Michael Swartz
Author-Scientist
Children born with congenital heart disease, or structural abnormalities of the heart, are the most common and resource-intensive birth defects, affecting approximately one in every 100 live births in the United States of America. Many of these children require cardiac surgery during the first days or months of life for continued survival. Although the success rate of these surgeries has dramatically increased over the past several decades, emerging questions about the risks for neurologic injury that may occur during the operation, and the long-term outcomes of these children as they reach adulthood remain unknown. Our lab is focused on the understanding of how to best care for children requiring pediatric cardiac surgery. We are currently focused on two projects: A) Using intra-operative electroencephalograms to identify and prevent neurologic injury, and B) Collaborating with other pediatric cardiac surgical centers to evaluate the long-term outcomes after pediatric cardiac surgery.
1. The use of intra-operative electroencephalogram monitoring evaluates the electrical activity of the brain during surgery. Although several decades ago, the use of electroencephalogram monitoring during pediatric cardiac surgery was thought to be ineffective, newer signal processing techniques have re-invigorated the field. Using advanced signal processing called Fast Fourier Transform, imperceptible differences in the electroencephalogram can be analyzed to identify those children at the highest risk for developing a seizure or stroke after surgery. This research has an opportunity to not only better care for these critically ill children but, more importantly, prevent the development of seizures or strokes and vastly improve these children's lives.
a. Seltzer LE, Swartz M, Kwon JM, Burchfiel J, Alfieris GM, Guillet R. Intraoperative EEG predicts postoperative seizures in infants with congenital heart disease. Ped Neurol. 2014;50(4):313-317. b. Seltzer LE, Swartz MF, Kwon J, Burchfiel J, Cholette JM, Wang H, Sweeney D, Adams HR, Meagher C, Angona R, Guillet R, Alfieris GM. Intermediate-term neurodevelopmental outcomes after neonatal cardiac surgery: Role of Cortical Isoelectric activity. J Thorac Cardiovasc Surg. 2016;151:1137-1142. c. Swartz MF, Seltzer LE, Cholette JM, Yoshitake S, Darrow N, Algahim MF, Alfieris GM. Intraoperative Cortical Asynchrony Predicts Abnormal Postoperative Electroencephalogram. Ann Thorac Surg. 2021 Feb;111(2):645-654. d. Swartz MF, Lansinger J, Scheffler EJ, Duncan A, Cholette JM, Yoshitake S, Alfieris GM. Changes in Neonatal Intraoperative Electroencephalogram Alpha: Delta Ratios Precede Neurologic Injury. World J Pediatr Congenit Heart Surg. 2025 Jan;16(1):21-29. e. Lansinger J, Swartz MF, Scheffler EJ, Duncan A, Cholette JM, Yoshitake S, Clifford HS, Wang H, Alfieris GM. Quantitative Electroencephalography Alpha:Delta Ratio and Suppression Ratio Monitoring During Infant Aortic Arch Reconstruction. Pediatr Neurol. 2025 Feb;163:96-103.
2. Collaborating with other pediatric cardiac surgical centers in New York State we can evaluate the healthcare utilization, costs, and outcomes following the repair and palliation of congenital heart disease. a. Crook S, Dragan K, Woo JL, Neidell M, Nash KA, Jiang P, Zhang Y, Sanchez CM, Cook S, Hannan EL, Newburger JW, Jacobs ML, Petit CJ, Goldstone A, Vincent R, Walsh-Spoonhower K, Mosca R, Kumar TKS, Devejian N, Biddix B, Alfieris GM, Swartz MF, Meyer D, Paul EA, Billings J, Anderson BR; New York State Congenital Heart Surgery Collaborative for Longitudinal Outcomes & Utilization of Resources (CHS-COLOUR). Impact of Social Determinants of Health on Predictive Models for Outcomes After Congenital Heart Surgery. J Am Coll Cardiol. 