Myocardiopathies are diseases where the myocardium is weak, dilated or has some other structural problem. Often, the heart is unable to pump or work properly. In the case of inherited myocardiopathies, due to the fact they are often treated as part of uncommon diseases, specialist management is not within the scope of all clinical cardiologists. It requires specific treatment and involves specific technology.

We have an outpatient clinic connected to a day hospital and conventional hospitalisation, with support from the Imaging, Haemodynamics, Electrophysiology and Arrhythmias Units.

This Unit is also responsible for teaching and research. It is connected to the Genetics Unit with a unit for clinical research and a unit for basic research.

The main healthcare objectives of our Unit are:

• Excellence in care for index patients and family members with hereditary and/or genetic myocardial diseases.
• The creation of a protocol for medical action in these diseases.
• Homogenisation of care.
• The optimisation of care resources, reducing the overall cost of treatment.
• The provision of technology required for patients.
• The performance of genetic studies on patients (control index) and relatives.
• Genetic counselling for families and individuals, which predict the likelihood of passing the illness on to children.
• We provide consultations for other doctors, both at our hospital and other hospitals and primary care centres.
• Creation of fast-stream pathways for referral or interconsultations for cases where the patient must be referred to another professional.
• Reduction of barriers that often limit direct contact between patients and healthcare staff, as well as communication between staff and other institutions.

The Adolescent and Adult Congenital Heart Disease Unit (UCCAA) was set up at Vall d'Hebron University Hospital more  than 40 years ago, and we have been providing paediatric care for congenital heart diseases ever since. This Unit is the result of a collaboration agreement between our Hospital and the University Hospital of Santa Creu i Sant Pau, to bring together the effort, resources and experience of these two leading hospitals in the treatment of this disease.

Outpatient visits to the UCCAA Unit take place in the Outpatient Clinic of the Maternity and Children's Hospital, next to the Paediatric Cardiology Department, meaning we can group outpatient care for cardiology of congenital heart disease in a single area. This means that we can share work stations, databases and tools (the ECO 3D) and it makes the transfer and continuity of treatment simple, from paediatric age to adulthood, for what is a congenital and life-threatening disease.

Patients who require admission are directed to the General Hospital, and stay in the cardiology 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.
• Patients just out of operations: Cardiology Department Postoperative Cardiac Surgery Unit.
• Pregnant patients with congenital heart disease: the Obstetrics, Foetal Medicine and Anaesthesia Departments have created a Working Unit for High-Risk Pregnancies for women with congenital heart disease. Following an established protocol, the checks carried out by the Obstetrics Unit are set to match any necessary cardiac checks to monitor the well-being of mother and foetus during pregnancy, birth and postpartum, with a care protocol that accounts for both the heart disease and the clinical circumstances. We also provide care for cases of postpartum with cardiological risk.

In parallel with these services, there is also a clinic for reproductive counselling for women with congenital heart disease. This clinic is a part of the Adolescent and Adult Congenital Heart Disease Unit (UCCAA), carried out jointly with the Gynaecology Department at the Outpatient Clinic of the Maternity and Children's Hospital. There, a cardiologist and a gynaecologist/angiologist, experts in congenital heart disease, work together to analyse the patient depending on their individual clinical and heart disease condition and explore their chances of conceiving children. Their mission is to inform, evaluate and offer sexual health planning, discussing the reproductive possibilities of the patients living with congenital heart disease.

The Vall d’Hebron Cardiology Department offers specialist care, with advanced procedures and the most innovative technology. It is a pioneer in developing and running clinical-practice protocols. It provides patient-centred service and offers medical care agreed on by the entire Cardiology team. Notable features include its own Clinical Epidemiology Unit and Experimental Cardiology Laboratory. 

The Cardiology Department boasts 37 highly qualified professionals, with specific skills and training.
The team is divided up into the following units: 

• Cardiovascular Critical Care Unit 
• Arrhythmia Unit 
• Cardiac Imaging / Echocardiography, Familial Heart Disease and Aortic Pathology Unit  
• Congenital Heart Disease in Adolescents and Adults
• Haemodynamics and Interventional Cardiology Unit
• Heart Failure Unit

These units are at the forefront of heart-disease treatment and offer multidisciplinary care for patients. The department aims to meet the future challenges of cardiology. A few examples of this are the Familial Heart Disease and Complex Congenital Heart Disease Units. And procedures such as transcatheter valve implanting and treatment for pregnant women with heart disease or endocarditis.

The nursing team is also a key feature for offering excellent care. They take part in every diagnostic and therapeutic procedure, in educating patients, in secondary prevention for the early detection of diseasesand in patient rehabilitation. Their work is especially important for elderly patients with multiple illnesses. Such patients have several programmes at their disposal, including clinical care and cardiac rehabilitation for ischaemic heart disease. The programmes are provided in coordination with the referred area’s primary care and gyms. 

 

Research

The research group in cardiovascular diseases carries out basic, clinical and epidemiological research. Its aim is to generate knowledge for improving prevention and patient diagnoses and treatment.
The group has 19 main researchers and 32 clinical projects and trials currently running. It published 142 papers in 2020.

The research group is part of the CIBERCV network, the Biomedical Research Networking Centre on Cardiovascular Diseases. It collaborates in the following areas: 

• Ischaemia-reperfusion injury: cardioprotection mechanisms, ischaemic conditioning and remodelling. 
• Coronary heart disease: genetic factors involved, determining factors in thrombotic complications and prognosis-factor studies. 
• Aortic diseases: determining factors in aortic dilation, anomalies in aortic biomechanics in Marfan syndrome and new methods for obtaining images. 
• Congenital or familial heart diseases: determining genetic factors and prognosis-factor studies. 

The research group takes part in the CIBERESP, the Biomedical Research Networking Consortium on Epidemiology and Public Health. It focuses on the following aspects:

• studying effectiveness
• cost-effectiveness of cardiovascular operations
• research in health results
• clinical research methods 

  

Education and Training 

The Vall d’Hebron training programme includes:

• undergraduate, master’s and doctoral students from the Autonomous University of Barcelona
• the medical specialisation in Cardiology programme (MIR)
• post-MIR subspecialisation programmes
• ongoing medical education 

The Cardiology MIR programme’s success enables the recruitment of high-level doctors to the hospital. 

The Cardiology Department also includes and jointly supervises an international doctoral school at the University of Barcelona as well as organising important scientific meetings. Vall d’Hebron enjoys international recognition for all the above reasons as well as considerable impact on many areas of knowledge. The department’s professionals collaborate in prestigious international bodies and societies, as well as on the editorial boards of scientific magazines in their field.