Steph Deschamps / November 25, 2022
A new miniature probe makes it possible to better treat children with serious heart defects, thanks to three-dimensional ultrasound scans taken as close as possible to the heart of the little patient.
"We can see the quality of the repair": in the operating room, a 10-month-old girl undergoes an open-heart surgery and Dr. Khaled Hadeed does not hide his satisfaction.
The new probe allowed this cardiologist at the Toulouse University Hospital, one of the first hospitals in the world to use it, to know with great precision the result of the operation even before it was completed.
The surgeon, Davide Calvaruso, has just redone the partition separating the left and right parts of the heart, where two perforations were letting blood through. He also repaired the valves of this vital organ.
Towards the end of this delicate operation, which lasted several hours, the faces of the caregivers turned to the control screen of the probe that, from the esophagus of the little patient, sent the images of the ultrasound of the heart in two or three dimensions.
Here we are looking at the valve that has been repaired by the surgeon with the sutures that have been made (...) We can judge the functioning of the valve and the quality of the repair more easily by doing the 3D echo than the classic two-dimensional echo," explains Dr. Hadeed, in front of the moving images.
This examination allows us to know if there are any "residual lesions" that still need to be repaired immediately, adds Dr. Calvaruso.
That morning, fortunately, this was not the case. Everything went well for the girl.
More than 15 children, including those from abroad, have already benefited from this medical advance at the Toulouse University Hospital since September.
Until now, this type of three-dimensional probe was reserved for adults: it could only be used to examine patients weighing at least 35 kilos.
The miniature probe can now be used to perform the examination even on children, from five kilograms. And it can also be used before a possible operation.
Eight babies out of 1,000 are born with cardiac malformations in France.
"We have been waiting for it for more than ten years because three-dimensional imaging is a way to better specify the child's cardiac malformation", explains the pediatric cardiologist Philippe Acar.
Like his colleagues, he would like the Toulouse University Hospital to have this probe permanently available.
For the moment, it is on loan from General Electric, which has been marketing it for two months, according to Carolina Bonilla, a biomedical engineer from the American industrial group, who was also present in the OR.
The Toulouse University Hospital is not immediately in a position to spend the tens of thousands of euros required to purchase this probe, says Professor Acar.
In the meantime, the "somewhat voluntary partnership" with General Electric allows it to use it from time to time, he explains, as the probe is shared with other French or European hospitals.
This loan system has its disadvantages: that morning, a delay in the private carrier transporting the probe from Madrid prevented an examination prior to the operation. However, it arrived during the operation and could be used afterwards.
Before the probe was used, only two-dimensional imaging probes were available for children.
But moving to 3D was not easy: "It is very difficult to miniaturize the crystals that send the ultrasound" from the probe to perform the ultrasound in three dimensions, says Carolina Bonilla.
"You need many more crystals for 3D," she adds. It's much more complicated!