Heart device helping keep kids alive before transplants

It's a deadly waiting game. As many as 20% of children standing by for a heart transplants die before they get one. But a device for adults is now helping kids.

These days, C.J. Moore is happy to be playing basketball, even if it's from the couch.

"Well, there's not much I can do right now," he says.

Several months ago, C.J. was in much worse shape. His heart was enlarged, and doctors didn't know why.

"I was scared," said C.j.

"It was a hard, hard thing to see my child,” said C.J.’s mother Reshella Moore. “And I couldn't do anything about it."

C.J. needed a new heart. He got on the transplant list, but to keep him alive until one was available Duke surgeon Andrew Lodge implanted this pump in his chest. It's in clinical trials for adults. C.J. was only the fourth child in the U.S. to receive it.

"So we had to pursue the company and the FDA to allow us to implant the device," said Lodge, cardiac pediatric surgeon at Duke University Hospitals.

The battery-powered device is placed in the left ventricle and pumps blood to the aorta. It is small enough to use in some kids, and portable, so patients don't have to stay in the hospital.

C.J. wore the device for four long months. Then they finally got the call.

"I just started hollering and screaming,” said Reshella. “And he said mama, what's wrong? And i said C.J., we got a heart!"

Since the transplant, C.J’s getting back to normal. He's on 32 pills a day, but couldn't be sad because he was so excited.

Excited about his new heart and his new life. All made possible by this pump.

C-j will be on some of his medications for the rest of his life. Doctor Lodge says he may need one or two more heart transplants because he is so young.

BACKGROUND: The human heart works like a pump, circulating blood to all the body's cells. The right side takes blood from the body and pumps it into the lungs, while the left side takes blood from the lungs and pumps it out to the body. An average heart beats about 100,000 times a day. When the heart starts to fail, it may struggle to pump blood, and muscle function can deteriorate. Patients with a failing heart may need a heart transplant. There are many devices that can support and keep adults healthy until they receive a donor heart transplant. However, that's not the case for kids. As many as 20 percent of children waiting for a transplant die before an organ is available.
(SOURCE: http://childrenshospitalblog.org/heart-week-francis-fynn-thompson/)

THE BERLIN HEART: The Berlin Heart is a device that was recently FDA approved for use in children. It takes over the heart's work of pumping blood and can be used while a child is waiting for a heart transplant. Most of the device sits outside the body. Only the tubes are implanted. The tubes emerge from small openings in the skin to enter the pump, which is a small, round chamber. While this device is currently the only pump approved for children, there are some drawbacks, according to Andrew Lodge, M.D., a cardiac pediatric surgeon at Duke University Hospitals. "The problem with that device is it's not an implantable device," Dr. Lodge told Ivanhoe. "It's not as neat. The pump is outside the body. The hardware is a little more cumbersome. It's not designed for hospital discharge. It's designed for shorter-term use." Patients must take a higher dose of a blood thinner medication, which can also lead to complications.
(SOURCES: Ivanhoe interview with Dr. Lodge, http://www.childrensmemorial.org/depts/heartcenter/berlin-heart.aspx)

HEARTWARE: Dr. Lodge recently used a pump that is currently in clinical trials for adults on a child with a failing heart. 10-year-old C.J. Moore was just the fourth child in the United States to have the HeartWare ventricular assist device implanted in his chest. The pump is placed in the left ventricle of the heart and takes blood through a tube to the aorta, which moves oxygen-replenished blood throughout the body. A cord extending from the patient's stomach to a battery pack keeps the machine alive. According to Dr. Lodge, the hardware in this pump is more portable because it's implantable. Patients can be discharged to their homes if they wish. "It takes a patient who is basically dying from heart failure, it takes that situation and turns it into a situation where the patient feels better, can be up rehabilitating from a physical standpoint...and it makes them better transplant candidates because they're healthier, basically, when they receive their transplant," Dr. Lodge told Ivanhoe. C.J. wore the HeartWare pump for four months until a donor heart became available.
(SOURCES: Ivanhoe interview with Dr. Lodge, Duke press release)


Debbe Geiger
Senior Media Relations Officer
Duke Medicine Office of News and Communications
(919) 660-9461

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