A photo of James Cnota.

Director, Fetal Cardiology


Board Certified

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"My philosophy of care is to be compassionate and honest, even when the news is difficult. This approach is how I hope my own family would be treated."

My Biography & Research


While pediatric cardiology involves aspects of acute care and technical expertise, I chose this specialty because my relationship with patients and families is often long-lasting. A fetal cardiologist starts a relationship at the time of prenatal diagnosis, helps a family through the stress of the diagnosis and early cardiac care, and then watches as the child grows up. This relationship with patients and families is very fulfilling for me.

As a pediatric cardiologist, I treat children with congenital heart defects. I am also involved with echocardiography, and I direct the Fetal Heart Program at Cincinnati Children’s. My philosophy of care is to be compassionate and honest, even when the news is difficult. This approach is how I hope my own family would be treated.

The Fetal Heart Program can make a detailed diagnosis that informs prenatal counseling and care. In partnership with the obstetrician, we support mothers and families in a comprehensive manner to achieve the best possible delivery outcome for mom and cardiac outcome for the baby.

In my research, my colleagues and I are trying to improve outcomes in children with heart disease through multicenter research collaborations. We are also seeking to understand how genetics contributes to the cause of congenital heart disease and how genetics contributes to differences in outcomes between patients with congenital heart disease. Another goal is to understand why babies with congenital heart disease are often born too small and too early.

In my free time, I enjoy relaxing with my family, running and travel.

Clinical Interests

Congenital heart disease; echocardiography; fetal cardiology; Cardiology Consult Service; General Cardiology Outpatient Clinic; Interstage Program

Research Interests

Multicenter clinical studies; perinatal outcomes in congenital heart disease

Clinical Divisions

Fetal Care, Single Ventricular Interstage, Cardiac MRI, Heart

Research Divisions

Cardiology, Heart

Blog Posts

My Locations

My Education

BS: Molecular and Cellular Biology, University of Arizona, Tucson, Arizona, 1991.

MD: Tulane University School of Medicine, New Orleans, Louisiana, 1995.

Residency: University of Arizona Health Sciences Center, Tucson, Arizona, 1998.

Fellowship: Cardiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, 2001.

MS: Clinical Epidemiology and Health Services Research, Wake Forest University School of Medicine, Winston-Salem, North Carolina, 2005.

My Publications

Selected Publication

Effect of fetal hemodynamics on growth in fetuses with single ventricle or transposition of the great arteries. Alsaied, T; Tseng, S; King, E; Hahn, E; Divanovic, A; Habli, M; Cnota, J. Ultrasound in Obstetrics and Gynecology. 2018; 52:479-487.

Preoperative Aortic Arch Size and Late Outcome After Coarctation Repair by Lateral Thoracotomy. Ramachandran, P; Khoury, PR; Beekman, RH; Michelfelder, EC; Manning, PB; Tweddell, JS; Cnota, JF. Annals of Thoracic Surgery. 2018; 106:575-580.

Fetal somatic growth trajectory differs by type of congenital heart disease. Puri, K; Warshak, CR; Habli, MA; Yuan, A; Sahay, RD; King, EC; Divanovic, A; Cnota, JF. Pediatric Research. 2018; 83:669-676.

Relationship of Echocardiographic Z Scores Adjusted for Body Surface Area to Age, Sex, Race, and Ethnicity: The Pediatric Heart Network Normal Echocardiogram Database. Lopez, L; Colan, S; Stylianou, M; Granger, S; Trachtenberg, F; Frommelt, P; Pearson, G; Camarda, J; Cnota, J; Cohen, M; et al. Circulation: Cardiovascular Imaging. 2017; 10.

Hypoplastic left heart syndrome is associated with structural and vascular placental abnormalities and leptin dysregulation. Jones, HN; Olbrych, SK; Smith, KL; Cnota, JF; Habli, M; Ramos-Gonzales, O; Owens, KJ; Hinton, AC; Polzin, WJ; Muglia, LJ; et al. Placenta. 2015; 36:1078-1086.

Somatic growth trajectory in the fetus with hypoplastic left heart syndrome. Cnota, JF; Hangge, PT; Wang, Y; Woo, JG; Hinton, AC; Divanovic, AA; Michelfelder, EC; Hinton, RB. Pediatric Research. 2013; 74:284-289.

Superior cavopulmonary anastomosis timing and outcomes in infants with single ventricle. Cnota, JF; Allen, KR; Colan, S; Covitz, W; Graham, EM; Hehir, DA; Levine, JC; Margossian, R; McCrindle, BW; Minich, LL; et al. Journal of Thoracic and Cardiovascular Surgery. 2013; 145:1288-1296.

Congenital heart disease infant death rates decrease as gestational age advances from 34 to 40 weeks. Cnota, JF; Gupta, R; Michelfelder, EC; Ittenbach, RF. Journal of Pediatrics. 2011; 159:761-765.

Prediction and perinatal management of severely restrictive atrial septum in fetuses with critical left heart obstruction: clinical experience using pulmonary venous Doppler analysis. Divanovic, A; Hor, K; Cnota, J; Hirsch, R; Kinsel-Ziter, M; Michelfelder, E. Journal of Thoracic and Cardiovascular Surgery. 2011; 141:988-994.

Management of Neonates Admitted with Tetralogy of Fallot: Changing Patterns Across the United States. Thangappan, K; Fatuzzo, S; Zafar, F; Winlaw, D; Lehenbauer, D; Batlivala, S; Cnota, JF; Redington, A; Tweddell, JS; Morales, DL S. Annals of Thoracic Surgery. 2021.