World first: unique method of treating children born with heart defects - results announced
15 Dec 2002, PR 57/02 Doctors and scientists have today reported on a successful new way of diagnosing and treating children born with heart defects. Every year at least eight out of every 1,000 babies born in the UK have a heart defect and about half these will require treatment. As these children grow up they often require further procedures going on into their adult life.
Diagnosis and treatment of patients with congenital heart defects typically involves a procedure called a 'cardiac catheterisation', where a thin plastic catheter is inserted into an artery or vein in the neck or leg and then advanced into the heart. X-rays are normally used to guide the catheter, but only provide information about the position of the catheter and not the shape of the surface of the heart. The use of x-rays, especially in children, has harmful effects that can lead to problems later in life.
The team of researchers at King's College London and Guy's & St Thomas' Hospital NHS Trust, have carried out a trial on 12 children with congenital heart disease using a new XMR facility that integrates magnetic resonance imaging (MRI) with conventional x-rays, to help diagnosis and deliver treatment more effectively.
Dr Derek Hill, Reader in Medical Imaging Science, Guy's, King's & St Thomas' School of Medicine, King's College London, describes:
'It's all about creating a better picture of what's going on inside the child's heart. At the moment X-rays alone are used to guide the catheters into and around the heart. Doctors can get a reasonable idea of the catheter's position, but have little idea about the shape of the inner surface of the heart where they might want to place the catheter or other device.
'This is where the MRI part of the XMR system can help. Our XMR trial has been successful in giving us a three-dimensional picture of the heart and a much better idea of how well blood is being pumped through it. It's like being able to see the model of a house rather than a floor plan.'
Dr Reza Razavi, Director of Cardiac MRI Guy's & St Thomas' Hospital NHS Trust, explains:
'We carried out cardiac catheterisation on 12 children in total. Eight underwent the procedure for diagnosis, two had a heart defect repaired with a device and two were treated with radiofrequency energy to correct an abnormally fast heartbeat. In each case we used MRI to guide our actions and help plan the procedure.
'The new XMR system gives us three dimensional imaging, a way of measuring blood flow and tells us how the heart is beating - all extremely useful clinical information that helps us treat patients with greater accuracy and efficiency. X-rays, alone don't offer these benefits. The use of this system also significantly reduces the x-ray radiation dose to the patient, which is particularly important in children.'
The XMR facility located at Guy's Hospital was supplied by Philips Medical Systems. It is the first of its type in the UK, and the first in the world to carry out these pioneering procedures on children with heart defects. A patient being treated can be moved seamlessly between the x-ray and MRI imaging systems in a few seconds. Catheters can be manipulated within the heart and major blood vessels using either the MRI or x-rays for guidance.
The team at Guy's have already carried out one diagnostic procedure on a patient without using x-rays. But, at the moment, it is usually necessary to use both imaging systems, as the specialised devices that need to be inserted into the heart are not suitable for use inside the MRI scanner. As new devices become available, and the team gains experience of the new technology, they plan to carry out more and more of the procedure using MRI alone.
The system was funded by grants from the Higher Education Funding Council for England (HEFCE) and the Guy's and St Thomas' Charitable Foundation.
Dr Edward Baker, Senior Lecturer, Guy's King's & St Thomas' School of Medicine, King's College London, Honorary Consultant Paediatric Cardiologist, Guy's & St Thomas' Hospital NHS Trust said:
'The success of our XMR facility is likely to lead to all major hospitals performing most cardiac catheter procedures on children using MRI guidance within a few years. This will reduce, or even eliminate the risks from x-rays, and greatly improve the quality of information about the heart available to the doctors treating these sick children.'Notes to editors Images - are available at: http://www-ipg.umds.ac.uk/cmrii/introduction.htm (Picture Gallery)
King's College London is one of the oldest and largest colleges of the University of London with some 12,400 undergraduate students and over 4,700 postgraduates in ten schools of study. The College had 24 of its subject-areas awarded the highest rating of 5* and 5 for research quality, demonstrating excellence at an international level. It is in the top group of five universities for research earnings and has an annual turnover of over £300 million and research income from grants and contracts in excess of £90 million (2001-2002).Further informationPublic Relations Department
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