Pediatrica intensiva: Art & Science of Pediatric Critical Care

Author: Pediatrica Intensiva

Bridging the gap between literature and practice in pediatric intensive care. Featuring guests from around the world and pediatric intensive care specialists Greg Kelly (Westmead Children's Hospital Sydney), Peta Alexander (Boston Children's Hospital), Karen Choong (McMaster Children's Hospital Canada) and Mike Clifford (Royal Children's Hospital Melbourne) Pediatrica intensiva won't tell you the answers, because no one knows what they are, but we can give you a chance to hear respected experts talk about what they actually do with some of the toughest problems in our field. Rather than having short episodes on a topic, we have whole seasons. And that gives us the chance to go deep. We really hope that you find it helpful - please listen and subscribe to Pediatrica intensiva wherever you listen to podcasts and follow us on iTunes and Twitter (https://twitter.com/PedsIntensiva), share with your friends and reach out with any feedback, requests or comments. Of course, information in the podcast is not meant to replace the advice of a health professional and is in no way a substitute for the relationship between a patient and his/her/their own physician
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Peter Laussen — 50 Years of Fontan, and What Comes Next
Episode 2
Wednesday, 22 April, 2026

In the second episode of our Fontan at 50 short season with @PCICS, Dr. Peter Laussen (Boston Children's Hospital) joins Greg and Deanna Tzanetos for the long view on how the Fontan evolved and where it's heading next. Peter traces the procedural arc — atriopulmonary, lateral tunnel, fenestration, extracardiac conduit — and the physiology behind each shift: PAs in continuity, early staging of the pulmonary connection, setting the circulation up for passive flow. He covers the ICU preparation that still holds today, and why pushing the Fontan to younger ages stalled on an immature pulmonary vascular bed. The conversation then turns forward. MRI-derived flow vectors and tailored anastomoses as the new standard. The adult Fontan problem, and why community EDs get into trouble applying a two-ventricle lens. "My Heart," a patient-carried app in development at Boston to help close that gap. And the most exciting shift of the last decade — staged myocardial growth for borderline left hearts, aiming at a two-ventricle endpoint instead of Fontan. Peter closes with a challenge to the field: PCICS at the centre of a learning ecosystem that captures not just our actions, but our decisions. Produced in collaboration with @PCICS.