Broken heart: congenital heart defect in child
According to the Children's Heart Foundation, about 6-8 babies in every 1000 are born with congenital heart diseases. In the 80s, there was little expertise around this area of science. How children with heart failure survive? Dr Leung Ping answers.
Dr Leung Ping (Croucher Fellowship 1982) is an internationally renowned paediatric cardiologist, who has been a vanguard of the specialisation of his field in Hong Kong, and a founding member of the Hong Kong Society of Paediatric Cardiology. Leung was chief of service at the Grantham Hospital in the 1990s, and is now in private practice.
Of his inspiration to go into this area of science, Leung ponders, “I think simply helping and healing people was a major motivation, because as a child, I suffered from poor health. I always found children’s hearts and circulation to be fascinating: I never thought disruptive circulation, as a result of a congenital heart defect, could be so interesting,” says Leung and when he scored the highest mark for paediatric medicine in his final graduate exams at the University of Hong Kong in 1978, his future path was set out.
Heart failure in children differs from that in adults in many respects, and the causes and clinical presentations may differ considerably among children of different age groups. Unlike in adults, where heart failure is most of caused by lifestyle factors, heart conditions in children are most often caused by congenital heart disease (CHD). Despite considerable demand, there was little expertise around this area of science in Hong Kong during the 1980s.
Leung used his fellowship to study under the supervision of the pioneering cardiac morphologist, Professor Robert Anderson, at the Royal Brompton Hospital in London. Anderson is widely recognised for his expertise in clarifying the morphology of the congenitally malformed heart, and demonstrating, within the malformed heart, the location of otherwise invisible conduction tissues. “It was humbling to learn from such an eminent scientist, and it was something that was just not possible in Hong Kong at the time. During this time, I was exposed to the specimens of congenital heart abnormalities, and that opened up new fields of interest for me which led me to this specialisation very early in my career,” Leung explains.
On returning to Hong Kong, Leung continued with his medical duties at the Grantham hospital and also took periods of extended study leave to further his knowledge in the field, and work with oversees experts in the field, allowing him to publish papers on the subject.
He amassed an unrivalled degree of international experience while working at the Hospital for Sick Children in Toronto (1986) and Pittsburgh (1986), and he worked as a locum consultant in paediatric cardiology at the Royal Hospital for Sick Children in Liverpool (1988).
Leung became widely regarded for his expertise in Interventionist Cardiac Catheterisation. This requires the insertion of a catheter into a chamber or vessel of the heart, and is undertaken for diagnostic and interventional purposes. Typically, the catheter is inserted into an artery of the leg, and, under X-ray visualisation, the cardiologist guides the tip of the catheter to the heart.
Transcatheter structural heart repair devices have largely replaced open-heart surgery as the therapy of choice, and percutaneously deployed septal occluders make it possible to repair atrial septal defects with better outcomes, fewer complications, faster patient recovery and lower health care costs. Leung returned to Hong Kong with his new-found expertise and enjoyed building a world class team of paediatric cardiologists at the Grantham Hospital.
When the paediatric cardiac department of the Grantham Hospital was planned to be merged with Queen Mary Hospital in 2000, Leung took the personal decision that it was an appropriate time for him to move into private practice.
Initially, he says the transition was professionally challenging, as at the time, paediatric cardiology was not recognised as a specialisation in private practise, so he found himself “going from saving lives, to treating children with common colds and flu”. Seventeen years later, however, Leung has successfully developed a strong reputation, and while a constant percentage of his patients are cardiac cases, he estimates that they take about half of his time, and much of the rest of his time is spent educating parents about the impact of cardiac problems on their children. Leung explains, “while some cases require surgery, there are many conditions relating to the heart that do not require surgery”. Another part of his caseload is fetal heart problems discovered via pre-natal echo-cardiograms.
Having made a valuable contribution to paediatric cardiology, Leung now enjoys sharing his expertise with others, both colleagues and parents whom seek out his guidance in relation to their children’s heart conditions.
Dr Leung Ping received his Bachelor of Medicine and Bachelor of Surgery in 1978, and MD in 1992, both from the University of Hong Kong. After this, he became chief of service of the Paediatric Unit at Grantham Hospital whilst undertaking a number of international fellowships, with the Royal College of Physicians of Edinburgh and the Royal College of Physicians of London, among others. With his wide breadth of experience, Leung returned to Hong Kong to set up the first paediatric cardiology team at the Grantham Hospital in Hong Kong. He is now in private practise, consulting as a paediatric cardiologist.
To view Dr Leung’s Croucher profile, please click here.