Green Lane Paediatric and Congenital Cardiac Service
The Green Lane Paediatric and Congenital Cardiac Service (PCCS) is a national service based on Level 3, in the link between Starship and Auckland City Hospital. The service moved from a combined adult/child facility at Greenlane Hospital to a purpose-built facility at Starship Children's Hospital in December 2003.
We are the sole provider of cardiology and cardiac surgical services for infants and children with congenital and acquired heart disease in New Zealand and parts of the Pacific Basin. We provide cardiac care across the life spectrum with a fetal cardiology service through to care of those born with congenital heart disease who are now adults (ACHD). Continued diagnosis and treatment improvements mean our patient population is growing and with it, our service.
Inpatient care ranges from simple overnight procedures to complex heart operations.
We also have an extensive network of outreach clinics and offer consultation and support to clinicians caring for patients within the regional hospital setting.
Our team is made up of health professionals from many different areas. Together, we aim to provide the best possible care for children and adults with congenital and acquired heart problems. We include:
- Paediatric cardiac surgeons and cardiologists
- Paediatric anaesthetists
- Specialist nurses
- Ward doctors and nurses
- Allied health professionals
- Technical staff
- Social workers and psychologists
- Play therapists and teachers
- Administrative support
- Clinical psychologist
In addition there is an active clinical research and audit programme that includes collaborative ventures with academic groups nationally and internationally.
Referral Expectations
The Paediatric and Congenital Cardiac Service (PCCS) provides cardiac specialist care for children and adults living with cardiac disease across New Zealand.
For children living within the Auckland District Health Board (AHDB) area, referrals are accepted from General Practitioners. For children living outside of the ADHB area, referrals are primarily through the local paediatrician, but in rural areas where access is difficult, General Practitioner referrals are accepted.
If your child requires acute/urgent cardiac assessment, you will be asked to bring your child to be seen and reviewed in the Children's Emergency Department.
If your problem is not urgent, your referring doctor will write a letter to PCCS asking for an appointment for your child in the Outpatient clinic. When you come to clinic you will be seen by a member of the cardiac team, who will ask questions about your child's illness and examine him/her to try to determine or confirm the diagnosis. Your child may need to have some tests (e.g. blood tests, electrocardiogram (ECG), x-rays, scans etc). Sometimes this can be done during one clinic visit, but for some conditions this will mean having follow-up appointments. Your child's visit can take several hours, depending on the tests required.
Once a diagnosis has been made, the medical staff will discuss treatment with you. In some cases this will mean surgery, while others can be managed with medication and advice. If surgery is advised, your child will be put on the surgical waiting list. The steps involved in the surgical process and the likely outcome are usually discussed with you at this time. See the factsheet 'Heart Surgery for Children' for more information.
Common Conditions / Procedures / Treatments
Fetal Cardiology
The Paediatric and Congenital Cardiac Service (PCCS) is the national referral centre for fetal diagnosis of congenital cardiac defects. Advances in technology mean that it is now possible to diagnose many congenital heart defects before birth. Early diagnosis and assessment allows families and health services the opportunity to identify a baby's needs after birth and plan for delivery and postnatal care.
Expectant mothers are referred to the service by their obstetrician for assessment and confirmation of diagnosis. Once a heart defect has been diagnosed, the service works together with the National Women's Maternal Fetal Medicine Unit - part of the National Maternal Fetal Medicine Network - to provide families with the information and support they need and to develop a plan for delivery and afterward.
For families from outside the Auckland area, we work with the local obstetric team and specialists from the National Maternal Fetal Medicine Network. In some cases, babies are able to be safely born locally and in others it is necessary for the baby to be delivered at National Women's in Auckland.
In Auckland, the fetal cardiology clinic is held at the National Women's fetal medicine clinic. For those families living significant distances from Auckland remote video- or tele-conferences may be organised in conjunction with the local obstetric team to discuss findings and plans.
The paediatric cardiac nurse specialists and maternal fetal medicine clinic midwives are the primary contacts for fetal cardiology enquiries.
