The innovative design of the facilities involving Benjamin Russell Hospital for Children and UAB represents a visionary concept that allows a neonate, an adolescent, or an adult patient to receive care in an environment best suited for his health care needs. It also brings the necessary cardiovascular resources to the point of patient care, says Yung Lau, MD, chief of pediatric cardiology at Children’s of Alabama.
“We are the only center in Alabama that has facilities to treat both children and adults with mild to severe congenital heart disease,” Lau says. “We can care for a patient population from birth through adulthood with this unique platform. They are cared for by experts for their disease in well-connected facilities, regardless of their age.”
The Joseph S. Bruno Heart Center links with the adult congenital heart surgery facilities at UAB, connected by the Women & Infants Center, to provide the single platform continuum of care. The unified team of multidisciplinary congenital heart disease specialists from both hospitals offers unparalleled expertise and can move efficiently from one end of the three-block platform to the other, as needed, to treat various patients. Also part of this platform are world class neonatologists, geneticists, experts in all areas of pediatrics, as well as fetal and maternal medicine specialists in the Women & Infants Center. As these young patients grow, they will be treated at the Adult Congenital Heart Services located in UAB’s North Pavilion, which is also connected to the other hospitals by a bridge.
“The platform starts with fetuses that have been diagnosed with a heart problem prior to birth. Physicians care for the fetus and the mother as a high-risk obstetric case at the Women & Infant Hospital, which houses a cardiology clinic and the Regional Neonatal Intensive Care Unit (RICU) and Obstetrics,” Lau says. “When the baby is born there, we can take it immediately to the Pediatric Heart Center at Children’s, just over the 40-foot bridge. At the center, the infant can have a heart catheterization or cardiothoracic surgery, depending on the need. There is also a dedicated pediatric cardiovascular intensive care unit, a cardiac care unit, a 16-bed cardiovascular telemetry unit, and a state-of-the-art hybrid catheterization suite, all at the Pediatric Heart Center.”
The hybrid catheterization suite is the cornerstone of the Pediatric Heart Center. The only one of its kind in Alabama and one of only a few in the country, the suite is equipped with $3 million of state-of-the-art technology that allows it to be converted immediately to a surgical suite, eliminating the need to bring a child out of anesthesia for a second procedure in a different room.
Surgeons are finding the single platform of care and the shared resources particularly useful, says Robert Dabal, MD, a pediatric cardiothoracic surgeon at Children’s of Alabama. “We are the primary link between the pediatric and adult patients with congenital heart disease, and this system of care is benefitting the caregivers as well as the patients,” he says.
It was a group of surgeons that included Lau, James K. Kirklin, MD, and Jeffrey Alten, MD, that first envisioned this care model in 2006 and began to create the vision for a truly multidisciplinary program to provide expert care across the spectrum of congenital heart disease from fetus to adult. They worked with Children’s of Alabama CEO Mike Warren and his administrative team to make that vision a reality. “Kirklin established the platform, and now the surgeons have everything on one floor that we need to care for our patients,” Dabal says.
From a technical standpoint, Dabal says the hybrid suite is the most exciting feature in the new Pediatric Heart Center, but what he likes best about the new center are the cardiovascular operating rooms. “These rooms are the ones we use most often, and they are as technically advanced as the hybrid suite,” he says. “The rooms are designed well, and we have better monitoring in the hospital. You can see the monitors from different locations in the building, and an ICU staff can watch the actual surgery of patients they will be caring for in the unit.”
Dabal adds that they have purchased a web-based monitoring system from Stryker for the pediatric surgeons that will allow others to watch surgeries online. “We will be the first hospital in the country to use this technology from this company. It will be good for the whole state of Alabama when we have that technology available,” he says. “It will be up and running at Children’s and UAB in early February, but it will take some time for the technology to evolve enough for pediatric cardiologists throughout the state to use it.”
Lau says that patients with congenital heart defects are benefitting from the single platform of care and updated technology, as well as the surgical advances made over the past several decades. “In the last 40 years, surgeons have become better at repairing or palliating congenital heart disease. Instead of dying at a young age, these patients are living well into adulthood,” he adds. “Actually, we now have a larger number of adults with congenital heart disease than we do children. That’s a great improvement.”
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The Joseph S. Bruno Heart Center at Benjamin Russell Hospital for Children links with UAB’s Women & Infant Center and the Adult Congenital Heart Services at the North Pavilion to provide continuum of care for patients from fetus to adulthood.