Explaining heart defects and repairs with animation

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Toy cars zipping around a racetrack, along with tiny buzzing robots and a few furry friends, tell a story about the heart that pamphlets and diagrams can’t.

These are the characters brought to life in animated videos co-created by Daniel J. Penny, M.D., Ph.D., chief of cardiology at Texas Children’s Hospital. As a care provider, Penny longed to have a better way to communicate medical information to his young patients and their families.

“When we see a parent and a patient in clinic, we usually draw a diagram of the heart and then we are proud of ourselves that we feel we’ve informed that family,” Penny said. “It’s much, much more difficult to find out ways of helping you to deal with the emotions you feel when you hand your child with Tetralogy of Fallot—a rare combination of four congenital heart abnormalities— over to an anesthetist worrying that you’re never going to see them again.”

Not only can the information patients and parents need to know about a heart condition be hard to understand, it also can be hard to take in, given the heightened emotional stress of the situation.

Years after the scars of congenital heart surgery have healed, Penny said, post-traumatic stress disorder (PTSD), divorces and other negative outcomes can impact families.

“When you speak to children with congenital heart disease and you ask them what would help them to deal with their condition, they will usually say they want more information,” Penny said, “They want information for them and also for the people around them—their friends at school, their relatives, et cetera, et cetera.”

To achieve this, Penny sought the help of Michael Liddy, an old friend who works as an architect in Australia, to create videos to share critical information with his patients. For 10 years, the pair has been creating the videos together from opposite sides of the globe, exchanging text messages and Skyping when their schedules allow.

“We had discussed an idea that, wouldn’t it be great to explain to children not only the processes they’re going through, but help them understand what’s wrong in the first place?” Liddy said. “If we can demystify that, help them to understand, then perhaps they start to feel that it isn’t their whole body that’s broken.”

Using a racetrack to represent circulation in the body, the videos show children how clogs and blockages can impact the function of the heart and how the heart can be repaired. Ruby, a Texas armadillo, and Beau, a bison, teach viewers about heart problems, while “blings”—little buzzing robots— perform the operations.

Beau, a bison, and Ruby, a Texas armadillo, teach viewers about heart defects.

For Matt Timmons, assistant vice president at Texas Children’s Hospital West Campus, the videos continue to help educate his own family about the heart condition of his son, Luke.

“We have a family history of congenital heart disease and Luke was diagnosed with coarctation of the aorta,” said Timmons, who has worked with Penny in the past. “The animated spin on the information brought it to a level we could understand. … You can see the blood flow and, in Luke’s case, you can see where the racetrack narrows. We understood that is where the aorta is narrowing. … It was just easier for

us to understand on a racetrack than on a two-dimensional diagram of the heart.”

Penny said he and Liddy have been able to reproduce the abnormalities of virtually every congenital malformation of the heart and also many of the heart operations and transcatheter procedures using these videos.

But the videos are not limited to educating children and their families about heart conditions and subsequent surgeries. Penny and Liddy also created videos to help parents understand the social and emotional challenges of having a child with congenital heart disease

and help make the overall hospital experience less frightening for children.

“The stresses these parents are put through often at a very young age can destroy their relationships. A lot of parents fulfill the clinical criteria for post-traumatic stress dis- order, so we have to do everything we can to alleviate that,” Penny said. “We don’t want to be left with a population of psychologically damaged children and failed marriages.”

By making the medical information more accessible, outcomes improve for all parties, Penny said.

“There’s a whole science now around this idea of health care literacy, which suggests the more you know about your illness, the better the likelihood of a good, long-term outcome,” Penny said. “The reason we decided on the videos and the animation is that we felt that it would be easier to disperse that across the world than a traditional book.”

Currently, the videos are free and accessible online to Texas Children’s patients, as well as children and families around the world via YouTube (search for TexasChildrensVideo and hit “subscribe”). Penny and Liddy plan to create more videos and produce them in other languages.

“Whatever we do as a great children’s hospital,” Penny said, “we have to do that as part of a worldwide community.”