Dr. Woo is a board-certified, fellowship-trained cardiologist with the Adult Congenital Heart Program at Stanford Health Care. She is also a clinical assistant professor in the Divisions of Cardiovascular Medicine and Pediatric Cardiology at Stanford University School of Medicine.
She diagnoses and treats a range of cardiovascular diseases, with a focus on adult congenital heart disease. Dr. Woo has Level III training with the National Board of Echocardiography, a certification that recognizes her experience in complex cardiac imaging. She also has specialized expertise in cardiac MRI. Each of her patients receives a personalized, comprehensive care plan delivered with compassion.
Dr. Woo is heavily involved in adult congenital heart disease research. She has a particular interest in imaging and heart failure in adults with congenital heart disease. She has received grant funding for her work, including from the Adult Congenital Heart Association. The National Institutes of Health awarded granted her the Ruth L. Kirschstein National Research Service Award.
She has published research in several peer-reviewed journals, such as the Journal of the American College of Cardiology and Pediatric Cardiology. Dr. Woo has presented her findings at regional and national meetings, including the Adult Congenital Heart Disease Bay Area Conference and the International Symposium on Adult Congenital Heart Disease.
Dr. Woo is a member of the Adult Congenital Heart Association, American College of Cardiology, American Heart Association, and American Society of Echocardiography.
- Adult Congenital Heart Disease
- Cardiac MRI
Honors & Awards
Advanced Adult Congenital Heart Disease Fellows Grant, Heartfelt Dreams Foundation (2022)
Conference Research Award, Caring for Adults and Teens with Congenital Heart Disease (CATCH) (2021)
Innovation Award, University of California, Los Angeles (UCLA) Women’s Cardiovascular Center (2017)
Code for the Mission Challenge Finalist, UCLA (2016)
Commendation for Excellence in Medical Student Teaching, UCLA (2015)
Glasgow-Rubin Award for Academic Achievement, American Medical Women’s Association (2014)
Internal Medicine and Pediatrics Chief Resident, UCLA School of Medicine
Albert Schweitzer Fellowship, UCLA (2011)
Boards, Advisory Committees, Professional Organizations
Member, ASE Writing Committee on ACHD Echocardiography Guidelines (2023 - Present)
Member, American Heart Association (2022 - Present)
Member, Adult Congenital Heart Association (2021 - Present)
Member, American Society of Echocardiography (2020 - Present)
Member, American College of Cardiology (2018 - Present)
Board Certification: National Board of Echocardiography, Adult Echocardiography (2020)
Board Certification: American Board of Internal Medicine, Cardiovascular Disease (2021)
Board Certification: American Board of Pediatrics, Pediatrics (2018)
Board Certification: American Board of Internal Medicine, Internal Medicine (2018)
Fellowship, Stanford University Adult Congenital Heart Disease Fellowship Program, CA (2023)
Fellowship: Stanford University Cardiovascular Medicine Fellowship Program (2021) CA
Residency: UCLA Medical Center Internal Medicine (2018) CA
Medical Education: UCLA David Geffen School Of Medicine Registrar (2014) CA
Curriculum and Instruction
Validating a Patient-Reported Outcomes Tool in Adults with Congenital Heart Disease, Stanford
Heart failure is a growing reason for hospitalization and the leading cause of death in adults with congenital heart disease (ACHD). Data are limited on health outcomes and therapeutic options for adults with CHD with heart failure; adults with CHD are often excluded from heart failure clinical trials. The lack of validated and sensitive measurements of patient-reported outcomes and health status are major barriers to studying health outcomes in adults with CHD. In adults with acquired heart failure, the Kansas City Cardiomyopathy Questionnaire (KCCQ) predicts hospitalization and mortality. Adults with CHD are different from those with acquired heart failure. As a result, no such instrument has been validated in adults with CHD. The lack of a validated tool to measure heart failure-specific patient-reported outcomes is vital for monitoring patients’ clinical status and symptom burden over time and evaluating drug therapies. The research study will examine the KCCQ scores in CHD patients with heart failure and evaluate the association with measurements of ventricular function and functional capacity. This research will provide us with a validated and sensitive patient-reported outcomes tool that reflects patients’ health status and disease severity.
Palo Alto, CA
Infective Endocarditis- ACHD registry study, Stanford
The purpose of the registry is to document the incidence of IE in ACHD population, assess impact of limiting antibiotics in ACHD patients (change in SBE ppx guidelines), identify risk factors of adverse events associated with IE.
Palo Alto, CA
Right Ventricular Kinetic Energy in Tetralogy of Fallot, Stanford
The project quantifies and compares the kinetic energy in the RV of Tetralogy of Fallot patients using 4D-Flow MRI.
