New probe for better treatment of children’s hearts – Science et Avenir

A new miniature probe makes it possible to better treat children suffering from serious heart defects, thanks to a three-dimensional ultrasound examination carried out as close as possible to the heart of a small patient.

Know with great accuracy the result of the operation

“We can clearly see the quality of the repair”: A ten-month-old girl is undergoing open-heart surgery in the operating room, and Dr. Khaled Hadid is not hiding his satisfaction. The new sensor allowed this cardiologist at the University Hospital of Toulouse, one of the first hospitals in the world to use it, to know the outcome of an operation with great accuracy even before it was completed.

Surgeon Davide Calvaruso had just remodeled the septum separating the left and right sides of the heart, where two holes let blood through. He also restored the valves of this vital organ. Towards the end of this delicate intervention, lasting several hours, the faces of the caregivers turn to the control screen of the transducer, which sends two or three-dimensional ultrasound images of the heart from the small patient’s esophagus.

Weight limit

“Here we are looking at a valve that was repaired by a surgeon with sutures (…) It will be easier for us to judge the function of the valve and the quality of the repair by performing a 3D echo than a classic 2D echo. spatial echo,” explains Dr. Hadid in front of moving images.

This examination allows, in particular, to know whether any “residual damage” needs to be repaired immediately, adds Dr. Calvaruso. This morning, fortunately, this is not the case. Everything went well for the little girl. Since September, more than fifteen children, including those from abroad, have benefited from this medical achievement at the University Hospital of Toulouse.

Prior to this, these types of 3D probes were only intended for adults: they could only be used to examine patients weighing at least 35 kg. From now on, a miniature probe allows examination even in children from five kilograms. And it can also be used before a possible operation.

Long awaited probe

In France, eight out of 1000 children are born with heart defects. “We have been waiting for this for more than a decade, because the 3D image is the way to better identify a heart defect in a child,” explains pediatric cardiologist Philippe Akar. Like his colleagues, he would like to have this probe permanently available at the University Hospital of Toulouse.

So far, it has been loaned to General Electric, which has been marketing it for two months, according to Carolina Bonilla, a biomedical engineer for an American industrial group also on the block. The University Hospital of Toulouse is unable to immediately allocate the tens of thousands of euros needed to purchase this probe, points out Prof. Akar. At the same time, he explains, a “somewhat voluntary partnership” with General Electric allows him to use it from time to time, since the probe is shared with other French or European hospitals.

This credit system has its drawbacks: for example, the delay of the private carrier that brought the investigation from Madrid that morning prevented a preliminary examination. Arriving at the time of the intervention, it could be used afterwards.

Before that, only probes were available for children, allowing them to obtain two-dimensional images. But the move to 3D hasn’t been easy: “It’s very difficult to miniaturize the crystals that send out the ultrasounds” from a three-dimensional ultrasound probe, says Bonilla. “3D needs a lot more crystals,” she adds. “It’s much more difficult!”

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