Q & A with Piers Barker, MD

Back to Dr. Barker’s physician profile

Where did you receive your undergraduate and/or medical training?
I received my undergraduate and medical degree at Cornell University. My internship and residency was at the Johns Hopkins Hospital, and my fellowship was at the University of Michigan/C.S. Mott Children's Hospital.

How long have you been at Duke?
I’ve been here since November 2004.

Where did you work prior to coming to Duke?
My previous position was at SUNY Upstate Medical University in Syracuse, New York.

Have you received any awards or honors? Do you sit on any boards or journals?
The awards that I’ve received include:

• Medical School: Mitchell Spivak Memorial Prize in Pediatrics, Alpha Omega Alpha Honor Medical Society
• Residency: David M. Kamsler Award in Pediatrics
• Fellowship: ACC/Bristol-Myers-Squibb Travel Scholarship
• Syracuse: Crouse Hospital Auxiliary Distinguished Service Award
• Duke: Young Faculty Travel Award, American College of Cardiology

I am a reviewer for the American Heart Journal and the Journal of Pediatrics.

What are your board certifications and society memberships?
I’m board certified in pediatrics and pediatric cardiology. I am a Fellow of the American Academy of Pediatrics, a Fellow of the American College of Cardiology, and a member of both the American Society of Echocardiography and the Society of Pediatric Echocardiography.

What led you into the field of pediatric cardiology/pediatric cardiac surgery?
I was always interested in pediatrics, but became fascinated by pediatric cardiology during a summer research program following my first year of medical school. There I saw the wide range of pathology and the many opportunities to help so many children lead a normal life. Pediatric cardiology also offers a perfect balance of intensive inpatient care and outpatient follow-up, high technology diagnosis and reliance on the physical exam and interaction with the patient, and close collaboration with surgeons and interventionalists.

What are your areas of sub-specialty and how have things changed since you entered the field?
My area of subspecialty is noninvasive imaging of the heart, primarily echocardiography. There have been dramatic advances in this field since my first exposure to cardiac ultrasound in 1992, with much improved two dimensional imaging of the heart possible from the fetus to the adult, coupled with the new capability to perform real-time 3-dimensional reconstruction and improved quantification of blood flow and cardiac motion. The even newer additions of cardiac MRI and multislice CT will only add to our ability to correctly diagnose and follow children with congenital heart disease, thus decreasing the need for more invasive procedures while also improving our understanding of the underlying pathophysiology.

Are you involved with any clinical trials or research studies? If so, what are you examining?
I am the study cardiologist for an NIH funded trial assessing the safety of an HIV vaccine in older children. I am starting a clinical research project that has been funded by the Children's Miracle Network comparing how maximal and submaximal exercise testing correlate to home physical activity levels in children with congenital heart disease. Additionally, I am involved in the Pediatric Heart Network (NIH funded) Single Ventricle Reconstruction Trial examining which variation on the Norwood procedure (modified Blalock-Taussig shunt vs. Sano right ventricle to pulmonary artery conduit) works best as an initial procedure for children with hypoplastic left heart syndrome.

What is the focus of your current research and how will your research contribute to the field of medicine?
My current research focuses on improving the utility of exercise testing in children with congenital heart disease and improving our understanding of the cardiac mechanics in various congenital heart defects. By improving our exercise testing, we can hopefully better predict when children will need future interventions, as well as the best timing for these interventions. By understanding cardiac mechanics better, we can then improve our interventions to preserve cardiac function as best as possible.

What drew you to Duke and what do you enjoy most about your work?
I was drawn to Duke because of the potential to contribute to a young, enthusiastic and exciting division, coupled with the wisdom of senior faculty that was driven to become a national leader in the care and treatment of children with congenital heart disease. Each day I enjoy meeting children, solving difficult clinical problems and shared learning with my colleagues at the cutting edge of medicine.

Share a special story to explain more about your experience helping children with congenital heart disease.
My first pediatric cardiology transport happened after only one month of fellowship. The call came from a hospital on the other side of the Midwest, with a new baby just diagnosed with hypoplastic left heart syndrome. I managed to quickly organize my thoughts, my team and my coverage before changing into a blue flight suit and flying three hours in a small fixed-wing jet to a state that I wouldn't have been able to point out on a map (having grown up in Canada). After a short ambulance ride from the airport to the hospital I met the baby, the referring cardiologist and the family. The mother accompanied us back to University Hospital in the jet, and she and I spoke about the baby's condition, prognosis and various upcoming procedures for the entire flight. Over the next several years I watched the baby grow to a strong boy, proceed through the surgical steps to help his heart, and the family adjust to having a child with this condition. I was both honored and privileged to be included in their pain, tears and eventual joy as their son survived, and each year eagerly await the next family update.

This experience has been repeated many times since, mostly with a happy ending, but sometimes not, and each time I feel tremendously fortunate to be able to share in the care of a family's child and honored by the family's trust.

What do you think sets Duke Pediatric Cardiology apart from other practices in the area?
Duke Pediatric Cardiology is the only center in the area that offers complete care of every sub-subspecialty area within pediatric cardiology, providing us the opportunity to help any child with any condition. This care even extends beyond the cutting edge of pediatric cardiology -- rather than staying current with the newest technology and treatments, we are helping discover where the next cutting edge will be.

What are your personal hobbies or interests?
My personal hobbies include reading, canoeing, sailing, any outdoor activities with my family and formerly biathlon (cross country skiing and target shooting), although the lack of snow in North Carolina has forced me to hang up my skis for the time being.