Teaming up to advance pediatric heart care

Each year, almost 1 percent of all newborns –about 35,000 babies—enter this world with a congenital heart defect. In some cases the defect is minor and causes no complications, but other times these defects can be serious or even life threatening. Given the powerful responses children in distress evoke, one might imagine that significant resources are devoted to pediatric heart issues.

Yet, infants and children with congenital heart disease represent an underserved community, simply because they account for a tiny segment of overall heart disease burden in the United States. Companies that develop cardiac instruments and devices have little incentive to develop child-specific technologies, particularly expensive technologies such as an X-ray or magnetic resonance imaging (MRI) machine. Thus, pediatric heart patients typically make do with equipment designed for adults, with doctors and technicians making adjustments as best they can.  

Through a partnership with Children’s National Medical Center (CNMC) in Washington, D.C., the National Heart, Lung, and Blood Institute (NHLBI) is helping to address this need. A new state-of-the-art pediatric facility dedicated to cardiac imaging and intervention is now up and running at CNMC. Opened on April 26, 2013, the facility, called the interventional cardiac magnetic resonance (ICMR) suite features an MRI optimized for scanning children, an adjoining X-ray to allow seamless patient transfer between devices, and an observation/control room featuring the latest software. The ICMR suite will serve as a focal point for combining the NHLBI’s cardiac imaging expertise with the CNMC’s renowned clinical care.

Researchers, clinicians, engineers, and physicists from both organizations will work closely together to take on the unique challenges of working with children with heart problems. These challenges include anatomical obstacles (a child’s heart is smaller and more delicate), the difficulty in having children lie still for imaging procedures, the increased sensitivity of children to radiation damage from X-rays, and the need for supportive devices like incubators when working with infants.

The ICMR program focuses primarily on technology development, especially MRI, which is well suited for children as it is a radiation-free imaging tool. Cardiac MRI for use in adults has been a strong research area at the NHLBI, and the institute is looking forward to translating some of these diagnostic and therapeutic research advances into practical applications for children. The ICMR team will make use of the brand new imaging suite to test protocols for improving the capabilities of MRI technology, such as:  The MRI in the new pediatric imaging suite

• Enhancing the speed and quality of MRI machines to reduce the need to sedate children during imaging procedures
• Increasing the capability of MRI to take high-resolution fetal images
• Developing pediatric-specific catheters for use under MRI to probe the heart and blood vessels in a minimally invasive and radiation-free manner.
• Incorporating an incubator into an MRI scanner to enable efficient procedures for premature babies

For the team undertaking this challenge, the ultimate sign of success would be the ability to diagnose and treat children with heart problems without invasive surgery or potentially harmful radiation—and not just at the CNMC’s ICMR suite. The team hopes that after developing and demonstrating the usefulness of these new pediatric tools and techniques, small businesses will take their discoveries to the marketplace so that they are available to hospitals and clinics across the nation and around the world.

The advances made through this partnership promise to benefit not only children who go to the ICMR facility, but the greater congenital heart defect community. Minimizing the time and invasiveness of cardiac procedures means hospitals can diagnose and treat more children each day and children and their families spend less time in the hospital and more time at home.