Background

This Issue of Cardiology in the Young represents the 13th annual publication in Cardiology in the Young generated from the two meetings that composed “HeartWeek in Florida”.Reference Jacobs and Anderson^1–Reference Jacobs, Quintessenza, Dadlani, Everett and Anderson¹² The first nine previous publicationsReference Jacobs and Anderson^1–Reference Jacobs, DeCampli and Cooper⁹ were free-standing Supplements to Cardiology in the Young; however, in December, 2012, we transitioned to publishing these proceedings as a regular Issue of Cardiology in the Young, as the annual December Issue.Reference Jacobs, Cooper and Dadlani^10–Reference Jacobs, Quintessenza, Dadlani, Everett and Anderson¹² Many of the manuscripts published in the 12 previous HeartWeek Supplements and Issues rank among the most referenced manuscripts in Cardiology in the Young. Consequently, we intend to keep the proceedings from HeartWeek as the December Issue of Cardiology in the Young in the future. This December, 2015 Issue of Cardiology in the Young that you are about to read features highlights of the two meetings that compose HeartWeek:

• ∙ Johns Hopkins All Children’s Heart Institute’s 15th Annual International Symposium on Congenital Heart Disease, which was held at the Renaissance Vinoy Resort & Golf Club, Saint Petersburg, Florida, from Friday 6 February, 2015, to Monday 9 February, 2015. This Symposium was co-sponsored by The American Association for Thoracic Surgery (AATS), and its special focus was “Congenital Abnormalities of the Coronary Arteries”.

• ∙ The Children’s Hospital of Philadelphia’s annual meeting – Cardiology 2015, the 18th Annual Update on Paediatric and Congenital Cardiovascular Disease: “Challenges and Dilemmas” – which was held at the Hyatt Regency Scottsdale Resort and Spa at Gainey Ranch, Scottsdale, Arizona, from Wednesday, 11 February, 2015, to Sunday, 15 February, 2015.

On Tuesday, 23 December, 2014, population estimates from the Census Bureau of the United States of America were released showing that between 1 July, 2013, and 1 July, 2014, Florida passed New York to become the third most populous state in the nation.¹³ “HeartWeek in Florida” is a joint collaborative project sponsored by the Cardiac Centre at the Children’s Hospital of Philadelphia, Pennsylvania, together with Johns Hopkins All Children’s Heart Institute of Saint Petersburg, Florida. The programme for care of children with congenital cardiac malformations at Children’s Hospital of Philadelphia is one of the largest and most comprehensive in the world. Similarly, Johns Hopkins Children’s Heart Surgery is one of the largest and most comprehensive programmes in the world [www.allkids.org/Heart]. “HeartWeek in Florida” averages over 1000 attendees every year and is recognised as one of the major planks of continuing medical and nursing education for those working in the fields of diagnosis and treatment of cardiac disease in the foetus, neonate, infant, child, and adult.

All the institutions involved with the organisation of the events of “HeartWeek in Florida” are very grateful to Bob Anderson, Ted Baker, and the team at Cardiology in the Young for their support and for the opportunity to publish the HeartWeek Supplements and Issues of Cardiology in the Young. On a personal note, I would like again to thank Ted Baker for his awesome leadership as Past Editor-in-Chief of Cardiology in the Young. It was a true pleasure for Allen Everett and me to serve as Associate Editors of Cardiology in the Young and collaborate with Ted. Also, on a personal note, I would like once again to congratulate Bob Anderson for his ability to remain massively involved in the academic world of professionals caring for patients with congenitally malformed hearts, even after his official so-called “retirement”. I would again like to thank Bob for his support, friendship, mentorship, professional guidance, and advice over the past 17 years. Bob has played a major role in the development of my own career, and I am appreciative for all that he has done for me. He placed an amazingly high level of trust in me when I was very young, and I appreciate this support. Bob has also been a strong supporter and advocate of our programme at All Children’s Hospital for quite some time. In February, 2015, Bob was a featured speaker at our annual February meeting at All Children’s Hospital for the 14th consecutive year. Every day for these past 14 years, we have started our sessions with an anatomy lesson from Bob. On a daily basis, he sets the stage for the rest of the day, and raises the academic level of our meeting.

The Annual Update on Paediatric and Congenital Cardiovascular Disease hosted by the Cardiac Centre at the Children’s Hospital of Philadelphia was held in Scottsdale, Arizona, in February, 2015. This meeting is typically attended by over 750 professionals and exhibitors gathered from around the globe to hear late-breaking research, to discuss controversial topics, to review current practices, and to enjoy each others’ company and insight.Reference Wernovsky¹⁴ Physicians make up approximately half of the attendees, and include representation from all disciplines involved in the care of children with cardiac disease, including surgeons, cardiologists, intensivists, anaesthesiologists, neonatologists, and maternal fetal specialists. The remaining attendees include advanced practice, operating room, catheterisation lab, and bedside nurses, sonographers, physician assistants, respiratory therapists, perfusionists, and administrators. A highlight of the meeting organised by the Children’s Hospital of Philadelphia is the featured lectures in Cardiovascular Surgery, Cardiology, Nursing, Anaesthesia and Critical Care, and Basic Sciences (Table 1). The 2015 meeting organised by the Children’s Hospital of Philadelphia – The 18th Annual Update on Paediatric and Congenital Cardiovascular Disease: “Challenges and Dilemmas” – was held at The Hyatt Regency Scottsdale Resort and Spa at Gainey Ranch, Scottsdale, Arizona, from Wednesday, February 11, to Sunday, 15 February, 2015.

Table 1

The featured lectures during the Annual Postgraduate Course in Paediatric Cardiovascular Disease organised by the Children’s Hospital of Philadelphia.