Palo Alto, CA
- Response by Loube et al to Letter Regarding Article "Stroke Caused by a Paradoxical Embolus From a Rare Congenital Anomaly in the Adult: Persistent Left Superior Vena Cava Draining Into the Left Upper Pulmonary Vein". Circulation. Cardiovascular imaging 2023; 16 (9): e015862
- Stroke Caused by a Paradoxical Embolus From a Rare Congenital Anomaly in the Adult: Persistent Left Superior Vena Cava Draining into the Left Upper Pulmonary Vein. Circulation. Cardiovascular imaging 2023: e014205
- Improved Right Ventricular Energy Efficiency by 4-Dimensional Flow Magnetic Resonance Imaging After Harmony Valve Implantation. JACC. Advances 2023; 2 (3)
High Prevalence of Abnormal Hemoglobin A1c in the Adolescent and Young Adult Fontan Population.
Little is known about diabetes risk in adolescents and young adults with Fontan palliation. We sought to understand the prevalence of abnormal hemoglobin A1c (HbA1c) in the adolescent and young adult population with Fontan palliation. Between 2015 and 2021, 78 Fontan patients > 10 years of age were seen in our single ventricle clinic; 66 underwent screening with HbA1c. 50% of the study cohort (n = 33) had HbA1c ≥ 5.7%; 2% (n = 1) had HbA1c ≥ 6.5%. There was no correlation between BMI and HbA1c, with no difference in the prevalence of overweight or obesity (BMI ≥ 85th percentile) between those with and without abnormal HbA1c (31% versus 27%, p = 0.69). While 20% of the cohort had a family history of diabetes, there was no difference in family history between those with and without abnormal HbA1c (21% versus 19%, p = 0.85). There were no differences in other risk factors and characteristics (race, glomerular filtration rate, liver function, liver elastography, hematocrit, and years from Fontan surgery) between those with and without abnormal HbA1c. Our results highlight the importance of recognizing that abnormal HbA1c is highly prevalent in the Fontan population. Whether abnormal HbA1c in this population correlates with atherosclerotic cardiovascular disease in adulthood is not known. The mechanism for an abnormal HbA1c in the adolescent and young adult Fontan population remains unclear and further studies are needed.
View details for DOI 10.1007/s00246-023-03139-4
View details for PubMedID 36943450
View details for PubMedCentralID 4859356
Improved Right Ventricular Energy Efficiency by 4-Dimensional Flow Magnetic Resonance Imaging After Harmony Valve Implantation
2023; 2 (3)
View details for DOI 10.1016/j.jacadv.2023.100284
Tetralogy of Fallot and Aortic Dissection: Implications in Management.
JACC. Case reports
2022; 4 (10): 581-586
We present the case of a 61-year-old man with tetralogy of Fallot postrepair and mechanical aortic valve replacement with an aortic root/ascending/arch aneurysm with chronic type A aortic dissection. He underwent uncomplicated aortic root and total arch replacement. Continued surveillance for aortic aneurysm is necessary in the tetralogy of Fallot population. (Level of Difficulty: Intermediate.).
View details for DOI 10.1016/j.jaccas.2022.02.021
View details for PubMedID 35615213
The challenges of an aging Tetralogy of Fallot population.
Expert review of cardiovascular therapy
INTRODUCTION: Advancements in surgery and management have resulted in a growing population of aging adults with tetralogy of Fallot (TOF). As a result, there has been a parallel growth in late complications associated with the sequelae from the underlying cardiac anomalies as well as the surgical and other interventional treatments.AREAS COVERED: Here, we review challenges related to an aging population of patients with TOF, particularly late complications, and highlight advances in management and key areas for future research. Pulmonary regurgitation, heart failure, arrhythmias, and aortic complications are some of these late complications. There is also a growing incidence of acquired cardiovascular disease, obesity, and diabetes associated with aging. Management of these late complications and acquired comorbidities continues to evolve as research provides insights into long-term outcomes from medical therapies and surgical interventions.EXPERT OPINION: The management of an aging TOF population will continue to transform with advances in imaging technologies to identify subclinical disease and valve replacement technologies that will prevent and mitigate disease progression. In coming years, we speculate there will be more data to support the use of novel heart failure therapies in TOF and consensus guidelines on management of refractory arrhythmias and aortic complications.
View details for DOI 10.1080/14779072.2021.1940960
View details for PubMedID 34102942
- Early Cardiovascular Health Outreach SMS (ECHOS): A Preventive Health Text Messaging Program Pilot Study Journal of Healthcare Communications 2021
The Rogue P-wave: Atrial Dissociation Following Bicaval Heart Transplantation.
The Journal of innovations in cardiac rhythm management
2019; 10 (1): 3472-3475
We report the first case, to our knowledge, of atrial dissociation in a patient who underwent bicaval orthotopic heart transplantation. It was believed that atrioventricular dissociation prompting pacemaker implantation likely represented donor sinus bradycardia/arrest with intact atrioventricular conduction with surgically isolated recipient atrial activity.
