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King’s Health Partners Cardiology Collectively we are one of the largest providers of cardiovascular services in the UK Introduction Our services in numbers: Heart disease is still the single highest cause of death in London, the UK and globally, with approximately 3,000 deaths per year in south east London alone. It is also the leading cause of mortality in women and 25% of all cardiovascular disease (CVD) cases are premature and preventable. 46,243 non-surgical cardiology procedures in the last year The good news is that outcomes for patients greatly improve if they are brought to a specialist centre and given access to dedicated cardiac teams. King’s St Thomas’ heart team performing X-ray guided transcatheter procedure. Health Partners is collectively one of the largest providers of cardiovascular services in the UK, delivering extensive heart services for patients in south east London and Kent. We host a British Heart Foundation Centre of Research Excellence, and deliver outstanding training for clinicians and researchers. Our Cardiovascular Clinical Academic Group (CAG) integrates the Cardiovascular Division of King’s College London and the cardiology, cardiac surgery and vascular surgery teams at Guy’s and St Thomas’ and King’s College Hospital NHS Foundation Trusts. Our partners G uy’s and St Thomas’ provides a wide range of planned and emergency services to the local population, and, as a specialist centre, primarily to South East London and Kent. The centre is comprised of three departments; cardiology, cardiac surgery and vascular surgery, providing treatment in the outpatient, day-case, inpatient and community setting. The team has expertise in coronary intervention, electrophysiology and rhythm management devices, structural and valvular heart disease, cardiac imaging, non-invasive services, heart failure and inherited cardiac conditions. E velina London Children’s Hospital’s heart service (cardiology) deals with the diagnosis and treatment of a full range of children’s heart problems including, those many conditions detected in the womb/pre-birth, those that develop after birth, and rhythm disturbances. The team in Evelina London carry out between 480-520 surgeries Learn more about Education and Training opportunities 4,998 cardiac surgeries in the last year 172 dedicated cardiac beds on patients with congenital heart disease each year and see about 400-450 patients in their catheter laboratory. K ing’s College Hospital’s cardiology service provides a full range of adult heart care, including, invasive and non-invasive diagnostic procedures, state-of-theart cardiac interventional treatments and outpatient services that include community outreach. The team provide both planned and emergency care for a large regional population. This includes the UK’s first 24/7 primary angioplasty service for heart attack patients, a life-saving alternative to clot-busting drugs. The cardiology department has close links with King’s Heart Failure Service, the Rapid Access Chest Pain Clinic (RACPC) and Cardiac Rehabilitation. K ing’s College London’s Cardiovascular Division pursues internationally leading research programmes that address the fundamental mechanisms Read about our research success stories underlying normal and abnormal cardiovascular function, and drives translation of strong basic science into advances in clinical practice. The division is allied to the British Heart Foundation Centre of Research Excellence at King’s College London which brings together a unique range of internationally renowned scientists and clinicians to focus on basic and applied work that leads to advances in the early diagnosis, prevention and treatment of heart diseases, and delivers outstanding research training for clinical and non-clinical scientists. S outh London and Maudsley, with the Institute of Psychiatry, Psychology and Neuroscience (IoPPN), work with teams at both hospitals to ensure patients are treated for their mental health, as well as their physical health, as mental and physical health conditions are often connected. At King’s Health Partners we are working to treat the whole person, mind and body. What procedures do we most commonly perform? 48 consultants 8 catheter labs 7 operating theatres 1 hybrid theatre (A surgical theatre also equipped with advanced medical imaging devices) Image of heart muscle cells from King’s College London. kingshealthpartners.org @kingshealth OVERVIEW OF OUR SERVICES We offer the majority of procedures and treatments for cardiovascular disease with the exception of cardiac transplantation and cardiac assist device services Mind & Body CARDIAC SURGERY- we are the dominant provider of cardiac surgery across South East London and Kent, providing comprehensive sub-specialist care in heart valve service, coronary revascularisation, aortic vascular surgery and adult congenital cardiac surgery. Did you know your heart health and mental health are closely connected? The mind and body are inseparable, and mental and physical health conditions are often connected. INTERVENTIONAL CARDIOLOGY including structural heart disease- we are the leading UK interventional cardiology centre offering a wide range of services including, a Heart Attack Centre (first to provide 24/7 Primary Percutaneous Coronary Intervention