News archive 2003
World first: London team pioneers new technique for children born with heart defects05 Dec 2003, PR 80/03
The success of a new way of diagnosing and treating children born with congenital heart abnormalities – without exposing them to potentially harmful x-rays – is revealed in a paper to be published in The Lancet on Saturday 6 December.
In a world first, a team of doctors and scientists from Guy’s and St Thomas’ Hospital NHS Trust and King’s College London has used magnetic resonance imaging (MRI) to carry out a procedure called cardiac catheterisation.
This procedure, in which a thin plastic tube (or catheter) is inserted into a vein or artery and then guided into the correct position in the heart, is usually performed with x-rays to guide the catheter.
The benefits of using MRI for the procedure are threefold:
* Reduction of potential risks of radiation from x-rays.
* Extra information such as accurate quantification of blood flow in the heart and lungs, and the three-dimensional structure of the heart.
* The team can see the heart itself during the procedure whereas traditional x-ray methods only show the catheter.
Cardiac catheterisation is an important procedure, especially in planning surgery to correct heart defects – six in 1,000 babies are born with congenital heart disease.
But the risk of developing a solid cancer tumour after x-ray guided cardiac catheterisation is 1 in 2,500 for an adult, according to the UK National Radiological Protection Board, and the risk increases to 1 in 1,000 for a five-year-old – the younger the child, the greater the risk.
This week’s paper in The Lancet warns: ‘As a significant number of children with congenital heart disease undergo repeated x-ray guided catheterisations, the risk is likely to be multiplied.’
The extra information on blood flow and heart wall movement enables a more accurate diagnosis of the patient’s condition and the visualisation of the heart during the procedure is helpful in catheter manipulation and tracking. Imaging techniques used during these procedures have not, until now, kept up with improvements and complexities of the catheters themselves.
The London team have now used a new Philips XMR system, MRI in tandem with x-rays, to perform catheterisations on 33 patients, mainly children, since April 2002 – the research paper in The Lancet details the first 16.
Dr Reza Razavi, Director of Cardiac MRI at Guy’s and St Thomas’ Hospital NHS Trust, is lead author of the paper - Magnetic resonance guided cardiac catheterisation in children and adults with congenital heart disease.
He said: ‘MRI can overcome some of the disadvantages of x-rays such as poor delineation of anatomical structures and radiation exposure. Performing cardiac catheterisation under MR guidance allows greater access to physiological and anatomical information.
‘We were able to successfully visualise and manipulate catheters under MR guidance in nearly all the patients. In some of the patients the whole procedure was done without using any x-ray radiation, thus demonstrating for the first time that it is possible to perform diagnostic cardiac catheterisation entirely under MR guidance.’
Derek Hill, a Reader in Medical Imaging at King’s College London, said: ‘MRI gives us fantastic pictures of the heart but it is only now that we can use it in real time during interventions. We’ve shown that MRI can replace x-ray imaging in assessing and treating children with heart defects, and we believe this will soon be extended to adults with heart rhythm abnormalities and coronary artery disease.’
Notes to editors
Dr Reza Razavi, Director of Cardiac MRI at Guy’s and St Thomas’ Hospital NHS Trust, and Derek Hill, a Reader in Medical Imaging from the Guy’s, King’s & St Thomas’ School of Medicine at King’s College London, are both available for interview – visual images are available and a limited number of filming requests can also be accommodated.
King’s College London is one of the oldest and largest colleges of the University of London with some 13,400 undergraduate students and more than 5,000 postgraduates in ten schools of study. It is in the top group of five universities for research earnings and has an annual turnover of over £320 million and research income from grants and contracts in excess of £90 million (2001-2002). King’s is a member of the Russell Group, a coalition of the UK’s major research-based universities.
Guy’s and St Thomas’ Hospital NHS Trust opens a brand new, purpose-built children’s hospital on the St Thomas’ site next year – providing state-of-the-art care in a child-friendly environment – and intends to have an equivalent treatment facility to continue this pioneering MRI work.
Melanie Gardner, Senior Public Relations Officer, King’s College London (tel: 020-7848 3073, email: firstname.lastname@example.org).
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