My area of clinical expertise is pediatric and fetal interventional catheterization, with particular focus on device-based therapies. My professional activity is divided between clinical care (70%), research (20%) and teaching (10%).
As one of 6 invasive cardiologists staffing the largest pediatric catheterization program in the country, I perform over 250 procedures a year, most of which are interventional. I frequently provide interventional consultation to colleagues within my own Department, and to cardiologists throughout New England, and am also consulted by peers in interventional cardiology from around the country. My practice encompasses all types of catheter-based intervention for congenital heart disease, and includes several specific interventions that were either described by our group, or are almost exclusively performed here.
I also devote clinical time to the fetal cardiac interventional program, the only program of its kind in the world. Since its inception in 2000, the providers in this program have performed over 120 fetal catheterizations, an experience that is ten-fold any other in North America. In addition to responding to patient referrals and providing consultation to referring cardiologists and families, my role includes assessing candidacy for intervention, educating the families about these highly innovative procedures, and executing the interventional component of the procedures.
My research focuses on fetal cardiac catheterization, with emphasis on the development of new procedures and devices. I have been a coinvestigator on the first 2 prospective trials of fetal cardiac catheterization, and recently assumed the role of PI for one of them. Our team has published techniques and outcomes for in utero aortic and pulmonary valvuloplasty, and atrial septoplasty. I have designed 2 instruments for fetal intervention, securing a patent for one of these. In other work, I serve as the site principal investigator or coinvestigator for 3 prospective multicenter trials of investigational devices used to treat pediatric patients with congenital heart disease.
Training pediatric cardiology fellows to understand cardiac anatomy and physiology in the catheterization laboratory constitutes my primary teaching contribution, and teaching is a critical component of all of my procedural activity. In preparation for cath cases, I lead the rotating fellows in a discussion of each patient and procedure, covering acquisition and interpretation of hemodynamic data, and plans for intervention. In addition, each year my division trains a senior interventional cardiology fellow, selected from an international applicant pool. I have daily interaction with these senior trainees. Several have published successfully with my guidance and all have gained positions as interventional cardiologists at academic centers.
My clinical work also involves significant inpatient service commitments. Many patients are referred by a group of 4 pediatric cardiologists in Providence, RI, to whom I also frequently provide second opinions regarding broader management of complex cases. When these patients require inpatient care, catheterization or surgery, I serve as their attending physician, typically rounding on 4-6 patients daily. I have expanded my collaboration with this cardiology group by initiating a program in pediatric catheterization based at Rhode Island Hospital, where I perform procedures 1-2 times each month.
1988 B.A. summa cum laude, History, Yale University, New Haven, CT
1993 M.D. University of Pennsylvania, Philadelphia, PA
1993-1994 Intern in Pediatrics, Children's Hospital, Boston, MA
1994-1996 Resident in Pediatrics, Children's Hospital, Boston, MA
Clinical Fellow in Pediatric Cardiology, Children's Hospital, Boston, MA
1998-2000 Research Fellow in Pediatric Cardiology, Children's Hospital, Boston, MA
2000-2001 Senior Fellow in Interventional Cardiology, Children's Hospital, Boston, MA
Faculty Academic Appointments:
2001-2004 Instructor in Pediatrics, Harvard Medical School
2004- Assistant Professor in Pediatrics, Harvard Medical School
Appointments at Hospitals/Affiliated Institutions:
2001-2004 Assistant in Cardiology, Children's Hospital Boston
2001- Affiliate Consultant in Newborn Medicine, Brigham & Women's Hospital
2004- Associate in Cardiology, Children's Hospital Boston
2007- Staff Pediatric Cardiologist, Rhode Island Hospital (in attendance 2 days/ month)
Other Professional Positions:
2004- Member, Advanced Fetal Care Center, Children's Hospital Boston
Member, Board of Directors, The Ali Fund, a memorial fund established by a patient family, administered through the Children's Hospital Trust
2006- Adverse event reviewer, Congenital Cardiac Catheterization Outcomes Project, a multicenter consortium
2008- Member, Board of Directors, Boston Children's Heart Foundation
Major Administrative Leadership Positions:
Associate Director, Cardiac Catheterization Laboratory, Children's Hospital Boston
2009- Director, Cardiac Catheterization Laboratory, Children's Hospital Boston
2009- Chief, Division of Invasive Cardiology, Children's Hospital Boston
2009- Chair, Cardiovascular Program Inpatient Restructuring Task Force
Medical Director, Joint Program in Interventional Cardiology at
Children's Hospital Boston and Hasbro Children's Hospital
2003 Course Director, Prenatal Cardiac Interventions, a 2 day symposium on therapeutic fetal catheterization. Organized the program, recruited international faculty, created a syllabus, supervised course administration
