About the Berlin Heart
When a donor heart is not available during the end stage of heart failure, implantation of a ventricular assist device is often the best way to keep an individual alive until a heart transplant can be done. A ventricular assist device is a mechanical pump that takes over the function of the damaged ventricle of the heart and restores normal blood flow. Although many such devices are designed for adults, very few are available for children and infants, especially in the United States. Fortunately, the "Berlin Heart" (manufactured in the German city) comes in various sizes for a range of children, from newborn babies to teens.
What the device does
The device, first used in the United States in 2000, takes over the heart’s work of pumping blood. In a normal heart, blood moves from the right atrium into the right ventricle, which then pumps the blood through the pulmonary artery into the lungs. The blood then returns to the heart via the left atrium, then to the left ventricle and finally into the aorta, which carries the blood to the body. The Berlin Heart pumps can be used to pump blood to the body and/or the lungs. The blood is removed from inside the heart and then pumped directly into the blood vessels that go to the body and/or the lungs.
Most of the device is outside the body; only the tubes are implanted. They emerge from small openings in the skin to enter the pump, a small round chamber. The system consists of a pneumatic compressor that is run by a laptop computer.
The Berlin Heart is intended to be used as a bridge to recovery or as a temporary measure until a heart becomes available for transplantation. In the past, each time it was used in the United States, doctors had to appeal to the Food and Drug Administration for permission, then have the device flown in from Germany. And after the device is used on each child, it had to be returned.
Compassionate use
Although the device is not yet FDA approved, the FDA — in a case-by-case review — has allowed its "compassionate use." And thanks to a research study underway in this country, the device is now more readily available; as of 2008, a total of 160 U.S. children have used it. Children’s Memorial is one of 40 pediatric centers in the country currently allowed compassionate use.
The Berlin Heart is especially attractive for children awaiting heart transplantation because they can be removed from breathing machines and allowed to move and even walk. This allows them to be involved in at least some of their regular activities while they are waiting for a donor heart and be stronger when they are taken for transplantation.
In July 2008, Children’s Memorial became the first hospital in Illinois to implant the device.