Improving diagnosis of heart defects before birth
12 September 2018
Thanks to the generosity of donors, diagnosing babies with congenital heart disease has dramatically improved with the upgrade of a new cardiac MRI reporting workstation.
Congenital heart disease is a term used for a range of defects presenting at birth that affect the normal workings of a heart. It is one of the most common types of birth defect, affecting up to nine in every 1,000 babies born in the UK. Types of heart defect can range from blocked or narrowed valves to misplaced arteries.
‘In most cases, if we were to do nothing, the child would not have the chance to have a normal life,’ explains Dr Owen Miller, Paediatric Cardiologist at Evelina London.
World leaders in the field
‘We do fetal screening to look for abnormalities in the unborn fetus – that is something that was pioneered here at Guy’s and St Thomas’ about 30 years ago,’ says Dr Miller. ‘We’re world leaders in fetal diagnosis.’
‘Confirmation after birth uses both ultrasound (echocardiography) and increasingly we use MRI scans.’
The MRI workstation is used to process the 3D imaging of a heart to detect any abnormalities seen with an MRI scanner. The data is then transferred to a computer and analysed by the cardiology team to assess whether surgery is required, and if so, what type is needed and at what stage (immediately after birth or later in the child’s development).
‘It’s a matter of rearranging the heart if possible by corrective surgery to make it “more normal” and, if that’s not possible, to make the circulation cope better with the abnormality,’ describes Dr Miller.
‘Some babies require surgery in the first days of life, some later in infancy – depending on the type of problem we’re dealing with.’
Speeding up diagnosis
The previous workstation available to Cardiology shared its workspace with the radiology team, which meant there was not enough time or physical space for the volume of images being scanned.
Funding was therefore urgently needed to improve the efficiency of the process. Thanks to generous donations, the new workstation now located in Cardiology means that reports come back quicker, families get their results faster and patients can be operated on sooner.
‘It is a more holistic approach and allows the cardiologists and surgeons to see all of the data in one place so that, if we have questions – which we often do before surgery – we can access someone’s MRI scan much easier,’ says Dr Miller.
‘Not only this, but the quality of data we can give to the surgeons before the operation has significantly increased.’
Although the workstation is in daily and constant use by our cardiologists for diagnosis and management, it is also a valuable resource for teaching and training junior doctors and staff.
‘We now do routine 3D imaging on many more children whereas previously this was reserved for certain patients,’ says Dr Miller.
‘One of the big new developments is that we now have the capacity to use a 3D printer to print models of the abnormal heart to guide the surgeon and teach trainees.’
The workstation’s immediate and long-term benefits to patients and their families demonstrate how important donations have been for the future treatment of young patients born with often life-threatening or life-limiting heart disease.