2006- Member, Curriculum Committee, Fellows' Program in Cardiology,
2006- Interviewer, Boston Combined Residency Program
2007- Member, Children's Hospital Medical Peer Review Committee,
2008 Chair, Case-specific subcommittee, 2 cases
2007-2008 Member, Coarctation of the Aorta Clinical Practice Guideline Committee
2007-2008 Member, Hybrid Cath Lab and OR C-arm fluoroscopy Committee
2008-2009 Member, Children's Hospital Physicians' Leadership Committee
2008 Physician Leader, Implementation Committee for Cath Lab Extended Recovery Unit
Member, Cath Lab New and Emerging Technologies Committee
2009-2010 Chair, HLHS SCAMP (Standardized Clinical Action and Management Plan) Writing Committee
2009- Cardiology Fellow Scholarship Oversight Committee
2009- Member, Children's Hospital Radiation Safety Committee
2010- Member, Novel Organizational Approach, Operations Committee
2010- Member, Novel Organizational Approach, Procedural Committee
2010-2011 Chair, TOF SCAMP Writing Committee
2011- Chair, Cath Lab New and Emerging Technologies Committee
2008- Member, Congenital Cardiac Catheterization Outcomes Project, Manuscript Committee
2006 Member, Siemens Pediatric Catheterization Advisory Board
2011 Member, Siemens Pediatric Catheterization Advisory Board
Member, American College of Cardiology (ACC)
2006 Member, Special Program in Pediatric Cardiology
2007 Reviewer, Scientific Sessions Abstracts
2007- Member, Women in Cardiology Committee
2008 Reviewer, Scientific Sessions Abstracts
2009- Member, Congenital Cardiology Solutions Spotlight Planning Committee
2001- American Heart Association (AHA)
2001- Member, Council on Cardiovascular Disease in the Young
2003- Fellow, Society for Cardiac Angiography and Intervention (SCAI)
2009- Member, Structural Heart Disease Council
2009- Member, Objective Performance Criteria Writing Committee
2005- Member, Society for Pediatric Research (SPR)
2001- American Journal of Cardiology
2002- Journal of Thoracic and Cardiovascular Surgery
2007- Catheterization and Cardiovascular Intervention
2008- Cardiology in the Young
2009- Annals of Thoracic Surgery
Other Editorial Roles
Editorial Advisory Board, Pediatric Cardiology
2009- Editorial Board, Journal of Thoracic and Cardiovascular Surgery
Honors and Prizes:
2007 Henry Crown Fellowship
2006 CIMIT Johnson & Johnson Young Clinician Research Award
1999 American Heart Association Women in Cardiology Travel Grant
1998 NIH National Research Scholarship Award, Children's Hospital
1993 American Medical Women's Association Scholarship Citation
1993 Dr. Spencer Morris Prize Nominee, University of Pennsylvania
1992 American Heart Association Young Investigator Travel Citation
1991 American Heart Association Student Research Fellowship, The Wistar Institute
1991 Alpha Omega Alpha Honor Society, University of Pennsylvania
1989 NIH Student Research Fellowship, University of Pennsylvania
1988 Distinction in the Major, History, Yale University
1986 Phi Beta Kappa Honor Society, Yale University
Report of Funded and Unfunded Projects
Trainee, National Research Scholarship Award T32-HLO7572
Project: Differential characteristics of in stent restenosis following aortic and pulmonary arterial stenting in a swine model
Mentor: Elazer Edelman, MD PhD, Director, Harvard-MIT Biomedical Engineering Center
Project: Development of a fetal positioning device for ultrasound-guided, percutaneous, in utero cardiac intervention
Design and prototyping of potential devices for use in manipulating fetuses during interventional procedures
Role: Principal Investigator
Total Direct: $46,000
Project: STARflex occluder in Atrial septal defect--Long-term Status Assessment (SALSA)
Multicenter, retrospective analysis of prospectively collected data on an investigational device used to treat atrial septal defect
Role: Site Principal Investigator
Sponsor: NMT Medical
Total Direct: $11,250
Project: Coarctation of the Aorta Stent Trial (COAST)
Multicenter, prospective study of investigational device used to treat coarctation of the aorta
Role: 2007-2009 Site Principal Investigator; 2009- Coinvestigator
Sponsor: Johns Hopkins University
Total Direct: 54,700
Project: Transcatheter pulmonary valve implantation in patients with Tetralogy of Fallot
Multicenter, prospective study of investigational device used to treat obstructed and regurgitant right ventricular outflow tracts
Project: Amplatzer Duct Occluder II Clinical Study
Multicenter, prospective study of investigational device used to treat patent ductus arteriosus
Sponsor: AGA Medical
Total Direct: $5600 per patient enrolled, first enrollment pending
Current Unfunded Projects
Project: Prospective Evaluation of Fetal Cardiac Intervention
Single center, prospective study of in utero cardiac catheterization in fetuses with congenital heart disease
Role: Principal Investigator
Project: Impact of transcatheter left atrial decompression on outcomes during Extracorporeal Membrane Oxygenator (ECMO) support
Single center retrospective review of practice and techniques of left atrial decompression
Role: Mentor with fellow
Teaching of Students in Courses
2008 Group leader, Human Systems Module I: Pediatric Cardiology, HMS 2nd yr students, 4-hour session, 40 students/session, preparation 1 hour
Mentor, HMS Pediatric interest group, 1-2 students/yr, 1 day experience