Contact the paediatric cardiac nurse specialists by email at Paedcard.ns@adhb.govt.nz
See the National Women's Maternal Fetal Medicine Unit Healthpoint site for the fetal medicine clinic contact details.
Paediatric Inpatient Services
Ward 23B is the children's inpatient ward at Starship. Adult inpatient services are located within the adult cardiology department at Auckland City Hospital.
Coming to Ward 23B
The Heart Ward:
The Heart Ward (23B) has 22 beds, with four of these making up the high dependency room for children needing more intensive monitoring on the ward. We have wonderful views of the city from our windows. Not all of the rooms are single, so you may need to share with other children. You are welcome to visit the ward or playroom before admission; phone us for more information or to book a visit.
When you arrive, you will meet our ward clerk at the front reception area. Sometimes you may have to wait until your room is available as we can be very busy, but we can show you where the playroom and kitchen are. We will also show you how to find things on the ward, and the way to your room. There are a lot of things to do on the day before an operation or procedure, so it is important that you stay on the ward until everything is finished.
The Playroom:
We have a playroom on the ward for you to play in. The play specialists will also bring you some things to do in your room, and are good at explaining what happens in hospital. Most of the things here are designed for smaller children, however if you are older we can contact the adolescent play specialists to come and visit.
School:
If you are going to be in hospital for a long time, you will be enrolled in the hospital school programme. The teacher will either take you to the school room or bring you work to do on the ward if you are too sick to go. For more information for parents, see What about my child's school work? on the Kidshealth website.
Parents' / Caregivers' Facilities:
We have a small kitchen area for parents / caregivers on the ward. There are hot drinks provided, and breakfast for parents staying in the hospital. We provide meals for breastfeeding mothers of babies less than six months of age, but otherwise you will need to supply your own. You can keep some food in the fridge, but please make sure it is clearly labelled! Across the corridor there is a TV lounge for parents / caregivers as well. If you have a lot of family visiting, please talk to us about finding you a space to meet, as sometimes it can get too crowded in your room.
Telephone:
There is a telephone in the parents' kitchen for family to use. Family can call you on this number: (64 9) 630 4949 ext 23235. You can make local calls from this phone, or use a phone card to make toll calls.
Paediatric Outpatient Services
An increasing part of our service is focused on providing ongoing assessment and follow up for our patients after they leave hospital.
Our Auckland clinic is located next to the children's heart ward (23B), Level 3 of Starship Children’s Hospital. In addition to regular outpatient clinics, we also hold daystay clinics here for patients needing extra monitoring during procedures requiring sedation or for some medicine dose increases. Adult congenital heart service outpatient clinics are conducted both at Starship and the Greenlane Clinical Centre in Auckland.
As a national service, many of our patients live outside of the Auckland area. Our cardiologists travel to regional outpatient clinics throughout the country, as well as working closely with local paediatricians and cardiologists. These clinics are located at all District Health Board centres.
Please note: Contact the Starship Hospital Heart Clinic on (09) 307 4949 ext 23621 for information related to clinic or daystay appointments in Auckland. The paediatric cardiac nurse specialists Paedcard.ns@adhb.govt.nz are the primary contacts for other outpatient enquiries.
