JCCHD Meeting Minutes
September 18, 2006
Attendees:
Gerard R. Martin, M.D. (ACC Representative to JCCHD)
Catherine Webb, M.D. (AHA Representative to JCCHD)
Dr. Jack Colman, ISACCD
Tom Kulick (ABP representative to JCCHD)
Tom Klitzner (AAP representative to JCCHD & QI Steering Committee member)
Lynn Colegrove, AAP
Rob Beekman (QI Chair Steering Committee member)
John Kugler (QI Steering Committee member)
Jeff Jacobs T
Dr. Constantine Mavroudis, CHSS and STS
Jim Wong, Ph.D., Chairman of the Board, ACHA
Mona Barmash, President and Founder Congenital Heart Information Network
Ellen Weiss, Children’s Heart Foundation
Welcome/Call to Order:
The meeting was called to order by Dr. Gerard Martin at 9:40 a.m. on Monday,
September 18, 2006 at the Sheraton Suites Hotel in Elk Grove Village, Illinois.
Dr. Martin welcomed those present.
Updates from Member Organizations:
The representatives from the participating organizations provided updates of projects and
initiatives.

AAP, Dr. Klitzner:
o In the past year, the AAP section on Cardiology and Cardiac surgery
completed the initial phase of the Directory Project aimed a compiling a
comprehensive directory of Pediatric Cardiologists, Pediatric Training
Programs and Pediatric Cardiac Surgery Programs in the United States an
Canada. A hard copy of the directory is to be mailed out this month.
However, in recognition of constant changes in the location and contact
information of physicians in our field makes it desirable to have an
electronic copy of the directory to be posted on the AAP website. A
project to complete this task is currently ongoing. In addition, the section
completed and published a statement on cardiac manifestations of
neuromuscular disease focusing on Duchene's and Becker's
Musculodystrophy. We have also moved forward with the development of
our website including a page devoted to the JCCHD. Over the past year,
the section has continued awarding of Resident/Fellow Travel Grants, the
Section's Founder's Award and the Young Investigator research grant
which now has multi year funding. Because of the large number of
excellent grant applications which we received in recent cycles, we are
looking for funding to allow the awarding of more than one grant in future
years.
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JCCHD Meeting Minutes
September 18, 2006
o JCCHD representatives and summary of QI initiatives listed on AAP
website. http://www.aap.org/sections/cardiology/JCCHD.htm If there is
anything to add let Lynn know. Google JCCHD and it will bring you to
website.

ABP, Dr. Kulick:
o Part 2 of boards will consist of a bibliography of 25 articles that are
relevant to the field. Applicants will need to take a test and achieve a
score of 95%. Hope to be up and running by the end of 2006 and online
by 2007.
o There have been some technical difficulties with implementing an
electronic format for the board exams. Computer based exams still up in
the air as there are problems with vendors.
o Recertification will move from a 7 year to a 10 year cycle. There is a 4
part requirement.
1. Holding a valid license
2. Taking part 2
3. Recertification test
4. Part 4 maintenance
o There will be a module for the research requirement.
o Suggestion made to broaden communication base regarding these
requirements.

ACC, Dr. Martin:
o Career development seminar: ½ day event well attended. This was
followed by a reception where people could network.
o Travel awards being expanded to ACC scientific sessions.
o Dr. Girish Shirali is trying to add more congenital heart disease content for
both ACHD and pediatrics to the website.
o A working committee on quality of care has been formed.
Dr. Kathy Jenkins sent survey of CHD/PC programs inquiring about what
people are doing about quality of care.
o The section wants to continue their support of JCCHD QI project.
o Planning a registry for congenital cardiac catheterization data.
o Adult Congenital Heart Lobby Day. Patients and families representing 26
states came to Washington in September.

AHA, Dr. Webb:
o Efforts are being made to mentor young people in order to attract and
retain these members in the organization.
o Notification sent via email for a visiting professorship grant. The idea of
this grant is to provide funds to bring luminaries to your institution to give
lectures and to mentor fellows. Application and information offered and
funded by CVDY. Two will be offered for this year.
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o The Alliance for a Healthier Generation is a partnership with the Clinton
Foundation for preventative cardiology, e.g. taking soda pop out of
schools.
o Advocacy for the importance of care for adults with congenital heart
disease. CVDY will have a cross-council committee with 3 members
from the Clinical Cardiology Council and 3 members from CVDY for this
purpose.
o The CCD Committee is currently revamping guidelines regarding
stimulant medication.
o A proposal for paper on screening all newborn infants with pulse oximetry
is in the works
o The possibility of co-publishing 2 CVDY papers with AAP was discussed.
The papers are entitled: “The Genetic Basis for Congenital Heart Defects:
Current Knowledge” and “Non Inherited Risk Factors and Congenital
Cardiovascular Defects: Current Knowledge”.

CHS and STS, Dr. Mavroudis:
o ACGME has approved a residency/fellowship in pediatric cardiac surgery.
o Program will start in June or July 2008.
o Description/requirements:
1. Cardiac surgery boards
2. One year additional training program in congenital heart surgery
3. Paid at assistant professor level
o Ed Bove, MD is incoming president of CHSS.
o Concerns: Thirty percent of Cardiac Surgery Fellowships were not filled.
When polled, residents were concerned that there would not be enough
jobs to go around as coronary and angioplasty are siphoning some surgical
volume. There are also remuneration issues. Research indicates that 8 to
10 new congenital heart surgeons are needed per year in the U.S. and
Canada.

