I met Dr. Brian Reemtsen at Arkansas Children’s Hospital in April of 2018. My daughter, Ellie, who had just been born four days earlier, was on his schedule for her very first heart surgery. In a few hours, we would hand her over and he would cut open her tiny, flawless chest leaving her anatomy forever changed and scarred. And in the best-case scenario, her heart would still be beating on its own at the end of it.
Before we ever spoke, I watched him in the hallway through the glass doors of our cardiovascular intensive care unit (CVICU) room on the fourth floor of the hospital. The CVICU at ACH is a well-oiled machine with hundreds of doctors, nurses, students and specialists who move in and out of rooms — from family crisis to family crisis — with compassion, calm and control while taking care of some of the hospital’s sickest patients.
Machines beep and sustain life for the babies, toddlers, teens and adults born with heart disease. All are medically complex and each have their own unique challenges, but Dr. Reemtsen and his team truly treat every case like it is the most important one in the entire hospital.
He talked with the other medical professionals while looking at my daughter’s chart on the computer and then looked up at my husband and me, who were worse for the wear, unsure of what was about to happen — like a deer caught in headlights with no idea how we ended up here and with nowhere to escape.
Sliding open the door to our room, he confidently talked us through what would happen over the next few hours and into the next day. His comportment was genuine with eyes that spoke of a reassuring focus mixed with just the right amount of concern, both balanced with a spark of excitement, similar to an athlete who knew he had put in all of the work during training and was ready to take on the challenge. Aware of what was coming, but not afraid, he had set his goal and would achieve it.
By all accounts, my impression of his leadership is not unique to the operating room, and his desire to give back and create a legacy for Arkansas is more than just rhetoric. This year, he and his wife Noel will put their hearts on the line as chairs of the ACH Miracle Ball with fundraising efforts going toward the Arkansas Children's Heart Institute, the state’s only pediatric cardiology program.
WHERE THE HEART IS
Noel and Brian Reemtsen met in Tarrytown, New York, in October of 1992. A native of Bucks County, Pennsylvania, Noel had recently graduated from the University of Vermont when she ran into Brian at the local gym.
“We hit it off immediately,” Noel says. “I was 22, Brian was 24 and in his second year of medical school. He didn't want to date anyone during medical school because he didn't want any distractions.”
But by the next summer, they were official and living in New York City where they enjoyed rollerblading in Central Park on the weekends.
Brian graduated from medical school in 1995 and matched at UCLA for a general surgery residency. During that time, they got married and had two girls, Emma in 2000 and Margot in 2002. Shortly after Margot was born, they set off for Seattle for Brian's adult cardiothoracic fellowship at the University of Washington. From there, the family moved to London for his congenital pediatric cardiac fellowship at Great Ormond Street for Sick Children, a program that only selected one American.
After the year-long fellowship, the family went back to Los Angeles, but this time on the other side of town for Brian's first job — 10 years after graduating medical school — at Children's Hospital Los Angeles, and their third daughter, Vittoria, was born. Three years later, he was hired at UCLA Mattel Children’s Hospital as chief of pediatric and congenital cardiac surgery.
“I originally was attracted to medicine as a kid because I was competitive and that was the best thing I could think of,” Brian says. “Congenital heart surgery chooses you as much as you choose it, for it takes an unusual skill set to master all the variables that go into this job.”
In August of 2017, Brian was named professor of surgery, chief of cardiovascular surgery and director of the Heart Institute at ACH in Little Rock.
By then, the family was looking for a more “normal” way of life.
“We always wanted our kids to experience 'Friday night lights' and other things that come with a small town … It's pretty magical. We loved that growing up and wanted that for our children,” Noel says. (Both she and Brian were D1 athletes, with Brian playing football at UCLA and Noel as a gymnast at UVM.)
And in Little Rock, they found it. Emma finished at Pulaski Academy and then graduated from UC Boulder with a major in psychology and minors in education and dance. Margot, a junior at the University of Arkansas, plays on the Razorback Soccer team, which made it to the Elite 8 last year in the NCAA Tournament and won the SEC regular season championships in 2020 and 2021. Vittoria, a junior and honor roll student at Pulaski Academy, is a two-time dance team champion and studies with Rock City Dance.
“Little Rock is my favorite place I have ever lived. When we moved here, it made us a better family,” Brian says. “We all feel like this is home, and we are all interested in doing anything to make it a better place.”
tHE BEAT GOES ON
One percent of all live births are afflicted with congenital heart disease, according to Brian, and ACH performs 300 to 400 surgeries in a given year, with patients from Arkansas and the surrounding region.
While there are no preventative measures for congenital heart disease, early detection is the best line of defense with fetal echocardiography allowing doctors and families to plan and prepare for what is coming once a child is born.
