Compassionate Care for Our Youngest Patients

The youngest cardiac patients, from newborn infants to adolescents, require expert paediatric cardiologists and experienced pediatric support staff. The pediatric cardiology team at Health City includes a pediatric cardiologist, pediatric intensivists, nurses, and anesthesiologists that provide children with multidisciplinary care. Our specialists are devoted to diagnosing, treating and preventing heart and blood vessel disease in children, including structural, functional, and rhythm (heartbeat) problems. They utilize specialized diagnostic equipment to evaluate and treat cardiac conditions in children that deliver the least invasive and most efficient methods of treatment possible.

Invasive Hybrid Cath Lab Services

Our state-of-the-art Hybrid Cath Lab services are designed for the precise diagnosis and treatment of children with congenital heart defects. Congenital heart disease is the term for an abnormality in the heart's structure, present at birth. It is the most common individual type of birth defect, affecting nearly one out of every 100 babies born. A defect results when the heart or blood vessels near the heart do not develop normally in utero. Our expert team can usually diagnose this disease with minimally invasive approaches.

Our pediatric cardiologists treat many of these defects with minimally invasive methods and specialized devices, balloons, and stents. Comprehensive diagnostics and advanced medical technology enable us to treat these defects without the need for surgery in many cases. This reduces the risks and improves the outcome for our young patients.

Health City's Pediatric Cath Lab Services include:

Diagnostic Catheterisation
This procedure provides important information for the diagnosis of congenital heart defects and other functional cardiac issues. Conducted in our Hybrid Cathlab, using the most advanced medical equipment available, our pediatric cardiologists insert a small plastic tube called a catheter into the heart by way of the leg or arm. This procedure is done under deep sleep and the child will not feel any pain. The test records pressure and oxygen levels in different areas of the heart. Sometimes a small amount of an x-ray dye is injected to record a video of the heart function and coronary arteries.
Device Closure Of Atrial Septal Defect, Ventricular Septal Defects And Patent Ductus Arteriosus
Device closure of atrial septal defect, ventricular septal defects and patent ductus arteriosus are procedures used to close various types of holes in a baby’s heart that prevent adequate circulation between the lungs and the heart. Our pediatric cardiologists close the holes without surgery, in our Hybrid Cathlab. Using cardiac catheterization, cardiologists insert a device into the opening in the heart in order to close the hole, promote correct circulation, and restore proper functioning of the heart. It is conducted under deep sleep and the child will not feel any pain.

Device Closure of Atrial Septal Defect (ASD)
This is a hole in the two upper chambers of the heart – the wall that separates the heart’s left and right sides. This defect allows oxygen-rich blood to leak into the oxygen-poor blood chambers in the heart. In a child with ASD, blood can travel across the hole from the left upper heart chamber (left atrium) to the right upper chamber (right atrium) and out into the arteries of the lungs. If the ASD is large, the extra blood being pumped into the lungs’ arteries causes the heart and lungs to work harder and the lung arteries may gradually incur damage. Small ASDs that are discovered in infants often close or narrow on their own. However, in cases in which the hole does not close, our pediatric cardiologists use tiny devices to close it and return the heart to proper functioning.
Device Closure of Ventricular Septal Defects
This is a hole in the wall separating the two lower chambers of the heart. In normal development, the wall between the chambers closes before the fetus is born, so that by birth, oxygen-rich blood is kept from mixing with oxygen-poor blood. When the hole does not close, it may cause higher pressure in the heart or reduced oxygen to the body. In cases where the congenital heart defect prevents proper heart function, our pediatric cardiologists insert a device that closes the hole.
Patent Ductus Arteriosus
This congenital heart defect is a tube that connects the aorta to the pulmonary artery.  When large enough and left untreated, can allow poorly oxygenated blood to flow in the wrong direction, weakening the heart muscle and causing heart failure and other complications. Our pediatric cardiologists can close the hole without surgery by inserting a device using cardiac catheterization.
Balloon Dilatation And Stenting Of Tight Valves And Blood Vessels
Balloon dilatation and stenting of tight valves and blood vessels are procedures that improve blood supply to a child’s heart. In cases where the blood supply to the heart is restricted, these procedures can widen the narrowed areas and improve blood flow. In balloon dilatation, special tubing with an attached deflated balloon is threaded up to the coronary arteries. The balloon is inflated to widen blocked areas where blood flow to the heart muscle has been reduced or blocked. Frequently, a stent is then implanted where the narrowing occurred, to help prop the artery open and decrease the chance of another blockage.
Balloon Atrial Septostomy
Balloon atrial septostomy is a procedure that improves the heart function, resulting in the child’s heart making efficient use of 98%-99% of the oxygen uptake by the body. In some circumstances, it is necessary to create a larger hole between the walls of the heart’s upper chambers (the right and left atrium) so that this can occur. Special balloons and blade catheters are used to create these openings to increase blood flow between the heart’s upper chambers, thereby improving oxygen uptake. This procedure is performed in our Hybrid Cathlab and often prevents the need for surgery.
Coil Embolisation Of Collaterals
Coil embolisation of collaterals is a technique that uses a coil to remedy blood vessels that may be affecting the function of the heart. It is a catheter-based procedure that allows precise closure of abnormal blood flow in a blood vessel. A catheter with a metallic coil is inserted into an artery and advanced to the abnormal blood vessel. Once properly positioned, the metal coil is released, obstructing the abnormal blood flow beyond the coil. Eventually a scar will form, creating a permanent seal.
Interventions for ACHD (Adult Congenital Heart Disease)
Congenital Heart Disease can sometimes manifest for the first time in adult life. One of the most common ACHDs is atrial septal defect and majority of them can be closed successfully by occluders in the cardiac cath lab. Other congenital lesions like coarctation can sometimes present in adulthood and can be dilated with specific stents. Rarely young adults may present with stroke of unknown etiology and may benefit by transcatheter closure of patent foramen ovale to prevent future stroke recurrence.