2004-2005 Panelist, HMS Pediatric Clinical Careers Seminar, 1 hour lunch session
2006- Mentor, HMS Student Pediatric Shadowing Program, 1-2 students/yr, 1 day experience
Formal Teaching of Residents, Clinical Fellows and Research Fellows
2000- Preceptor, Angiography review, 1 fellow, 1 hour session each month, 2 hours preparation
2001- Discussion leader, Cardiology Fellows' Precatheterization conference, 4 pediatric cardiology fellows, 30 minutes, 2 days each week
2001- Lecturer, Cardiology Fellows' Core Lecture Series, "Hemodynamic measurements in the catheterization lab", 20 pediatric cardiology fellows, 1hour lecture each year, 1 hour preparation
2001- Lecturer, Cardiology Fellows' Core Lecture Series, "Technical aspects of cardiac catheterization" 20 pediatric cardiology fellows, 1hour lecture each year, 1 hour preparation
2001-2008 Lecturer, Cardiovascular Ward, "Cath lab calculations", 6 pediatric residents and students, 1 hour each month, 1 hour preparation
2001 Preceptor, Pediatric Interventional Cardiology Journal Club, 5 fellows, 1 hour twice a month
2006 Lecturer, Anesthesiology Fellows' Core Lecture Series, "Acquisition of hemodynamic data in the cardiac catheterization lab", 5 anesthesia fellows, 1 hour lecture, 1 hour preparation
2006 Lecturer, Cardiac Catheterization Lab Monthly Didactic Lecture series, "Hemodynamic Assessment in the Cath Lab", 15 nurses and technicians, 1 hour lecture, 1 hour preparation
Clinical Supervisory and Training Responsibilities
2001- Supervising one pediatric cardiology fellow or senior interventional fellow in the cardiac catheterization laboratory at Children's Hospital Boston, 8 hours/day, 2-3 days/week
Supervising one fellow in a general pediatric cardiology ambulatory clinic, 2 sessions/month
Formally Supervised Trainees: clinical research
Athar Qureshi, MD
Project: Outcomes of stenting for coarctation of the aorta, manuscript published
Current position: Attending physician and interventional cardiologist, The Cleveland Clinic
Aphrodite Tzifa, MD, MRCPCH
Project: Catheter intervention for superior vena caval obstruction, manuscript published
Current position: Fellow in MRI-guided catheterization, Guy's Hospital, London
Jeffery Meadows, MD
Project: Transcatheter creation of ventricular septal defect, manuscript published
Current position: Attending physician and interventional cardiologist, UCSF
Vladimiro Vida, MD
Project: Surgical outcomes for hypoplastic left heart syndrome with intact atrial septum, manuscript published
Current position: Pediatric cardiothoracic surgeon, University of Padova, Padua, Italy
Joshua Robinson, MD
Project: Valve-sparing repair of Tetralogy of Fallot incorporating intraoperative balloon pulmonary valvuloplasty, manuscript published
Current position: Attending physician in pediatric cardiology, Children's Memorial Hospital, Chicago
Formally Supervised Trainees: interventional catheterization
Nicole Sutton, MD
Current position: Attending physician and interventional cardiologist, Montefiore Medical Center
Doff McElhinney, MD
Current position: Attending physician and interventional cardiologist, Children's Hospital Boston
Shilpi Epstein, MD
Current position: Attending physican and interventional cardiologist, Schneider Children's Hospital
Lynn Peng, MD
Current position: Attending physician and interventional cardiologist Lucille Packard Children's Hospital
Jeffrey Darst, MD
Current position: Attending physician and interventional cardiologist Denver Children's Hospital
Daniel Springmueller, MD
Current position: Attending physician and interventional cardiologist, Santiago, Chile
Diego Porras, MD
Current position: Attending physician and interventionalist, Children's Hospital Boston
Local Invited Presentations:
1999 Stent Implantation for the Treatment of Coarctation. Boston Adult Congenital Heart Service Combined Morbidity/Mortality Conference, Boston, MA
2002 Transcatheter Closure of Atrial Septal Defects. Children's Hospital Study Group, Boston, MA
2005 Balloon Dilation of Critical Aortic Stenosis in the Fetus: You Have to Kiss a lot of Toads. Grand Rounds, Children's Hospital, Boston
Report of Regional, National and International Invited Teaching and Presentations
Report of Teaching: Regional:
2002 Fetal Interventional Catheterization: Preventing Hypoplastic Left Heart Syndrome? Northeast Pediatric Cardiology Nurses Association Annual Conference, Mystic, CT
2006 Interventional Catheterization and Device-based Repair of Congenital Heart Defects. Pediatric Grand Rounds, Boston Medical Center
2007 Catheter and Device-Based Repair of Congenital Heart Disease, Pediatric Grand Rounds, Rhode Island Hospital
2009 Update on Fetal Intervention. Multi-disciplinary antenatal diagnosis and management conference, Rhode Island Hospital
Report of Teaching: National:
Graduate Medical Education:
Proctor, NMT Medical, CardioSEAL device closure of patent foramen ovale
2005- Proctor, NMT Medical, CardioSEAL device closure of ventricular septal defect
2003 Foundations of a Program for Prenatal Cardiac Interventions. Sibley Heart Center Physician's Journal Club, Atlanta, GA
2003 Fetal Cardiac Interventions. Society for Cardiac Angiography and Interventions 26th Annual Scientific Sessions, Boston, MA
2003 Techniques and tools for fetal cardiac intervention. First International Symposium on Prenatal Cardiac Interventions, Boston, MA
2003 Fetal Intervention for HLHS with Intact Atrial Septum. First International Symposium on Prenatal Cardiac Interventions, Boston, MA
