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3D Imaging of Young Patient's Hearts Revolutionizing Valve Surgery

As a specialist in three-dimensional (3D) echocardiography, Dr. Tim Colen provides pediatric heart surgeons with virtual images of their young patients’ hearts, so that they can see what’s going on before they operate.

“3D-ECHO helps us to identify exactly where the problem is and what we think surgeons can do to fix it,” says Colen, who was recruited as an assistant professor in pediatric cardiology to the U of A’s department of pediatrics with support from WCHRI. Colen is also a clinical-researcher in the pediatric echocardiography unit at the Stollery Children’s Hospital where he uses this technology to image up to six pediatric heart patients a week.

A pediatric cardiologist who trained in Australia, Colen was drawn to the U of A by its expertise in 3D ECHO technology and the Stollery by its established reputation as a leading – and second largest – pediatric cardiac treatment centre in Canada. The Stollery Children’s Hospital treats about 10,000 patients with congenital heart problems a year. Between 10 and 20 percent of those patients suffer from some sort of valve pathology.

Advanced 3D ECHO imaging technology, which can produce 25 to 50 frames per second, is particularly useful in assessing valve defects, notes Colen. It uses high frequency ultrasound that can capture the movement of highly mobile valves, including in infant hearts, which thump away at 120 to 160 beats per minute. 3-D images of the heart can provide critical, life-saving information prior to surgery, especially when dealing with tiny patients. Colen cites a recent case where a surgeon had to repair a valve that was blocked from below in the newborn.

“If he had just gone in and operated, he may not have been able to see the blockage through the valve opening, which was only 5-6mm wide,” says Colen. “We were able to give him crucial information that he wouldn’t have been able to see otherwise – i.e. where the blockage was and what it was attached to. So that he knew what he needed to do.”

“There are not many programs in North America that have the ability or experience in 3D ECHO with pediatric heart patients that we have here. We have developed a very unique set of skills in imaging valve data. I anticipate that in the next five to 10 years, we will use this data to produce computer models of valves and potentially allow virtual valve surgery and better predict treatment outcomes ahead of time. This could absolutely change surgery practices and result in better care and quality of life for children with valve abnormalities.”

Published Winter 2016, Women & Children’s Health Research Institute