Adults may also come back with residual lesions from their previously corrected congenital heart disease. Defects like residual VSD, paravalvar leak can be successfully treated by transcatheter interventions. Transcatheter pulmonary valve implantation is slowly becoming the procedure of choice in young adults who have severe regurgitation post repair of Tetralogy of Fallot.

Noninvasive Services

Congenital heart disease is the term for an abnormality in the heart's structure, present at birth. It is the most common individual type of birth defect, affecting nearly one out of every 100 babies born. A defect results when the heart or blood vessels near the heart do not develop normally in utero. Our pediatric cardiologists have access to the most advanced cardiac radiology services to help diagnose and treat a wide variety of heart conditions and other structural and functional heart diseases using minimally invasive procedures.

Our services related to congenital heart disease and other structural and functional heart diseases include:

Transthoracic Echocardiography And Doppler Technology
Transthoracic echocardiography
These are noninvasive diagnostic tools used to detect congenital heart disease, problems with heart valves, structural and functional disease of the heart, and to conduct check-ups after heart surgery. Most children with heart defects need periodic heart checkups. Transthoracic echocardiography (TTE) is the most commonly performed exam. Performed via the top of the skin of the chest, this ultrasound uses sound waves to create an image of the heart. These images enable the pediatric cardiologist to evaluate the function of both sides of the heart, performance of the valves and strength of the heart wall.
Doppler
This is an ultrasound technology that can sometimes detect heart defects that other diagnostic tools cannot. The 2-D and color-flow Doppler echocardiograms we utilize can show the origins of the coronary arteries and detect a wide variety of potentially life-threatening congenital anomalies.
Transesophageal Echocardiography
Transesophageal echocardiography (TEE): This is a procedure that uses high-frequency sound waves (ultrasound) to make detailed pictures of the heart and the arteries that lead to and from it. The mechanism that produces the sound waves is attached to a thin tube that is passed through the mouth, down the throat and into the esophagus. Because the esophagus is so close to the upper chambers of the heart, very clear images of those heart structures and valves can be obtained. Your childwill be asleep during this procedure and will not feel any pain or discomfort.
ECG And Holter Monitoring
ECG and holter monitors: these are small, battery-operated, portable devices worn by a cardiac patient during daily activities, so that the heart’s electrical activity can be monitored and recorded continuously. These digital devices are used to diagnose various types of electrical and functional heart conditions including cardiomyopathy. The pediatric cardiologist will educate parents about how to use these devices so that the child’s cardiac function can be recorded during different times of day and levels of activity.
Tilt Table Test
Tilt table testing: If a child experiences f frequent fainting or lightheaded spells, a tilt table may be used to diagnose the cause. This test is conducted to measure blood pressure and heart rate. The child lies on a table that is slowly tilted upward so that the head is elevated 60 to 80 degrees above the rest of the body. A nurse or technician keeps track of the child’s blood pressure and heart rate (pulse) to see how they change during the test and respond to the force of gravity. Parents can stay with a child during the test to provide reassurance.
Cardiac Radiology Services: X-Ray, Cardiac CT And Cardiac MRI
Chest x-ray
This is a basic imaging test that provides the pediatric cardiologist with information about the size and shape of the child’s heart. The amount of radiation from a chest x-ray is extremely small and does not cause any long-term side effects.
Cardiac CT (computed tomography) scans
This is an imaging test that uses CT technology to visualize the heart anatomy, coronary circulation, and great vessels which includes the aorta, pulmonary veins, and arteries. The test may require a small IV to be inserted into the child’s hand in order to inject a dye that will better elucidate the images. Numbing solution will be rubbed on the hand before the IV insertion, so the child will not experience any pain.
Cardiac MRI (magnetic resonance imaging)
This is a noninvasive imaging procedure that uses magnetic technology, not radiation, to create detailed images of the heart. A pediatric cardiologist may order an MRI to evaluate the anatomy and function of the child’s heart, major vessels, and the outside lining of the heart. The procedure provides the child’s heart team with a series of high-resolution images of the moving heart and blood vessels, so they can see how the heart looks and functions. An MRI can detect congenital heart disease, coronary artery disease, pericardial disease, cardiac tumors, heart valve disease, and heart muscle disease. The patient lies on a platform that slides into a large tube. This is a loud test, so patients are usually given headphones that play music of their choice. Some patients feel claustrophobic due to the close quarters of the tube, so if necessary, light sedation is administered.
Fetal Echocardiography
Fetal echocardiography is a test similar to an ultrasound. It is usually done during the second trimester of pregnancy when the woman is about 16 – 22 weeks pregnant. The exam uses sound waves that “echo” off the structures of the fetus’s heart. A machine analyzes these sound waves and creates a picture, or echocardiogram, of their heart’s interior. This image provides information on how your baby’s heart formed and whether it’s working properly. It also enables your doctor to see the blood flow through the fetus’s heart. This in-depth look allows your doctor to find any abnormalities in the baby’s blood flow or heartbeat.

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