ISACCD, Dr. Colman:
o Dr. Colman will represent ISACCD one more year and will be followed
by Dr. Michael Landzberg.
o The group is in the process of defining the role of ISAACD in the US
environment.
o Advocacy for adult congenital heart disease. There are now more adults
than children with congenital heart disease.
o Focusing on training opportunities nationally and internationally and
looking at producing a directory.
o ISAACD is likely to be involved at some level in the electronic medical
passport for congenital heart disease patients.
o There is an increasing interest in ACHD and an increased interest in the
use of APN’s.
o Trying to expand international connections and the connection to APNs
and clinical associates, who will work under the ISAACD umbrella.
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o Like the CVDY, ISACCD is trying to find ways to link with younger
members

Quality Improvement in Pediatric Cardiology, Dr. Beekman (Chair, QI
Steering Committee Chair)
o See PowerPoint attachment
o QI projects differ from registry projects in that once a change is suggested,
it can be interjected into the system to see if it results in improvement.
o Change bundles are groups of actions or changes which are uniformly
interjected into systems.
o The plan is to identify 3 or 4 things the QI team considers to be a change
bundle and to test the outcome of the changes. Central Line infection rate
was used as an example.
o The “Perfect Discharge” in a newborn with a single ventricle was
discussed as a place to start.
Overview of JCCHD activities:
1. Communication. Each of our roles is to go back to parent organizations and tell
them what is going on. Each of us needs to think of way of communicating, that
will work best for our organization.
2. Should some sort of approval for the JCCHD exist in each member organization?
3. Should JCCHD take on an endorsement function?
4. All JCCHD members are in favor of having the QI taskforce continue moving in
the direction in which they are going. This will be communicated to the
respective member organizations to see if they are interested in having members
participate on the task force.
Council of Pediatric Specialties, Dr. Martin:
 Discussion as to whether the subspecialty match should be moved to April of the
3rd year of residency per requests of residents. Not all were in agreement that this
was a good idea due to problems with scheduling interviews. Dr. Martin to
discuss with Dr. Dick.
STS CHS Database, Dr. Jacobs:
 Nomenclature details were published in Annals of Thoracic Surgery.
 As they were working on the nomenclature project, progress articles were
published. This would be a good idea for the JCCHD QI project.
 Since 2002, participation in the database has grown from 16 centers to 47, which
is approximately 1/3 of the total number of surgical programs.
 In 2006 the number of congenital heart surgeries programs performed an average
of 11 to 12,000 operations per year evenly distributed. These are broken down by
pediatrics and adults. Discharge mortality analyzed. Outcomes in Europe and
North America were compared and evaluation of case complexity was done.
 Risk adjustment methods including Aristotle, RACHS-1, and RASCH-2 were
discussed. The plan is to combine these risk adjustment methodologies in
collaboration with Dr. Kathy Jenkins.
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

A module for pediatric anesthesia was discussed.
JCCHD interaction with this database project was discussed. The group felt we
should commit to a teleconference in November.
Welcome and Introductions of Advocacy and Subspecialty Groups
Jim Wong, Ph.D., Chairman of the Board ACHA
ACHA Mission:
The ACHA is a nonprofit organization which seeks to improve the quality of life and
extend the lives of adults with congenital heart defects. Education of patients and the
medical community is included as well. The organization is patient run. CME education,
research support and presentations to patients and the medical profession were discussed.
www.achaheart.org
Mona Barmash, President and Founder, The Congenital Heart Information
Network
Mona Barmash helped create this congenital heard disease support network website in
1996. In 2006, the site has received 3,000 unique visitors/day. During January, 2006,
5000 visitors were recorded. There is a parent/family matching program. The program
allows families to find others dealing with the same issues. Additionally, a financial
assistance program was started a few years ago to aid families having financial hardship.
This fund has helped pay mortgages, travel expenses, and bills, etc. There are affiliate
programs including 35 to 40 local support groups. These support groups range from
small groups of 10 or 12 moms to very large groups with experienced leaders. The
organization is interested in bringing more groups into the affiliate program.
PDHeart@tchin.org
Ellen Weiss, Board Member, Children’s Heart Foundation
The Children’s Heart Foundation was begun as a not for profit organization which raises
funds to be used exclusively for research in congenital or pediatric heart disease.
So far over two million has been donated to CHD research through the CHF. The
organization is currently funding 24 different national studies. This year they will fund
another $500,000. Three chapters are up and running across the country. There is one
staff member in Chicago. The medical advisory board includes Dr. Mavroudis, Dr.
Webb as well as an additional group of cardiologists and cardiothoracic surgeons. Basic
science and clinical research is funded. A free of charge book has been published called
It’s My Heart for patient and parent education.
www.childrensheartfoundation.org
Discussion with the three members of the advocacy organizations followed.
There being no further business, Dr. Martin adjourned the meeting at 3:33 p.m.
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