Small, Implantable Cardiac Pump to Help Children Awaiting Heart Transplant

Implantable ventricular assist devices, available for adults for over 40 years, fit inside the chest and are generally safer and easier to use than external devices. These devices enable patients to live at home, attend work or school, and engage in activities like walking and biking. In contrast, pediatric medical technology lags significantly. The only ventricular assist device for young children is the Berlin Heart, which is external, suitcase-sized, and linked with a high stroke risk. This device requires hospitalization, often for extended periods, as children wait for a donor heart. This situation places a greater burden on children compared to adults, who can typically leave the hospital with similar devices. Now, a small, implantable cardiac pump that has proved successful in initial human trials could allow children to await heart transplants at home rather than in hospital settings.

This pump, known as the Jarvik 2015 ventricular assist device, is surgically attached to the heart to boost its pumping capability, buying time for a donor heart to be found. This could bridge a significant gap in pediatric heart transplant care. Researchers at the Stanford School of Medicine (Stanford, CA, USA) have tested this device in a feasibility trial involving seven children with failing hearts, out of which six proceeded to heart transplants, and one recovered without the need for a transplant. The Jarvik 2015, about the size of an AA battery, can be implanted in children as light as 18 pounds, allowing them to engage in normal activities while they await a heart transplant. Pending further validation in a larger trial, this device could simplify the transplant waiting process for young patients and their families.

Image: The implantable ventricular assist device can support a child’s failing heart (Photo courtesy of Jarvik Heart, Inc.)

“While we are extremely grateful to have the Berlin Heart, a life-saving device, ventricular assist devices for adults have been improving every decade, but in pediatrics, we’re using technology from the 1960s,” said the study’s lead author, pediatric cardiologist Christopher Almond, MD, professor of pediatrics at Stanford Medicine. “There’s a huge difference in the medical technology available to kids and adults, which is an important public health problem that markets have struggled to fix because conditions like heart failure are rare in children.”

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Stanford School of Medicine