In February, 2016, the meeting organised by the Children’s Hospital of Philadelphia will again return to Florida. Cardiology 2016, the 19th Annual Update on Paediatric and Congenital Cardiovascular Disease, organised by the Children’s Hospital of Philadelphia, will be held at the Loews Royal Pacific Resort at Universal Orlando^®, Orlando, Florida, from Wednesday, 24 February to Sunday, 28 February, 2016. To view the entire programme and register for the meeting, please visit the following web site: (http://www.chop.edu/events/cardiology-2016). For detailed information, please e-mail Tina Mannices at (mannices@email.chop.edu) or call +1 (215) 590 - 5263.

In 2015, the component of the HeartWeek in Florida organised by The Johns Hopkins All Children’s Heart Institute, and representing the fifteenth annual International Symposium on Congenital Heart Disease, was held from Friday, 6 February, 2015, to Monday, 9 February, 2015, with its focus on “Congenital Abnormalities of the Coronary Arteries”. Our Annual International Symposium on Congenital Heart Disease with Echocardiographic, Anatomical, Surgical, and Pathological Correlation is held every February, and is now entering its sixteenth year. The first eleven meetings were sponsored by the All Children’s Hospital (www.allkids.org), The Congenital Heart Institute of Florida (CHIF), and the University of South Florida. Beginning in 2012, our meeting has been presented by the All Children’s Hospital and sponsored by Johns Hopkins Medicine. Our meetings in 2009, 2010, 2011, 2012, 2014, and 2015 were co-sponsored by The American Association for Thoracic Surgery (http://www.aats.org/CME/Programs.html), and our 2016 meeting will also be co-sponsored by The American Association for Thoracic Surgery. Our meeting in 2015 had as its focus “Congenital Abnormalities of the Coronary Arteries”, with sessions aimed specifically at multidisciplinary issues related to the following topics:

• ∙ Anatomy of the coronary arteries

• ∙ Echocardiography of the coronary arteries

• ∙ Critical care of patients with diseases of the coronary arteries

• ∙ Surgery of the coronary arteries

• ∙ Ethics

We also continued two exciting symposia that we first held in 2011:

• ∙ Nursing Symposium

• ∙ Ethics Symposium

We also continued several of our popular features:

• ∙ Hands-on demonstrations,

• ∙ Panel discussions,

• ∙ Q&A sessions, and

• ∙ Pathological heart specimens on exhibit.

Finally, a new feature that began in 2014 is that our meeting now features three unique pathways:

• ∙ PRIMARY PATHWAY (MAIN CONFERENCE) (Plenary Pathway)

• ∙ NURSES PATHWAY

• ∙ ADMINISTRATORS PATHWAY

The overall emphasis of the meeting is multidisciplinary, with involvement of paediatric cardiac surgery, paediatric cardiology, paediatric cardiac critical care, paediatric cardiac anaesthesia, nursing, perfusion, and ultrasonography. Attendance at our meeting is typically between 250 and 350 participants.

• ∙ Our meeting held in 2007 had 269 attendees from 30 states of the United States of America and 14 countries. The attendees were 43% physicians, 41% nurses, perfusionists, and ultrasonographers, and 16% allied healthcare professionals. The University of South Florida designated this educational activity for a maximum of 24.25 AMA PRA Category 1 Credits.

• ∙ Our meeting held in 2008 had 270 attendees from 32 states of the United States of America and 16 countries. The attendees were 52% physicians, 31% nurses, perfusionists, and ultrasonographers, and 17% allied healthcare professionals. The University of South Florida College of Medicine designated this educational activity for a maximum of 30.25 AMA PRA Category 1 Credits.

• ∙ Our meeting held in 2009 had 270 attendees from 32 states of the United States of America and 16 countries. The attendees were 40% physicians, 49% nurses and physician assistants, and 11% perfusionists, ultrasonographers, and allied healthcare professionals. The University of South Florida College of Medicine designated this educational activity for a maximum of 29.5 AMA PRA Category 1 Credits (Programme #BD2009399/1170).

• ∙ Our meeting held in 2010 had 230 attendees from 29 states of the United States of America and 18 countries. The attendees were from the following categories: physicians (115), physician assistants (7), nurse practitioners (17), registered nurses (35), sonographers (16), perfusionists (4), and others (36).

• ∙ Our meeting held in 2011 had 263 attendees including 116 physicians and 147 non-physicians The highlight of the 2011 conference was the George R. Daicoff Dinner Presentation, which was presented by Edward L. Bove, MD, titled “Innovation and Regulation: Can They Both Exist in Today’s Medical Environment?”. Dr Bove is the Helen and Marvin Kirsch Professor and Head of the Section of Cardiac Surgery, which includes Divisions of Paediatric and Adult Cardiac Surgery, at the University of Michigan C. S. Mott Children’s Hospital. The Division of Paediatric Cardiac Surgery is one of the busiest congenital heart programmes in the United States of America, performing over 900 procedures annually. Additional featured speakers included William I. Norwood, Leonard L. Bailey, Robert Anderson, Tom Spray, and Constantine Mavroudis.

• ∙ Our meeting held in 2012 had 309 attendees including 112 physicians and 187 non-physicians from 27 countries including the United States of America. The highlight of the 2012 conference was the George R. Daicoff Dinner Presentation, which was presented by Richard A. Jonas, MD, and was titled “A View of Shanghai from Washington, DC: 25 Years of Change.”. Dr Jonas is Chief of Cardiac Surgery, Co-Director of the Children’s National Heart Institute, and Cohen Funger Professor of Cardiac Surgery at the Children’s National Medical Center in Washington, DC. He is a world-renowned paediatric cardiac surgeon specialising in optimising the developmental and cognitive outcomes of patients after surgery for congenital heart disease. Dr Jonas also has helped in the development of a number of international cardiac surgical programmes around the world and is a coveted international speaker and guest surgeon. At the time of his George R. Daicoff Visiting Professorship, Richard Jonas, MD, was the current President of The Congenital Heart Surgeons’ Society (CHSS). Additional featured speakers included Robert Anderson, Tom Spray, and Constantine Mavroudis.