2003 Fetal Intervention for Critical AS/HLHS. Seventh Pediatric Interventional Cardiac Symposium, Orlando, FL
2003 Fetal Catheterization Intervention. American Academy of Pediatrics Annual Meeting, New Orleans, LA
2004 Ultrasound-Guided Fetal Atrial Septoplasty. American Heart Association Scientific Sessions, New Orleans, LA
2005 Antenatal Intervention for Hypoplastic Left Heart Syndrome. 10th Vail Symposium on Pediatric Cardiac Diseases, Denver Children's Hospital, Vail, CO
2005 Cardiac Fetal Surgery. United Resource Networks 6th Annual Emerging Technologies and Innovative Approaches for Managing Patients with Complex Medical Conditions, Scottsdale, AZ
2005 Current management options in prenatally diagnosed hypoplastic left heart syndrome. Mead Johnson Nutritionals 66th Perinatal and Developmental Medicine Symposium, Aspen, CO
2005 Fetal aortic valvuloplasty for the prevention of hypoplastic left heart syndrome. Mead Johnson Nutritionals 66th Perinatal and Developmental Medicine Symposium, Aspen, CO
2005 Moderator, Current practice in pediatric interventional cardiology at the Scientific Sessions of the AHA, Dallas, T
2006 Update of fetal interventional catheterization. Society for Cardiac Angiography and Interventions, Chicago, IL
2007 How to treat the intact/restrictive atrial septum in the fetus, International Symposium on the Hybrid Approach to Congenital Heart Disease, Nationwide Childrens' Hospital, Columbus, OH
2007 Hybrid approach to stents: VSD stents, International Symposium on the Hybrid Approach to Congenital Heart Disease, Nationwide Childrens' Hospital, Columbus, OH
2007 Plugging holes--devices update. Novel medical interventions and their role in children with heart disease, Sibley Heart Center, Amelia Island, FL
2007 Interventions in the fetus-past, present and future. Novel medical interventions and their role in children with heart disease, Sibley Heart Center, Amelia Island, FL
2008 Interventional options for the child with pulmonary vein stenosis. American College of Cardiology Scientific Sessions, Chicago, IL
2008 Fetal cardiac intervention. Management of Congenital Heart Disease in the Fetus and Neonate, Children's National Medical Center, Washington, DC
2009 When new techniques should be used to treat pulmonary artery stenoses: cutting balloons, very high pressure balloons, covered stents. American College of Cardiology Scientific Sessions, Chicago, IL
Update of fetal intervention. Evolving Concepts in the Management of Congenital Heart Disease II, San Diego, CA
The role of bare metal stent placement in the lifetime management of right ventricle to pulmonary artery conduits. American College of Cardiology Scientific Sessions, Atlanta, GA
2010 Fetal cardiac interventions. Society for Pediatric Radiology. Boston, MA.
Report of Teaching: International:
2001 Large and Difficult ASD's. 3rd International Workshop in Interventional Pediatric Cardiology, IRCCS Policlinico San Donato, Milan, Italy
2005 Interventional catheterization in utero for fetuses with congenital heart disease. XVes Journees Europeennes de la Societe Francaise de Cardiologie, Paris, France
2007 Fetal Interventional Catheterization. XIII Curso de Actualization en Cardiologia Pediatrica, Hospital Gregorio Maranon, Madrid, Spain
2007 Fetal Cardiac Interventions: The Boston Experience. New Developments in Fetal Cardiology, The Hospital for Sick Children, Toronto, CA
2007 Fetal Interventions: Do They Really Help? Contemporary Questions in Congenital Heart Disease: The Left Heart, The Hospital for Sick Children, Toronto, CA
Report of Clinical Activities and Innovations
Current Licensure and Certification
1994 Diplomate, National Board of Medical Examiners
1996 Diplomate, American Board of Pediatrics: Pediatrics, recertified 2004
1997 Board of Registration in Medicine, Commonwealth of Massachusetts
2000 Diplomate, American Board of Pediatrics: Pediatric Cardiology, recertified 2007
2007 Board of Registration in Medicine, State of Rhode Island
2008 Certified, Pediatric Advanced Life Support (recertified 2011)
Area of practice: Pediatric Cardiology
1. Interventional Cardiology
Performing diagnostic and interventional cardiac catheterization in the Children's Hospital Cardiac Catheterization Laboratory, 5 cases/wk (~250 cases/year).
Performing cardiac catheterization at Rhode Island Hospital as part of collaborative program, 1-2 cases/month
2. Fetal Interventional Cardiology
Performing fetal cardiac interventions, 1-2 cases/month, with a collaborative multidisciplinary team from the Brigham and Women's Hospital and Children's Hospital
Consulting nationally with referring cardiologists and families regarding cardiac intervention through the Advanced Fetal Care Center at Children's Hospital Boston, 2-3 cases/month
3. Inpatient Cardiology Services
Examining and completing rounds on inpatients, including postoperative patients in the intensive care unit, cardiology inpatient unit, or extended recovery unit at Children's Hospital Boston, typically 4-6 inpatients/day
4. Outpatient Cardiology Clinic
Managing both new patients with general cardiology chief complaints, as well as known patients with more complex structural heart disease in the ambulatory clinic at Children's Hospital Boston, 2 sessions/month
Prevention of hypoplastic left heart syndrome by means of in utero aortic valvuloplasty in the second trimester of pregnancy.
