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The goal of the Paediatric Cardiology Department is to provide care, teaching and research in the field of heart disease, be it congenital or acquired, from before birth up to adulthood. With more than 40 years’ experience offering patient care, this Department created the Adolescent and Adult Congenital Heart Disease Unit (UCCAA) to provide continuity in care for patients with congenital heart disease
The Paediatric Cardiology Department deals with diseases that affect the heart from the foetal period. Foetal cardiology is developed in collaboration with the Obstetrics, Gynaecology and Neonatology Departments, which have all the human and technical resources necessary to guarantee quality care for treatment of heart disease, congenital or otherwise, detected during the foetal period.
In Catalonia, around 600 babies are born every year with congenital heart disease (between 5 and 12 per 1,000 live babies), of which about 25% will need surgical care during childhood.
Thanks to technological advances and improvement in surgical techniques, the survival rate of these patients has increased in recent years. This does mean that more and more children are growing up to develop cardiac insufficiency and suffer heart failure, meaning they will need a heart transplant. In addition, the rate of myocardiopathies, meaning genetic or acquired diseases that affect the strength of the heart muscle, is 1 per 100,000 inhabitants, and about 40% of children die within two years of diagnosis of the disease.
The Adolescent and Adult Congenital Heart Disease Unit (UCCAA) is the result of a collaboration agreement between Vall d'Hebron University Hospital and University Hospital of Santa Creu i Sant Pau, to bring together the efforts, resources and experience of the two hospitals with the greatest tradition in treatment of these diseases in a single level three congenital heart disease unit for adolescents and adults.
In order to group together outpatient care for congenital heart disease into a single area, the UCCAA Unit outpatient clinic is located in the Maternity and Children's Hospital, next to the Paediatric Cardiology clinic. This common area allows us to share workstations, databases and tools (3D ultrasound) and makes transfer and continuity of treatment simple, from paediatric age to adulthood, for what is a congenital and lifelong pathology.
Patients who require admission do so at the General Hospital, and stay on the Cardiology and Cardiac Surgery ward. Depending on their clinical circumstances, some of these adult patients with congenital heart disease must be admitted onto special wards:
Patients in critical condition: Coronary and Intensive Cardiological Care Unit of the Cardiology Department.
The Cardiology Department Arrhythmia Unit treats heart rhythm disorders. It is responsible for diagnosis, treatment, research and training for all illnesses related to arrhythmias. These may be slow or fast. Slow arrhythmias often need a pacemaker to be fitted. Fast arrhythmias may cause the patient to lose consciousness, or even cardiac arrest.
The Arrhythmia Unit works closely with the Critical Cardiology Unit, the Adult Congenital Heart Disease Unit, and the Inpatient and Cardiac Surgery Areas. The Arrhythmia Unit was created in 1975. Since then it has expanded and specialises in various fields. The most important are as follows:
The Arrhythmia Unit has two theatres. One of them is completely dedicated to procedures such as:
The unit also has specific clinics to treat and monitor patients with cardiac arrhythmia. These include consultations about devices and five clinics dealing with the following matters:
In 2019, the unit carried out:
The Arrhythmia Unit works jointly with the Paediatric Cardiology Department on invasive treatment of cardiac arrhythmia in paediatric patients.
People can suffer from slow arrhythmia or fast arrhythmia. This often occurs in hearts affected by a cardiac disease, but also occurs in hearts with a normal structure.The most common fast arrhythmia is atrial fibrillation, which requires medical treatment and, occasionally, ablation with a catheter. This is a safe procedure and commonly gives good results.The most common slow arrhythmias are those that appear with age. They are caused by degeneration of the heart’s electrical system. They usually require a pacemaker to be fitted.
The Arrhythmia Unit also carries out common non-invasive procedures such as:
The Arrhythmia Unit has extensive experience in researching the field of cardiac arrhythmias. It has published many times in specialist journals. The following research lines are highlights:
The Arrhythmia Unit's team of professionals take active part in academic education and practical training on the medicine and nursing degree courses. Cardiology residents usually spend time at the unit, along with residents in other specialities at the hospital. Residents from other hospitals in the Vall d’Hebron area and from other Spanish, European and Latin American hospitals also do so, if they are interested in training on the treatment of arrhythmia diseases.
The unit's team regularly takes part in training activities outside the hospital. The unit offers the following specific, staff training courses periodically:
The Arrhythmia Unit has a coordinator and four assistants. They work with the nursing staff, consisting of seven specialist professionals, who deal with caring for patients and doing the invasive electrophysiology treatments. They also monitor patients with intracardiac devices on-site and remotely.
Resident doctors in Cardiology are offered the chance to work in a centre with highly specialised care activities thanks to the operational structure and cross-cutting programmes that include cardiac surgery and paediatric surgery. Specialists working here deal with a diverse range of disorders such as arrhythmia, congenital heart disease, heart failure, acute coronary syndrome and valvulopathy, among others.
Cardiology training itinerary
The Cardiology Department Teaching Unit at Vall d’Hebron Hospital is divided into nine operational units. These include Outpatients, conventional wards, the Day Hospital, the Coronary Care Unit, Intensive Coronary Care, Semi-critical Care, Echocardiography and Cardiac Imaging, Haemodynamics and Angiocardiography, Arrhythmia, Nuclear Cardiology and the Experimental Laboratory. It should be said that the Cardiovascular Epidemiology Unit, part of the Cardiology Department, is unique within Spain.
We work in multidiscipline areas to treat specific medical problems such as Marfan syndrome and Congenital Heart Disease, and are national leaders in both fields. Our activity is always patient-centred and aims to maximise outpatient care and general cardiology. To this end we regularly run clinical care and scientific sessions that involve all professionals in the Department.
During training, residents progressively increase their level of skill, from taking medical histories at the start of their training, for example, to the use of automatic defibrillators in the final phase of their residency.
During the first year residents undertake shifts in Internal Medicine, with one shift a month in Cardiology. In the second and third year they do shifts in clinical cardiology within the Accident and Emergency Department. The fourth and fifth year include shifts in the Coronary Care Unit and Haemodynamics.
In terms of training, there are sessions, seminars and courses, and residents’ participation in national and international congresses, conferences, seminars and courses is encouraged.
At the end of the cardiology residency, it is possible to continue training in research as part of the Riu Ortega programme for the Carlos III Health Institute. We also take part in undergraduate and postgraduate research staff training programmes run by the Generalitat of Catalonia’s Department for Education and Universities and the Ministry of Education.
Research activities of note include collaboration with the International Doctorate School on myocardial consequences, in cooperation with the University of Giessen (PROMISE), funded by the German organisation DFG and BIOCAT.
Why should you specialise at Vall d’Hebron?
Cardiology, General Hospital
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