Texas Children's Hospital has become the first paediatric hospital in the US to discharge a child while on an intracorporeal ventricular assist device (VAD), a feat previously accomplished only at adult institutions.
The patient, 16-year-old Francisco "Frank" De Santiago, who was implanted with a mechanical heart pump called the HeartMate II on May 19, 2009, was discharged on Oct. 29, 2009.
"This is a promising next step for the care of children with heart failure as Frank is the first patient on record to be medically discharged from a pediatric hospital with a mechanical heart assist device. The device, which is implanted into the chest cavity near the heart, stays inside the body rather than outside. It has helped the patient grow stronger by allowing him to eat well, exercise and enjoy life," said Dr. David L.S. Morales, paediatric cardiovascular surgeon at Texas Children's Heart Center, who performed the surgery on De Santiago.
Texas Children's Hospital is the first paediatric hospital in the world to use the HeartMate II.
Since April, 2008, Morales, Director of the Pediatric Mechanical Circulatory Support Program, has implanted five teen and pre-teen patients, including De Santiago, with VADs.
Four of these patients have already received successful heart transplants and are enjoying their teen years in good health.
"What's especially significant about De Santiago's case is that his life outside the hospital signals a new era of possibilities for pediatric heart failure patients, especially as the number of cases diagnosed annually continues to rise. Until now, pediatric hospitals have kept patients in the hospital, if not the ICU, while awaiting transplant," said Morales.
The Thoratec HeartMate II, about the size of two "D" cell batteries laid end-to-end, received U. S. Food and Drug Administration approval on April 26, 2008.
The pump is a long-term, mechanical circulatory support device designed for a broad range of advanced-stage heart failure patients.
It allowed paediatric patients to live until a donor heart becomes available.
The device could also allow some of these children to recover their heart function.
De Santiago was flown to Texas Children's Hospital in May after having suffered a temporary stroke.
He was diagnosed with dilated cardiomyopathy, a condition in which his heart was enlarged to more than twice a normal size and could not pump blood efficiently.
Physicians placed him on a heart transplant list and decided to implant a HeartMate II.
Morales said that De Santiago is able to enjoy a more normal life outside the hospital.
"He can do many of the things he loves like eating his mother's home cooking, exercising outdoors and going to the movies. He'll be coming to Texas Children's for follow-up visits and physical therapy. We're keeping a close eye on him while he waits for a donor heart," Morales said.