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Pediatric Cardiology – Former Child Heart Patient Now A Cardiologist

In 1958 at age five, Donald Leichter, MD, Summit Medical Group pediatric cardiologist, was one of the first generation to undergo open heart surgery.

Now a pediatric cardiologist whose son was also born with a heart defect, Dr. Leichter knows well the challenges parents face when their child is diagnosed with a heart problem.  

Dr. Leichter  specializes in diagnosing and treating heart conditions in infants, children, and adolescents. He has extensive experience with everything from common heart murmurs to rare, complex heart defect.

Listen in as Dr. Leichter shares his story and gives great advice to parents of children with heart problems.
Pediatric Cardiology – Former Child Heart Patient Now A Cardiologist
Featured Speaker:
Donald Leichter, MD
In addition to his position at Summit Medical Group, Donald A. Leichter, MD, is an attending physician in Pediatrics and Pediatric Cardiology at Overlook Medical Center in Summit, Morristown Medical Center in Morristown, and Saint Barnabas Medical Center in Livingston, all located in New Jersey. He is Former Director of Pediatric Cardiology at Overlook Medical Center. Dr. Leichter is Associate Clinical Professor of Pediatrics at New York Presbyterian Medical Center Children's Hospital of New York in New York City.

Dr. Leichter has practiced at Long Island Jewish Medical Center Schneider Children's Hospital. He has been a consulting pediatric cardiologist at Queens Hospital Center, Union Memorial Hospital Children's Specialized Hospital, Mountainside Hospital, Elizabeth General Hospital, Chilton Memorial Hospital, and Muhlenberg Medical Medical Center. Dr. Leichter is Former Associate Director of Pediatric Cardiology and Former Vice Chair of Pediatrics for Atlantic Health System. He has been Assistant Clinical Professor of Pediatrics at the State University of New York in Stonybrook.

Dr. Leichter is a fellow of the American Academy of Pediatrics and American College of Cardiology. He is a member of the American Heart Association, Union County Medical Society, and American Society of Echocardiography. He has been a member of the American Heart Association Committee on Heart Health in the Young.

A gifted teacher, Dr. Leichter has taught courses for physicians' board review, the New York State Society of Cardiovascular and Pulmonary Technology, and pediatric / family practice rotations.He is a recipient of the Overlook Medical Center House Staff Teaching Award. Dr. Leichter has delivered invited presentations on congenital heart disease for pediatric, family practice, and radiology staff at Overlook Medical Center, Saint Barnabas Medical Center, Hunterdon Medical Center, Bayonne Hospital, and Saint Claire's Medical Center. He is the coauthor of articles and abstracts, which are published in prestigious, peer-reviewed scientific journals, including Journal of the American College of Cardiology, Pediatric Emergency Care, and Circulation.

For more than 15 years, Dr. Leichter has been featured in Castle Connolly and New Jersey Monthly "Top Doctor" listings. His Castle Connolly listings are reprinted in US News and World Report, Inside Jersey, and New York Magazine.

Learn more about Donald A. Leichter, MD
Transcription:
Pediatric Cardiology – Former Child Heart Patient Now A Cardiologist

Melanie Cole (Host): At age five in 1958, Dr. Donald Leichter, Summit Medical Group pediatric cardiologist, was one of the first generation to undergo open heart surgery. Now a pediatric cardiologist, whose son was also born with a heart defect, Dr. Leichter knows well the challenges parents face when their child is diagnosed with a heart problem. Welcome to the show, Dr. Leichter. Tell us your story.

