We are the combination of four hospitals: the General Hospital, the Children’s Hospital, the Women’s Hospital and the Traumatology, Rehabilitation and Burns Hospital. We are part of the Vall d’Hebron Barcelona Hospital Campus: a world-leading health park where healthcare plays a crucial role.
Patients are the centre and the core of our system. We are professionals committed to quality care and our organizational structure breaks down the traditional boundaries between departments and professional groups, with an exclusive model of knowledge areas.
Would you like to know what your stay at Vall d'Hebron will be like? Here you will find all the information.
The commitment of Vall d'Hebron University Hospital to innovation allows us to be at the forefront of medicine, providing first class care adapted to the changing needs of each patient.
Respiratory syncytial virus (RSV) is responsible for 75% of bronchiolitis cases diagnosed during the epidemic period, from October to April. The main symptoms are respiratory difficulty and the existence of audible wheezing. Although it is a highly contagious virus, there are a series of highly effective preventive measures.
Acute bronchiolitis is a respiratory tract infection common in infants under two. This infection, caused by RSV, manifests itself in mild or moderate catarrhal symptoms, although if it is not treated, it may progress and cause serious bronchiolitis or pneumonia.
The symptoms of acute bronchiolitis may vary depending on the patient’s age:
This virus may be transmitted in two ways:
The preventive measures to avoid transmission of the virus are:
Admission to hospital is more likely in infants belonging to high risk groups:
In the above cases, administering prophylaxis with palivizumab is recommended, as it is proven to reduce hospital admissions for RSV.
Congenital heart diseases are structural and/or functional malformations of the heart present at the time of birth and, in the vast majority of cases, the causes are unknown. This type of heart disease is multiple and varied, and the signs and symptoms are diverse: they range from asymptomatic, which do not require specific treatment, to severe ones, which need surgery during the first days of life.
What do you need to bear in mind if you care for an infant with congenital heart disease?
To improve the quality of life of infants with congenital heart disease, you are advised to follow these daily tips and routines.
The heart is made up of four cavities, two atria and two ventricles. The atria are separated from each other by an interatrial wall or septum, and the ventricles by an interventricular wall or septum. Between the atrium and the ventricle there is the atrioventricular valve. The veins arrive into the atria and the major arteries leave the ventricles. Between the ventricle and its artery outlet there is the semilunar valve. The heart is divided into the right and left sides.
Non-oxygenated blood arrives at the right atrium via the venae cavae, from the head and arms (upper vena cava) and from the abdomen and legs (lower vena cava). This blood passes to the right ventricle through the tricuspid valve. The right ventricle pumps this blood, through the pulmonary valve, into the lungs through the pulmonary arteries, which is where the blood gets it oxygen.
This oxygenated blood returns to the left atrium via the pulmonary veins. From the left atrium it is directed to the left ventricle through the mitral valve. The left ventricle pumps the blood to the aorta through the aortic valve to distribute it to all the organs and tissues in the body.
The heart is irrigated by the coronary arteries, right and left. These coronary arteries divide into several branches to carry oxygenated blood throughout the heart tissue.
The heart contracts due to an electric stimulus triggered by the conduction system. The cardiac conduction system is made up of a series of cells that have the capacity to create this stimulus and determine heart rate. This stimulus begins in the sinus node, which is found where the superior vena cava enters the right atrium. This stimulus causes the atrium to contract. This stimulus then propagates the ventricle through another structure called the atrioventricular node. This conduction system is capable of increasing the heart rate when necessary, such as for example during exercise, when you have a fever, when you feel emotions, etc., or decreasing the heart rate when you are sleeping. This system is regulated by the action of different hormones or in response to nervous stimuli in the cardiac plexus.
The cardiac cycle has two phases: systole and diastole. In systole, the heart contracts to send blood to the major arteries and during diastole it relaxes to fill with blood to later be ejected.
Cardiac ablation is a procedure used for treating arrhythmia (abnormal heart rhythms). The child's treatment continues even after surgery and discharge from hospital.
Before they leave the hospital, the child and their family will be provided with the guidelines and recommendations for the recovery process by the medical and nursing team.
The following recommendations have to be borne in mind:
The child may have a shower 24 hours after the procedure. Immersion baths can be taken after 7 or 10 days, once the puncture area has completely healed.
The wound must be cleaned with soap and water every day, and a small amount of antiseptic applied, during the child’s first 3 or 4 days at home. We recommend use of 2% aqueous chlorhexidine. The area should be sealed afterwards with a fabric dressing.
The child must rest at home for 3 or 4 days. They must not do any heavy exercise such as walking upstairs nor should they stand up for long periods. Once that period has passed, the child can go back to school.
They can lead a normal life, but without doing any sport for the first two weeks after the procedure. During the summer, the child can swim at the beach or in a swimming pool from 10 days after their operation.
