SA hospital will continue sending paediatric heart patients to Melbourne: review

SA’s Women’s and Children’s Hospital will continue sending children to Melbourne for cardiac surgery but could get a heart-lung bypass service.

Dr Todd Maddock (in scrubs) Dr Jayme Bennetts, Dr Gavin Wheaton and WCH chief executive Lindsey Gough. Picture: Tricia Watkinson

South Australia’s Women’s and Children’s Hospital (WCH) could get a heart-lung bypass service after an independent review suggested it was needed.

However, the review also recommended to continue flying patients to Melbourne’s Royal Children’s Hospital and not perform paediatric heart surgery at the hospital.

The initial review was conducted earlier this year and noted case numbers were too low to maintain a safe service.

But the deaths of four babies at the WCH – which was revealed in a parliamentary inquiry – sparked an independent look into the review.

Women's and Children's Hospital in North Adelaide. Picture: Naomi Jellicoe

The latest review estimated case numbers would be around 50 a year, which is lower than the first report’s estimate of 70 to 110 a year.

“We do not see that such a program would be either sustainable in the long term or reliably able to provide excellent quality of care and outcomes,” the recent report states.

Open-heart surgery ended at the WCH in 2002.

Since then, only a very small number of lower-complexity closed cases were performed by one cardiac surgeon.

Dr Gavin Wheaton, Dr Todd Maddock and Lindsey Gough address the media at the WCH. Picture: Tricia Watkinson

“It would be difficult to justify the establishment of a low-volume unit based on a single paediatric cardiac surgeon in Adelaide,” it read.

WCH chief executive Lindsey Gough said the hospital board needed a second opinion because there were disagreements about the first review.

“That second opinion fully supports the recommendation of the first review that the paediatric cardiac surgery service should remain at the Royal Children’s in Melbourne and we should explore an ECMO (extracorporeal membrane oxygenation) service here in South Australia,” she said.

SA Health says ECMO is a form of advanced life support for patients with severe cardiac or respiratory failure.

The board will consider the report at its meeting next week before making a formal decision.

Cardiothoracic surgeon at WCH, Dr Jayme Bennetts, said he and another doctor were the only two people in the state who had the surgical skills to undertake the access and initiation of ECMO.

Dr Todd Maddock (in scrubs) Dr Jayme Bennetts and Dr Gavin Wheaton at the WCH. Picture: Tricia Watkinson

“ECMO is a high-risk service associated with complications and high mortality, just because of the nature of the indication for ECMO,” he said.

“Those risks means if you establish the service, you have to be able to provide enough support structure and expertise around that that allows you to deal with complications and make sure you're not exposing babies to a higher risk than if you had no service.

“That's part of the discussion at the moment as to how we can develop an appropriate level of care that allows us to initiate and provide an ECMO service, and whether that's in collaboration with existing access to an interstate team or as an independent stand-alone service.”

Earlier in October, a parliamentary inquiry heard four babies died at the WCH within a month after a lack of access to cardiac facilities.

Deputy Chief Medical Officer Dr Michael Cusack. (AAP Image/David Mariuz)

It was later announced SA Health‘s Deputy Chief Medical Officer Michael Cusack would work with the hospital to review the cases to see what lessons could be learnt and if there were any implications due to COVID-19.

He said the “unusual cluster” was a “cause for concern.”