2024 Jun 18;83(24):2440-2454. b. Woo JL, Nash KA, Dragan K, Crook S, Neidell M, Cook S, Hannan EL, Jacobs M, Goldstone AB, Petit CJ, Vincent R, Walsh-Spoonhower K, Mosca R, Kumar TKS, Devejian N, Kamenir SA, Alfieris GM, Swartz MF, Meyer D, Paul EA, Newburger JW, Billings J, Davis MM, Anderson BR; New York State Congenital Heart Surgery Collaborative for Longitudinal Outcomes and Utilization of Resources (CHS-COLOUR). Chronic Medication Burden After Cardiac Surgery for Pediatric Medicaid Beneficiaries. J Am Coll Cardiol. 2023 Sep 26;82(13):1331-1340. c. Crook S, Dragan K, Woo JL, Neidell M, Jiang P, Cook S, Hannan EL, Newburger JW, Jacobs ML, Bacha EA, Petit CJ, Vincent R, Walsh-Spoonhower K, Mosca R, Kumar TKS, Devejian N, Kamenir SA, Alfieris GM, Swartz MF, Meyer D, Paul EA, Billings J, Anderson BR; New York State CHS-COLOUR. Long-Term Health Care Utilization After Cardiac Surgery in Children Covered Under Medicaid. J Am Coll Cardiol. 2023 Apr 25;81(16):1605-1617. d. Allen P, Zafar F, Mi J, Crook S, Woo J, Jayaram N, Bryant R 3rd, Karamlou T, Tweddell J, Dragan K, Cook S, Hannan EL, Newburger JW, Bacha EA, Vincent R, Nguyen K, Walsh-Spoonhower K, Mosca R, Devejian N, Kamenir SA, Alfieris GM, Swartz MF, Meyer D, Paul EA, Billings J, Anderson BR; New York State CHS-COLOUR. Risk Stratification for Congenital Heart Surgery for ICD-10 Administrative Data (RACHS-2). J Am Coll Cardiol. 2022 Feb 8;79(5):465-478.
2. Collaborating with other pediatric cardiac surgical centers in New York State we can evaluate the healthcare utilization, costs, and outcomes following the repair and palliation of congenital heart disease. a. Crook S, Dragan K, Woo JL, Neidell M, Nash KA, Jiang P, Zhang Y, Sanchez CM, Cook S, Hannan EL, Newburger JW, Jacobs ML, Petit CJ, Goldstone A, Vincent R, Walsh-Spoonhower K, Mosca R, Kumar TKS, Devejian N, Biddix B, Alfieris GM, Swartz MF, Meyer D, Paul EA, Billings J, Anderson BR; New York State Congenital Heart Surgery Collaborative for Longitudinal Outcomes & Utilization of Resources (CHS-COLOUR). Impact of Social Determinants of Health on Predictive Models for Outcomes After Congenital Heart Surgery. J Am Coll Cardiol. 2024 Jun 18;83(24):2440-2454. b. Woo JL, Nash KA, Dragan K, Crook S, Neidell M, Cook S, Hannan EL, Jacobs M, Goldstone AB, Petit CJ, Vincent R, Walsh-Spoonhower K, Mosca R, Kumar TKS, Devejian N, Kamenir SA, Alfieris GM, Swartz MF, Meyer D, Paul EA, Newburger JW, Billings J, Davis MM, Anderson BR; New York State Congenital Heart Surgery Collaborative for Longitudinal Outcomes and Utilization of Resources (CHS-COLOUR). Chronic Medication Burden After Cardiac Surgery for Pediatric Medicaid Beneficiaries. J Am Coll Cardiol. 2023 Sep 26;82(13):1331-1340. c. Crook S, Dragan K, Woo JL, Neidell M, Jiang P, Cook S, Hannan EL, Newburger JW, Jacobs ML, Bacha EA, Petit CJ, Vincent R, Walsh-Spoonhower K, Mosca R, Kumar TKS, Devejian N, Kamenir SA, Alfieris GM, Swartz MF, Meyer D, Paul EA, Billings J, Anderson BR; New York State CHS-COLOUR. Long-Term Health Care Utilization After Cardiac Surgery in Children Covered Under Medicaid. J Am Coll Cardiol. 2023 Apr 25;81(16):1605-1617. d. Allen P, Zafar F, Mi J, Crook S, Woo J, Jayaram N, Bryant R 3rd, Karamlou T, Tweddell J, Dragan K, Cook S, Hannan EL, Newburger JW, Bacha EA, Vincent R, Nguyen K, Walsh-Spoonhower K, Mosca R, Devejian N, Kamenir SA, Alfieris GM, Swartz MF, Meyer D, Paul EA, Billings J, Anderson BR; New York State CHS-COLOUR. Risk Stratification for Congenital Heart Surgery for ICD-10 Administrative Data (RACHS-2). J Am Coll Cardiol. 2022 Feb 8;79(5):465-478.