Collaborated with a pioneering team to successfully perform the first procedures and report the results. As a result, there is greater emphasis on prenatal diagnosis of HLHS and the potential for prenatal intervention has been recognized throughout the field. Centers in the US and overseas have attempted the procedure, with our input and training, and have succeeded in several sites.
Prenatal intervention to avert neonatal shock presentation in babies with hypoplastic left heart syndrome with intact atrial septum variant.
Designed and performed the first ever creation of an atrial septal defect in utero, and placed the world's first fetal intracardiac stent. Demonstrated that this intervention can improve postnatal presentation in a highly lethal disease. We now receive referrals from all over the country to assist in the management of these fetuses.
Hybrid approaches to congenital heart disease
Worked with cardiac surgical colleagues to adopt hybrid surgical and catheter approaches and integrate these innovative approaches into practice at Children's Hospital. Examples include hybrid Stage I operation for hypoplastic left heart syndrome, intraoperative angiography, intraoperative valvuloplasty and angioplasty.
Report of Technological and Other Scientific Innovations
Marshall AC, Lock JE, Kierce P, inventors; Introducer cannula and cannula straightener US Patent number D533270. 2006 December 5.
Designed and prototyped the first instrument intended specifically for use in fetal cardiac intervention. Now commercially available.
Report of Education of Patients and Service to the Community
2005- The Ali Fund Summer Internship Program, a 2-week observation experience in the Children's Hospital Cardiovascular Program, awarded to a high school student from The Portsmouth Abbey School interested in pursuing a career in medicine. Service includes reviewing applications, interviewing applicants, and direct overseeing of the internship with daily contact and instruction.
Baldwin HS, Shen HM, Yan HC, DeLisser HM, Chung A, Trask T, Kirschbaum NE, Newman PJ, Albelda SM, Buck CA. Platelet endothelial cell adhesion molecule-1 (PECAM-1/CD31): alternatively spliced, functionally distinct isoforms expressed during mammalian cardiovascular development. Development 1994; 120: 2549-2553.
Park M, Lewis C, Turbay D, Chung A, Chen J, Evans S, Breitbart R, Fishman M, Izumo S, Bodmer R. Differential rescue of visceral and cardiac defects in Drosophila by vertebrate tinman-related genes [published erratum appears in Proc Natl Acad Sci 1998; 95: 13348b]. Proc Natl Acad Sci 1998; 95: 9366-9371.
Marshall AC, Perry SB, Keane JF, Lock JE. Early results and medium-term follow-up of stent implantation for mild residual or recurrent aortic coarctation. American Heart Journal 2000; 139: 1054-60.
Marshall AC, Lock JE. Structural and compliant anatomy of the patent foramen ovale in patients undergoing transcatheter closure. American Heart Journal 2000; 140:303-7.
Geva T, Greil GF, Marshall AC, Landzberg M, Powell AJ. Gadolinium-enhanced 3-dimensional magnetic resonance angiography of pulmonary blood supply in patients with complex pulmonary stenosis or atresia: comparison with x-ray angiography. Circulation 2002; 106: 473-8.
Huang T, Lock JE, Marshall AC, Basson C, Seidman JG, Seidman CE. Causes of clinical diversity in human TBX5 mutations. Cold Spring Harbor Symposia on Quantitative Biology 2002; 67: 115-20.
Marshall AC, Love BA, Lang P, Jonas RA, del Nido P, Mayer JE, Lock JE. Staged repair of tetralogy of Fallot and diminutive pulmonary arteries using a fenestrated ventricular septal defect patch. J Thorac Cardiovasc Surg 2003;126: 1427-33.
Knauth A, Marshall AC, Geva T, Jonas RA, Marx G. Respiratory symptoms secondary to aortopulmonary vessels in tetralogy of Fallot absent pulmonary valve syndrome. Am J Cardiol 2004; 93: 503-5.
Marshall AC, van der Velde ME, Tworetzky W, Gomez CA, Wilkins-Haug L, Benson CB, Jennings RW, Lock JE. Creation of an atrial septal defect in utero for fetuses with hypoplastic left heart syndrome and intact or highly restrictive atrial septum. Circulation 2004; 110: 529-33.
Tworetzky W, Wilkins-Haug L, van der Velde ME, Marshall AC, Colan SD, Benson CB, Lock JE, Perry SB. Balloon dilation of severe aortic stenosis in the fetus: Potential for prevention of hypoplastic left heart syndrome. Candidate selection, technique, and results of successful intervention. Circulation 2004; 110: 2125-2131.
Garg R, Powell AJ, Sena L, Marshall AC, Geva T. Effects of metallic implants on magnetic resonance imaging evaluation of Fontan palliation. Am J Cardiol 2005; 95: 688-91.
