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Heartware: Saving Kids Waiting For Transplants

Heartware: Saving Kids Waiting For Transplants

CREATED Apr 14, 2014

ST. LOUIS, Mo. (Ivanhoe Newswire) - When children experience heart failure, they often need a transplant to replace their defected organ, but waiting can take time. Now, there's a new device that helps the heart do its job—without stopping a kid from being a kid.

It doesn't look like much, but a day out like this is big for 11-year-old Jacque Fair.

Last summer, Jacque and her mom found out she had heart failure and needed a transplant.

"It was a surprise," Jacque told Ivanhoe.

"I had to step out of the room to be honest with you. It was a little much to take," Katrina Fair, Jacque's mom, told Ivanhoe.

While she waits for a transplant, Jacque wears the HeartWare device.

"They used to be bigger, bulkier, so only adults could receive them," Mary Mehegan, RN, VAD Coordinator, St. Louis Children's Hospital, told Ivanhoe.

The pump is implanted in the heart and attaches to a battery pack outside the body. It takes blood out of the left ventricle and pumps it into the aorta—helping the heart function when it's too weak to do so on its own.

The device is small enough to be used in kids and it is portable—so patients don't have to stay in the hospital.

"It's a beautiful thing to let a child go home while they're still in heart failure," Mehegan said.

Jacque says the device has given her freedom.

"If I didn't have this, I'd probably be in the hospital, not allowed to do anything and taped up to the wall," Jacque said.

She's looking forward to her transplant, but says she's happy she can still be a kid while she waits.

Patients have to be at least 65 pounds to receive the device.  The HeartWare is a left ventricular assist device, commonly called an LVAD.

It's been used in adults for years, but only recently in children. In fact, fewer than ten children's hospitals in the nation have used these devices.


RESEARCH SUMMARY

BACKGROUND: In order for a child to grow and develop, the heart needs to maintain normal pump function to provide optimal blood flow throughout the body.  However, sometimes the heart of a child may not function normally.  Heart failure occurs in adults because of the effects of smoking, high blood pressure, diabetes, coronary artery disease, and bad heart valves.  It can occur in newborns, infants, toddlers, and teenagers for other reasons. (Source: www.heart.org)

CAUSES:  There are two primary causes for heart failure. 

  1. Over-circulation failure:  It occurs when blood mixes inside the heart due to a congenital heart defect. About one percent of all newborn infants will have some type of structural heart defect.  In some of the defects, there are holes between the right and left chambers inside the heart and because of these holes, the blue and red bloods mix inside the heart.  A defect of blood vessels in the head or other body parts can cause similar mixing of the blue and red blood but outside the heart. Also, abnormal heart valves can cause heart failure.  Rarely, a strep throat infection can cause damage to normal heart valve, causing them to leak as well. Finally, anemia can also result in heart failure.  These defects lead to over-circulation failure.
  2. Pump failure:  Like an adult, a child's heart may develop pump failure. This can be due to a virus infection that damages otherwise normal heart muscles or from problems with the coronary arteries that occur from birth.  Teenagers and older children may complain of becoming tired quickly, especially if a virus has caused heart muscle damage.  Certain drugs, some necessary to treat other medical problems like cancer, can also damage the heart.  Rarely, severe chest trauma may damage the heart.  Children with muscular dystrophy may eventually also develop problems with their heart.  In other cases, the heart muscle fails to function normally and the heart becomes an inefficient pump. (Source:http://emedicine.medscape.com/article/2069746-overview andhttp://www.heart.org/HEARTORG/Conditions/CongenitalHeartDefects/TheImpactofCongenitalHeartDefects/:%2520Heart-Failure-in-Children-and-Adolescents_UCM_311919_Article.jsp)

HEARTWARE:  Adults with heart failure have the option to use an internal ventricular assist device to bridge their heart for a transplant.  Now, kids are receiving that option too. "Application of this technology in children may eventually allow physicians to ‘defer' a decision on transplantation and give a child's native heart a better chance for recovery," Dr. Canter, director of the heart transplant program at St. Louis Children's Hospital, was quoted as saying. "It also allows patients with end-stage heart failure who are not heart transplant candidates to have effective therapy." It is believed that fewer than ten children's hospitals in the nation have used implantable ventricular assist devices. HeartWare is a disk-like device that is sewn into the heart's left ventricle that pumps blood when the heart is too weak to do so on its own.  It is connected by a lead through the abdominal wall to a controller and battery pack that fit into a small handbag and weighs less than four pounds, making it possible for a child to be discharged from the hospital. (Source: http://www.prweb.com/releases/2013/10/prweb11173922.htm)

FOR MORE INFORMATION, CONTACT:

Jackie Ferman
Manager, Media Relations
St. Louis Children's Hospital
(314) 286-0304
slchmedia@bjc.org