• ∙ Our meeting in 2013 was held at the 6th World Congress of Paediatric Cardiology and Cardiac Surgery in Cape Town, South Africa, where The Johns Hopkins All Children’s Heart Institute hosted the following Symposium: The Birth of Heart Surgery: Lessons Learned from Tetralogy – a Dinner Conversation. Videos from this Symposium can be viewed at the following hyperlink: (http://www.allkids.org/wcpccs). This Symposium was also featured in the December, 2013 Issue of Cardiology in the Young.Reference Jacobs, Rychik, Dadlani, Everett and Anderson¹¹

• ∙ Our meeting held in 2014 offered 23.25 hours of continuing medical education and had 345 attendees representing 28 states and 22 countries, including the United States of America. Attendees included 152 physicians, 79 Registered Nurses, 19 Nurse Practitioners, 14 Physician Assistants, 10 Sonographers, 9 Trainees, 2 Perfusionists, and 55 vendor representatives. The highlight of the 2014 conference was the George R. Daicoff Dinner Presentation, which was presented by John William Brown and was titled “Pediatric Cardiac Surgery – It’s a Wonderful Life”. This truly awesome and inspiring lecture was published in the December, 2014 HeartWeek Issue of Cardiology in the Young.Reference Jacobs, Quintessenza, Dadlani, Everett and Anderson¹² At the time of his George R. Daicoff Visiting Professorship, John Brown, MD, was the Harris B Shumacker Emeritus Professor of Surgery at Indiana University School of Medicine and the current President of The Congenital Heart Surgeons’ Society (CHSS). Additional featured speakers included Robert Anderson, Tom Spray, and Constantine Mavroudis.

• ∙ Our meeting held in 2015 offered 25.75 hours of continuing medical education and had 350 attendees from 16 countries and 27 states of the United States of America. The 16 countries included the following:

  • ∙ Australia

  • ∙ Brazil

  • ∙ Canada

  • ∙ Ecuador

  • ∙ England

  • ∙ India

  • ∙ Indonesia

  • ∙ Jamaica

  • ∙ Malaysia

  • ∙ Netherlands

  • ∙ Norway

  • ∙ Poland

  • ∙ Saudi Arabia

  • ∙ South Korea

  • ∙ Turkey

  • ∙ United States of America

  • ∙ Wales

Attendees included 135 physicians, 75 Registered Nurses, 22 Nurse Practitioners, 15 Trainees, 14 Sonographers, 13 Hospital Administrators, 7 Physician Assistants, 6 CME staff, 1 Perfusionist, 1 Pathologist, 1 Certified Surgical Technician, 1 Certified Genetics Counsellor, and 59 vendor representatives. The highlight of the 2015 conference was the George R. Daicoff Dinner Presentation, which was presented by Duke Cameron, MD, Professor of Surgery at Johns Hopkins University and Cardiac Surgeon-in-Charge at The Johns Hopkins Hospital. Additional featured speakers included Robert Anderson, Constantine Mavroudis, James S. Tweddell, Carl Backer, and Marshall L. Jacobs.

Table 2 highlights the featured topics and speakers from the meeting held at Saint Petersburg. The true summit of this meeting is the George Daicoff Lecture, given by the featured speaker to honour the founder of our surgical programme in Saint Petersburg: George R. Daicoff, MD. Previous and future Daicoff Lectures are presented below:

• ∙ (2003) Leonard L. Bailey and his wife Nancy from Loma Linda University Medical Center, California

• ∙ (2004) Martin J. Elliott from The Great Ormond Street Hospital for Children, London, United Kingdom

• ∙ (2005) Marc deLeval from The Great Ormond Street Hospital for Children, London, United Kingdom

• ∙ (2006) Ross M. Ungerleider and his wife Jamie Dickey from Oregon Health Sciences University, Oregon

• ∙ (2007) Constantine Mavroudis and Carl Backer from Children’s Memorial Hospital, Chicago

• ∙ (2008) Tom Spray from Children’s Hospital of Philadelphia, Philadelphia

• ∙ (2009) Marshall Lewis Jacobs from Drexel University College of Medicine, Philadelphia, Pennsylvania

• ∙ (2010) Roberto Canessa from Montevideo, Uruguay

• ∙ (2011) Edward L. Bove from the University of Michigan, Ann Arbor, Michigan

• ∙ (2012) Richard A. Jonas from Children’s National Medical Center, Washington, DC

• ∙ (2013) 6th World Congress of Paediatric Cardiology and Cardiac Surgery in Cape Town, South Africa, Chaired by Christopher Hugo-Hamman (http://wcpccs2013.co.za/), 17–22 February, 2013

• ∙ (2014) John Brown from Indiana University School of Medicine, Indianapolis, Indiana

• ∙ (2015) Duke Cameron, MD, Cardiac Surgeon-in-Charge, The Johns Hopkins Hospital

• ∙ (2016) James A. Quintessenza, MD, Johns Hopkins All Children’s Heart Institute

• ∙ (2017) 7th World Congress of Paediatric Cardiology and Cardiac Surgery in Istanbul, Turkey, Chaired by Sertac Cicek (http://wcpccs2017.org/en/), 18–23 June, 2017

• ∙ (2018) Professor Christo Ivanov Tchervenkov from The Montreal Children’ Hospital, Canada: Executive Director & Founding President, The World Society for Pediatric and Congenital Heart Surgery. Our 2018 meeting will be combined with the 2018 Scientific Meeting of the World Society for Pediatric Congenital Heart Surgery, which will be Chaired by Jeff Jacobs and Marshall Jacobs and held from 23 July, 2016, to 26 July, 2018, at Walt Disney World, Orlando, Florida (www.WSPCHS2018.com)

• ∙ (2019) Professor Robert Anderson

• ∙ (2021) 8th World Congress of Paediatric Cardiology and Cardiac Surgery in Washington DC, United States of America, Chaired by Jeff Jacobs and Gil Wernovsky (http://www.wcpccs2021.org/), 18–23 June, 2017

Table 2

Featured topics and speakers during the symposiums organised by All Children’s Hospital.