McElhinney DB, Marshall AC, Lang P, Lock JE, Mayer JE, Jr. Creation of a brachial arteriovenous fistula for treatment of pulmonary arteriovenous malformations after cavopulmonary anastomosis. Annals of Thoracic Surgery 2005; 80: 1604-9.
Marshall AC, Tworetzky W, Bergersen L, McElhinney DB, Benson CB, Jennings RW, Wilkins-Haug LE, Marx GR, Lock JE. Aortic valvuloplasty in the fetus: Technical characteristics of successful balloon dilation. J Peds, 2005; 147:535-539.
Tworetzky W, del Nido PJ, Powell AJ, Marshall AC, Lock JE, Geva T, MD. Usefulness of magnetic resonance imaging of left ventricular endocardial fibroelastosis in infants after fetal intervention for aortic valve stenosis. Am J Cardiol 2005; 96:1568-70.
Makikallio K, Levine JC, Marx GR, Colan SD, Marshall AC, Lock JE, Tworetzky W. Fetal aortic valve stenosis and the evolution of hypoplastic left heart syndrome: patient selection for fetal intervention. Circulation, 2006; 113: 1401-5.
Wilkins-Haug LE, Tworetzky W, Benson CB, Marshall AC, Jennings RW, Lock JE. Factors affecting technical success of fetal aortic valve dilation. Ultrasound in Obstetrics and Gynecology, 2006; 28: 47-52.
Peng L, McElhinney DB, Nugent AW, Powell AJ, Marshall AC, Bacha EA, Lock JE. Endovascular stenting of obstructed right ventricle to pulmonary artery conduits: a fifteen-year experience. Circulation 2006; 113: 2598-2605.
Qureshi AM, McElhinney DB, Lock JE, Landzberg M, Lang P, Marshall AC. Outcomes of stent implantation for native and recurrent coarctation of the aorta. Cardiol Young, 2007; 17: 307-18.
Selamet Tierney ES, Wald RM, McElhinney DB, Marshall AC, Benson CB, MD, Marcus EN, Marx GR, Levine JC, Wilkins-Haug L, Lock JE, Tworetzky W. Changes in left heart hemodynamics after technically successful in utero aortic valvuloplasty. Ultrasound Obstet Gynecol, 2007; 30: 715-20.
Meadows J, Pigula F, Lock JE, Marshall AC. Transcatheter creation and enlargement of ventricular septal defects for relief of ventricular hypertension. J Thorac Cardiovasc Surg, 2007; 133: 912-8.
Tzifa A, Marshall AC, McElhinney DB, Lock JE, Geggel R. Endovascular treatment for superior vena cava occlusion or obstruction in a pediatric and young adult population: A 22-year experience, JACC, 2007; 49: 1003-9.
Vida VL, Bacha EA, Thiagaragan R, Gauvreau K, Larrazabal LA, Fynn-Thompson F, Pigula FA, Mayer JE, del Nido PJ, Tworetzky W, Lock JE, Marshall AC. Hypoplastic left heart syndrome and intact or highly restrictive atrial septum: surgical experience from a single center, Ann Thorac Surg, 2007; 84: 581-5.
Mizrahi-Arnaud A, Tworetzky W, Bulich LA, Wilkins-Haug LE, Marshall AC, Benson CB, Lock JE, McElhinney DB. Pathophysiology, management, and outcomes of fetal hemodynamic instability during prenatal cardiac intervention, Pediatric Research, 2007, 62: 325-330.
Vida VL, Bacha EA, Larrazabal LA, Gauvreau K, Dorfman A, Marx G, Geva T, Marshall AC, Pigula FA, Mayer JE Jr, del Nido PJ, Fynn-Thompson F. Surgical outcome for patients with the aortic atresia-mitral stenosis variant of hypoplastic left heart syndrome, Ann Thorac Surg, 2008; 135: 339-346.
McElhinney DB, Bergersen L, Marshall AC. In situ fracture of stents implanted for branch pulmonary artery stenosis in patients with congenital heart disease, Cardiol Young, 2008; 18: 405-14.
Brown D, Chong E, Keane JF, Lock JE, Marshall AC. Aortic injury as a complication of neonatal aortic valvuloplasty: incidence and risk factors, Circulation: Cardiovasc Intervent, 2008; 1: 53-9.
Marshall AC, Levine J, Morash D, Silva V, Lock JE, Benson C, Wilkins-Haug L, McElhinney DB, Tworetzky W. Results of in utero atrial septoplasty in fetuses with hypoplastic left heart syndrome, Prenatal Diagnosis, 2008; 28: 1023-8.
Lim HG, Bacha EA, Marx GR, Marshall A, Fynn-Thompson F, Mayer JE, Del Nido P, Pigula FA. Biventricular repair in patients with heterotaxy syndrome, J Thorac Cardiovasc Surg, 2009;137: 371-379.
Senthilnathan S, Gauvreau K, Marshall AC, Lock JE, Bergersen L. Contrast administration in pediatric cardiac catheterization: dose and adverse events, Catheterization and Cardiovasc Int, 2009; 73: 814-820.