Dr. Donald Leichter (Guest): The story, I think, is somewhat unusual. When I was born in 1952, it was quickly recognized that I had a cardiac defect of some sort. Diagnostic techniques back then were quite different than they are today. There was no ultrasound. They weren’t so quick to catheterize new children because there was really nothing to be done. They were a few years out at that point from extracardiac repairs, but intracardiac repairs – open heart surgery – was not in existence at the time. I have lived my early childhood with a large hole between my two pumping chambers. Nothing was really known about the natural history of that. It was only when I went to roaring heart failure, I got measles on top of the congestive heart failure I had, and I ended up admitted in a local hospital. That would have been in ’57. Because of that deterioration, I ended up going for heart surgery. The bypass machine had only been available for a year or two at that point. I was sent out to Minnesota for open heart surgery at the Mayo Clinic with Dr. John Kirklin. I did well. I was very fortunate. Natural history of children with large VSTs that need to be repaired, a significant subset of them will develop irreversible lung disease by two years of age. We would not wait to repair a large defect until the age which I was operated on. I was just lucky to dodge a bullet. From that point on, my father, who was a reporter for Associated Press and United Press International, had done all the research leading to identifying where I could get surgery and setting all this up. That was encouraging me to go to science and become a physician. Of course, as a young child, my idea of what I was going to do with my future was quite different. When I got to the point of going away to college and then making decisions about what to do after college, I did decide to go into medicine and then it’s pediatrics, and then finally, I decided that I wanted to “pay back the system” and do pediatric cardiology. Of course, life threw major curves and after getting married and after having our first child, who did quite well, our second child was born with heart disease. Recognized early on, surely after birth, it’s not when it’s a roaring heart failure and had a relatively unusual lesion and anomalous origin of the left pulmonary artery off of the aorta. Some people mistakenly call it hemitruncus, and that was repaired at the time. He also had an associated developmental genetic problem called velocardial facial syndrome, which has led to other developmental issues. But he is doing quite well and we’re obviously in love with him and he is now 26 and thriving. I’ve been on all sides of the table. I’ve been a patient and I’ve gone through bypass. I remember certain pieces in flashes. Now I am a pediatric cardiologist and I’ve been a parent of a patient who went through heart surgery. I think it’s a little different view of the profession than most of my colleagues.

Melanie: Well, Dr. Leichter, that’s absolutely fascinating, and I applaud your really uplifting attitude about all of this. Tell us, as a pediatric cardiologist and as a parent, what are some of the conditions that we face that we see, that our children face that would leave us to go to a pediatric cardiologist.

Dr. Leichter: Well, the reasons one would be sent to a pediatric cardiologist… most of us, we are catchers, not pitchers. We are sent patients by consulting pediatricians, family practitioners, sometimes, in terms of fetal work, OB-GYNs or perinatologists. Patients will be sent in for a number of issues to rule out heart disease more than to rule it in. You might be sent in for a cardiac murmur that sounds somewhat atypical, that is to say, a heart sound that doesn’t sound quite right. You might be sent in because your child is having chest pain when exercising. Or you might be sent because your child is blacking out. Most of the time, these things turn out to be nothing. They turn out to be normal physiologic, benign issues. Every once in a while, we pick up somebody who needs care and the job of the pediatric cardiologist is to identify these kids and make sure that they get proper management. For my Jersey practice, here in Summit, it’s largely the diagnosis of a technician of significant underlying heart disease. A lot of my day is spent telling patients they’re fine. The patients who have heart disease, for the most part, are referred out to the major surgical centers in the area. I’m on faculty at Columbia Presbyterian in Manhattan, so the bulk of my surgical work is taken there. We have a very experienced, very large, very well recognized pediatric cardiology, cardiothoracic surgical program there. In some patients, for insurance reasons and other reasons, they end up going to other major centers in the area; but again, most of the simple issues are taken care of right here at Summit.

Melanie: Tell us, if parents have experienced a child with heart disease, what’s going on in the world today of pediatric cardiology and what’s on the horizon, hope-wise?