In 2016, our 16th annual meeting will take place from Saturday, 13 February, 2016, to Tuesday, 16 February, 2016, presented by All Children’s Hospital, sponsored by Johns Hopkins Medicine, and co-sponsored by The American Association of Thoracic Surgery. The focus will be “Pediatric and Congenital Diseases of the Aorta”. The George Daicoff Lecture for 2015 will be entitled, “Leadership”, and will be given by James A. Quintessenza, MD. To view the entire programme for our 2015 meeting and to register for the meeting, please visit the following web site: (www.allkids.org/conferences). For detailed information, please e-mail Melodye Farrar at (mailto:Melodye.Farrar@jhmi.edu) or contact us at +1 (727) 767 - 8584.

We have now reached the situation whereby the proceedings of the meetings held in 2003, 2004, 2005, 2006, 2007, 2008, 2009, 2010, 2011, 2012, 2013, 2014, and 2015 have been published as HeartWeek Supplements or Issues of Cardiology in the Young.Reference Jacobs and Anderson^1–Reference Jacobs, Quintessenza, Dadlani, Everett and Anderson¹² This December, 2015 HeartWeek Issue of Cardiology in the Young is therefore the thirteenth Supplement or Issue of Cardiology in the Young that we have produced from the annual meeting held in Saint Petersburg; we have produced 10 of these 13 Issues or Supplements jointly with Children’s Hospital of Philadelphia (2004, 2006, 2007, 2008, 2009, 2010, 2011, 2012, 2013, and 2015Reference Jacobs, Wernovsky, Gaynor and Anderson^2, Reference Jacobs, Wernovsky, Gaynor and Anderson^4–Reference Jacobs, Quintessenza, Dadlani, Everett and Anderson¹²):

• ∙ 2003 Meeting: Controversies Relating To The Hypoplastic Left Heart Syndrome

• ∙ 2004 Meetings: Controversies of the Ventriculo-Arterial Junctions and Other Topics

• ∙ 2005 Meeting: Controversies and Challenges in the Management of the Functionally Univentricular Heart

• ∙ 2006 Meetings: Controversies and Challenges of the Atrioventricular Junctions and Other Challenges Facing Paediatric Cardiovascular Practitioners and their Patients

• ∙ 2007 Meetings: Controversies and Challenges Facing Paediatric Cardiovascular Practitioners and their Patients

• ∙ 2008 Meetings: Controversies and Challenges of Tetralogy Of Fallot and Other Challenges Facing Paediatric Cardiovascular Practitioners and Their Patients

• ∙ 2009 Meetings: Innovation Associated with the Treatment of Patients with Congenital and Paediatric Cardiac Disease

• ∙ 2010 Meetings: Rare and Challenging Congenital Cardiac Lesions: an Interdisciplinary Approach

• ∙ 2011 Meetings: A Holistic Approach to Hypoplastic Left Heart Syndrome and Other Evolving Challenges in Paediatric and Congenital Cardiac Disease

• ∙ 2012 Meetings: A Lifelong Interdisciplinary Approach to Common Arterial Trunk, Transposition of the Great Arteries, and Other Evolving Challenges in Paediatric and Congenital Cardiac Disease

• ∙ 2013 Meetings: Highlights of HeartWeek 2013 at The Sixth World Congress of Paediatric Cardiology and Cardiac Surgery in Cape Town, South Africa

• ∙ 2014 Meeting: Highlights of HeartWeek 2014: Diseases of the Cardiac Valves from the Foetus to the Adult

• ∙ 2015 Meetings: Highlights of HeartWeek 2015: Challenges and Dilemmas of Pediatric Cardiac Care including Heart Failure in Children and Congenital Abnormalities of the Coronary Arteries

The part of the joint programme of HeartWeek organised by Johns Hopkins All Children’s Heart Institute and Sponsored by Johns Hopkins Medicine will continue to take place in Saint Petersburg, even in the years when the part designed by the Children’s Hospital of Philadelphia will be held outside of Florida, as occurred in 2009 in the Bahamas, as well as in 2011 and 2015, when the meeting organised by the team from the Children’s Hospital of Philadelphia returned to Arizona. Even during these years when the meeting organised by the Children’s Hospital of Philadelphia is held outside of Florida, “HeartWeek” will continue to be a collaborative project as manifest by the collaborative publication of HeartWeek Issues of Cardiology in the Young, as well the various shared members of our international faculties.

• ∙ In 2017, Johns Hopkins All Children’s Heart Institute will not host a meeting in Florida and instead will host a symposium at the 7th World Congress of Paediatric Cardiology and Cardiac Surgery in Istanbul, Turkey, which will be held from 18 to 23 June, 2017, under the leadership of Sertac Cicek (http://wcpccs2017.org/en/).

