Alexander (Sasha) Opotowsky, M.D.
Director, Adult Congenital Heart Disease Program
Co-Director, Exercise Laboratory
Co-Director, Heart Institute Research Core Cincinnati Children’s
Professor, UC Department of Pediatrics
Q: How does your work with the Heart Institute make a difference in the lives of congenital heart disease patients?
Cincinnati Children’s is committed to serving patients with congenital heart disease from before birth through adulthood, and our work helps adults born with congenital heart disease live full, healthy lives. Our Adult Congenital Heart Disease Program is one of just 37 ACHD programs in the United States accredited by the Adult Congenital Heart Association, and the only one in the tri-state area.
Q: Why is it important for adults born with heart defects to be seen at a specialized center?
While congenital heart disease isn’t that uncommon, the level of expertise among adult medical and surgical practitioners is limited in this area. While they are experts in acquired heart disease, their training in treating congenital defects is often limited. At Cincinnati Children’s, the cardiologists have specialized training in treating congenital heart disease at all ages. We’ve known some of our adult patients through- out their childhoods and understand the nuances and pitfalls of their conditions.
Q: Please share your most exciting news as it relates to innovation and research.
We are building an incredible and unique resource, an adult congenital heart disease bio-bank, which involves collecting and storing blood and other tissue for future research studies to understand why others develop complications. Long-term complications aren’t limited to the heart — physical and psychosocial stresses can have a very divergent impact on different people. Some can compensate and adjust, but others can’t, leading to outcomes like hypertension and liver disease. Another exciting initiative which has been pioneered by Cincinnati Children’s is the concept of a learning network of researchers and clinicians. We serve as the primary coordinating site in the nationwide National Pediatric Cardiology Quality Improvement Collaborative (NPC-QIC) and the Fontan Outcomes Network (FON), which work to dramatically improve outcomes across the lifespan for children and adults with specific forms of heart disease.
Q: What is the best piece of advice you were given as it relates to your field or what is the best piece of advice you can give out?
Just taking a moment to observe and think as you care for people may open the door to “natural experiments” that help us understand basic biologic questions. During my internship, residency and fellowship, I took care of a handful of people living with a very rare tumor. It affects just 1 in 10,000 people each year, so it was quite surprising to care for five people with this tumor who had congenital heart disease. I asked friends in the field about this and we were able to get tissue from more patients with congenital heart disease who had developed this type of tumor. Those samples and studies helped us explain common factors in that type of tumor growth and ways we could potentially address it.