Tworetzky W, McElhinney DB, Marx G, Benson C, Brusseau R, Morash D, Wilkins-Haug L, Lock J, Marshall AC. In utero valvuloplasty for pulmonary valve atresia with hypoplastic right ventricle: techniques and outcomes, Pediatrics, 2009;
McElhinney DB, Marshall AC, Wilkins-Haug L, Brown DW, Benson C, Silva V, Marx GR, Mizrahi-Arnaud A, Lock JE, Tworetzky W. Predictors of technical success and postnatal biventricular outcome after in utero aortic valvuloplasty for aortic stenosis with evolving hypoplastic left heart syndrome, Circulation, 2009, 120: 1482-90.
Hasan BS, Keane JF, Tworetzky W, Lock JE, Marshall AC. Postnatal angiographic appearance of left ventricular myocardium in patients with fetal aortic valvuloplasty, Am J Cardiol, 2009, 104: 1271-5.
Bergersen L, Marshall A, Gauvreau K, Beekman, RH, Hirsch R, Foerster S, Balzer D, Vincent JA, Hellenbrand WE, Holzer R, Cheatham JP, Moore JW, Lock JE, Jenkins K. Adverse event rates in congenital cardiac catheterization – A multi-center experience, Catheterization and Cardiovascular Intervention, 2010, 75: 389-400.
McElhinney DB, Benson CB, Brown DW, Wilkins-Haug LE, Marshall AC, Zaccagnini L, Tworetzky W. Cerebral blood flow characteristics and biometry in fetuses undergoing prenatal intervention for aortic stenosis with evolving hypoplastic left heart syndrome, Ultrasound in Medicine and Biology, 2010, 36: 29-37.
Holzer R, Marshall A, Kreutzer J, Hirsch R, Chisolm J, Hill S, Galantowicz M, Phillips A, Cheatham J, Bergersen L. Hybrid procedures: adverse events and procedural characteristics--results of a multi-institutional registry, Congenit Heart Dis. 2010, 5:233-42.
McElhinney DB, Vogel M, Benson, CB, Marshall AC, Wilkins-Haug LE, Silva V, Tworetzky W. Assessment of left ventricular endocardial fibroelastosis in fetuses with aortic stenosis and evolving hypoplastic left heart syndrome, Am J Cardiol, 2010, 106: 1792-7.
McElhinney DB, Marx GR, Marshall AC, Mayer JE, Del Nido PJ. Cavopulmonary pathway modification in patients with heterotaxy and newly diagnosed or persistent pulmonary arteriovenous malformations after a modified Fontan operation, J Thorac Cardiovasc Surg, 2010.
Vogel M, McElhinney DB, Wilkins-Haug LE, Marshall AC, Benson CB, Juraszek AL, Silva V, Lock JE, Marx GR, Tworetzky W. Aortic stenosis and severe mitral regurgitation in the fetus resulting in giant left atrium and hydrops pathophysiology, outcomes, and preliminary experience with prenatal cardiac intervention, J Am Coll Cardiol 2011, 57: 348-55.
Shuhaiber JH, Bergersen L, Pigula F, Emani S, McElhinney D, Marshall A, Fynn-Thompson F, Bacha EA. Intraoperative assessment after pediatric cardiac surgical repair: initial experience with C-arm angiography, J Thorac Cardiovasc Surg, 2010 e1-3.
O'Brien P, O'Connell C, Fenwick S, Stewart B, Marshall AC, Hickey P. Improved bed use with a creation of a short-stay unit in a catheterization recovery room, Heart and Lung, 2010, 40: 56-62.
Robinson J, McElhinney DB, Bacha E, Marshall AC. The evolving role of intraoperative balloon pulmonary valvuloplasty in valve-sparing repair of tetralogy of Fallot, J Thorac Cardiovasc Surg, in press.
Bergersen L, Gauvreau K, Marshall A, Kreutzer J, Beekman R, Hirsch R, Foerster S, Balzer D, Vincent J, Hellenbrand W, Holzer R, Cheatham J, Moore J, Lock J, Jenkins K. Procedure-type risk categories for pediatric and congenital cardiac catheterization, Circ Cardiovasc Interv, 2011, 4: 188-94.
Lund AM, Vogel M, Marshall AC, Emani SM, Pigula RA, Tworetzky W, McElhinney DB. Early reintervention on the pulmonary arteries and right ventricular outflow tract after neonatal or early infant repair of truncus arteriosus using homograft conduits, Am J Cardiol, 2011.
Bergersen L, Gauvreau K, Foerster SR, Marshall AC, McElhinney DB, Beekman RH, Hirsch R, Kreutzer MJ, Balzer D, Vincent J, Hellenbrand WE, Holzer R, Cheatham JP, Moore JW, Burch G, Armsby L, Lock JE, Jenkins K. Catheterization for congenital heart disease adjustment for risk method (CHARM), Circ Cardiovasc Interv, in press
Non-peer reviewed scientific or medical publications/materials
Buck CA, Baldwin HS, DeLisser H, Mickanin C, Shen HM, Kennedy G, Chung A, Edelman JM, Albelda SM. Cell adhesion receptors and early mammalian heart development: an overview. C R Acad Sci Paris 1993; 316: 849-59.