• ∙ In 2018, Johns Hopkins All Children’s Heart Institute will not host a meeting in Saint Petersburg, Florida. Instead, we will combine our meeting with the 2018 Scientific Meeting of the World Society for Pediatric Congenital Heart Surgery, which we will host from 23 to 26 July, 2018, at Walt Disney World, Orlando, Florida (www.WSPCHS2018.com). This programme will be Chaired by Jeff Jacobs and Marshall Jacobs and promises to be truly AWESOME!!!

• ∙ In 2019, the meeting hosted by Johns Hopkins All Children’s Heart Institute will again return to the beautiful Saint Petersburg, Florida, after a two year absence!

As it has been stated on the web site for the programme coordinated by the Children’s Hospital of Philadelphia, “Providing optimal care for neonates, children, and young adults with heart disease requires a multidisciplinary team approach, including physicians, from cardiology, cardiac surgery, cardiothoracic anaesthesia, neonatal and paediatric critical care medicine, and multiple consulting services, nurses, perfusionists, respiratory therapists, social workers, and many others. All of these various practitioners must be experts in their own area, but should also be knowledgeable in what the other members of the team provide to the overall care of the patient.” This statement presents the rationale not only for the annual part of HeartWeek emanating from the Children’s Hospital of Philadelphia but also for “HeartWeek in Florida”. Both meetings are proud to emphasise collaboration that spans traditional geographical, subspecialty, and professional boundaries.

In recent years, we have dedicated this “HeartWeek Supplement or Issue” to leaders in paediatric and congenital cardiac care:

• ∙ The Supplement from the 2007 HeartWeek was dedicated to Professor Robert Anderson.

• ∙ The Supplement from the 2008 HeartWeek was dedicated to Hiromi Kurosawa of The Heart Institute of Japan and Tokyo Women’s Medical University, Tokyo, Japan, and Norman Silverman of Stanford University and Lucile Packard Children’s Hospital, Palo Alto, California, United States of America.

• ∙ The Supplement from the 2009 HeartWeek was dedicated to Marshall Lewis Jacobs and Charles S. Kleinman.

• ∙ The Supplement from the 2010 HeartWeek was dedicated to Constantine Mavroudis and Gerald Marx.

• ∙ The Supplement from the 2011 HeartWeek was dedicated to Martin Elliott and Gil Wernovsky.

• ∙ The December, 2012 HeartWeek Issue of Cardiology in the Young was dedicated to Richard A. Jonas.

• ∙ The December, 2013 HeartWeek Issue of Cardiology in the Young was dedicated to John Brown.

• ∙ The December, 2014 HeartWeek Issue of Cardiology in the Young was dedicated to Duke Cameron and Joel Brenner.

• ∙ This December, 2015 HeartWeek Issue of Cardiology in the Young is dedicated to Juan Valentín Comas, MD, PhD (13 May, 1960 to 16 June, 2015) and Donald Nixon Ross, FRCS (4 October, 1922 to 7 July, 2014).

Tributes to Juan Valentín Comas, MD, PhD (13 May, 1960 to 16 June, 2015) and Donald Nixon Ross, FRCS (4 October, 1922 to 7 July, 2014)

We would like to dedicate this December, 2015 HeartWeek Issue of Cardiology in the Young to two global leaders in the field of paediatric and congenital cardiac care: Juan Valentín Comas, MD, PhD (13 May, 1960 to 16 June, 2015) and Donald Nixon Ross, FRCS (4 October, 1922 to 7 July, 2014).

Tribute to Donald Nixon Ross, FRCS (4 October, 1922 to 7 July, 2014)

Donald Nixon Ross, FRCS (4 October, 1922 to 7 July, 2014) was a South African-born British cardiothoracic surgeon, who developed the pulmonary autograft, known as the Ross procedure, for the treatment of aortic valve disease, and also performed the first heart transplant in the United Kingdom in 1968. It is a fact that Donald Ross is responsible for many innovations in paediatric and congenital cardiac surgery:^15, Reference Somerville¹⁶

• ∙ 1961: homograft aortic valve replacement

• ∙ 1966: homograft pulmonary valve replacement

• ∙ 1967: pulmonary autograft aortic valve replacement, known as The Ross Operation

• ∙ 1968: the first heart transplant performed in the United Kingdom, 10th in the world

It is also a fact that the world of paediatric cardiac surgery has been transformed by each of the above groundbreaking and critical contributions. Figure 1 shows Donald Ross and his team in 1968 when they met the press outside of The National Heart Hospital after Britain’s first heart transplant. Donald Ross is shown at the bottom right, in spectacles. Jane Somerville is in the striped shirt on the left.

Figure 1

Donald Ross is responsible for many innovations in paediatric and congenital cardiac surgery, including homograft aortic valve replacement (1961), homograft pulmonary valve replacement (1966), pulmonary autograft aortic valve replacement (1967), and the first heart transplant performed in the United Kingdom, and 10th in the world (1968). This photograph shows Donald Ross and his team in 1968 on the steps of the front entrance of The National Heart Hospital, when the team met the press in the hour after Britain’s first heart transplant.¹⁵ Donald Ross is shown at the bottom right, in spectacles. Jane Somerville is in the striped shirt on the left by the pillar; Jane was the cardiologist for the patient Fred West, described by Jane as “a courageous man”. According to Jane, “We were amazed at press outside!”. Others in this photograph include surgeon Keith Ross – blond, straight hair – the Matron, by the other pillar on the right opposite Jane, Theatre Sister Curry, and the innovative Donald Longmore who ran the bypass and made the transplant possible, behind Keith Ross. When describing this picture, Jane Somerville states “We went outside as the house governor who stayed on told us to, and we were amazed by television, news reporters, cameras and police, blocking the whole small street outside The National Heart Hospital. We were live on the news. We had never met the press in force. What an awakening. Celebrity overnight!! They became a complete pain over the next week. Our lives were no longer our own!! But so exciting…new medicine…new experiences!!!”. Photograph taken in 1968 on the steps of the front entrance of The National Heart Hospital.

