Address:

Cardiorespiratory Unit
Nurses Home Level 7
Great Ormond Street Hospital
Great Ormond Street
London
WC1N 3JH


Phone:
020 7405 9200


Web Address:
http://www.ich.ucl.ac.uk/



London - Great Ormond Street Hospital for Children (Profile)

The Cardiorespiratory Unit at Great Ormond Street is responsible for all aspects of the diagnosis, management and treatment of heart conditions in infants, children and adolescents at which point they are transferred to the Grown Up Congenital Heart Unit (GUCH). Our primary function is to provide fully integrated medical, surgical and intensive care services to children with heart disease, with special reference to neonates and young infants.

The expert team have pioneered non-surgical replacement of pulmonary heart valves and play a leading role in developing alternatives to surgery for other heart conditions.

Specialist Services

The Unit is also a national service provider for Complex Tracheal Disease, Extra Corporeal Membrane Oxygenation (ECMO), Heart and Lung Transplantation, Pulmonary Hypertension and Mechanical Heart Support. The services we provide include;

Berlin Heart – Mechanical support
Catheter Laboratory
ECMO
Electrophysiology
Fetal
Inherited cardiovascular disease
Pulmonary Hypertension
Thoracic and chest wall
Tracheal
Transplant

Pulmonary Hypertension

GOSH is the national service provider for children with pulmonary hypertension - a rare lung disorder which sees excessively raised blood pressure in the pulmonary artery. For the benefit of all the children in the UK, the Unit provides state of the art diagnosis, medical treatment and overall care, including psychological and logistical support for those suffering from all types of Pulmonary Hypertension including Idiopathic Pulmonary Hypertension, and Pulmonary Hypertension caused by congenital heart disease, connective tissue disorders, chronic lung disease and other conditions. The service covers England, Wales, Scotland, Northern Ireland, and also cooperate with the Republic of Ireland, in the form of ‘shared care’ with 8 major UK regional hospitals. The service also treats and advises patients from Europe and overseas.

Since setting up the network, quality of life has been improved, and children are integrated rapidly back into society as soon as their condition permits.

Survival has improved.
The children have ready access to all new therapies.
Children deteriorating on maximal medical therapy have rapid access to the Paediatric Thoracic Transplantation Service.
There is equity of care throughout the UK, with no post-code prescribing.
Education of health professionals is ongoing, in order to improve disease recognition and prompt referral.
Research into the clinical management and pathobiology of pulmonary hypertension in childhood has continued.

Transplant

Paediatric Heart Lung Transplant has been performed at Great Ormond Street Hospital for Children NHS Foundation Trust since 1988 conducting over 440 transplants since the unit opened . As one of two cardiac centres performing paediatric cardiac transplant in the UK the team have:

generated excellent and improved clinical results
maximised the use of donors (including marginal and ABO mismatch)
developed innovative methods of bridging to cardiac transplant using ECMO
demonstrated thorough and popular follow-up strategies
built good relationships with Newcastle (the other paediatric Heart Lung Transplant unit)

ECMO

First set up at Great Ormond Street Hospital in 1992, the UK collaborative trial of ECMO demonstrated that ECMO is an effective therapy for neonates with severe respiratory failure. In 1997 the Department of Health funded four centres in England and Scotland to provide a national ECMO service. In 2005 this service was extended to cover the paediatric age range (0-16 years). GOSH is registered with ExtraCorporeal Life Support Organisation (ELSO).

ECMO is used to support patients in the Intensive Care Unit who have severe cardiac and respiratory failure by oxygenating the blood through an artificial heart-lung machine. The ECMO team are responsible for coordinating the treatment of children whilst they are on ECMO, this involves a number of people with specialized skills - cardiac surgeons, an ECMO physician, physiotherapists, perfusionists and nurses.

Berlin Heart - Mechanical Support

GOSH provide a specialist service for mechanical heart support. The Berlin Heart is an extracorporeal, electro-pneumatically driven ventricular assist device (VAD) which is used to support children in end stage heart failure whilst they await a suitable donor heart for transplantation.

Tracheal

Formed in 2001, the Tracheal Service at GOSH has become one of the largest and most successful services in Europe and is a world leader in the field. As the sole national provider, the service manages children with severe tracheal stenosis or malacia and other rare conditions such as laryngotracheal cleft or complex lymphatic anomalies. With a strong record of innovation, the Tracheal team has forged strong links with other units throughout the World. In March 2010 a Europe Wide medical team involving GOSH carried out the World’s first tracheal transplant in a child using the child’s own stem cells to rebuild it.

Thoracic and chest wall service

The thoracic and chest wall service is an integral part of GOSH that has expanded into one of the biggest referral centres in the UK. The service has been at the forefront of 2 techniques that have improved the care delivered to patients: firstly, the introduction of thoracoscopic operations; secondly the minimally invasive NUSS procedure. GOSH treat a wide range of thoracic and chest wall conditions from congenital anomalies to oncological management and from cosmetic surgery to the chest wall. The team aims to continue to provide a service recognised internationally and to continue participating in improvements in the care of children requiring this surgical management.