Marshall AC and Lang P. Closing Ventricular Septal Defects in the Cardiac Catheterization Laboratory. Heart Disease 2002; 4: 51-53.
Marshall AC and Lang P. Hemodynamic and interventional catheterization of the patient with single ventricle. Progress in Pediatric Cardiology 2002; 16: 39-46.
Marshall AC and Perry SB. "CardioSEAL/STARflex devices in transcatheter closure of ventricular septal defects" Chapter 27 in Catheter-based devices for the treatment of non-coronary cardiovascular disease in adults and children, Lippincott Williams & Wilkins, 2003.
Tworetzky W and Marshall AC. Balloon valvuloplasty for congenital heart disease in the fetus. Clinics in Perinatology 2003; 30: 541-550.
Cua CL, Sanghavi D, Voss S, Laussen PC, del Nido P, Marshall A, Breitbart RE. Right ventricular pseudo-aneurysm after modified Norwood procedure. Annals of Thoracic Surgery 2004; 78: e72-e73.
Tworetzky W and Marshall AC. Fetal Interventions for cardiac defects. Pediatric Clinics 2004; 51: 1503-14.
Marshall AC and Lang P. Cardiac Catheterization and Catheter-based interventions. In: Sellke FW, del Nido PJ, Swanson SJ (editors), Sabiston and Spencer Surgery of the Chest. Philadelphia, PA: Elsevier Saunders; 2004
Bulich LA, Tworetzky W, Marshall AC. Anesthesia for Fetal Cardiac Intervention. In: Myers LB and Bulich LA (editors), Anesthesia for Fetal Intervention and Surgery. Hamilton, Ontario: BC Decker Inc.; 2005
Marshall AC and Lock JE. Leaving Neverland: A randomized trial for coarctation shows pediatric interventional cardiology is growing up. Circulation 2005; 111: 3347-8.
Wilkins-Haug LE, Benson CB, Tworetzky W, Marshall AC, Lock JE. In utero intervention for hypoplastic left heart syndrome--a perinatologist's perspective. Ultrasound Obstet Gynecol 2005; 26: 481-6.
Mizrahi-Arnaud A, Wilkins-Haug L, Marshall A, Silva V. Maternal Mirror Syndrome after in utero aortic valve dilation. Fetal Diagnosis and Therapy 2006; 21: 439-43.
Meadows J, Marshall AC, Lock JE, Scheurer M, Laussen PC, Bacha EA. A hybrid approach to stabilization and repair of obstructed total anomalous pulmonary venous connection in a critically ill newborn. J Thorac Vasc Surg 2006; 131: e1-e2.
Geva T and Marshall AC. Magnetic resonance imaging-guided catheter interventions in congenital heart disease. Circulation 2006; 113: 1051-2.
Bacha EA, Marshall AC, McElhinney DB, del Nido PJ. Expanding the hybrid concept in congenital heart surgery. Semin Thorac Cardiovasc Surg Pediatr Card Surg Ann 2007; 10:146-150.
Dibardino DJ, McElhinney DB, Marshall AC, Bacha EB. A review of ductal stenting in hypoplastic left heart syndrome: bridge to transplantation and hybrid stage I palliation. Pediatric Cardiol 2007; 29: 251-7.
Lock JE, Marshall AC, Invited Commentary. Ann Thorac Surg 2007 84: 1638-1639.
Marx GR, Tworetzky W, Marshall A. Three-dimensional echocardiography: present and future applications in the catheterization laboratory. In Peurcutaneous Interventions for Congenital Heart Disease.Sievert H, Qureshi SA, Wilson N, Hijazi ZM, Informa Health Care London 2007.
Congenital Heart Disease: The Catheterization Manual. Bergersen L, Foerster S, Marshall AC, Meadows J (Eds). Springer, New York, 2009.
Vogel M, Wilkins-Haug LE, McElhinney DB, Marshall AC, Benson CB, Silva V, Tworetzky W. Reversible ductus arteriosus constriction due to maternal indomethacin after fetal intervention for hypoplastic left heart syndrome with intact/restrictive atrial septum, Fetal Diagn Ther, 2010, 27: 40-5.
Marshall AC, Lock JE. Still working on our short game: technique and accuracy of stent placement in congenital heart disease. JACC Cardiovasc Interv. 2010, 3:1087-8.
Vassileva CM, Bautista-Hernandez V, Sekhavat S, Marshall A, Pigula F. Neonatal closure of a large coronary cameral fistula in a case of single coronary artery: the utility of intraoperative angiography. J Card Surg. 2010, 25: 228-30.
Professional Educational Material
1999 Contributor "Stenting of Coarctation" The Fellows' Cardiac Catheterization Manual, 2nd edition
2003 Editor, The Fellows' Cardiac Catheterization Manual, 3rd edition
2006 Editor, The Fellows' Cardiac Catheterization Manual, 4th edition, a 145-page practical guide to pediatric catheterization including diagrams, case-specific discussions and references, distributed to all pediatric cardiology fellows and senior fellows at Children's Hospital Boston
Lechpammer M, Marshall A, Juraszek A, Vargas SO, Folkerth RD. Instrumentation-associated embolic foreign material in the central nervous system of children dying with congenital cardiopulmonary disease. American Association of Neuropathologists, 2009.