In October, 2015, Cardiology in the Young published a paper, written by Jane Somerville, Professor of Cardiology (Retired), Imperial College London, London, United Kingdom, which provided Jane’s personal recollections about Donald Ross, and thus a unique snapshot of cardiac surgical history.Reference Somerville¹⁶ This touching and powerful tribute to Donald Ross is must do reading for anyone interested in paediatric and congenital cardiac care. Jane Somerville is a true authority on paediatric and congenital cardiac care and the history of the art and science of the speciality; Jane has made “TNTC” – too numerous to count – contributions to paediatric and congenital cardiac care and has held multiple important professional positions and titles, including the following two notable roles:

• ∙ Professor of Cardiology (Retired), Imperial College London, London, United Kingdom

• ∙ Founder, World Congress of Paediatric Cardiology and Cardiac Surgery (WCPCCS).

In her powerful tribute to Donald Ross, Jane states:

“I know Donald Ross as well as anybody and better than most, with the exception of his family. I became his colleague, knew most of what he was thinking and going to do, at least in surgery, and was privileged to be part of the many successful advances he made in cardiac surgery for congenital heart disease. Parallel and deeply intertwined with our professional relationship were our family relations. I met Donald Ross for the first time when I was a dresser* in the firm of Sir Russell Brock in 1954. Donald Ross, at the time, was the surgical research fellow.” *“Dresser” is the term used in Guys hospital when a medical student was attached to a surgical firm for 3 months. The term “dresser” was used, since the 18th century, because the medical student would assist nurses or surgeons with dressing of wounds, and in the process learn about wound care, and also scrub up with the surgeon. Jane Somerville was on the firm of Sir Russell Brock by choice as the 12th appointment of medical student training, where students were all allowed to choose whichever firm they wanted.

Jane then describes the professional accomplishments, personality, leadership, and vision of Donald Ross. She shares some awesome professional and personal stories about one of the founding fathers of paediatric and congenital cardiac care. Jane concludes by stating: “I believe it is enough for us to have known Donald well and to have benefitted from his good example in teaching, innovation, and care of patients. Thanks to Donald Ross, we have been so fortunate, as has the world of cardiac surgery in the last 50 years!”.Reference Somerville¹⁶

Tribute to Juan Valentín Comas, MD, PhD (13 May, 1960 to 16 June, 2015)

Juan Comas is remembered as a European paediatric cardiac surgical leader who extensively promoted the collaboration and cooperation between cardiac surgeons and cardiologists in multiple domains. Juan Comas was an important leader in many domains of paediatric and congenital cardiac care including the following:

• ∙ European Association for Cardio-Thoracic Surgery (EACTS)Reference Brawn¹⁷

• ∙ Association for European Paediatric and Congenital Cardiology (AEPC)Reference Jacobs^{18, 19}

• ∙ European Congenital Heart Surgeons Association (ECHSA)

• ∙ World Congress of Paediatric Cardiology and Cardiac Surgery (WCPCCS).

In The European Association for Cardio-Thoracic Surgery, Juan served as Chair of the European Association for Cardio-Thoracic Surgery Domain of Congenital Heart Disease.Reference Brawn¹⁷ As Chair of the congenital domain, Juan tirelessly and energetically promoted an agenda of collaboration that spanned traditional boundaries of geography and subspecialty. At the 2011 annual meeting of European Association for Cardio-Thoracic Surgery in Lisbon, Portugal, Juan Comas, Chair of the European Association for Cardio-Thoracic Surgery Domain of Congenital Heart Disease, was able to thank the past Chairs for developing the Congenital Domain and organising the annual meetings and educational programmes of the Congenital Domain (Fig 2).Reference Brawn¹⁷ Since the inception of the Congenital Domain, the involvement of the Domain with The Association for European Paediatric and Congenital Cardiology has increased, as has the involvement of colleagues from North America. Meetings of the European Association for Cardio-Thoracic Surgery Congenital Domain have therefore developed not only a European but also a worldwide accent.¹⁷

Figure 2

Juan Comas is remembered as a European paediatric cardiac surgical leader who extensively promoted the collaboration and cooperation between cardiac surgeons and cardiologists in multiple domains. At the 2011 annual meeting of the European Association for Cardio-Thoracic Surgery (EACTS) in Lisbon, Portugal, Juan Comas, the Chair of the EACTS Domain of Congenital Heart Disease, was able to thank the past Chairs for developing the Congenital Domain and organising the annual meetings and educational programmes of the Congenital Domain. Since the inception of the Congenital Domain, the involvement of the Domain with The Association for European Paediatric and Congenital Cardiology (AEPC) has increased, as has the involvement of colleagues from North America. Meetings of the EACTS Congenital Domain have therefore developed not only a European but also a worldwide accent.¹⁷ From left to right, this photograph from 2011 shows the following past Chairs of the EACTS Domain of Congenital Heart Disease: Bohdan Maruszewski, Francois Lacour-Gayet, Pascal Vouhé, James Monro, and Juan Comas.Reference Brawn¹⁷ Photograph taken in October, 2011 at the 25th Annual Meeting of EACTS in Lisbon, Portugal.

In The Association for European Paediatric and Congenital Cardiology, Juan previously served as a Councillor and was the Chair of the Association for European Paediatric and Congenital Cardiology Congenital Heart Surgery Working Group at the time of his death. Cardiology in the Young is honoured to be the official journal of Association for European Paediatric and Congenital Cardiology,Reference Jacobs¹⁸ and we are pleased to reproduce the letter below from Association for European Paediatric and Congenital Cardiology President Eero Jokinen.¹⁹

Letter from Association for European Paediatric and Congenital Cardiology President Eero Jokinen

In memory of Juan Comas

Dear Colleagues,

We have received sad news from Madrid on Tuesday, 16 June, 2015.

