Congenital heart diseses are the most common congenital malformations: 8 out of every 1,000 children born in the world suffer from them. In Catalonia alone, each year 600 children are born with congenital heart disease, of whom around 25% will require surgery, most of them before they reach the age of one. Knowing the exact physiology of each patient is crucial to improving the diagnosis and surgical treatment of congenital heart disease.

Vall d’Hebron Barcelona Hospital Campus and General Electric Healthcare, a leading multinational company in the field of heart imaging, have co-developed the first 4D transoesophageal probe in the world that can explore the heart of all paediatric patients, from babies weighing over 5 kilos to adolescents: the 9VT-D.According to Dr Ferran Rosés, clinical head of Paediatric Cardiology at Vall d’Hebron, the CSUR (Centros, Servicios y Unidades de Referencia del Sistema Nacional de Salud [National Healthcare System Reference Centres, Services and Units]) reference centre in Catalonia for the healthcare of paediatric patients with heart disorders and the only centre in Catalonia with a paediatric heart failure and heart transplantation programme, “The new 9VT-D transoesophageal probe has an extraordinary image quality, which offers an exact correlation between the heart image and the patient’s anatomy, thus helping ensure greater planning of the surgical interventions and catheterisations each child requires. All this is in a minimal sized probe, which means it can be used even in newborns over 5 kilos in weight.” Dr Gemma Giral, a paediatric cardiologist at Vall d’Hebron, states that, “The new 9VT-D technology has been built in miniature, enclosing the latest 4D technology in a flexible probe with a diameter of 3.5 millimetres, compared to ones measuring over 10 millimetres used in adult patients. Due to this thickness, adult 4D transoesophageal probes cannot be used in patients under 20 kilos, for whom a 2D probe has been used up to now, providing less information and image detail.”

In the opinion of Luis Ortega, Ultrasound General Manager for GE Healthcare Iberia, “Our commitment to creating a world in which healthcare has no limits means we have developed the most state-of-the-art technology in pioneering paediatric cardiology on the market, providing healthcare professionals with a 4D paediatric probe to improve diagnosis and take action as quickly as possible, even in newborns with heart disease.”

In the opinion of Carolina Bonilla, a clinical innovation specialist at GE Healthcare, “The development of this probe is a matter of great satisfaction to me and our R&D team because of the opportunities it provides for those most vulnerable of heart patients, children, while culminating the innovation work that started seven years ago with a fantastic team of professionals headed by Dr Ferran Rosés.”

The transoesophageal ultrasound produces an image of the heart and shows its functioning, the same as with a conventional transthoracic echocardiogram, but the sound waves are sent through a tube that is inserted in the mouth and throat until it reaches the oesophagus. This means that heart structures can be seen with much greater precision, as the heart is in contact with the oesophagus and the ultrasound is not blocked by skin, ribs and lungs. The 9VT-D zone offers real-time 3-dimensional moving images. It is 90 centimetres in length and provides 90º vision. As well as the vivid image quality, comparable to an MRI scan, it has applications such as dual crop, which simultaneously displays the chosen heart section from two perspectives, such as the ventricle and aorta. It also has 4D markers to mark points that serve as a guide during the ultrasound and which remain in place when the image switches from 2D to 4D.

Paediatric heart diseases re a heterogeneous group of heart disorders, which include congenital and hereditary heart disease, heart arrhythmias, such as cardiomyopathies, and acquired disorders such as myocarditis. Ultrasound scans are an essential tool during the diagnostic phase, but a transthoracic ultrasound is normally used, which does not require anaesthesia, only a probe on the child’s chest. This new probe is specially designed for use in treatment procedures for infant heart disorders, where the patient is anaesthetised, permitting transoesophageal access and providing a better image quality. Dr Ferran Rosés stresses that, “this probe will be revolutionary worldwide by providing precise guidance for heart surgeons in heart surgery on newborns and small children, and for cardiologists during interventional heart catheterisations and electrophysiological studies to treat infant arrhythmias, offering high-precision image quality that will improve safety and efficacy during operations. All this stems from a vision of continually advancing towards excellent precision medicine for children with paediatric heart disease.”