View details for DOI 10.19102/icrm.2019.100106
View details for PubMedID 32494402
View details for PubMedCentralID PMC7252805
- Successful Orthotopic Heart Transplantation in a Patient With Chronic Pancreatitis: Selective Medical and Surgical Considerations. Pancreas 2018; 47 (7): e41-e42
Clinical phenomapping and outcomes after heart transplantation
JOURNAL OF HEART AND LUNG TRANSPLANTATION
2018; 37 (8): 956–66
Survival after heart transplantation (HTx) is limited by complications related to alloreactivity, immune suppression, and adverse effects of pharmacologic therapies. We hypothesize that time-dependent phenomapping of clinical and molecular data sets is a valuable approach to clinical assessments and guiding medical management to improve outcomes.We analyzed clinical, therapeutic, biomarker, and outcome data from 94 adult HTx patients and 1,557 clinical encounters performed between January 2010 and April 2013. Multivariate analyses were used to evaluate the association between immunosuppression therapy, biomarkers, and the combined clinical end point of death, allograft loss, retransplantation, and rejection. Data were analyzed by K-means clustering (K = 2) to identify patterns of similar combined immunosuppression management, and percentile slopes were computed to examine the changes in dosages over time. Findings were correlated with clinical parameters, human leucocyte antigen antibody titers, and peripheral blood mononuclear cell gene expression of the AlloMap (CareDx, Inc., Brisbane, CA) test genes. An intragraft, heart tissue gene coexpression network analysis was performed.Unsupervised cluster analysis of immunosuppressive therapies identified 2 groups, 1 characterized by a steeper immunosuppression minimization, associated with a higher likelihood for the combined end point, and the other by a less pronounced change. A time-dependent phenomap suggested that patients in the group with higher event rates had increased human leukocyte antigen class I and II antibody titers, higher expression of the FLT3 AlloMap gene, and lower expression of the MARCH8 and WDR40A AlloMap genes. Intramyocardial biomarker-related coexpression network analysis of the FLT3 gene showed an immune system-related network underlying this biomarker.Time-dependent precision phenotyping is a mechanistically insightful, data-driven approach to characterize patterns of clinical care and identify ways to improve clinical management and outcomes.
View details for DOI 10.1016/j.healun.2018.03.006
View details for Web of Science ID 000441535600005
View details for PubMedID 29802085
View details for PubMedCentralID PMC6064662
- The Frontier of Transition Medicine: A Unique Inpatient Model for Transitions of Care. Journal of hospital medicine 2018; 13 (1): 69-70
Fevers and abnormal blood and cerebrospinal fluid studies after pediatric cerebral hemispherectomy: impact of etiology and age at surgery.
Journal of neurosurgery. Pediatrics
2013; 12 (6): 595-603
The object of this study was to determine if etiology and age at surgery were linked with fevers and altered white blood cell and CSF laboratory values after cerebral hemispherectomy.Seizure etiologies (n = 76) were classified into hemimegalencephaly (HME), cortical dysplasia (CD), infarcts (stroke), Rasmussen encephalitis (RE), history of infections, and Sturge-Weber syndrome (SWS) and were compared with clinical variables, maximum daily temperature (Tmax), and blood and CSF studies through Day 12 posthemispherectomy.The Tmax on Days 2-4 and 9-12 postsurgery were higher for HME and RE cases than for stroke cases. Patients with RE showed positive correlations, whereas those with SWS had negative correlations between Tmax and age at surgery. Blood WBC counts on postsurgery Days 3, 6, and 9-12 were higher in the HME and CD cases than in the stroke and RE cases. The percentage of blood polymorphonuclear cells (%bloodPMNs) was higher in the RE cases than in the HME, CD, and SWS cases. The RE, HME, and CD cases showed positive correlations between %bloodPMNs and age at surgery. The percentage of blood monocytes (%bloodMono) was higher in the patients with HME than in those with stroke or RE. The HME and CD cases showed negative correlations between %bloodMono and age at surgery. The CSF red blood cell counts were higher in the RE than in the CD and stroke cases. The percentage of CSF monocytes was higher in patients with CD than in those with stroke and RE. The percentage of CSF lymphocytes positively correlated with age at surgery.Seizure etiology and age at surgery were associated with developing fevers and altered blood and CSF values after pediatric cerebral hemispherectomy. These findings indicate that besides infections, other clinical variables have an impact on developing fevers and abnormal laboratory values posthemispherectomy. Cultures appear to be the most reliable predictor of infections.
View details for DOI 10.3171/2013.9.PEDS13264
View details for PubMedID 24116983
Etiology associated with developing posthemispherectomy hydrocephalus after resection-disconnection procedures.
