Global Health Asia-Pacific September 2020 September 2020 | Page 66

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Caring for young hearts
Dr Marhisham Che Mood, Head and Consultant Paediatric Cardiologist of Paediatric & Congenital Heart Centre (PCHC) explains
how to treat children
The centre also
carries out
foetal echocardiograms,
where
the heart of
foetus is
examined using
an ultrasound
machine
While heart disease can be difficult enough when
it strikes adults, it can be especially tragic in
children. From congenital heart defects to
heart diseases acquired later in childhood due to illnesses
or genetic syndromes, managing such conditions in young
patients can be a complicated affair.
However, Institut Jantung Negara (IJN) has been
meeting this challenge head-on through its paediatric
cardiology services. The centre’s Paediatric and Congenital
Heart Centre (PCHC) is currently the go-to hospital for
complex heart surgery in children, and also presently the
only centre in Malaysia offering established treatments
for paediatric heart rhythm problems.
IJN consultant paediatric cardiologist Dr Marhisham
Che Mood, who also heads the PCHC, explains that the
centre primarily focuses on congenital heart disease.
“Around 95% of our patients are those who have congenital
heart defects,” he says. “This includes adult patients
with congenital heart disease who continue to receive care
from our team of dedicated adult congenital heart disease
specialists.”
He adds that adults with congenital heart disease
require specialised care, as they have different and often
more complex needs than regular heart patients. “These
patients may have undergone multiple surgeries in the
past to manage their condition, and some can have hearts
that look and function differently than the average heart.
Our adult congenital heart disease cardiologists are
trained to provide specialised long-term care so that these
patients can have a better quality of life,” he says.
The centre also carries out foetal echocardiograms,
where the heart of foetus is examined using an ultrasound
machine. “This enables us detect any issues earlier,
especially for pregnant women who risk having babies
with congenital heart disease. The procedure is safe and
simple, but it does require the expertise of foetal imaging
specialists and paediatric cardiologists to interpret the
results accurately,” adds Dr Marhisham.
Pioneering cutting-edge techniques
One of PCHC’s trademark strengths is its track record
in performing simple and complex heart surgeries in
children, as well as being a pioneer in introducing newer
techniques and treatments.
In 2019 alone, the centre has introduced remarkable
procedures for some of its youngest patients.
The first is a bio-absorbable stent for infants suffering
from complex congenital heart disease. PCHC was the first
in the world to implant this stent in humans, as part of a
clinical trial carried out last year. Stents are tube-like devices
that are used to open and widen clogged heart arteries
in adults. In infant, it’s used to prolong the patency of
ductus arteriosus as initial palliation for congenital heart
disease. The advantage of bio-absorbable stents is that
they will clear the body after a few years, hence reducing
possible long-term complications that are associated with
regular stents.
“This particular stent is absorbed into the blood vessels
after some time,” explains Dr Marhisham. “We implanted
these stents in 10 patients, and our follow-ups with them
have been very promising. Next, we’re planning to implant
similar stents for more complex heart cases; there’s
also a pulmonary artery stent currently in development,
so that’s something we want to do as well.”
Another recent groundbreaking procedure carried out
was device closure of patent ductus arteriosus (PDA). PDA
is a condition where there is an opening between the two
major blood vessels leading from the heart. While this
opening (called the ductus arteriosus) is a normal part of
a baby’s circulatory system before birth, it usually closes
shortly after birth.
PDA tends to be a common occurrence in preterm
babies, and the usual surgical methods used to correct it
can be troublesome. With this new procedure however,
doctors are able to deliver a device via transcatheter to
occlude the opening. Dr Marhisham says that PCHC are
Patent ductus arteriosus (PDA)
64 SEPTEMBER-OCTOBER 2020 GlobalHealthAsiaPacific.com