About the Paediatric Cardiology department

The Paediatric Cardiology department at Great Ormond Street Hospital (GOSH) in London provides medical and surgical treatment to children with congenital and acquired heart disease.

Children are treated from birth until adolescence when they are transferred to the Grown Up Congenital Heart Unit (GUCH). The team provides a tertiary referral service both nationally and internationally.

We are the only paediatric hospital in the UK to offer the full range of National Commissioning Group (NCG) cardiac services. These are ECMO, bridge to transplant, heart transplant, tracheal services and pulmonary hypertension. The hospital is the largest centre for child heart surgery in the UK and one of the largest centres for heart transplantation in the world.

As well as conducting over 500 heart and lung transplants since the unit opened, our 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.

We recognise that many patients with heart problems require the expert care of different clinical teams. We have over 50 clinical specialities based under one roof at the hospital.

The paediatric cardiology department provides a complete spectrum of medical and surgical services and aims to provide care for children in a child-friendly environment with internationally established evidence-based standards. Our aim is to provide close collaboration between clinical services and academia. In order to achieve this, the unit will endeavour to provide patient pathways and efficient and timely access to care in line with all government access and choice targets.  The paediatric cardiology team strive to ensure that patient views are reflected in service development and policy making.

The purpose of the catheterisation laboratory 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 include devices to close holes in the heart, valve replacements or inflated balloons to enlarge narrow vessels.

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 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.

A weekly outpatient clinic is attended by approximately 15 patients per week.

The Fetal Cardiac Service provides services for the diagnosis, counselling and management of prenatal cardiac disease. The service has a unique role as an interface between the paediatric cardiothoracic services at Great Ormond Street Hospital (GOSH) and obstetric and maternal health units throughout London and across the UK.

We aim to put the patient at the centre of everything that we do. As the main providers of fetal cardiac services for the North Thames, we also cover a much wider population base and are committed to developing networks to co-locate fetal and paediatric practice. This is to ensure holistic, seemless care from the moment of antenatal diagnosis, up through childhood into adolescence.

We are based at two sites: at GOSH and with an integrated fetal cardiology-fetal medicine service at University College Hospital London (UCLH).

We have great clinical expertise in all forms of prenatal cardiac disease and the service dovetails seamlessly with the neonatal cardiac surgical and paediatric cardiac programmes at GOSH.

The diagnosis of heart disease in pregnancy is a very emotive area, so we adopt a flexible working practice and are always able to see an urgent referral the same day, seven days/week.

The on-site services we provide at GOSH include:

• four fetal cardiac clinics – weeky
• one ‘early gestation’ fetal cardiac clinic – weekly
• fetal cardiac surgical clinic (prenatal counselling)

Off-site services we provide are:We also provide 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.

• dedicated joint fetal medicine/fetal cardiology clinic at UCLH – weekly
• outreach fetal clinics at the Whittington and Addenbrooke Hospitals

We have a strong cardiac liaison nurse service to help and support families. The GOSH fetal cardiac parents group is a day-course we have developed for families with pregnancies complicated by heart disease.

The Inherited Cardiovascular Diseases Service is a multidisciplinary service specialising in the diagnosis, evaluation and management of young people with inherited cardiac conditions. It is the only unit in the UK dedicated to the evaluation and treatment of the full range of paediatric inherited cardiovascular conditions (ICCs).

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.