Cardiovascular Section

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Contents

1.0 Aim of pathway
2.0 Scope of pathway
3.0 Background
4.0 Principles

Appendices:
Appendix 1: Thames Valley & Wessex Neonatal Cardiac pathway: Antenatal diagnosis
Appendix 2: Thames Valley & Wessex Neonatal Cardiac Referral pathway
Appendix 3: Thames Valley & Wessex Neonatal Patent Ductus Arteriosus Ligation Referral pathway

1.0 Aim of pathway

The aim of Thames Valley & Wessex Neonatal cardiac pathways is to describe the pathway for neonates who have been identified as having a cardiac abnormality or needing cardiothoracic surgery i.e. patent ductus arteriosus ligation within Thames Valley and Wessex Neonatal Network.

2.0 Scope of pathway

This pathway applies to all neonatal and maternity units covered by Thames Valley & Wessex Neonatal Network. This includes the following hospitals:

3.0 Background

Currently 5.9 / 1,000 babies born in England have some form of Congenital Heart Disease (CHD) and paediatric cardiac care is managed within paediatric cardiac networks. This includes those infants who are diagnosed antenatally or postnatally e.g., at Newborn Infant Physical Examination NIPE. The care of children with congenital heart disease is provided in different types of children’s cardiac centres within the UK as set out in NHS England Paediatric Congenital Heart Disease May 2016, including Specialist Children’s surgical centres (Level 1 services), Specialist Children’s Cardiology Centres (Level 2 services) and local Children’s Cardiac Centres (Level 3).

This document outlines the clinical cardiac pathways for neonates within Thames Valley and Wessex Neonatal Network.

4.0 Principles

Key principles which have been agreed nationally and are widely accepted include:

• Paediatric cardiac services are provided in designated cardiac centres within a managed paediatric cardiac network of care.
• Individual Trusts are responsible for ensuring neonates requiring cardiology services should be referred to the designated centre within the paediatric cardiac network.
• Neonates who need cardiac surgery should be referred to the designated specialist paediatric cardiac surgical centre where paediatric and neonatal intensive care capacity is available.
• When an antenatal cardiac abnormality diagnosis is made it is expected that women are referred to fetal medicine services for a fetal echocardiogram and cardiology assessment. A management plan including location of delivery should be discussed with the fetal medicine team, cardiology team and neonatal/ local paediatric and obstetric teams and parents.
• Neonatal cardiac care should be provided in a centre as close to the neonates home or booked hospital as possible.

Appendices:

Appendix I: Thames Valley & Wessex Neonatal Cardiac pathway: Antenatal diagnosis

Appendix 2: Thames Valley & Wessex Neonatal Cardiac Referral pathway

Appendix 3: Thames Valley & Wessex Neonatal Patent Ductus Arteriosus Ligation Referral pathway