Bio

I'm passionate about delivering high quality, equitable care to patients with congenital heart disease.

Honors & Awards

  • Honor Roll for Clinical Teaching, Lucile Packard Children's Hospital - Pediatric Residency (May 2021)
  • Honor Roll for Clinical Teaching, Lucile Packard Children's Hospital - Pediatric Residency (May 2022)
  • Excellence in Scholarship: Clinical Research, Lucile Packard Children's Hospital - Pediatric Residency (May 2023)
  • Caroline Graham Lamberts Gratitude and Service Award, Lucile Packard Children's Hospital - Pediatric Residency (May 2023)
  • Frederick de la Vega Medical Scholarship, Creighton University School of Medicine (October 2019)

All Publications

  • Younger age at initiation of subcutaneous treprostinil is associated with better response in pediatric Group 1 pulmonary arterial hypertension. Pulmonary circulation Kochanski, J. J., Feinstein, J. A., Ogawa, M., Ritter, V., Hopper, R. K., Adamson, G. T. 2024; 14 (1): e12328

    Abstract

    Children with severe Group 1 pulmonary arterial hypertension (PAH) have an unpredictable response to subcutaneous treprostinil (TRE) therapy, which may be influenced by age, disease severity, or other unknown variables at time of initiation. In this retrospective single-center cohort study, we hypothesized that younger age at TRE initiation, early hemodynamic response (a decrease in pulmonary vascular resistance by ≥30% at follow-up catheterization), and less severe baseline hemodynamics (Rp:Rs < 1.1) would each be associated with better clinical outcomes. In 40 pediatric patients with Group I PAH aged 17 days-18 years treated with subcutaneous TRE, younger age (cut-off of 6-years of age, AUC 0.824) at TRE initiation was associated with superior 5-year freedom from adverse events (94% vs. 39%, p = 0.002), better WHO functional class (I or II: 88% vs. 39% p = 0.003), and better echocardiographic indices of right ventricular function at most recent follow-up. Neither early hemodynamic response nor less severe baseline hemodynamics were associated with better outcomes. Patients who did not have a significant early hemodynamic response to TRE by first follow-up catheterization were unlikely to show subsequent improvement in PVRi (1/8, 13%). These findings may help clinicians counsel families and guide clinical decision making regarding the timing of advanced therapies.

    View details for DOI 10.1002/pul2.12328

    View details for PubMedID 38348195

    View details for PubMedCentralID PMC10860541

  • Right Atrial Lines as Primary Access for Postoperative Pediatric Cardiac Patients. Pediatric cardiology Anton-Martin, P., Zook, N., Kochanski, J., Ray, M., Nigro, J. J., Vellore, S. 2022

    Abstract

    To characterize the use of right atrial lines (RALs) as primary access in the postoperative care of neonatal and pediatric patients after cardiothoracic surgery and to identify risk factors associated with RAL complications. Observational retrospective cohort study in pediatric cardiac patients who underwent RAL placement in a tertiary children's hospital from January 2011 through June 2018. A total of 692 children with congenital heart disease underwent 815 RAL placements during the same or subsequent cardiothoracic surgeries during the study period. Median age and weight were 22days (IQR 7-134) and 3.6kg (IQR 3.1-5.3), respectively. Neonates accounted for 53.5% of patients and those with single-ventricle physiology were 35.4%. Palliation surgery (shunts, cavo-pulmonary connections, hybrid procedures, and pulmonary artery bandings) accounted for 38%. Survival to hospital discharge was 95.5%. Median RAL duration was 11days (IQR 7-19) with a median RAL removal to hospital discharge time of 0days (IQR 0-3). Thrombosis and migration were the most prevalent complications (1.7% each), followed by malfunction (1.4%) and infection (0.7%). Adverse events associated with complications were seen in 12 (1.4%) of these RAL placements: decrease in hemoglobin (n=1), tamponade requiring pericardiocentesis (n=3), pleural effusion requiring chest tube (n=2), and need for antimicrobials (n=6). Multivariable logistic regression showed that RAL duration (OR 1.01, p=0.006) and palliation surgery (OR 2.38, p=0.015) were significant and independent factors for complications. The use of RALs as primary access in postoperative pediatric cardiac patients seems to be feasible and safe. Our overall incidence of complications from prolonged use of RALs remained similar or lower to that reported with short-term use of these lines. While RAL duration and palliation surgeries seemed to be associated with complications, severity of illness could be a confounding factor. A prospective assessment of RAL complications may improve outcomes in this medically complex population.

    View details for DOI 10.1007/s00246-022-03000-0

    View details for PubMedID 36094531

  • A Case of Epinephrin-associated Refractory Hypotension Secondary to Lactic Acidosis. Inflammatory bowel diseases Joseph, M., Kochanski, J., Goyal, A. 2021

    View details for DOI 10.1093/ibd/izab268

    View details for PubMedID 34718560