Dr. Kathiriya is a pediatric cardiac anesthesiologist and Professor of Anesthesia at the University of California, San Francisco who specializes in congenital heart defects at UCSF Benioff Children’s Hospital. Congenital heart defects are structural problems that affect the cardiovascular system, the heart's ability to pump blood effectively. His research focuses on how the human heart develops from a simple tube into a complex four-chambered organ and what goes wrong during this process. Congenital heart defects are one the of the most common types of birth defects, affecting about 1% of newborns. Dr. Kathiriya presented his findings during a Marin Science Seminar presentation on March 18, 2026, titled “How to Make or Break Your Heart.” He introduced how specific genes guide heart cell organization during development. His work aims to improve the diagnosis, treatment, and long-term outcomes for children born with heart conditions.
1. What initially motivated you, as a pediatric cardiac anesthesiologist, to focus your research on infants with congenital heart disease? Was there a particular experience, patient interaction, or scientific discovery that shaped your path?
My interest in congenital heart defects began when I was a graduate student in the laboratory of Dr. Deepak Srivastava, where I focused on how important genes work together to develop the heart before birth. During that time, a colleague, Dr. Vidu Garg, was studying families affected by congenital heart defects to understand how some of these defects could be inherited. He uncovered mutations in a gene called GATA4, which happened to be one of the genes I was studying. I helped reveal how those mutations changed the gene’s functions. These discoveries showed me how basic science could help explain how disease happens in patients, and how studying patients could help us better understand basic biology. Since then, my research has been guided by the links between congenital heart defects in patients with congenital heart defects and the biology of heart development.
2. What are some specific advancements or breakthroughs that have significantly improved patient outcomes, and how have these changes impacted your own work?
A breakthrough in caring for newborns with serious congenital heart defects was the development of synthetic prostaglandins. For some newborns with critical heart disease, this medication can keep open a small blood vessel, which is essential for circulation and gives physicians valuable time to stabilize babies and plan life-saving treatment or surgery. Advances like this have improved survival for infants with complex heart defects. Over time, improvements in diagnosis, medical management, intensive care, surgery, anesthesia, and postoperative care have all helped children do much better than they did in earlier generations.
3. In your clinical and research experience, have you noticed any changes in the rates of congenital heart defects and severity over time?
Congenital heart defects are still the most common type of birth defect, and their frequency has not really changed. What has changed is our ability to detect them earlier and more accurately. With better prenatal imaging and newborn screening, pediatric cardiologists find many heart defects that might once have gone unrecognized. This has contributed to improvements in survival. Many children born with serious heart defects are now living longer and healthier lives because of advances in medical and surgical care. As a result, we now care for more children, teenagers, and adults living with congenital heart defects than ever before.
4. Does the timing of when a heart defect develops during embryonic growth influence how serious the defect becomes?
Timing is important. The heart is one of the first organs to form in pregnancy, by a carefully orchestrated series of steps. If something disrupts that process at an early stage, it can sometimes lead to a more complex heart defect. If the disruption happens later, the problem may be more limited, depending on which part of the heart is developing then. However, timing is only one part of the story. The seriousness of a heart defect also depends on which structures may be affected, how much blood flow is altered, and if other genetic or developmental factors may be involved.
5. Once a heart defect forms during development, is there any stage where it can naturally correct itself, or is medical intervention always required?
Some heart defects can improve on their own. For example, small holes in the heart may sometimes close naturally as a baby grows. In those cases, careful monitoring may be all that is needed. However, many congenital heart defects do not correct themselves and require medical treatment, a procedure, or surgery. It depends on the type of defect and how much it affects the heart’s function.
