The Department of Pediatric Cardiology at the Royal Hospital evaluates and treats children, of all ages, suffering from congenital or acquired forms of heart disease. It also provides care for adult patients with congenital heart defects. The Department was started in 1991 and has grown into a busy and well respected clinical program. As the only tertiary-level Pediatric Cardiology service in the Sultanate of Oman, the Department has integrated specialized services for neonates, infants, children and adolescents with complex cardiovascular conditions. Cardiologists, Pediatricians, Cardiovascular surgeons, Cardiac Anesthesiologists, Intensivists, Neonatologists and Cardiac Nurses work closely to provide expert interdisciplinary care for a wide variety of cardiac problems.
STAFF
Dr. Salim Maskeri, MD,DCH, MRCPI, FRCPCH (UK), Senior Consultant and Head
Dr. Abdullah Mohammed Al Furqani, MD, DCH, MRCPCH(UK), Sr. Consultant
Dr. Boris Dimitrov, MD, MRCP, Sr. Consultant
Registrar by rotation from the General Pediatric pool.
FACILITIES
The Pediatric Cardiology department uses the following facilities for the management of patients:
- Biplane cineless cardiac catheterisation laboratory
- Two dimensional echocardiography machine with color doppler
- Portable echo-doppler machine
- Ambulatory ECG holter and blood pressure monitors
- Electrocardiograph and stress testing
- Transesophageal echocardiography
- 3D echocardiography.
Pediatric cardiac patients are electively assessed in the Outpatient Department. Patients needing inpatient care or invasive cardiac procedures are admitted to the Pediatric Ward. In addition, acute cardiac patients are admitted to the Neonatal Unit, Pediatric Intensive Care Unit or Cardiothoracic Unit.
SERVICES AND WORKLOAD
This is the only unit in the Sultanate of Oman offering the full range of specialized pediatric cardiac care including cardiac catheterisation and interventional catheter procedures. Hence the unit gets a large number of referrals from all other hospitals in the country. The activities include OPD clinics (six per week), daily acute and planned admissions, ward rounds, neonatal and intensive care unit rounds, echocardiography, cardiac catheterisations, discussions with the cardiac surgeons, meetings regarding the problems and long-term management with the parents, organizing referrals to the Treatment Abroad Committee, and follow-up of post-operative patients. In addition the unit takes an active part in teaching programs. It is also actively involved in the management of adult patients with congenital heart diseases, in association with the adult cardiology team and provides consultation regarding fetuses with congenital heart diseases.
Within a short period since its inception, the Pediatric Cardiology unit has seen a sharp increase in the volume of work and a rapid advance in the sophisticated nature of procedures. Several new procedures for diagnosis and treatment have been introduced for the first time in this country. These include nonsurgical correction of congenital heart defects by catheter methods. There are more than 6500 registered children with heart disease in the clinic, and at least a two thirds of them continue to need regular follow-up. The pediatric echocardiography studies have increased steadily and more than 2000 studies are done annually. More than 250 children and adults with congenital heart diseases undergo invasive cardiac catheterisation procedures a year: 50-60% of them are for transcatheter cardiac intervention. All sort of pediatric cardiac interventions are performed in the catheterization laboratory including atrial and ventricular septal defects device closure, patent ductus arteriosus device closure and stenting, coarctation of aorta and pulmonary arteries angioplasties and stenting, coil embolization of the collaterals, valvuloplasties and balloon atrial septostomies. Over 500 new cardiac referrals are seen every year in the wards and clinics, and round the clock consultation service is provided to all other hospitals in the Sultanate. The pediatric cardiac surgical program has also grown rapidly during the same period with the strong involvement of Pediatric Cardiology team in the diagnosis and pre-, intra- and post-operative management. About 200 cardiac surgical procedures for congenital heart diseases are performed every year. All types of cardiac surgeries are done from the neonatal life to the adulthood for all sorts of congenital heart diseases including transposition of great arteries, Tetrology of Fallot repair, Fontan procedure, etc.
SPECIAL NONOPERATIVE THERAPEUTIC PROCEDURES
- Balloon valvuloplasty for pulmonary stenosis, aortic stenosis, mitral stenosis.
- Balloon angioplasty for coarctation of aorta and pulmonary arteries.
- Coil and device closure of patent ductus arteriosus
- Device closure of atrial and ventricular septal defect
- Therapeutic embolisation for AV and coronary fistulas
- Pacing therapy for bradycardia and tachycardia
- Retrieval of intravascular objects
- Balloon atrial septostomy and septal dilatation.
- Stenting of the coarctation of the aorta, pulmonary artery and other major vessels.
- Patent ductus arteriosus stenting.
ACHIEVEMENTS
- Establishment of an efficient referral and management system for paediatric cardiac patients in Oman.
- Protocols for congenital and acquired heart diseases in children.
- Marked reduction in the number of referrals for treatment abroad.
- Introduced invasive cardiac cath studies for the diagnosis of heart diseases in children.
- Introduced a number of nonoperative transcatheter therapeutic procedures for the treatment of congenital heart defects.
- Built up a large data base on Congenital Disease in Oman.
ACADEMIC ACTIVITIES
- Teaching and Training: Medical students, Residents, Nurses and Technicians.
- Regular Medical Education Programs: Symposia, Lectures and CME.
- Practical training in Echocardiography for doctors from other hospitals.
- Clinical Research and Analyses.
- Medical Audit.
FUTURE PLANS AND GOALS
- To start a fetal cardiac service with prenatal echocardiography, fetal cardiac therapeutic and counseling service - for the early diagnosis and efficient treatment of congenital heart disease.
- Start a pediatric cardiac electrophysiology program for the efficient management of cardiac arrhythmias.
- To start a program of preventive cardiology and cardiovascular health education for Oman.
- To establish a well structured and recognized pediatric cardiology training program.