Dr. Leichter: Surgery for most lesions has become very routine. Certainly the bread-and-butter issues, holes in the heart and damaged valves and obstructed pathways for blood flow can all be well repaired and can be recognized pretty simply with noninvasive techniques such as echocardiography and magnetic resonance imaging. Diagnostic cardiac catheterizations are of limited use, so limited necessity anymore. In terms of surgical approaches, many of the things that used to be repaired surgically certainly, again, relatively simple issues – holes between the upper chambers of the heart, for example – can be handled without surgery, can be closed in the cath lab by experienced interventional cardiologists. Many of what used to be considered complex lesions, things like tetralogy of Fallot, which is a four-part lesion that was part of that television movie that was on not too long ago, expressing the early work of Blalock and Taussig in Hopkins, those sorts of repairs have become very routine. The much more complex issues having to do with patients who are born without a chamber, for example, have led to a breakthrough over the last 20 years or so, 30 years, of multiple palliative surgeries leading to a successful three-chamber heart physiology, a so-called Fontan palliation. Many of these patients are surviving into adulthood and the adult cardiologists are now having to learn to how to deal with them. Heart transplantation has become a more routine procedure. Patients whose hearts are too damaged, either by an acquired issue or by multiple surgical interventions [end] with a new heart. That has become a successful way to deal with patients who have end-stage heart disease. Supporting patients who need support, waiting for transplantation in terms of extracorporeal membrane oxygenation, also called ECMO, and cardiac assist devices, these have become much more available for children and work is being done on miniaturizing them further so they can be used in younger and smaller children to support them until all repairs can be done. That piece of the practice is the far end of the spectrum. Again, most children who have cardiac problems have things that are pretty simple to deal with. Many of them are brought to our attention for things that don’t need intervention.

Melanie: With the obesity epidemic that we’re facing today, are you seeing more cardiovascular and heart disease going on in children because of obesity that you did not use to see?

Dr. Leichter: I’m glad you brought that up. It’s not that I’m seeing disease really, but the emphasis on the epidemiologic issues pertaining to obesity and what it means for our society, what it means for medical practice later in life when these kids are not children any longer. That has been re-emphasized among pediatricians and pediatric cardiologists and what we are trying to do is to identify these kids as they come through many times for other issues and to emphasize the need to deal with the weight issue, the hypertensive issues, and the poor eating issues, so that they don’t become the cardiac patients of tomorrow. That sort of acquired heart diseases is something that can be avoided, but it requires intervention early in life. It is very hard to change one’s lifestyle dramatically, not impossible, but difficult as a 40 or 50 or 60-year-old. Getting a handle on these kids when they are 5, 6, 7, and 8 and having them learn how to eat healthy, not necessarily diet but eat healthy, and to exercise on a regular basis and make that a part of their lives, that’s a way of getting into the system early and trying to avoid future problems, which helps everybody and helps the system. It’s economically more feasible than trying to treat everybody’s heart disease when they have it. There’s an emphasis among my colleagues and I to try and get into this and to intervene on these issues early when we recognize them.

Melanie: In just the last minute or so, Dr. Leichter, give parents listening your best advice if they are worried that their child might have a cardiovascular situation or condition and why they should come to Summit Medical Group for their cardiology care.

Dr. Leichter: Well, my dad used to say, “Self-praise stinks,” so I won’t go in that direction. What I will say is that if you suspect that your child has significant cardiac problem, either because of symptoms or because of something you’ve heard from one of these practitioners, and you wanted looked into it further, you should discuss it with your personal physician or your pediatrician or your family practitioner. At Summit Medical Group, I’m available and happy to see such patients. I think that the group and I [treat] them in a prompt and professional manner. I think that, as you heard from the earlier discussion, my take on how to deal with children is shaped, flavored a lot by my own experience, so I think the kids and the families have a pleasant experience when evaluated and that people get the proper information that they need to go forward.

Melanie: Well, you certainly have a unique perspective on it and it’s absolutely fascinating story, so thank you so much for sharing it with us. You’re listening to SMG Radio. For more information, you can go to summitmedicalgroup.com. That’s summitmedicalgroup.com. Thank you so much for listening. This is Melanie Cole. Have a great day.