Thanks to funding secured from high street fashion entrepreneur George Davies, Mr Nigel Drury, a Consultant in Paediatric Cardiac Surgery at our hospital, was able to lead the launch of the UK’s first national study into identifying research priorities for patients diagnosed with congenital heart disease (CHD). 

Twelve children in the UK are born with CHD every day, making it the most common type of birth defect.  

Medical and surgical advances over the last 70 years have meant survival rates have improved, with approximately 97% of children diagnosed with CHD now expected to reach adulthood. However these children often need treatment throughout their lives, requiring specialist review during childhood and into adulthood. 

A team of UK patients, parents and healthcare professionals worked with the non-profit initiative, James Lind Alliance, to determine the set of focuses. 

Among the priorities identified was improving the outcomes of heart surgery for CHD patients and the impact of CHD on mental health, recognising the significant psychological effect of diagnosis and life-long management of the disease. 

A long-term supporter of the Children’s Hospital, Mr Davies gifted the money through the George Davies Charitable Trust in celebration of his granddaughter who was treated for CHD at our hospital in 2006. 

Mr Davies said: “Supporting Birmingham Children’s Hospital and its research into CHD is very dear to my heart as my granddaughter received life-saving treatment at the hospital when she was just seven-days-old, after she was diagnosed with a rare heart defect. The hospital is a world-renowned centre of excellence for cardiac procedures and I’m delighted to support the team in its vision to identify the areas of research needed to enable advances in treatment and care.” 

More than 500 people responded to the initial survey and, following a prioritisation survey and two workshops, two top 10 lists of key priorities for research into child/antenatal CHD and adult CHD were agreed. 

Other areas of focus included research to enable less invasive interventions, improve CHD screenings before and after birth, using new technologies and innovation to personalise care and better outcomes, and improve quality of life for children and adults living with CHD. 

Mr Drury, said: “Working with parents, patients and the healthcare workers who care for them, we have identified the research areas that are key to advancing the management of CHD from before birth through to adulthood. 

“The Top 10 lists cover a wide range of issues which impact those with CHD, looking beyond early survival to encompass more holistic outcomes such as quality of life and reducing the burden of living with it. Identifying national priorities for research provides a platform to answer the questions that matter most. We will now finalise a national strategy on how to address them.” 

The strategy has seen the development of a new network in the UK and Ireland for studies across multiple sites, focusing on clinical trials that have the potential to change clinical practice in CHD. 

Other initiatives include the setting up of a national CHD patient and public involvement group made up of patient, parent and charity members, who will actively contribute to the development, conduct and reporting of research. 

The priority areas in full: 

Children 

Adults 

1. How can damage to organs (eg. heart, brain, lung, kidney, bowel) during heart surgery in children with CHD be minimised to reduce complications, especially in those who require multiple operations? 

1. How can less invasive interventions be performed for CHD with the same outcomes as open-heart surgery? 

2. How can prenatal and postnatal screening strategies (eg. scans, pulse oximetry, novel techniques) be improved to achieve greater accuracy, avoid late diagnosis and reduce complications from CHD? 

2. How can the longevity of the Fontan circulation be prolonged and the impact of complications (eg. liver, protein-losing enteropathy, renal, endocrine, fertility) be reduced? 

3. What are the effects of CHD, low oxygen saturations and interventions on brain development and behavioural outcomes, and how can these be improved? 

3. What is the impact of living with CHD on mental health in adults and how can this be improved through access to psychological support and other therapies? 

4. How can the frequency or need for reoperations be reduced for people with CHD (eg. improved valve/conduit longevity or that grow with the patient)? 

4. How can technology be used to deliver personalised care and improve outcomes of those with CHD (eg. artificial intelligence, 3D printing, genomics, stem cells, organ regeneration)? 

5. How can technology be used to deliver personalised care and improve outcomes in CHD (eg. artificial intelligence, 3D printing, genomics, stem cells, organ regeneration)? 

5. What are the risks and limitations associated with pregnancy, childbirth and motherhood for women with CHD, and what information and support is available? 

6. What is the impact of living with CHD on mental health in children and how can this be improved through access to psychological support and other therapies? 

6. What are the best treatment strategies for heart failure in adults with CHD, in particular those with a systemic right ventricle? 

7. What is the impact of living with CHD on quality of life in children and how can this be improved? 

7. How can the management of arrhythmias, including sudden cardiac death, in adults with CHD be improved? 

8. How can less invasive interventions be performed for CHD with the same outcomes as open-heart surgery? 

8. How can the indications, timing of referral and outcomes of transplantation and long-term mechanical support in adults with CHD be improved? 

9. How can the longevity of the Fontan circulation be prolonged and the impact of complications (eg. liver, protein-losing enteropathy, renal, endocrine, fertility) be reduced? 

9. What is the impact of living with CHD on quality of life in adults and how can this be improved? 

10. What are the long-term outcomes and life expectancy of children born with CHD? 

10. How can the frequency or need for reoperations be reduced for people with CHD (eg. improved valve/conduit longevity or that grow with the patient)?