Contact details for PCCS regional clinics for patients who live outside of the Auckland area:
| Bay of Plenty DHB Tauranga Hospital Ph: 07 579 8000 |
Northland DHB Whangarei Hospital Ph: 09 430 4100 |
| Capital and Coast DHB Wellington Hospital Ph: 04 385 5999 |
Southern DHB Dunedin Hospital Ph: 03 474 7975 |
| Canterbury DHB Christchurch Hospital Ph: 03 378 6148 or 0800 023445 |
Tairawhiti DHB Gisborne Hospital Ph: 06 869 0500 |
| Hawke's Bay DHB Hawke's Bay Hospital, Napier/Hastings Ph: 06 878 8109 |
Taranaki DHB Taranaki Base Hospital, New Plymouth Ph: 06 753 6139 |
| Hutt DHB Hutt Hospital Ph: 04 566 6999 |
Waikato DHB Waikato Hospital, Hamilton Ph: 07 957 6050 or 0800 687674 |
| Invercargill Hospital Ph: 03 218 1949 |
Waitemata DHB |
| Lakes DHB Rotorua Hospital Ph: 07 348 1199 |
Whakatane Hospital |
| Midcentral DHB Palmerston North Hospital Ph: 06 356 9169 |
Whanganui DHB Whanganui Hospital Ph: 06 348 3231 |
| Nelson Marlborough DHB Blenheim (Wairau) Hospital Ph: 03 520 9979 |
|
| Nelson Hospital Ph: 03 546 1800 |
Adult Congenital Cardiac Diseases (ACHD) Service
We also provide ongoing care for those born with congenital heart disease who are now adults. We run outpatient clinics for these patients and liaise with adult cardiology services to provide comprehensive care. Primary contacts for ACHD enquiries please call the ACHD senior nurses phone 027 2271400 or the adult nurse practitioner AnnetteN@adhb.govt.nz
ACHD Inpatient Services
Adult inpatient services are located within the adult cardiology department at Auckland City Hospital.
ACHD Outpatient Services
Adult congenital heart service outpatient clinics are conducted both at Starship and the Green Lane Clinical Centre in Auckland.
Transition Services
The transition from children's to adult services is an important one for many teenagers. We work together with the adult service to make this transition as smooth as possible.
Information for young people and their families transitioning to adult cardiology services can be found on the Starship Website. This includes information about the adult cardiology wards, and resources for young people on managing lifestyle issues with a heart condition.
Cardiac Inherited Diseases Service
The Cardiac Inherited Diseases Service is a national network of specialist clinicians and scientists working to prevent sudden death due to inherited heart diseases. These include Long QT syndrome, Brugada, CVPT and familial heart muscle conditions such as hypertrophic cardiomyopathy.
The clinical leader is Professor Jon Skinner. Queries can be directed to CIDGadmin@adhb.govt.nz
See the Starship website for further information.
Cardiac Catheterisation
Cardiac catheterisation is a medical procedure used to assess, diagnose and treat heart conditions.
A plastic tube called a sheath is placed into a large blood vessel (usually via the groin in infants and children) and a long thin tube (catheter) is inserted through this and threaded up to the right or left side of the heart, using X-rays to guide the procedure. The cardiologist can then use the catheter to carry out tests and treatments. Reasons a cardiac catheterisation may be carried out include:
- to find out information such as cardiac pressures and oxygen levels which aid in diagnosis and assessment
- to further define cardiac anatomy
- to obtain small heart muscle samples (called a heart biopsy)
- to open the atrial septum in congenital heart problems that cause infants to become cyanotic (blue colouring due to insufficient oxygen)
- to place mesh devices or plugs to close small holes inside the heart (e.g. atrial septal defect, ventricular septal defect)
- to expand narrow valves or vessels with balloon catheters
- to place wire devices/tubes (stents) in narrow blood vessels to keep them open.
The procedure is performed by a cardiologist and can be carried out on children of any age, including newborn infants. Usually children admitted to 23B for a cardiac catheter will need to stay overnight, but this is not always necessary. If the cardiologist determines an overnight stay is not needed, Auckland patients may have a pre-admission visit the week before the cardiac catheter is performed, which minimises the amount of time needed for preparation on the day of the procedure. For patients living outside of Auckland who don't need to stay overnight in hospital, the nights before and after the cardiac catheter are spent at Ronald McDonald House.
Echocardiogram
An echocardiogram or ‘echo’ is a scan that uses ultrasound waves to produce images of the heart. It is a painless procedure that doesn’t have any side effects. An echo uses no radiation and is safe. An echocardiogram is used to diagnose heart defects and to gain a better understanding of how the heart is functioning. An echo is similar to an ultrasound many woman have had of their unborn baby; however the echo focuses specifically on the heart and the blood vessels around the heart.
See the information sheet below for more details.
Exercise Test
An exercise test is a useful test for a number of cardiac conditions. It is used to assess the response of the heart to maximal exercise, and is undertaken in hospital to allow the child to be maximally exercised in a closely monitored environment.
See the information sheet below for more details.