Children's Memorial is first in Illinois to use Berlin Heart
On July 29, 2008, Children’s Memorial became the first hospital in Illinois to use the Berlin Heart—a state-of-the-art ventricular assist device that takes over the pumping action of the heart when a patient is in a state of profound heart failure.
The device provides the child significantly more time to wait for a donor heart. It is the only such device in the world that is designed for use in pediatric patients as small as infants.
"One of our biggest obstacles in heart transplantation is waiting for a donor heart to become available,” says cardiovascular-thoracic surgeon Carl L. Backer, MD, surgical director of the Heart Transplant Program. “Now we have a device that is so streamlined that even babies can be supported by it for a year if need be.”
Children’s Memorial is now one of only 40 pediatric centers in the country allowed to use the Berlin Heart. In addition to Backer, the Berlin Heart team included cardiovascular-thoracic surgeon Sunjay Kaushal, MD; and cardiologist Jeffrey G. Gossett, MD. Their patient was just a few months old at the time of the rare procedure.
The device itself consists of finely calibrated catheters that are placed within the heart and attached to two small pumps that sit outside of the body. The drive console with computer controller that is the “nerve center” of the apparatus is on a portable cart.
Children using the Berlin Heart can be held, are free to play, sit up, watch television, participate in child life activities or do homework.
Because the German-made device has not yet been approved for use in the U.S. by the Food and Drug Administration, Children’s Memorial enacted a protocol that allows the hospital to petition the FDA for a “humanitarian exemption” to use it. Kaushal and Gossett, who both came to Children’s Memorial just last year, had previous experience with the Berlin Heart.
“Because we’d done this before, we were able to get permission in a couple of days,” says Kaushal. “It took another two or three days for it to arrive. Some parts came from Berlin where it’s manufactured, and other parts came from around the country.”
The procedure
The patient arrived at Children’s Memorial by helicopter in critical condition with dilated cardiomyopathy, which causes the heart to weaken and enlarge, disabling the heart’s pumping system.
“We then reached the point where the infant needed extensive cardiac support through ECMO [extracorporeal membrane oxygenation]. This is a complex and highly technical heart-lung machine that requires babies to be confined and heavily sedated,” explains Gossett. “There are numerous downsides to long-term ECMO use. For one thing, you typically can’t keep a baby on ECMO for more than a few weeks, and many babies have to wait much longer than that for a heart. We knew the Berlin Heart could extend the child’s life for up to a year, not just days or weeks.”
Among the other advantages of the Berlin Heart over ECMO is that patients do not have to be intubated and can breathe on their own. This strengthens the lungs in preparation for receiving a new heart and reduces the risk of infection. Once the child is on the Berlin Heart, he no longer has to be paralyzed and sedated while hooked up to an ECMO machine. He can be held, is free to play, sit up, watch television, participate in child life activities, or do homework.
“When children can enjoy this kind of mobility,”says Kaushal, “it greatly enhances the quality of life and improves their chances when they receive a heart transplantation.”
The six-hour surgery to implant the Berlin Heart went very smoothly. The baby demonstrated significant improvement within 24 hours. As the child moved towards removal of the breathing machine and required significantly fewer medicines, a donor heart became available. The heart transplant by Backer and Kaushal went well and the baby was discharged from the hospital at the end of August.
Children's Memorial Hospital seeks philanthropic funding to enhance its programs and services. As a proud partner of the Children's Miracle Network (CMN), all funds raised in the Chicago area through CMN also benefit Children's Memorial. To find out how your support can help the hospital better serve children and families, please contact the Children's Memorial Foundation at 773.880.4237 or Foundation@childrensmemorial.org.