evolving hypoplastic left heart syndrome as well as for babies with established hypoplastic left heart syndrome and a highly restrictive or intact atrial septum. We will also consider in utero therapy for fetuses affected by pulmonary atresia with intact ventricular septum. Our goal is to make sure that every baby has the best treatment options available today for his or her condition.
Babies with heart defects often require special care at birth. With the right plan in place, you, your baby, and your team of providers will be prepared for your baby’s birth, even if it is complex. At NewYork-Presbyterian Morgan Stanley Children’s Hospital, a free-standing women’s and children’s hospital, you will deliver and your baby will be cared for in the same, exceptional place. We pride ourselves on having one of the first and best Infant Cardiac Care Units in the world, dedicated to the care of newborns with heart issues.
Our Fetal Cardiac Program is tied to our Congenital Heart Center, one of the largest and most pre-eminent cardiac surgery centers in the nation. Patients come from all over the world for the most advanced treatments for congenital heart disease. We look forward to welcoming you and your family to our team from the earliest possible moment – before birth!
Carmen and John Thain Center For Prenatal Pediatrics
CHONY Central, 12th Floor
New York, NY 10032
Columbia Doctors Midtown
51 West 51st Street, 3rd Floor
New York, NY 10019