Congenital heart disease (CHD) affects 8 in 1000 children and is the most common reason for serious illness in newborns and is responsible for a significant part of the work carried out in specialist children’s hospitals. Management of these children relies heavily on technology from advanced imaging and monitoring tools, to a range of technologies and devises used for key-hole interventions and surgery. Despite this, the technologies used in this group have been developed for adults. Developing technologies that are designed to meet the needs of children would therefore have substantial clinical impact to help improve diagnosis and treatment.
Our strategy focuses on the development and adoption of novel imaging and computational modelling technologies for diagnosis and treatment of children with congenital heart disease. The strategy incorporates a broad scope, from pregnancy and the developing fetus, through to children and young adults with congenital heart disease.
Some of the key areas are as follows:
- Assessment of the cardiovascular system of the developing foetus, allowing for both greater understanding and prediction of risks of subjects born prematurely, and the planning of the optimal timing and strategy of interventions when managing congenital conditions. This utilises novel imaging technologies such as fetal MRI and the development of novel ultrasound imaging technology within a related fetal screening program (iFIND study). Exploiting synergies between roboticassisted imaging, multi-transducer ultrasound and machine learning to enable ubiquitous expert-like fetal screening, including fetal cardiac screening contributes to advancing our fetal cardiovascular work. By utilizing these novel methodologies we aim to assess the influence of maternal factors (i.e. diabetes, obesity or hypertension) and the impact of maternal interventions (such as hyper-oxygenation) or gestational insults (premature birth, intrauterine growth restriction) on the cardiovascular system of the developing foetus and infant.
- Development of MRI guided cardiac catheterisation in children with congenital heart disease. These reduce or eliminate x-ray radiation dose and improve outcome by allowing the cardiovascular structures to be visualised during the procedure.
- Development of new technologies for better visualisation and understanding of complex congenital heart disease in children. These include our work in 3D printing and new work on holographic visualisation, analysis and surgery planning.
- A number of programs to better understand the physiology of congenital heart disease particularly in complex patients such as those with Fontan circulation. This includes new imaging methods including exercise MRI, and computational modelling techniques. These studies will lead to identification of better treatments and improvement of the morbidity and long term survival of these children.
- Validation of novel imaging techniques and development of protocols for detailed foetal cardiovascular and haemodynamic assessment in normal hearts and congenital heart disease.