service), high volume innovative TAVI (transcatheter aortic valve implantation) programme, national venovenous extracorporeal membrane oxygenation (VV-ECMO) centre for South of England. inherited cardiac conditions and pulmonary hypertension. ELECTROPHYSIOLOGY / CARDIAC RHYTHM MANAGEMENT- we are one of the leading UK arrhythmia centres treating complex atrial arrhythmia, complex ventricular arrhythmia, adult congenital arrhythmia and inherited arrhythmia. INHERITED CARDIAC CONDITIONS (ICC)- we are one of top 5 ICC Centres in the UK. With integrated clinical service across our partners we are the only UK centre to cover every single aspect of ICC. HEART FAILURE (including mechanically assisted devices/heart transplantation)- we are a leading UK heart failure centre with fully integrated heart failure services promoting innovative work on acute heart failure pathways. Our interventional valve programme deals with circulatory support, cardiac resynchronization therapy and implantable cardioverter defibrillators, cardio oncology, ADULT CONGENITAL HEART DISEASE (ACHD)- we are one of largest UK congenital heart disease centres for adults and children. Our clinical services cover the complete pathway from foetus to adult including, congenital imaging, catheter intervention, and chronic heart disease surgery and transition services. NON-INVASIVE CARDIOLOGY- our large clinical and academic centre is internationally renowned for noninvasive cardiology procedures. We are world class in echocardiogram procedures and have one of the largest computed tomography (CT) units in the UK. We also have one of the largest magnetic resonance imaging (MRI) units in Europe. Our most common surgical procedures Research has shown that people with severe mental health problems are two to three times more likely to suffer from cardiovascular disease due to medication and lifestyle factors. At King’s Health Partners we are working to overcome these barriers by treating the whole person. > Read about Guy’s and St Thomas’ research on the effect of strong emotion on the heart. > Read the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King’s College London’s research into why victims of childhood bullying are at higher risk of cardiovascular disease in later life. > How to maintain a healthy heart. An overview of the most commonly performed procedures across our partnership Aortic Valve surgery (TAVI) Transcatheter 650 procedures from 2007-2013 TAVI (transcatheter aortic valve implantation) is an alternative to open heart surgery to replace the aortic valve in the heart. It is recommended for patients who are too ‘high risk’ for usual surgical procedures, and it is only carried out at specialist centres. Recovery times are quicker because TAVI uses keyhole surgery. > UK first heart operation saves London’s strongest man T otal Aortic Valve Surgery 382 procedures per year Aortic valve surgery is a type of open-heart surgery used to treat problems with the heart’s aortic valve. The aortic valve controls the flow of blood out of the heart’s left ventricle to the body’s main artery (the aorta). From here, the blood travels to the rest of the body. The aortic valve may need to be replaced for two reasons: narrowing of the valve (aortic stenosis) – the aortic valve becomes narrowed and obstructs the blood flowing through it, or leaking of the valve (aortic regurgitation) – where the aortic valve leaks and blood flows back through into the left ventricle. If the aortic valve is no longer working properly, surgery is usually needed to replace it. P ercutaneous coronary intervention (PCI or angioplasty with stent) 2,250 procedures per year This is a non-surgical procedure that uses a catheter (a thin flexible tube) to place a stent into a blood vessel in the heart. Stents are used to keep blood vessels open if they have been narrowed by plaque build-up. A PCI will improve blood flow to the heart, reducing heart-related chest pain (angina), and giving patients a better quality of life. The procedure is done by inserting the catheter into a blood vessel through the groin or in the arm. The catheter is threaded through blood vessels until it reaches the area where narrowing has occurred. When in place, the stent is expanded via balloon inflation. The stent then remains in place while the balloon and catheter are withdrawn. P acemaker installation Nearly 800 procedures per year People can develop an abnormal heartbeat, also called an arrhythmia. The heart may beat too slowly or too fast. A pacemaker can regulate the heart beat and treat this condition. Inserting a pacemaker can be carried out under local or general anaesthetic. It is usually put in on the opposite side to your dominant arm. For example, if you are right handed, it will be put in on the left side. To insert the pacemaker a doctor will put in one or two wires into the heart through a vein. In some cases, up to four wires may be put in. The wires are put in under X-ray guidance. Once in place a cardiac physiologist will test these wires to make sure they have good contact with the heart muscle. After the wires are in position, the doctor will make a small pocket under the skin to fit the battery (generator) and will then connect the wires to this. Patients can get back to the normal activity after approximately one month. > Better treatments for arrhythmia