Dawn M. Coleman, MD, vascular surgeon, joined Duke University and Duke Children’s Hospital as chief of the Division of Vascular and Endovascular Surgery in 2022. Coleman provides comprehensive vascular care to adult and pediatric patients with developmental and acquired vascular disease. She has expertise in the open and endovascular surgical reconstruction of complex aorto-mesenteric diseases, including thoracoabdominal and visceral/renal aneurysms and narrowings. Additionally, Coleman is a world-renowned expert in pediatric renovascular hypertension. 

In this Q&A, Coleman describes how the program is on the path to providing leading vascular care to pediatric patients while expanding exceptional care of rare vascular conditions.

I was compelled to transition to Duke from the University of Michigan because I felt I could create a parallel pediatric vascular program to support kids in the Southeast. There was a perceived gap in multidisciplinary programs delivering high-level care for pediatric vascular conditions and pediatric renovascular hypertension specifically — a major clinical focus of my practice. 

Over the last two years, we’ve built strong collaborations with our subspecialty colleagues to offer children with rare vascular conditions the highest level of surgical and medical care. We are on track with delivering on my vision to create a regional referral hub for children with complex and challenging vascular needs. We’ve had great institutional and stakeholder support in investing in programs for rare diseases. Duke is known as a place that offers patients solutions for challenging cases.

Duke Children’s delivers high-level subspecialty care, including a world-class Vascular Malformations and Hemangiomas Clinic and a high-volume congenital cardiac and pediatric transplant program. We frequently collaborate with congenital cardiac surgeons, interventional radiologists, pediatric nephrologists, pediatric anesthesiologists, critical care teams, geneticists, advanced practice providers, and specialty-trained nursing staff. With the depth of expertise here at Duke Children’s, each patient and their family can feel comfortable and confident they are getting a cohesive and comprehensive assessment and treatment plan curated for them. 

Multidisciplinary care doesn’t just happen within Duke Children’s. I continue to collaborate clinically and academically with the team at the University of Michigan, so we can learn from each other to enhance patient care. While some children do very well with simply medical therapy, multi-modal therapy including complex medical management, invasive procedures and surgery are often required from a diverse team. That’s something we do very well here at Duke.

I’m heavily involved in research around pediatric renovascular hypertension. There’s a gap in available literature around this disease and we’re committed to finding critical discoveries. 

I lead an international pediatric renovascular hypertension patient-centered outcomes research collaborative. We have a conglomerate of patients, families, multidisciplinary providers, and stakeholders around the country contributing to research to glean insights. We’re actively identifying gaps that patients feel inhibit a timely diagnosis, adequate and early referrals, access to care, and treatment challenges. Our goal is that these learnings lead to higher-level funding and collaborative work that solves key challenges in diagnosing and treating this disease. We also recently hosted the International Symposium on Pediatric Renovascular Hypertension at Duke, attracting the attention of stakeholders. We hope this translates into support for further exploration of this disease through research.

The vision for care is also changing to a precision medicine approach. We are looking at genetic underpinnings and anatomic differences in patient disease that will help us develop more personalized care. It’s a big priority for us to understand what modalities of care are most effective for each patient. For example, how does each patient’s unique case (age, disease severity, genetics, anatomy, etc.) influence how we recommend medical therapy with antihypertensives or a catheter intervention versus a more invasive surgical procedure? These are the questions we want to answer.

We want to build a regional referral center of excellence for pediatric vascular conditions. We also want to power research that influences multidisciplinary clinical practice. I feel compelled to steward and lead research efforts that build partnerships with other children’s hospitals, partners, and our community.