DEC. 16, 2004 | A surgical team led by Jonathan Drummond-Webb, M.D., chief of pediatric cardiovascular surgery and associate professor of surgery at the University of Arkansas for Medical Sciences (UAMS) College of Medicine and chief of pediatric cardiovascular surgery at Arkansas Children’s Hospital (ACH), recently completed the first successful heart transplant on a patient supported by a newly developed miniature heart pump.
Travis Marcus, 14, of Cabot is now recovering at ACH following the November heart transplant surgery. In September, the teen-ager became the second child to receive the DeBakey VAD Child heart pump, the first such device approved by the FDA for use in children. As he waited for a new heart, Travis became the longest survivor on the ventricular assist device. The first patient implanted with the device earlier this year in another state died after only 14 days.
“Travis was a high-risk candidate for this but he had no other options,” Drummond-Webb said. The DeBakey VAD Child allowed Travis’ organs time to recover from heart failure, allowing his body to be more prepared for transplant, once a heart became available.
Travis was born with a congenital heart defect and has undergone two surgical procedures and received three pacemakers. But nine weeks after receiving the heart pump, the family received news that a donor heart had been located. Drummond-Webb flew out of state to harvest the heart himself, returning even as the surgery team prepared Travis for the transplant surgery.
“I was relieved to get the heart back here safely and in a safe amount of time for the transplant procedure. There was also relief in knowing the heart team was progressing well with Travis and ready for the next step,” Drummond-Webb said.
Surgery to remove Travis’ failing heart and the revolutionary pump that kept him alive began within minutes. The procedure would last more than 10 hours in its entirety.
“The implantation was quite difficult and we expected that,” Drummond-Webb said. “It’s not uncommon to have this degree of difficulty, but the task was more complex due to the fact that Travis has had so many surgeries in the past.”
This would be the first time in the world a pediatric patient has been taken off the DeBakey VAD Child pump to receive a new heart. Although this technology buys time for children who are very sick and waiting on a transplant, it can’t replace their failing heart.
Each year there are approximately 2,000 heart donors in the United States, meeting the needs of little more than half of the 3,300 patients (pediatric and adult) who are on the list for transplant. Approximately one in 24 patients on the waiting list will receive a heart.
“I believe the DeBakey VAD Child will be used more once it becomes widely available because it gives us the opportunity to bridge more candidates to transplant freely,” Drummond-Webb said. “But it doesn’t get away from the fact that we’ve got a shortage of donor organs, that’s the bottom line. My nightmare is that we’ve got all these children on these devices and they’re backed up like an assembly line because there’s no available organ and no where to go.”
The surgeries took place at ACH, an affiliate hospital where members of UAMS’
The DeBakey VAD Child, manufactured by MicroMed Technology, Inc., was designed to improve blood flow in children ages 5 to 16 who are awaiting a heart transplant. This ventricular assist device (VAD) will allow many patients to walk around and some may even return home while waiting for a transplant.
The 1”x3” pump weighs only 4 ounces and is silent in operation, utilizing the same technology of the implantable adult pump, also manufactured by MicroMed Technology, Inc. Designed in collaboration with NASA, the Baylor College of Medicine and Drs. Michael DeBakey and George Noon, the DeBakey VAD is intended for end-stage heart failure patients who can no longer provide necessary blood flow with their native heart.
DeBakey, 96, considered the father of modern cardiovascular surgery, attended an Oct. 13 news conference on the successful operation to implant the heart pump. He told The Associated Press he was “absolutely delighted and grateful” to see the 14-year-old patient doing so well.
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UAMS surgeon performs successful implant of heart pump in child at ACH: http://www.uams.edu/update/absolutenm/templates/news2003v2.asp?articleid=2161&zoneid=18