Professor Juan Comas, past Councillor of Association for European Paediatric and Congenital Cardiology, died suddenly yesterday morning. We have lost an excellent cardiac surgeon and teacher and a dear friend far too early. Juan had a big and warm heart and had friends all around the world.

Juan extensively promoted the cooperation between cardiac surgeons and cardiologists in several ways during his tenure as Councillor and continued this work even till the last night of his life – actively finding new innovative ways of co-operation. Juan was a great surgeon with big visions. The cooperation between cardiologists and cardiac surgeons has never been so good as it is now – thanks to Juan.

We have lost a great cardiac surgeon and a dear friend. Even during the time of sadness, we always should remember Juan’s laugh, his friendship, and all the work he has done for two disciplines – congenital cardiac surgery and paediatric cardiology – and especially to the children with heart defects all around the world.

We will have Juan’s wife Montse and his son Jan in our thoughts

Eero Jokinen

Association for European Paediatric and Congenital Cardiology President

Juan was actively engaged in the World Congress of Paediatric Cardiology and Cardiac Surgery. He led the Spanish bids to host the 7th World Congress of Paediatric Cardiology and Cardiac Surgery and the 8th World Congress of Paediatric Cardiology and Cardiac Surgery. Although the Spanish bid was the second choice in the highly competitive bidding process to host the 2017 and 2021 meetings, Juan remained an active supporter of the World Congress of Paediatric Cardiology and Cardiac Surgery. Moreover, although Juan and I were in competition to host the 8th World Congress of Paediatric Cardiology and Cardiac Surgery, this competition was a friendly competition, where we both pushed each other to be better and excel! I expect that it is highly likely that Spain would have hosted the 2025 or 2029 World Congress of Paediatric Cardiology and Cardiac Surgery under the leadership of my friend Juan Comas.

In this December 2015 Issue of Cardiology in the Young, we are very pleased to publish a touching and meaningful tribute to Juan Comas written by the following two authors:Reference Karl and Galletti²⁰

• ∙ My partner Tom R. Karl MS, MD, FRACS, Associate Editor of Cultural, Ethical, and Humanitarian Affairs for Cardiology in the Young, Professor of Surgery, University of Queensland, and Cardiac Surgeon at Johns Hopkins All Children’s Heart Institute in Saint Petersburg, Florida, United States of America

• ∙ Lorenzo Galletti MD, Direttore USC Cardiochirurgia I, Azienda Ospedaliera “Papa Giovanni XXIII”, Piazza OMS 1, 24127 Bergamo, Italia

On a personal note, I truly miss my friend Juan. Juan accomplished so much in his life, professionally and personally. He excelled and was awesome in multiple domains. International meetings of professionals dedicated to paediatric and congenital cardiac care will miss the presence and personality of Juan! My wife Stacy and I offer our sincere condolences to Juan’s wife Montserrat and their young son Jan. They are in our thoughts and prayers. I miss you my friend!

This December, 2015 HeartWeek Issue of Cardiology in the Young

We are pleased and honoured to dedicate this December 2015 HeartWeek Issue of Cardiology in the Young to Juan Valentín Comas, MD, PhD (13 May, 1960 to 16 June, 2015) and Donald Nixon Ross, FRCS (4 October, 1922 to 7 July, 2014).

All manuscripts in Cardiology in the Young, and all manuscripts in all the Supplements to Cardiology in the Young, including the December, 2015 HeartWeek Issue of Cardiology in the Young, are listed in MEDLINE^®, which is the premier bibliographic database of the National Library of Medicine of the Unites States of America covering the fields of medicine, nursing, dentistry, veterinary medicine, the healthcare system, and the pre-clinical sciences. All manuscripts in Cardiology in the Young, and all manuscripts in all the Supplements to Cardiology in the Young, including the December, 2015 HeartWeek Issue of Cardiology in the Young, are assigned a Digital Object Identifier, DO or DOI, which is a unique and persistent digital identification code for any object of intellectual property. The references to these articles and their Digital Object Identifier can be found in PubMed, which comprises more than 20 million citations for biomedical literature from MEDLINE, life science journals, and online books. Citations in PubMed may include links to full-text content from PubMed Central and publisher web sites.

It is gratifying for Jim Quintessenza, Tom Karl, and me, as representatives of Johns Hopkins All Children’s Heart Institute, to confirm our ongoing commitment to continue “HeartWeek in Florida”, combining the International Symposium on Congenital Heart Disease now organised by the All Children’s Hospital and Johns Hopkins Medicine, with the annual postgraduate course in Paediatric Cardiovascular Disease organised by Children’s Hospital of Philadelphia. We thank Jack Rychik, Director of the meeting organised by the Children’s Hospital of Philadelphia, Tina Mannices, Manager of Continuing Medical Education at the Children’s Hospital of Philadelphia, and also Tom Spray and Bill Gaynor for their support.

The December, 2015 HeartWeek Issue of Cardiology in the Young that you are now about to read, therefore, focusses on “Highlights of HeartWeek 2015: Challenges and Dilemmas of Pediatric Cardiac Care including Heart Failure in Children and Congenital Abnormalities of the Coronary Arteries”. It has been prepared to give a flavour of the two meetings that compose the HeartWeek:

• ∙ Johns Hopkins All Children’s Heart Institute’s 15th Annual International Symposium on Congenital Heart Disease, which was held at the Renaissance Vinoy Resort & Golf Club, Saint Petersburg, Florida from Friday, 6 February, 2015, to Monday, 9 February, 2015. This Symposium was co-sponsored by The American Association for Thoracic Surgery (AATS) and its special focus was “Congenital Abnormalities of the Coronary Arteries”.

