Professors Mark Hazekamp and Nico Blom try to push the boundaries of pediatric cardiology every day. Thanks to the continuous improvement of quality guidelines in research, education and patient care, they contribute to improving the diagnosis and treatment of (congenital) heart defects and cardiac arrhythmias worldwide. They don’t do it alone. The specialists from the Amsterdam-Leiden Center for Congenital Heart Defects (CAHAL) are in contact with colleagues all over the world.
Both specialists feel called to make a difference in their field. “We don’t just want to consume knowledge, we also want to do our part,” says Blom. Hazekamp nods. “We work in a relatively young and highly specialized field. Improving our field is an important part of our work. In order to actually advance knowledge about congenital heart defects, international cooperation is necessary,” he adds.
Optimize treatment strategies
The urgency of international knowledge sharing has to do with the rarity of (congenital) heart disease and cardiac arrhythmias in childhood. “This involves complicated procedures that are not often performed. It is therefore very important that the results of treatments are shared widely,” says Hazekamp, who is also currently working part-time in Lille to help establish a pediatric heart surgery program there. He did this before in Hamburg. Blom: “By comparing results internationally, we know what works well and what doesn’t. With that knowledge, we can continue to optimize our treatment strategies.”
International knowledge networks
Mark Hazekamp is a professor of pediatric cardiac surgery and has been active for years, including as chairman, in the European Association for Cardio-Thoric Surgery (EACTS), the largest knowledge network in this specialty in the world. Nico Blom (professor of pediatric cardiology, especially cardiac arrhythmias in children) was appointed chairman of the Association for European Pediatric and Congenital Cardiology (AEPC) earlier this year. This is a unique network committed to spreading knowledge about the normal and diseased heart in children worldwide.
Thanks to the international network of CAHAL*, new scientific insights are quickly implemented at LUMC and Amsterdam UMC. “We offer state-of-the-art treatments. This means that we apply the latest scientific insights into practice,” says Hazekamp. He likes to give an example. “At CAHAL, we perform a complicated double replacement operation in patients with a congenitally corrected transposition of the great vessels. is a rare congenital heart defect in which the ventricle is in the wrong place,” he explains. “We learned the treatment from specialists in New York, but now doctors from all over the world come to us to learn how to do this surgery.”
Global knowledge exchange
New scientific insights are incorporated into international quality requirements and guidelines. Because both academic centers have great expertise in specialist treatments for congenital heart defects and cardiac arrhythmias, CAHAL experts are often asked to contribute to these quality documents. Within AEPC, Blom has e.g. helped write new international guidelines for educational quality for pediatric cardiologists. “Last year we further standardized the educational requirements,” he says. “For example, pediatric cardiologists in training now have to take a European exam. As a result, they are all trained uniformly and in accordance with high standard requirements.”
Since the founding of CAHAL in 1995, much research has been carried out at LUMC and Amsterdam UMC, with more than 1500 publications in scientific journals. In addition, more than 100 people have been promoted within CAHAL. “As a result, we have built up a good international reputation,” says Blom. “Specialists from other countries in and outside Europe come here to gain and share knowledge. For example, some of the pediatric cardiologists in Belgium and Portugal have been trained by us.”
Conversely, CAHAL employees also gain knowledge abroad. “Recently, one of our pediatric cardiologists in training to become an interventional cardiologist went to Munich to spend some time with the specialists there,” says Blom. “Then he brought back new knowledge about how they do things a little differently there. Based on that information, we also look critically at how we work and where we can improve further.”
For many specialists, there is another good reason to come to CAHAL. There is a lot to explore here. For example, LUMC has a large anatomical collection of congenital heart defects. In addition, CAHAL has a long-lived patient population who have undergone treatment for transposition of the great vessels. This means that the two large arteries come out of the heart in reverse. CAHAL also has a successful program for the treatment of the small left heart complex. Blom and Hazekamp emphasize the importance of continuing to investigate heart defects and cardiac arrhythmias and also looking at how treated patients fare in the long term. “This way we gain new insights and it improves the field,” both say.
*CAHAL is part of Amsterdam UMC and Leiden University Medical Center.
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