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Leicester - Glenfield Hospital (Profile)
Our comprehensive congenital cardiac service integrates care from fetus to late adult life. Our program is designed to respect the varying needs of different age-groups. We are fortunate in that our unit is supported by all regional adult and paediatric sub-specialty services on-site. Our unit comprises adjacent but separate paediatric, adolescent and adult inpatient and outpatient facilities
The East Midlands Congenital Heart Centre is situated at Leicester’s Glenfield Hospital, which is part of the University Hospitals of Leicester NHS Trust congruent with Leicester’s large adult Cardiothoracic Service. With our comprehensive facilities we are able provide integrated care for patients with congenital heart disease from before birth throughout their lives. We have a close working relationship with the local and regional Fetal Medicine Units and with the neonatal, general paediatric and paediatric surgical units at the Leicester Royal Infirmary (approx 4 miles away). In addition we work closely with our adult Cardiologists, especially in for patients with complex arrhythmias.
The Children’s Ward, Ward 30, has 14 beds, in a mixture of cubicle and open ward spaces. There are both indoor and outdoor play areas and dedicated play specialists. Part of the ward is set-aside for teenagers. Family accommodation is available immediately adjacent to ward 30 and the paediatric intensive care unit, as well as elsewhere on site.
Adults with congenital heart disease (ACHD, also known as GUCH – Grown Up Congenital Heart patients) are admitted to the adjacent adult cardiac ward.
The paediatric intensive care unit has 12 beds and is managed by a team of paediatric intensive care specialists. The whole team of Surgeons, Cardiologists and Intensivists do a joint morning ward round. Following surgery, adults are admitted to the adult cardiac surgical intensive care unit.
Our purpose built Congenital cardiac outpatients and non-invasive investigations facility has been set up to allow optimal provision of our integrated digital echocardiography service, as well as the full range of other cardiac physiological investigation. We have a dedicated biplane cardiac catheter laboratory for congenital procedures alongside a further four single plane catheter labs and 2 ‘state of the art’ cardiac electrophysiology laboratories. All of these areas are staffed by trained Children’s nurses as required. Parental and patient support is coordinated by our expert team of Cardiac Liaison Nurses, of whom there are currently four who provide fetal, paediatric and transition support and two supporting the ACHD service.
The unit also receives strong support from our local patient/parent charity and support groups http://www.heartlink-glenfield.org.uk and http://www.keepthebeat.co.uk . Our 2011 PICU expansion was funded by a grant of £300,000 from the Thomas Cook Children’s Charity.
Leicester is the largest ECMO (Extra-corporeal Membrane Oxygenation; total life support) centre in the world and provides the majority of the UK’s ECMO, with about 100 paediatric cases annually. It is the only centre that provides ECMO for all ages; from newborns to adults. Hence we are able to support complex thoracic (chest) surgery in children, especially in those who also have cardiac problems, as well as cardiac surgery in children whose reduced heart or lung function makes them otherwise poor candidates for surgery.
The full range of interventional cardiac catheter procedures are performed including device closure of atrial and ventricular septal defects, percutaneous valve implantation, stenting and complex multi-operator and hybrid procedures. A comprehensive invasive electrophysiological (arrhythmia) service runs in close collaboration with the ‘acquired’ adult heart disease service and there is also an active tertiary fetal cardiac service.
We have excellent cross sectional cardiac imaging facilities with both high resolution CT and MRI scanning facilities used routinely for infants, children and adults with congenital heart disease.
There is an active research programme; not only alongside our ECMO programme, but in other areas as well. We have a large British Heart Foundation funded research project into the genetic causes of congenital heart disease, and several ongoing pharmacology projects and drug trials for children with heart disease.
We currently have 3 congenital cardiac surgeons; Mr Giles Peek, Mr Attilio Lotto, and Mr Simone Speggiorin who operate on both children and adults with congenital heart disease. They also undertake a significant amount of paediatric thoracic surgery, and ECMO. We will be advertising for a fourth congenital heart surgeon as case load demands. We have one Paediatric Cardiac Surgical fellow, 3 ECMO fellows and a surgical SHO.
At present we have 8 congenital cardiologists, 6 of whom practice general paediatric cardiology but also sub specialise in their particular areas of expertise, and two (Dr Aidan Bolger and Dr Simon McDonald), who solely care for adults with congenital heart disease. Dr Abdul Duke is our lead interventionist and also specialises in arrhythmia work along with Dr Shankar Sadagopan. Dr Frances Bu’Lock also cares for adults with congenital heart disease, and Dr Bu’Lock, Dr Suhair Shebani and Dr Linter provide our tertiary fetal cardiac service. Dr’s Demetris Taliotis, Dr Shankar Sadagopan and Dr Simon McDonald also provide interventional cardiology. We are currently training 4 dedicated paediatric cardiology specialist registrars (who also rotate to Birmingham Children’s Hospital at times) and two paediatric registrars receiving ‘special interest training in cardiology.