Catheter laboratory

The purpose of the catheterisation laboratory at GOSH is to gather evidence in the diagnosis of cardiac or pulmonary disease and to carry out interventional procedures for the non-surgical repair of congenital heart defects.

Currently the interventional procedures conducted at GOSH include devices to close holes in the heart, valve replacements or inflated balloons to enlarge narrow vessels.

Electrophysiology

The Electrophysiology (EP) Service offers a full range of diagnostic and therapeutic interventions for primary arrhythmias in children, some of which may be inherited or associated with congenital heart disease. The team at GOSH perform over 100 catheter based EP procedures annually, more than 90 per cent of which are interventional. Diagnostic EP includes non-invasive testing such as continuous ambulatory monitoring, exercise testing and pharmacological assessment testing; there are plans to develop transtelephonic event monitoring. Invasive diagnostic interventions include catheter based electrophysiology testing, implantable loop recorders and insertion of devices.

Interventional EP include catheter-directed radiofrequency or cryoablation therapy for both ventricular and supraventricular arrhythmias. This procedure has a greater than 90 per cent success rate for treatment of tachycardias associated with Wolff-Parkinson-White syndrome as well as refractory cases of paroxysmal supraventricular tachycardia, ectopic atrial tachycardia, and permanent junctional reciprocating tachycardia.

More advanced mapping and ablation technologies are available for more complex arrhythmias, including ventricular tachycardia and post operative scar related arrhythmias. Implantable device therapies are also available, including implantation of pacemakers, single, dual and biventricular systems as well as defibrillators.

Inherited cardiovascular disease

The Inherited Cardiovascular Diseases Service is a multidisciplinary service specialising in the diagnosis, evaluation and management of young people with inherited cardiac conditions.

The service is part of the Cardiology Department at GOSH and has close clinical links with University College London (UCL), the Cardiology in the Young service at the Heart Hospital, University College London Hospitals and other adult inherited cardiac conditions services in London and the UK.

Fetal

A Fetal Cardiac Service providing a tertiary referral service for the diagnosis, counselling and management of prenatal cardiac disease exists at GOSH. There is provision of an ‘Early Fetal’ cardiac imaging service with the aim of providing early cardiac diagnosis to improve the quality and delivery of care to these patients

Contact Details

General enquiries:

Cardiorespiratory Unit
Nurses Home Level 7
Great Ormond Street Hospital
Great Ormond Street
London
WC1N 3JH

Telephone number: 020 7405 9200
Fax number: 020 7829 8643

http://www.gosh.nhs.uk/medical-conditions/clinical-specialties/cardiology-information-for-parents-and-visitors/


Medical Staff

Consultant Cardiac SurgeonsClinical Specialty/Other Detail
Professor Martin ElliottCo-Medical Director, Director of Tracheal

Surgical procedures include paediatric, neonatal and infant simple and complex cardiothoracic surgery, complex tracheal disease in children and thoracic and chest wall surgery.

Mr Victor TsangLead Clinician – Cardiothoracic Surgery

Surgical procedures include paediatric, neonatal and infant simple and complex cardiothoracic surgery.

Mr Tan-Yen HsiaLead Surgeon: Mechanical Support

Surgical treatment of congenital heart defects in children and adults.

Mechanical heart support and heart transplantation for end stage heart failure.

Mr Martin KostolnyLead Surgeon: Neonatal Cardiac Surgery

Surgical procedures include paediatric, neonatal and infant simple and complex cardiothoracic surgery.

Mr Nagarajan MuthialuPaediatric Cardiac Surgeon

complex cardiothoracic surgery, complex tracheal disease in children and thoracic and chest wall surgery.

Consultant CardiologistsClinical Specialty/Other Detail
Dr Jasveer Mangat Electrophysiology
Dr Michael BurchDirector of Transplantation
Dr Graham DerrickInterventional Cardiologist
Dr Matthew FentonHeart Transplant
Dr Alessandro GiardiniPaediatric Cardiologist
Dr Marina HughesClinical Lead Cardiac MRI
Dr Sachin KhambadkoneInterventional Cardiologist, Consultant in Paediatric and Adolescent Cardiology
Dr Martin LoweElectrophysiology
Dr Jan Marek Director of Echocardiography
Dr Philip ReesPaediatric Cardiologist
Dr Helen SpencerLung Transplant
Dr Ingram Schulze-NeickDirector of the National Service of Pulmonary Hypertension in Children
Dr Shankar SridharanFetal Cardiologist
Dr Ian SullivanConsultant Cardiologist – Fetal
Professor Andrew TaylorProfessor of Cardiovascular Imaging
Director – Centre for Cardiovascular MR
Dr Robert YatesConsultant Paediatric Cardiologist
Dr Rachel Andrews Heart Transplant
Dr Paul Aurora Lung Transplant

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