“We perform surgeries on newborns — 30% of our cases are in the patient’s first week of life — children and adults that usually have been operated on as a youth and require reapportion,” Brian says.
The hospital also has a robust heart failure program that treats end-stage heart disease in children with ventricular assist devices and heart transplants. Since 1985, 370 heart transplants have been performed at ACH, and more than 600 patients are treated annually in the CVICU.
And, as if that day-to-day operation wasn’t enough, in fiscal year 2021, the CVICU had a 100% survival rate for surgical patients.
“I’ve been doing this for a long time, and it’s a first for this hospital. And it’s a first for any hospital I’ve ever worked in,” Brian says. “It’s truly amazing for a program of our size and the complexity of what we do — from neonatal surgery, as well as transplant surgery — that we had every single patient survive. It’s something we’re very proud of.”
Brian credits the community for the success of the program. The people giving their time and money “are directly responsible for helping us improve our outcomes, and I know for a fact that there’s not a better program in the country, outcomes-wise, than us.”
The Heart Institute is the first clinical institute at ACH. It takes personnel from different specialties like surgery, cardiology, anesthesiology, nursing and administration and places them in a single institute to create an efficient, self-administered program in order to optimize clinical and research goals.
The four pillars of the Heart Institute are clinical outcomes, research, education and philanthropy. The department set goals for each of the four pillars in order to transition to the Heart Institute, and early this summer, it met those goals and the institute distinction is now official.
In 2021, the team opened two new highly-advanced biplane catheterization (cath) labs and a hybrid cath lab, becoming the first hospital in the world to utilize this brand-new technology. It also unveiled a new cardiac recovery unit, which provides a dedicated space for patients to recover before and after outpatient procedures.
“In most institutions, an institute includes a stand-alone building. While we don't have a separate building, we do have an all-inclusive area that was finished by moving the new hybrid cath labs adjacent to the operating rooms and CVICU,” Brian says. “This allows the complete care to [happen] in a single unit and infinitely improves safety, [which] improves outcomes for our patients.”
The institute has scored a ranking in the Top 50 Children’s Hospitals in the Country for Pediatric Cardiology & Heart Surgery by U.S. News & World Report and is a recipient of the Beacon Award from the American Association of Critical Care Nurses for distinguished patient care in the CVICU.
ACH was also one of the first hospitals across the nation trained to administer Medtronic’s Harmony Transcatheter Pulmonary Valve, performing its first valve replacement in October 2021. The procedure provides an alternative to open-heart surgery for patients in need of a pulmonary valve replacement with a congenital heart defect of the right ventricle.
“Philanthropy has a real-world effect on children's survival,” Brian says. “We have upgraded our operating rooms and have brand new hybrid cath labs, paid for in part with philanthropic funds, that have improved our safety for patients and have directly affected patient survival.
“One year ago, we were able to have 100% survival of our surgical patients. For a large program like ours, I cannot emphasize how incredible a team has to be to accomplish this feat.”
A MIRACLE BALL
The plan for the future of the ACH Heart Institute includes expanding and growing highly advanced procedures to continue to provide compassionate, comprehensive and innovative care close to home. Philanthropy is a key driver for this kind of innovation and excellence in order to make children better today and healthier tomorrow. Though the department reached many of its goals in becoming a heart institute, there is still work to do.
By increasing diagnosis and referrals of babies with congenital heart disease before they’re even born, the team at the Heart Institute can reach even more babies to develop the earliest possible treatment plans, changing the trajectory of that child’s birth and entire future. And advanced care driven by innovative technologies and research where top-notch surgeons and teams can perform faster, less invasive surgeries means children recover faster.
Excited to be back in-person at the Miracle Ball this year, the Reemtsens are kicking off the holiday season with a cozy, Aspen-inspired winter wonderland where they plan to raise money to support this mission-critical endeavor.
“We both have pretty busy schedules, but when we were asked to chair the Miracle Ball, it was an easy answer,” Noel says. “How could we not want to support? Brian knows first-hand the other side of why Children's is so great. … He tells me all the time that it's the best place he's ever worked. Everyone is invested in what they do there, and it shows.”
Brian agrees their commitment to the ball was a natural thing to do and adds that Noel is the perfect person to chair because of her deep commitment to ACH and genuine care for kids with medical needs.
“I can think of no better investment,” Brian says. “This is a great opportunity to get back to normal after the last couple of years and allow all of us to dress up a little, socialize and raise some money for kids in need.”
To date, Dr. Reemtsen has operated on my daughter two more times and is now very much part of our family’s story. We last saw him in July when he repaired a complicated problem in Ellie’s heart that included a great deal of uncertainty and risk.
“I think most people know how great the hospital is. However, I don't think people realize how outstanding the hospital is on a national level,” he says. “I cannot think of another children's hospital that I would rather be affiliated with.”
I agree, wholeheartedly.
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