Tal Geva: Cardiologist-in-Chief

Following an international search, Dr. Tal Geva was selected to succeed James Lock as Chief of Cardiology, effective May 1, 2016.  This article reviews Dr. Geva’s contributions to the field of pediatric cardiology and his vision for the future.After spending just one month at the Heart Center at Boston Children’s Hospital as a medical student in 1982, Dr. Tal Geva knew he wanted to make pediatric cardiology the focus of his career. He went on to earn his medical degree from the Sackler School of Medicine in Tel-Aviv in 1985 and completed a residency in pediatrics at the Sheba Medical Center.  He returned to Boston Children’s as a fellow in cardiac pathology in 1988 and afterward pursued clinical cardiology training at Texas Children’s Hospital. Dr. Geva was recruited to join the pediatric cardiology faculty at Boston Children’s Hospital and Harvard Medical School in 1994.  He rose to become a full professor in 2006.For over 20 years, Dr. Geva has dedicated his career to advancing care for children and adults with congenital heart disease. His contributions to cardiac imaging have led to more accurate diagnoses and widespread improvements in practice.A world renowned leader in cardiac imaging

Shortly after coming to Boston Children’s, Dr. Geva established the first-of-its-kind pediatric cardiovascular magnetic resonance (CMR) program, which he directed until he assumed the position of chief of the Division of Noninvasive Cardiology in 2006. The program has served as a national and international model since its inception. Until recently, it was the only one in the country to offer formal pediatric CMR training.

Dr. Geva’s research has focused on the morphology and pathophysiology of congenital heart disease using noninvasive imaging. Notable achievements include imaging-based prediction models of clinical outcomes and clinical trials that established the role of CMR in clinical pediatric cardiology.

As a teacher and mentor, Dr. Geva’s commitment and passion are unmatched. He is the “go to person” for staff at all levels when faced with a clinical dilemma, regardless of the time of day (or night!).

“Teaching was never a decision I made,” he says.  “It’s integral to what I do — what we do. Plus, it comes naturally to me and I enjoy it. I enjoy when people ask probing questions and challenge dogmas.”

In 2014, Dr. Geva received the highest teaching honor bestowed by the American Society of Echocardiography (ASE), the Excellence in Teaching in Pediatrics Award.

Looking back and looking ahead

In Dr. Geva’s time, cardiac imaging has seen significant improvements in existing modalities as well as the advent of new modalities.

“At first,” he says, “CMR could capture mostly static images and only 50 per hour. Now we can get thousands of images in a short period with very rich data on blood flow, function, physiology, and fine details of tissue composition. Echocardiography has also become much better at revealing myocardial function, with the shift from 2-D to 3-D images.”

“The next frontier is multi-modality data sets,” says Dr. Geva. Also, 4-D is the new 3-D.

“The fourth dimension is motion. 4-D imaging can help us see not just a heart’s unique anatomy, but exactly how it is functioning.”

On a broader scale, Dr. Geva has observed the field of pediatric cardiology shift in focus from early childhood survival to long-term quality of life.  “Now that there are more adults than children with congenital heart disease, we need to maximize their potential to be active members of society and as productive as possible.”

Upholding the mission

Dr. Geva describes the Heart Center’s mission in four parts:
1)      We put the patients first.
2)      We support each other. These jobs are hard intellectually, emotionally, and often physically; there’s a high bar for excellence.
3)      We feel joy in the discovery that comes with research and innovation.
4)      We believe in educating the next generation.

“I am highly optimistic about this department because of its people,” he says. “The faculty, the nurses, the technologists, the support staff, everyone. The people of this department make it great.”

The Heart Center looks forward to Dr. Geva’s leadership as chief, and to continuing the legacy of innovation in pediatric and congenital cardiology in the years to come.

James Lock, MD: A reflection on 22 years of leadership

After more than two decades of brilliant leadership, Dr. James E. Lock has stepped down as chief of the Department of Cardiology and is handing over the reins to Dr. Tal Geva.

Dr. Lock’s contributions to the field of pediatric cardiology, and to Boston Children’s Hospital and the Heart Center, have been deep and visionary. From quality improvement projects to surgical device development to raising funds for clinical programs, he has touched nearly every aspect of medicine.

Dr. Lock received his Doctor of Medicine from Stanford University School of Medicine. He completed an internship and residency at the University of Minnesota Hospital & Clinics and a fellowship at the Hospital for Sick Children in Toronto.

In 1984, Dr. Lock was recruited to Boston Children’s Hospital as director of the cardiac catheterization laboratory. His consummate skills, drive, and vision led him to become Cardiologist in Chief in 1993 and the Alexander S. Nadas Professor of Pediatrics at Harvard Medical School in 1995.

Pushing the boundaries to improve care and outcomes

Dr. Lock conceived, designed, and developed nearly a dozen new techniques in interventional cardiology. He is the author of almost 300 original peer-reviewed publications and has been issued eight patents. He has also designed successful intracardiac device trials for catheter-based treatment of congenital heart defects including ventricular septal defects and patent foramena ovale.

As co-developer of the Heart Center’s fetal cardiac intervention program, Dr. Lock pioneered groundbreaking fetal cardiac procedures. The program remains the largest of its kind in the world and serves as a model for other top pediatric heart centers.

Dr. Lock’s legendary skills in interventional catheterization, along with his development of new treatments for children with congenital heart disease, have attracted patients from around the globe and inspired a generation of young pediatric cardiologists. His trainees and mentees now populate medical centers around the nation and the world as department chairs and directors of pediatric cardiology divisions, cardiac catheterization laboratories, and intensive care units.

Beyond the clinic and the cath lab

Dr. Lock’s legacy extends well beyond his clinical work. During his tenure as cardiologist-in-chief, he was a leader in developing a new model of governance and operations to drive excellence and innovation in the Heart Center.

Dr. Lock has also been dedicated to collaboration with regional colleagues to share knowledge and advance congenital heart disease care and research. To this end, he conceived and established the New England Congenital Cardiac Association, solidifying the historically outstanding relationships among pediatric cardiologists in this region.

Dr. Lock has also been instrumental in fundraising efforts that support the Boston Children’s institutional endowment. He has been committed to policy innovations for patient safety and quality. He conceived the principles that underlie the Hospital’s Associate Attending Policy and developed a program that incents departmental adherence to such regulatory requirements.
Although he has stepped down as cardiologist-in-chief, Dr. Lock will continue his work at the Heart Center in cardiac catheterization, patient care, teaching and mentoring, and scholarly publication. His colleagues are grateful for the ongoing opportunity to benefit from his wisdom and guidance.