The child can continue with their usual diet. It must be complete and varied.
The following aspects need to be monitored for the first few days:
Monitoring the puncture point. If it turns red or oozes fluid, or if the child has a fever, their reference health centre must be consulted about this.
It is normal for a small bruise to appear at the puncture point. If the swelling is large, this is a sign of haemorrhaging. It can cause pain and discomfort for the child. In that case, the child’s reference doctor must be consulted about this.
A piercing, low-intensity pain of short duration may appear in the puncture area, back or abdomen.It usually gets better after a few days and can be controlled with conventional painkillers. It is common and not a cause for concern.
If the pain is more intense and prolonged, then the medical team should be consulted to avoid any possible complications.
If the child's temperature rises, the reference medical centre must be consulted.
The child may sense a stronger heartbeat for the first few days after ablation. This is normal and goes away after a few days.
The prescribed treatment and the recommendations from the cardiology and nursing teams must be followed.
Menudos corazones
Kawasaki disease is a rare condition that causes blood vessel inflammation. It mainly affects breastfeeding babies and children under the age of five.
Diagnosis is based on clinical examination. Treatment consists of administering aspirin and immune globulin intravenous (IGIV).
To avoid possible heart sequelae, early diagnosis and correct treatment are essential.
Kawasaki disease is a form of systemic vasculitis that affects small and medium-sized blood vessels. The main complication of the condition is the formation of aneurysms in the coronary arteries. It is an acute and self-limiting inflammatory process.
1. Avoid using soap as this may cause the skin to dry further. Wear soft, flannel or cotton clothing.
2. Massage the skin with neutral hydrating cream.
3. Stop the child rubbing their eyes and protect them from light due to light sensitivity.
4. Ensure the child gets plenty of rest as it reduces irritability.
5. Apply passive exercises with soft toys and calm games.
Kawasaki disease is the main cause of acquired heart disease in children in developing countries. Greater incidence of the disease is observed in Asian countries, but distribution is currently universal and it is found in all races. It is more common in middle and upper socio-economic classes and in winter and spring.
Diagnosis of Kawasaki disease requires the presence of a fever for five days along with four criteria, or the presence of fever with three criteria if there is no other cause. The criteria are: bilateral conjunctival injection; alteration of labial mucosa and/or pharynx or “strawberry” tongue; alterations in hands and feet; skin rash; lymph nodes in the neck greater than 1.5 cm.
There is no specific laboratory test to diagnose this disorder.
Given that the symptoms of Kawasaki disease are non-specific and common to other conditions, a differential diagnosis must be conducted to correctly assess the treatment required.
The aim of treatment is to reduce inflammation in the myocardial coronary arteries, alleviate the symptoms and prevent clotting by inhibiting platelet aggregation. Immune globulin intravenous allows the disease to be cured in most cases and avoids heart sequelae. Treatment with acetylsalicylic acid (aspirin) is also used due to its anti-clotting properties.
Treatment with immune globulin is effective in reducing symptoms and avoiding coronary aneurysms. It is essential to start treatment between the fifth and tenth day of the disease.
Minority diseases, also called rare diseases, are those that affect between 5% and 7% of the population. They are very varied, affecting different parts of the body with a wide range of symptoms that change both between diseases and within the same disease. It is estimated that some 30 million people in the EU, 3 million in Spain, and around 350,000 in Catalonia suffer from one.
The complexity of most rare diseases requires multidisciplinary care with professionals from different medical specialities, case management for nursing, psychological support and also social work.
The Vall d'Hebron Barcelona Hospital Campus is home to more than 100 specialist professionals dedicated to the care of more than 2,000 rare diseases. Apart from treating the most rare diseases of any centre in Spain, it is one of the leading hospitals in Europe in this field. In fact, Vall d'Hebron is part of 20 European reference networks, known as ERN. This makes this hospital a highly specialised centre for rare diseases, from birth to adulthood, through a networked system that allows sharing of resources and knowledge with other world-class hospitals.
Adult and child
Pediatric
This concentration of patients with rare diseases at Vall d'Hebron improves knowledge and promotes research. Research in this field focuses above all on improving diagnostic capacity for diseases that are often difficult to diagnose and on developing new treatments for those diseases. In the case of diseases with few patients, publicly funded research is often the main avenue for the discovery of new drugs, and public health is the framework that provides the public with access to high medication complexity.
For more information, contact the Rare Disease Team at the following email address: minoritaries@vallhebron.cat
Hereditary metabolic diseases (HMDs) are a group of rare genetic disorders. The genetic defect causes a structural alteration in a protein that is involved in one of the metabolic pathways, causing it to block the affected pathway. As a consequence, this causes a build up of substances that may be toxic for the body and a deficiency of others that it needs.
