As one of the largest programs in the nation, our experience in treating patients with heart failure is leading the way in positive outcomes.
Since it's inception in 1984, Texas Children's Heart Center has become one of the largest and most successful heart transplant programs in the nation. As the number of diagnoses for pediatric heart failure increases, so has our experience in treating patients, as well as our ability to offer the right pediatric ventricular assist device (VAD) for each child.
Each year, our dedicated team of physicians, nurse coordinators and administrative personnel cares for more than 500 cardiomyopathy patients. We are also active participants in the national Pediatric Cardiomyopathy Registry, which was established to describe and understand the clinical course of children with cardiomyopathy.
When a transplant is not immediately available, we offer a variety of circulatory support devices as a bridge to transplantation. We are currently the only independent pediatric program to offer the following 6 devices, as well as extracorporeal membrane oxygenation (ECMO), to a children whose hearts are failing:
- Maquet Rotaflow: Short-term usage
This paired console and centrifugal pump is used for cardiac bypass support. As an external device, it is easier to install and remove than a conventional VAD. It requires the patient to remain intubated and sedated, so it is only for short-term use – as when a patient is suffering from a temporary condition or when the diagnosis is unclear. There are no age or size requirements for the Maquet Rotaflow.
- Cardiac Assist Tandem Heart: Short-term usage
This external VAD can be connected to the patient via a tube (called a cannulae) to the left atrium, or for a less invasive option with lower risk of infection, it can be connected via the femoral artery. The Cardiac Assist Tandem Heart is suitable for use in patients with a body weight of about 110 pounds – generally 14 or 15 years old.
- Thoratec Paracorporeal VAD: Long-term usage
The external Paracorporeal VAD is the only device approved by the Food and Drug Administration (FDA) for right ventricle support – that means it helps the heart pump blood to the lungs for oxygenation. In some cases, Texas Children's surgeons pair the Paracorporeal VAD with the HeartMate II to provide extra support for patients whose hearts are failing on both sides. It is suitable for children 7 to 8 years and older.
- Thoratec HeartMate II: Long-term usage
The HeartMate II is an internal device used for temporary support in children awaiting transplant and as a permanent device in transplant-ineligible patients. The HeartMate II is a ventricular assist device (VAD) that supports the left ventricle's work as the "power stroke" that sends blood throughout the body. It can be used in patients 13 to 14 years and older.
- Berlin Heart EXCOR: Long-term usage
The Berlin Heart EXCOR is an external VAD specifically designed for use in pediatric patients – with different sizes available for children ranging form 6 pounds to adolescents. While patients must remain in the hospital, they have considerable mobility with the device. Results of a highly successful national study on its effectiveness were published in 2012 in the New England Journal of Medicine. Charles D. Fraser Jr., MD, surgeon in chief at Texas Children's Hospital, was the principal investigator.
- Syncardia Total Artificial Heart: Long-term usage
Used in cases in which both sides of the heart are failing, this internal device completely replaces the child's heart awaiting a donor heart. In March 2012, the FDA approved a Humanitarian Use Device designation allowing the Total Artificial Heart to be used permanently for patients not eligible for transplant. The device can only be used on patients who are approximately normal adult size.
Since we implanted our first pediatric ventricular device in 1985, we have become one of the busiest VAD programs in the world. In the past 5 years, we have placed nearly 50 VADs in patients with acquired and congenital heart disease.