Journal of neurosurgery. Pediatrics
2013; 12 (5): 469-75
The authors sought to determine if clinical epilepsy variables, maximum daily temperature (Tmax), and blood and CSF findings were associated with the risk of developing hydrocephalus after first-time resection-disconnection hemispherectomy.Patients who underwent cerebral hemispherectomy in whom a standardized perioperative protocol was used, including the use of ventriculostomies (n = 79), were classified into those who developed and those who did not develop hydrocephalus requiring CSF shunts. The authors compared these 2 groups for clinical variables, Tmax, and blood and CSF studies through postoperative Day 12.In this cohort, 30% of the patients required CSF shunts, of which 8% developed late hydrocephalus up to 3 years posthemispherectomy. Multivariate analysis found that etiology was associated with developing posthemispherectomy hydrocephalus. Higher shunt rates were observed for patients with hemimegalencephaly (40%; n = 15) and a history of CNS infection (100%; n = 4) compared with cortical dysplasia (17%; n = 23) and Rasmussen encephalitis (17%; n = 12). In univariate analysis, other factors associated with developing hydrocephalus were elevated maximum daily temperatures, elevated white blood cell counts, decreased CSF protein, and increased CSF red blood cell counts.The findings of the study indicate that etiology was the factor most strongly associated with developing posthemispherectomy hydrocephalus. These findings suggest that there are variable mechanisms for developing hydrocephalus after cerebral hemispherectomy depending on the procedure, and in resection-disconnection operations the mechanism may involve changes in CSF bulk flow that varies by histopathology.
View details for DOI 10.3171/2013.8.PEDS13212
View details for PubMedID 24011367
Timing and Predictors of Fever and Infection After Craniotomy for Epilepsy in Children
PEDIATRIC INFECTIOUS DISEASE JOURNAL
2013; 32 (5): 450–59
Fevers and leukocytosis after pediatric craniotomy trigger diagnostic evaluation and antimicrobial therapy for possible brain infection. This study determined the incidence and predictors of infection in infants and children undergoing epilepsy neurosurgery.We reviewed the postoperative course of 100 consecutive surgeries for pediatric epilepsy, comparing those with and without infections for clinical variables and daily maximum temperatures, blood white blood cell (WBC) and differential and cerebrospinal fluid (CSF) studies.Infections were the most common adverse events after these surgeries. Four patients (4%) had CSF infections and 12 had non-CSF infections (including 1 with distinct CSF and bloodstream infections). Most (88%) infections occurred before postoperative day 12 and were associated with larger resections involving ventriculostomies. Fevers (T ≥ 38.5°C) were observed in the first 12 days postsurgery in 43% of cases, and were associated with patients undergoing hemispherectomy and multilobar resections. Fevers in the first 3 days postsurgery identified infections with 73% sensitivity, 69% specificity and 70% accuracy; 2 (13%) patients with infections never developed fevers. Peripheral blood WBC >15,000 was found in 49% of patients and 5 cases of infections never had elevated WBC counts. WBC differential, CSF protein, red blood cell, WBC and red blood cell/WBC ratios were poor predictors of infections. Longer hospital stays were associated with infections and hemispherectomy and multilobar resections. Patients with and without infections were equally likely to be seizure free after surgery.Fevers and elevated blood WBC counts were common after pediatric epilepsy surgery, but CSF infections were uncommon. Positive cultures and other confirmatory microbiologic tests should drive changes in antimicrobial therapy after surgery.
View details for DOI 10.1097/INF.0b013e318287b408
View details for Web of Science ID 000318684400012
View details for PubMedID 23348815
View details for PubMedCentralID PMC3717398
Epitope-based vaccination against pneumonic tularemia
2009; 27 (39): 5299–5306
Francisella tularensis, the etiological agent of tularemia, is one of the most infectious bacterial pathogens known. No vaccine is currently approved for public use. Previously, we identified epitopes recognized specifically by T cells obtained from individuals following infection with F. tularensis. Here, we report that a subunit vaccine constructed based upon these epitopes elicited protective immunity in "humanized" HLA class II (DRB1*0401) transgenic mice. Vaccinated mice challenged intratracheally with a lethal dose of F. tularensis (Live Vaccine Strain) exhibited a rapid increase in pro-inflammatory cytokine production and diminished number of organisms in the lungs, and a concurrent increased rate of survival. These results demonstrate the efficacy of an epitope-based tularemia vaccine and suggest that such an approach might be widely applicable to the development of vaccines specific for intracellular bacterial pathogens.
View details for DOI 10.1016/j.vaccine.2009.06.101
View details for Web of Science ID 000269629800003
View details for PubMedID 19616492
View details for PubMedCentralID PMC2772204