As the number of diagnoses for pediatric heart failure increases, so has our experience in treating patients. Each year, our dedicated team of physicians, nurse coordinators and administrative personnel cares for hundreds of cardiomyopathy and heart failure patients.
In many hospitals, the only option for pediatric heart failure patients is extracorporeal membrane oxygenation (ECMO). Although ECMO is a necessary intervention in some cases – and one with which we have particular expertise – it is not a long-term solution for heart failure. At Texas Children’s Heart Center, we offer a full range of treatment options from medication to heart transplantation and beyond. Treatment is tailored to the individual needs of each patient. The majority of cardiomyopathy and heart failure patients are managed with medication. A small percentage of patients will go on to require a heart transplant. Since its inception in 1984, Texas Children’s Heart Center has become one of the largest and most successful heart transplant programs in the nation.
Some patients awaiting a heart transplant may require mechanical circulatory support with a ventricular assist device (VAD) as a bridge to transplantation. Since we implanted our first VAD in 1996, we have become one of the most comprehensive pediatric VAD programs in the world, implanting 20-30 VADs annually. Texas Children’s Hospital offers a comprehensive range of both short- and long-term mechanical devices for children of all ages and sizes. Our program is also leading the way in using a VAD as a bridge to recovery.
Innovations in the Use of Ventricular Assist Devices for Children
For patients with heart failure, a ventricular assist device (VAD) can buy valuable time until a suitable heart is located. In some rare cases, a VAD can be used as a permanent therapy for heart failure or can even improve heart function to such a degree that it makes a transplant unnecessary. VADs can either simulate heart function with pulsing action or allow a continuous stream of blood to flow through the heart. Continuous-flow VADs tend to be smaller and quieter but also more durable, and in recent years have yielded improved results in adult heart failure patients.
Led by Dr. Iki Adachi, a world-renowned leader in the development of innovative VAD therapies, Texas Children’s Hospital assisted with the testing of the Jarvik 2015, which is the first and only implantable continuous-flow VAD designed specifically for small children. The development of the device took more than a decade. The Jarvik 2015 is an investigational device in the United States. Its safety and effectiveness have not been established and are currently being evaluated under the PumpKIN trial.
Dr. Adachi and the VAD team have also developed innovative therapies with other VAD devices, positioning Texas Children’s Hospital as a cardiac center where the newest VAD technology can be brought to the bedside to match the needs of each patient.