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Focus on David Balzer, MD

David Balzer, MD, is a professor of pediatrics in the division of pediatric cardiology, and director of the cardiac catheterization laboratory. He specializes in interventional pediatric cardiology, including interventional and diagnostic cardiac catheterization.

Dr. Balzer sees patients at St. Louis Children’s Hospital, One Children’s Place, 2nd floor, Suite D.

FOR AN APPOINTMENT, PLEASE CALL 314-454-6095.

What happened in the course of schooling to influence you to choose your specialty?

I liked most of my rotations in medical school, but enjoyed pediatrics the most. Pediatric cardiology appealed to me because I was drawn to the physiology and anatomy aspect of it. Interventional cardiology has lots of “toys” to work with -- it’s challenging from the technical as well as cognitive aspect.

Can you explain interventional pediatric cardiology?

It’s a sub-specialty of pediatric cardiology that involves cardiac catheterization procedures. Over the last ten to fifteen years, there has been exponential growth in therapeutic capabilities of the heart catheterization lab (cath lab). We can now create holes in the heart where they are needed, and close holes in the heart where they aren’t needed. We are able to dilate valves, stent vessels, and coil off unwanted vessels through small catheters in blood vessels – procedures that used to require open heart surgery. One of the most recent innovations is implanting valves through a vein catheter, rather than traditional open heart surgery.

We see patients of all ages -- from premature babies to adults. For the most part, we treat children born with congenital heart defects that need to be repaired. Occasionally, we’ll treat acquired heart defects, like cardiomyopathy (weakened and enlarged heart muscle) or mild carditis – (infection or inflammation of the heart). Also, after the repair of heart defects, there may be residual problems that occur later in life --that’s why we see the adult population, as well.
David Balzer, MD


What brought you to Washington University?

I attended medical school at St. Louis University on a scholarship from the United States Air Force, and stayed for my general pediatric residency. After medical school, I served in the Air Force as a pediatrician as payback for my schooling. I was stationed at Altus Air Force Base in southwest Oklahoma, and really enjoyed my time there. It was just like having a regular pediatric practice, but without the headaches of billing or insurance. After the Air Force, my training continued with a cardiology fellowship training here at Washington University and ended up staying on as faculty.


Which aspect of your practice is most interesting?

That’s a hard question, because every day in the cath lab is interesting. Each child is unique -- making every case different and potentially challenging. I enjoy it all.

What new developments in your field are you most excited about?

Most recently is the development of transcatheter pulmonary valve placements -- called the Melody® valve. This device became FDA-approved in January of 2010. It’s intended for people who have right ventricle to pulmonary conduits that, over time, have narrowed (conduits are tubes sewn in between the right side of the heart and the lungs during congenital heart surgery). Over the years, those tubes can degenerate, leak and become narrow. Previously, surgery would be necessary every few years to put a new conduit in place. Now, we can implant the Melody valve without surgery.

What’s the lifespan of the Melody valve?

The honest answer is we don’t know, because it’s so new. Most of our patients are doing great at their one year follow-up. I’m hopeful the valves will last 10 to 15 years. It is possible that in 10 years if something is needed to be repaired again, we could put a second valve inside the old one, and buy another 10 years. Over the course of someone’s lifetime we might be able to avoid two or three open heart surgeries. It’s a one-night hospital stay and no sternotomy is required (chest incision for heart surgery), so our patients love it.

Are you involved in any research?

We actually do quite a bit of research in our cardiac cath lab – mostly industry-sponsored device trials. Currently we’re in a post-market Melody valve study. We’ve also been involved in several different studies for implantable devices to repair ASDs (atrial septal defect – abnormal opening in the wall between the upper chambers of the heart ),VSDs (ventricular septal defect – abnormal opening in the wall between the right and left ventricle) and PDAs (patent ductus arteriosus– a connection between the aorta and pulmonary artery).
 
Is there a particular award or achievement that is most gratifying to you?

The last few years, we’ve participated in PICS – Pediatric Interventional Cardiac Symposium. It’s an international conference that involves satellite broadcast of live cases from various institutions around the country. This past year the broadcasts originated from Giessen, Germany, Riyadh, Saudi Arabia, San Paulo, Brazil, and St. Louis, MO and were sent via satellite to the conference in Boston, MA.
For the latest symposiuim, I performed three procedures. It’s very interactive -- the audience can see me, ask questions and I can answer them. It’s not really an award, but it’s very exciting to teach and showcase St. Louis Children’s Hospital and Washington University to an international audience.

What’s the best advice you’ve ever received?

I would say the best advice is to work hard, but stop and smell the roses.

If you weren’t a doctor, what do you think you’d be doing?

I’ve always loved the outdoors – when I was younger, our family would hike, camp and canoe together. So maybe I’d like to work for the National Parks Services as a forest ranger.

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