Heart Area (Hospital Sant Joan de Déu)

Pediatric cardiology primarily deals with arrhythmias or variations in heart rhythm and congenital heart diseases in children, from birth to adulthood.

In collaboration with the Daniel Bravo Andreu Private Foundation, the Hospital Sant Joan de Déu has established a new Heart Area, now positioned as a leading center for highly complex pediatric cardiology in Europe.

In mid-2021, the support from the Daniel Bravo Andreu Private Foundation, which began in 2014, was completed. This support has enabled the incorporation of:

• The state-of-the-art Hemodynamics Room (2014)
• The highly complex Pediatric Cardiology Operating Room (2019)
• The Cortex or real-time monitoring system (2021)

This initiative has provided equipment and support for staff recruitment, allowing a key technological leap forward and simultaneously boosting research and training of professionals to benefit patients.

The Hospital Sant Joan de Déu is a reference center in Spain for cardiovascular surgery and is accredited by the Ministry of Health for the treatment of pediatric arrhythmias. Currently, it performs about 250 open-heart surgeries annually, 900 catheterizations, and about 280 cardiac ablations with very satisfactory results. Its cardiac surgery survival rate is one of the highest in the world, at 98.4% compared to the European average of 95.2%.

State-of-the-Art Hemodynamics Room

In September 2014, the Daniel Bravo Andreu Hemodynamics Room was launched at the Hospital Sant Joan de Déu. This high-tech facility is exclusively for pediatric use and was the first of its kind in the country and the fourth in Europe.

The equipment consists of a three-dimensional biplane Flat Panel system that reduces patient radiation exposure by up to 70%. This reduction is crucial for pediatric patients to minimize their current and future accumulated radiation exposure. Additionally, thanks to its CT function, highly reliable and precise two-dimensional and three-dimensional images can be obtained, allowing real-time overlay and guidance during interventions.

The room occupies a 100-square-meter area, providing ample space for healthcare professionals to perform their tasks and develop innovative procedures in both cardiology and other specialties. Although its primary use focuses on treating complex pediatric arrhythmias, it also supports other forms of interventional and diagnostic cardiology. For example, new techniques have been developed for peripheral vascular processes, neurointerventionism, and more. It has also proven very useful for treating certain oncological pathologies like retinoblastoma.

Cardiac Ablation on the World’s Smallest Baby

In January 2019, a team of professionals from the cardiology, neonatology, anesthesiology, and intensive care nursing departments performed a cardiac ablation on a baby girl weighing only 1,310 grams in the Daniel Bravo Andreu Hemodynamics Room, marking a new milestone in cardiological catheterization. This intervention allowed the Arrhythmia Unit at Hospital Sant Joan de Déu in Barcelona to cure the incessant tachycardia (300 beats per minute compared to the usual 150) the baby girl had.

Highly Complex Pediatric Cardiology Operating Room

With the first open-heart surgery in November 2019, the new Highly Complex Pediatric Cardiology Operating Room commenced its journey within the surgical block of Hospital Sant Joan de Déu. The support from the Daniel Bravo Andreu Private Foundation enabled a long-awaited achievement for the professionals of the Hospital’s Cardiac Surgery Service: a new operating room to handle highly complex congenital heart conditions with the most advanced technology.

To reduce the sequelae sometimes associated with highly complex cardiac surgery, the Foundation’s support allowed for the establishment of an operating room with the latest technology, alongside four specialized recovery units constituting the Cardiology Intensive Care area. This setup facilitates highly precise surgery and ensures optimal recovery, minimizing issues from these interventions: up to 30% of patients can experience learning difficulties, such as developmental delays, relational alterations, and school failure, upon reaching adolescence.

The Highly Complex Pediatric Cardiology Operating Room is equipped with, among other things, a digitalized extracorporeal circulation system and a cerebral monitoring device for continuous patient monitoring during the intervention. This allows for the collection of numerous indicators valuable for both immediate and long-term recovery prognosis. Additionally, it features an advanced ultrasound imaging system that enables surgeons to analyze the surgical area to determine if any corrections are needed before completing the procedure and suturing the operative field.

Cortex

In July 2021, a real-time patient monitoring space named Cortex was introduced at Hospital Sant Joan de Déu. With the support of the Daniel Bravo Andreu Private Foundation, professionals now have access to a Command Center, allowing them to know at any moment how many patients are undergoing surgery, how many will need ICU admission in the coming hours, how many will be transferred from the ICU to a room, and how many are hospitalized on each floor. This comprehensive, real-time view enables them to make the most appropriate decisions to manage beds and resources optimally, avoiding saturations and bottlenecks.

In addition to the Command Center, the Cortex integrates a patient monitoring system (Ecare) and a patient and family contact service (Contact Center).

From Ecare, professionals remotely monitor hospitalized children at all times, whether they are in their rooms, walking through the hall, or playing in the playroom. This initiative has allowed, for example, babies with heart problems who previously had to be under ICU observation to be transferred to a room with their mother, thanks to a small connected device that continuously monitors their condition and alerts professionals of any changes.

The Cortex also features a multichannel communication space with patients’ families, known as the Contact Center. This space allows professionals to remotely visit patients who do not require in-person care and respond to assistive queries from families. In this space, the medical team visits them by phone or videoconference to discuss any concerns and anxieties generated around the patient, our focus.