Hereditary metabolic diseases (HMD) are chronic progressive multi-system illnesses that may appear at any age and that in most cases pose diagnostic and therapeutic challenges. Our Unit has been recognised as a leader within Spain (CSUR) and Europe (ERN) for this pathology and takes part in the neonatal screening programme in Catalonia. We are the only centre in Catalonia to offer complete care from paediatrics to adults with particular expertise in lysosomal storage disorders.
HMDs are divided into:
- Intermediary metabolism HMD: usually with acute symptoms.
- HMD related to the organelles (lysosomal storage disorders, peroxisomal diseases, mitochondrial disorders and endoplasmic reticulum storage diseases): chronic presentation with no decompensations (with the exception of some mitochondrial disorders)
Multiple systems in the body are affected and different organs and systems are involved with varying symptoms depending on the disorder and the patient’s age. These disorders require a coordinated approach to care and programmes to manage the transition to adulthood.
Many symptoms become evident during childhood in the form of delayed physical growth and delayed psychomotor development. There may be associated heart problems, kidney conditions, and at times decompensations leading to liver or kidney failure and neurological impairment. In the case of organelle disorders, symptoms are chronic and affect the bones and organs of the senses in greater measure. They are more common in adults than intermediary metabolism disorders.
Diagnosis is carried out by:
They are chronic disorders that need to be treated in specialised centres with multidisciplinary teams to provide support for all related health problems.
The following may be necessary, depending on the type of disorder:
Prevention consists of thorough genetic and reproductive counselling if there is a family history of the disease. Early diagnosis of some diseases through the neonatal screening programme enables effective treatment and improved prognosis.
The term “univentricular heart” encompasses a wide range of cardiac alterations characterized by the fact that just one ventricle supports systemic and pulmonary circulation.
Clinical symptoms and subsequent treatment are determined by the amount of flow that reaches the lungs. Depending on this, defects can be separated into two groups.
Echocardiogram is the most important tool to define the anatomy of the heart and the large vessels in patients with single ventricle.
Total caval-pulmonary deviation, or Fontan circulation, is achieved through a series of procedures in several stages:
Evolution following this treatment is very good. The survival rate is around 90% after 10 years and 85% after 15 years.
In some cases, a heart transplant may be required in the long term due to improper functioning.
Pulmonary atresia with ventricular septal defect is a rare heart condition characterised by a lack of connection between the right ventricle and the pulmonary arteries.
This is a rare congenital heart defect characterised by no connection between the right ventricle and the pulmonary arteries. It is an extreme type of Tetralogy of Fallot in which blood enters the lungs to be oxygenated by bypassing the heart.
Blood can reach the lungs via the pulmonary arteries themselves, which are not connected to the heart, or via the collateral arteries, which originate from the thoracic aorta and directly supply the lung. There are significant anatomical differences between vessels which must be studied in each individual child.
This condition is very heterogeneous, which creates the variability seen in the pulmonary arteries. Two groups can be distinguished:
The prognosis of this disease depends on the growth of the pulmonary arteries to be able to surgically repair the condition.
It is a rare congenital heart condition which makes up 1-2% of all congenital heart defects.
In most cases, diagnosis is via foetal echocardiogram. This ultrasound will show the lack of connection between the heart and the pulmonary arteries, as well as the presence of VSD. Through this test the size and position of the pulmonary arteries can also be measured.
When a child is born, it has a certain quantity of oxygen, known as “saturation”, in its blood which is around 80-90% of the normal level, although this is enough for the child to develop normally.
A heart transplant is when a new heart is implanted. When the organs to be transplanted are the heart and the lungs, this is known as a “cardiopulmonary” transplant. This procedure is necessary when the patient suffers from a heart failure that limits their daily activity and all other treatment options have been exhausted.
The purpose of the transplant is to implant a heart from another person (usually from a donor in a state of brain death) to take over the functions of the heart of the sick person. Sometimes, heart disease causes lung problems or vice versa: pulmonary disease can cause heart disease. In these cases, the heart and the lungs must be transplanted, which is called a "cardiopulmonary transplant". Depending on the type of illness, one or both organs will be transplanted, whatever offers the maximum benefit at the lowest risk.
Before the intervention, a team of professionals must study the patient following a clinical and surgical protocol in order to guarantee success.
The operation is performed under general anaesthesia. During the process of heart transplant, the sick heart is removed and in its place a new one is implanted. Sometimes, it is also necessary to transplant the lungs.
In order to perform these operations, a multidisciplinary team of highly specialised and experienced professionals is required, as well as advanced technology and appropriate facilities.
Post-operative care is handled by the Intensive Care Unit, where intensive doctors, cardiac surgeons, cardiologists and pulmonologists take care of the patient until they are stable, when they are then moved on to a conventional hospital ward.
During this process, the doctor indicates personalised immunosuppressive therapy programme and infection prevention to be followed by the patient, along with any appropriate modifications that might be needed during the post-operative period.
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