New surgeon will lead cardiac partnership with CCMC

Collaboration will mean better care, choices for families

Paul Kirshbom, MD

Families with children in Connecticut who need cardiac surgery can choose the best care closer to home, thanks to the blossoming partnership between Yale School of Medicine, Yale-New Haven Children’s Hospital and Connecticut Children’s Medical Center (CCMC) in Hartford.

The partnership began almost two years ago, when the three institutions created a joint medical foundation enabling them to share pediatric cardiac physicians. In August, a vital piece of the puzzle was put in place when Paul Kirshbom, MD, became Yale’s new chief of pediatric cardiac surgery—and the first chief to hold the title at the two hospitals.

“This is exciting for kids and parents of Connecticut, and it may pave a road that could lead somewhere very interesting,” said Dr. Kirshbom, a cardiac and thoracic surgeon with a focus in neonatal surgery. He joined Yale from Children’s Healthcare of Atlanta, and is now a member of the medical faculties at both Yale and the University of Connecticut.

Gary Kopf, MD

Better support for state’s patients

The first thing the collaboration does is solve the problem of how to provide pediatric cardiac surgery in Connecticut, which does not have enough patient volume to support two pediatric cardiac surgery and interventional cardiology programs, but still needs highly skilled physicians to provide coverage. Dr. Kirshbom said a surgeon needs to perform at least 100 surgeries a year to keep up his or her skills, and he estimates there are only about 300 pediatric surgeries a year in Connecticut.

Joining Dr. Kirshbom in the partnership is Gary Kopf, MD, who performed pediatric cardiac surgeries under an informal arrangement with CCMC for 10 years. "I did this and found it's really very workable," Dr. Kopf said. "We developed the same standards in both institutions, so surgeries are done the same way in both places, as are preoperative evaluation and postoperative care, including the care in the intensive care unit and in anesthesia care. So now it's really easy to go back and forth from one place to the other."

A third surgeon, Mohsen Karimi, MD, is the associate chief of pediatric cardiac surgery for the two hospitals. He provides surgical treatment for all types of congenital cardiac defects in pediatric and adult patients.

The surgeons expect the collaboration to lead to better service across the board, as well as more complex specialized services for patients with uncommon conditions. "It will take a little period of time to ramp up CCMC to a full slate of cases, but we plan to offer everything from soup to nuts, with the exception of transplant surgeries," Dr. Kirshbom said. There will also be outpatient clinics at both hospitals.

While he said he may have to invest in an energy-efficient car, Dr. Kirshbom is excited about the prospect of working in two different cities. So far he's been able to maintain regular schedules at each location, but he expects the amount of time he and Dr. Kopf spend at each hospital will depend upon demand in different parts of the state at any given time.

Open to future partnerships

While the current partnership with Connecticut Children’s is focused solely on pediatric cardiac care, the medical foundation does allow for future program partnerships if the need arises.

“It’s a good model for a lot of specialties, surgical and nonsurgical, for cardiology and for other programs as well,” said Dr. Kopf. “This model has been used in many places around the country, where they have two hospitals with one program. It works well in a number of different ways—on one hand because the surgery is very highly specialized, and on the other hand, because it’s convenient for families. It’s difficult for families with sick children to travel for care. Now they can have the surgery they need at their local institution,” he said.