• ∙ The Children’s Hospital of Philadelphia’s annual meeting – Cardiology 2015, the 18th Annual Update on Paediatric and Congenital Cardiovascular Disease: “Challenges and Dilemmas” – which was held at the Hyatt Regency Scottsdale Resort and Spa at Gainey Ranch, Scottsdale, Arizona, from Wednesday, 11 February, 2015, to Sunday, 15 February, 2015.

This December, 2015 HeartWeek Issue of Cardiology in the Young contains 29 manuscripts and is divided into 4 Parts:

• ∙ Part 1 includes this Introduction to December, 2015 HeartWeek Issue of Cardiology in the Young as well as a separate tribute to Juan Comas written by Lorenzo Galletti and my partner Tom Karl. Part 1 also includes an important Editorial from the Archiving Working Group of The International Society for Nomenclature of Paediatric and Congenital Heart Disease (ISNPCHD) about the preservation of cadaveric heart specimens through three-dimensional digital imaging.

• ∙ Part 2 is a series of five manuscripts related to heart failure in children.²¹ These manuscripts were presented at the Children’s Hospital of Philadelphia Cardiology 2015: 18th Annual Update on Pediatric and Congenital Cardiovascular Disease: “Challenges and Dilemmas”, Scottsdale, Arizona, United States of America, February 11, 2015 to February 15, 2015.

• ∙ Part 3 is a series of ten manuscripts related to congenital abnormalities of the coronary arteries. These manuscripts were presented at the Johns Hopkins All Children’s Heart Institute’s 15th Annual International Symposium on Congenital Heart Disease, Saint Petersburg, Florida, United States of America, Friday 6 February, 2015 to Monday 9 February, 2015.

• ∙ Part 4 includes eleven articles related to the theme of paediatric and congenital cardiac care. The first three articles relate to the relationship of volume to outcome, transparent reporting of outcomes, and the use of social media in medicine. Additional articles focus on ambulatory care, pregnancy in patients with Fontan circulation, medical ethics, and a variety of other topics. The final manuscript proposes a strategy for shared decision making within teams.

Over the years, HeartWeek in Florida has provided many opportunities for the excellent scientific exchange of ideas, and the development of awesome friendships. I would like again to thank Bob Anderson and Ted Baker for all of their help, support, trust, and patience during the preparation of these HeartWeek Supplements and Issues of Cardiology in the Young. I would also like to thank my good friends who compose the Editorial Board of this December, 2015 HeartWeek Issue of Cardiology in the Young: Jack Rychik, Gary Stapleton, Allan D. Everett, and Robert H. Anderson. Each of the members of the Editorial Board of this HeartWeek Issue of Cardiology in the Young has made important and valued contributions.

I would especially like to thank Nicki Marshall, Susie Bloor, Katie Henderson, Aled Hills, and Daniel Edwards of Cardiology in the Young for their incredible editorial support during the creation of these HeartWeek Supplements and Issues of Cardiology in the Young. Without their help, this project would not have been possible (Figs 3 and 4).

Figure 3

On 7 July, 2015, the members of The International Society for Nomenclature of Paediatric and Congenital Heart Disease (ISNPCHD) (www.ipccc.net) visited the headquarters of Cambridge University Press. The team from Cambridge University Press were excellent hosts. The meeting provided the opportunity for important academic collaboration, a tour of the historic Cambridge University Press, and awesome social interaction. The members of The International Society for Nomenclature of Paediatric and Congenital Heart Disease are very appreciative of the wonderful hospitality provided by our team at Cambridge University Press. Photograph taken 7 July, 2015, at Cambridge University Press, Cambridge, England.

Figure 4

Jeffrey P. Jacobs, MD, Editor-in-Chief of Cardiology in the Young, with the team of Cardiology in the Young, at Cambridge University Press: Nicki Marshall, Susie Bloor, Katie Henderson, Aled Hills, and Senior Commissioning Editor Daniel Edwards. Photograph taken 7 July, 2015, at Cambridge University Press, Cambridge, England.

I am especially grateful to Jonathan Ellen, MD, President and Physician-in-Chief at All Children’s Hospital and Vice Dean and Professor of Paediatrics, Johns Hopkins University School of Medicine, for facilitating the publication of this HeartWeek Issue of Cardiology in the Young. I would also like to thank several additional members of our team at the All Children’s Hospital – namely, Sylvia Ameen, Sylvia Powell, Roberta Alessi, Susan Collins, Jean Wilhelm, Lisa Moore, Ashley Collins, Jade Hanson, and all our cardiac nurses. I would also especially like to thank our AWESOME CME team: Melodye Farrar, Suzanne Anderson, Jaclyn Johnson, Lora Craft, Meaghan Gelinski, and Hannah Kline. I would also like to thank Patricia Hickey, PhD, MBA, RN, FAAN, NEA-BC, and her colleagues from Boston Children’s Hospital, Harvard University, for strengthening our nursing programme and mentoring Ashley and our nurses.

Finally, I would like to thank my current partners, Jim Quintessenza, Gus Mavroudis, Marshall Jacobs, Duke Cameron, Luca A. Vricella, Narutoshi Hibino, and Tom R. Karl, my former partners, Harald Lindberg, and Paul Chai, for their constant support and guidance, and my wife Stacy and children Jessica and Joshua, for their understanding and patience. It continues to be an ongoing fact that, as I have emphasised in previous introductions to Supplements and Issues, all the family members of the authors of the reviews included in this December, 2015 HeartWeek Issue of Cardiology in the Young are owed a debt of gratitude, because writing manuscripts markedly decreases the time available with them.