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Personalising surgery for babies born with a serious heart disease

Posted on 05/11/2015

ActionMedicalResearch_logoA team of King’s College London academics led by Dr Pablo Lamata, a lecturer in the Department of Biomedical Engineering, has been awarded a research grant to improve outcomes for babies born with a congenital heart disease. The team will be modelling the hearts of children with hypoplastic left heart syndrome (HLHS), making it easier for doctors to understand the cardiac anatomy and to plan the multiple surgical interventions required by HLHS patients over the early years of their lives. The £100,000 funded has been granted by Action Medical Research.

HLHS is a condition that affects around one in every five thousand babies. It results in a heart that is underdeveloped on the left-hand side and therefore unable to pump sufficient blood around the body. Babies with HLHS have problems breathing, a weak pulse and a blue tinge to their skin. Forty years ago, babies with the condition normally died within weeks of birth; but now, improvements in surgery have given them a much better chance of surviving to live a relatively normal life. Unfortunately, however, some babies still lose their lives to HLHS and others will have ongoing health problems into adulthood. More knowledge about the surgical interventions most commonly used would likely improve future outcomes for these children.

“Babies with HLHS normally have three complex operations – the first when they’re less than two weeks old,” says Dr Lamata. “Planning these operations is difficult, because there’s little evidence as to exactly which surgical technique would work best for each child at each stage. Research into the pros and cons of each technique is needed urgently.”

Dr Lamata and his team in the Division of Imaging Sciences & Biomedical Engineering, is conducting this research through building detailed, three-dimensional virtual models of the hearts of more than 150 children affected by HLHS. This is a large dataset for such a rare condition and will be made possible through the use of clinical records of MRI scans of babies from the Evelina Children’s Hospital and Boston Children’s Hospital. Drawing on this data and using cutting-edge computer modelling techniques, the team will create an avatar of each baby’s heart and its major vessel, the aorta.

View video showing an illustration of the change in shape of the cardiac chamber.

“By comparing virtual 3D models of babies’ hearts before and after surgery, we hope to reveal the benefits and drawbacks of different surgical techniques,” says Dr Lamata. “We also hope to develop ways to predict how each surgical approach is likely to benefit individual babies over the long term.”

Computer modelling of the cardiovascular systems of babies with HLHS will offer doctors a clearer picture of the condition of each patient’s heart at birth, helping them to make decisions about the treatments they use; it will allow them to monitor how the baby’s heart is responding to each stage of surgery; and it also has the potential to spare these children from invasive, catheterised interventions, enabling doctors remotely to measure blood pressure and to observe blood flow within the heart.

“Ultimately, we hope our work will give surgeons the tools they need to select the best treatment plan for each baby,” Dr Lamata concludes. “This could improve babies’ chances of surviving and having the best possible quality of life during childhood and beyond.”

Action Medical Research. and Great Ormond Street Hospital Children's Charity are jointly funding this research.

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