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By Amy O’Connor

New fetal cardiac program addresses critical concerns for expectant mothers

The news was a shock: A young expectant mother learned that her soon-to-be-born daughter had a major heart defect. The woman had only recently immigrated to the Bronx from Yemen and wasn’t fluent in English. She needed someone to explain what was wrong and tell her whether her baby would survive. But more than anything, she needed someone who could help save her baby’s life—and communicate with her in a sensitive way about what that meant.

Nadine Choueiter, M.D., uses a fetal heart monitor as she talks to maternity patient Tawhida Rahman at the John H. Gutfreund Fetal Heart Program’s Montefiore Hutchinson Campus in the Bronx. (Photo by Jason Torres)

Fortunately, a contact referred her to the John H. Gutfreund Fetal Heart Program at the Children’s Hospital at Montefiore (CHAM), where she met Nadine Choueiter, M.D., associate professor of pediatrics at Einstein and the program’s director.

“I speak Arabic, so I could understand her as well as her core values,” says Dr. Choueiter, a native of Lebanon. “We cared for her and built a personal relationship with her. We provide medical and genetic counseling to all of our families and make sure they receive the support they need.”

From left: Fetal heart nurse coordinator Guytree Keso watches as Dr. Choueiter goes over a model of an infant heart with maternity patient Tawhida Rahman and her husband, Mohammad Zahid Hessain. (Photo by Jason Torres)

We provide medical and genetic counseling to all of our families and make sure they receive the support they need.

— Dr. Nadine Choueiter

Dr. Choueiter (pronounced SHWAY-ter) explained to the young woman that her fetus had a serious condition called transposition of the great arteries (TGA). In TGA, the two main arteries leaving the heart are reversed, so blood pumped from the heart to the rest of the body contains too little oxygen. Fortunately, surgery in the first few weeks of life—a so-called arterial switch—can correct the condition.

“I’m happy to say that the baby received lifesaving surgery successfully,” Dr. Choueiter says. “She is now nearly a year old and doing well.”

Daphne Hsu, M.D., listens to a child’s heart at the Pediatric Heart Center at the Children’s Hospital at Montefiore.

A Common Birth Defect

Such success stories are common in the program, which provides care to an underserved community. The range of services includes expert diagnoses, interventional cardiology, postpartum support, quality-of-life counseling, and, when needed, neonatal cardiac surgery in a state-of-the-art facility.

The program team also cares for expectant mothers with diabetes or other conditions that can affect fetal heart development. In keeping with Montefiore’s mission, practitioners treat all patients regardless of ability to pay.

Congenital heart problems are relatively rare, affecting 1% of babies, but are the most common of all birth defects. In most cases, there’s no known cause for congenital heart disease, and there’s nothing the parents could have done differently to prevent the heart defect from happening.

In some cases, it’s thought that genetic factors and certain maternal environmental exposures may result in abnormal growth or formation of the heart early in pregnancy.

We serve a community in the Bronx with so many different cultures and languages and provide excellent care to people who would otherwise not receive it.

— Dr. Nadine Choueiter

Each year, the John H. Gutfreund Fetal Heart Program’s team of professionals—cardiologists, obstetricians, surgeons, maternal/fetal-medicine specialists, nurses, social workers, and allied health practitioners—provides comprehensive care to more than 1,000 expectant mothers and their families from the Bronx and across the tristate area. Dr. Choueiter and Daphne Hsu, M.D., professor of pediatrics at Einstein and co-director of the Pediatric Heart Center at CHAM, launched the program in 2017.

“It is the most gratifying feeling to save a life,” Dr. Choueiter says. “We serve a community in the Bronx with so many different cultures and languages and provide excellent care to people who would otherwise not receive it. If we weren’t here for these babies with heart problems, or if they had been born in a different place, they would not be alive today.”

The Stavros Niarchos Foundation (SNF) provided the initial funding for the program in memory of John H. Gutfreund, a philanthropist and longtime member of Montefiore Health System’s Board of Trustees, who died in 2016.

“Supporting the program just made sense,” SNF’s co-president Andreas C. Dracopoulos says. “The medical expertise, the vision, the leadership support and, most important, the need to care for these vulnerable children were all there. Dr. Hsu and Dr. Choueiter love what they do, and that feeling is contagious.”

Susan Gutfreund, center, cuts the ribbon on the fetal heart center named in honor of her late husband, John Gutfreund, who served Montefiore as a board member for decades. Her son, J.P. Gutfreund, a current Montefiore trustee, is at left; former Montefiore chief executive officer Steven Safyer, M.D. ‘82, is at right.

A Commitment to the Bronx

J.P. Gutfreund, the son of Mr. Gutfreund, is a current Montefiore trustee and supports the program with his time, passion, and philanthropy.

“My father was a true New Yorker with a strong sense of civic duty,” the younger Mr. Gutfreund says. “He believed that less-affluent communities deserved quality healthcare. So for more than 50 years, he had an unwavering commitment to Montefiore and the Bronx.” As plans for the program progressed, the younger Mr. Gutfreund and his wife learned they were expecting their first child. “Infant and family health were definitely on my mind,” he says.

In keeping with his family’s tradition of giving back, Mr. Gutfreund and his longtime friend Jon Moskowitz, a member of the Montefiore and Einstein Council (an affinity group designed to help shape the future of the institution), persuaded fellow donors to participate in the 2019 inaugural Heal-a-Heart Golf  Tournament at the Bayonne Golf Club in Bayonne, New Jersey—all to benefit the program.

That these doctors offer top-tier care to so many families and are saving so many children’s lives is truly John’s legacy. It takes the latest technology and the greatest people to make this work.

— Jon Moskowitz

“That these doctors offer top-tier care to so many families and are saving so many children’s lives is truly John’s legacy,” Mr. Moskowitz says. “It takes the latest technology and the greatest people to make this work. Through Heal-a-Heart and my personal philanthropy, I’m proud to do my part in ensuring that this legacy endures.”

Adds Dr. Choueiter: “We treat very sick children and, after they have gone through a lifesaving surgery, we do everything we can to make sure they will always be well. Every member of the team is deeply committed to serving the community. It is so gratifying for us to make a difference for so many children and their families.”

The baby born to that young Yemeni mother continues to seek care at CHAM. Thanks to the staff at Montefiore—and the commitment of generous donors such as SNF and the Gutfreund and Moskowitz families—the crucial support that began before her birth will continue long into her future.

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