HOUSTON – (Nov. 11, 2009) – Texas Children’s Hospital is the
nation’s first pediatric hospital to discharge a child while on an intracorporeal ventricular assist device (VAD), a feat previously
accomplished only at adult institutions.
The patient, 16-year-old
Francisco “Frank” De Santiago, who was implanted with a mechanical
heart pump called the HeartMate II on May 19, 2009, was discharged
on Oct. 29, 2009.
“This is a promising next step for the care of children with heart
failure as Frank is the first patient on record to be medically
discharged from a pediatric hospital with a mechanical heart assist
device,” said
Dr. David L. S. Morales, pediatric cardiovascular
surgeon at Texas Children's
Heart Center, who performed the surgery
on De Santiago. “The device, which is implanted into the chest
cavity near the heart, stays inside the body rather than outside. It
has helped the patient grow stronger by allowing him to eat well,
exercise and enjoy life.”
Texas Children’s Hospital is the first pediatric hospital in the
world to use the HeartMate II. Since April, 2008, Morales, Director
of the Pediatric Mechanical Circulatory Support Program, has
implanted five teen and pre-teen patients, including De Santiago,
with VADs – 4 of whom have already received successful heart
transplants and are enjoying their teen years in good health.
That’s especially significant about De Santiago’s case, Morales
adds, is that his life outside the hospital signals a new era of
possibilities for pediatric heart failure patients, especially as
the number of cases diagnosed annually continues to rise. Until now,
pediatric hospitals have kept patients in the hospital, if not the
ICU, while awaiting transplant.
The Thoratec HeartMate II, about the size of 2 “D” cell batteries
laid end-to-end, received U.S. Food and Drug Administration
approval on April 26, 2008. The pump is a long-term, mechanical
circulatory support device designed for a broad range of
advanced-stage heart failure patients. For these pediatric patients,
it allowed them to live until a donor heart becomes available.
There
is also the possibility that this device may allow some of these
children to recover their heart function. Pediatric patients must
have a body surface area of at least 1.3 square meters to be a
candidate for the device. This is equivalent to an adolescent about
5’ 1” tall and weighing about 100 lbs.
De Santiago was flown to Texas Children's Hospital in May after
having suffered a temporary stroke. He was diagnosed with dilated cardiomyopathy, a condition in which his heart was enlarged to more
than twice a normal size and could not pump blood efficiently.
Physicians placed him on a heart transplant list and decided to
implant a HeartMate II.
“We feel that Frank is a much better candidate for a heart
transplant today than he was 5 months ago when his heart was
failing. The device has improved his heart health and has allowed
him to enjoy physical activity during the wait for a donor heart,”
said
Dr. Jeffrey Dreyer, medical director of cardiac transplantation
at Texas Children’s Hospital.
According to Morales, De Santiago is able to enjoy a more normal
life outside the hospital. “He can do many of the things he loves
like eating his mother’s home cooking, exercising outdoors and going
to the movies. He’ll be coming to Texas Children's for follow-up
visits and physical therapy. We’re keeping a good eye on him while
he waits for a donor heart,” he said.
“Both the medical community and parents of children with serious and
medically resistant heart failure should know that, using VAD
technology, we can provide greater freedom and normalcy for young
people awaiting transplants,” Morales said. “This improvement in
their quality of life and outlook can contribute to their physical
health as well, assuming they follow their physician’s guidelines
for activity and personal care.”
Morales noted that the mechanical circulatory support team at Texas
Children’s Hospital Heart Center uses 5 different types of VADs
in treating pediatric heart patients, the most of any pediatric
hospital in the U.S. He points out that having this variety is
important because he knows that TCH can individualize their VAD
support for each child, taking the child's size and cause of heart failure
into account.
About Texas Children’s Heart Center
Texas Children’s Heart Center is a self-contained pediatric heart
treatment facility within Texas Children's Hospital. Its unique
design provides a single point of care including examinations,
echocardiography, heart catheterization, congenital heart surgery
and intensive care. This special setting enhances the continuum and
delivery of care. The Heart Center sees more than 15,000 patients
and performs more than 800 surgeries annually.
About Texas Children’s Hospital
Texas Children's Hospital is committed to a community of healthy
children by providing the finest pediatric patient care, education
and research. Renowned worldwide for its expertise and breakthrough
developments in clinical care and research, Texas Children’s is
ranked in the top ten best children’s hospitals by U.S. News & World
Report. Texas Children’s also operates the nation’s largest primary
pediatric care network, with more than 40 offices throughout the
greater Houston community. Texas Children’s has embarked on a $1.5
billion expansion, Vision 2010, which includes a comprehensive
neurological research institute, the formation of a maternity
center, and the development of the new West Campus, Texas Children’s
first pediatric hospital in a suburban setting.
For more information
on Texas Children's Hospital, go to
www.texaschildrens.org. Get the
latest news from Texas Children’s Hospital by visiting the
online
newsroom and on Twitter at
twitter.com/tch_news.
