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The Heart Center Update

Published quarterly for pediatric cardiologists ? Estimated Read Time: 11 minutes
A perspective on the
HeartMate II ® and use
at University of Minnesota
Amplatz Children?s Hospital
In 2005, the University of Minnesota
became one of 40 centers to conduct clinical
trials on the New HeartMate II. Although
HeartMate II clinical trials are limited to
patients 18 and older, in April 2008, the
FDA approved the device for bridge to
transplant (BTT) therapy, making the device
available to teenagers. In February 2009, I
implanted the HeartMate II in a 17-year-old
boy with severe dilated cardiomyopothy.
The LVAD supported the patient until he
received a donor heart in May 2009. The
teen is doing well, with no signs of rejection.
I?ve also implanted the HeartMate II in
several adult congenital patients and have
concluded that this LVAD represents the
next generation of devices.
The first generation of LVADs mostly
supported patients needing BTT
therapy. These devices provided excellent
pulsatile hemodynamic support but had
significant co-morbidity associations. Such
complications might have been related to the
need for extensive surgical dissection, a large
pump and a large-diameter percutaneous
lead. Additionally, the first LVADs were
limited in their long-term durability.
Continues on page 5-->
uofmchildrenshospital.org
U N I V E R S I T Y O F M I N N E S O T A A M p l A T z C H I l D R E N ? S H O S p I T A l
By James St. Louis, M.D.
Co-Director,
The Heart Center
Cardiac transplantation and
donor availability in Minnesota
Since University of Minnesota Amplatz Children?s Hospital began its pediatric heart failure
and heart transplant program in 1981, cardiac transplantation has become an accepted form of
therapy for pediatric patients who have end-stage congenital-heart disease and cardiomyopathy.
Tertiary medical centers that care for children with complex congenital heart disease offer cardiac
transplantation as a final therapy when other medical and surgical treatments fail.
A primary drawback to heart transplantation in children ? especially infants ? is donor organ
availability. Minnesota is not immune to this problem. According to the United Network for
Organ Sharing (UNOS), during the past 20 years in Minnesota, there have been only 41
cardiac donors less than 1 year of age, and 177 between the ages of 11 and 17 years.
Furthermore, over the past 14 years, nearly 70 percent of the pediatric heart
transplant waiting-list mortalities have been in patients less than 5 years old.
A contributing factor to this shortage is the criteria for pediatric donor
hearts ? such as age and size ? which makes them even less
available than donor hearts for adults. Compounding this
problem is the fact that hearts in the U.S. are offered
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October 2009 Vol. 2, issue 3
Evelyn, the University of Minnesota?s 500th heart transplant recipient, and her mother, Ing-Mari

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