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An Artificial Heart For The Children

Posted on Wed, May 5, 2004

By: Daniela Daniele

An artificial heart as small as a 2-euro coin is currently being experimented at the University of Pittsburgh Medical Center (UPMC). After the trial at the American center, the Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione (ISMETT) will benefit of this new device thanks to the international partnership between the two institutions.

The tiny artificial heart is a “device for pediatric ventricular assistance (PVAD), to be implanted into very young children affected by severe genetic cardiac malformations and defects,” as explained by a joint note of the American University and of the Center in Palermo. The device consists of a miniaturized centrifuge pump using an electromagnetic technology, to be implanted into children weighing between 2.5 and 15 kilos. “The pediatric artificial ventricle might be used up to six months,” – researchers explained, “as a bridge-therapy for children listed for a heart transplant.”

UPMC was granted 4,500 billion dollars by the National Heart, Lung and Blood Institute to start the experimentation at the McGowan Institute.

It will be possible to implant the artificial ventricle completely, with a small external derivation connected to an external power supply. This way, baby patients will be able to live an almost-normal life, and, most important, move freely.

Researchers expect to complete the first experimental trial within 5 years. “The pediatric ventricular assistance device will be a more complex version than the artificial device used to treat adults,” said Bradley Keller, pediatrician at UPMC, “as it needs to satisfy special medical needs mostly related to newborns’ circulatory assistance.”

“We have a strong need of devices for newborns: so far, the only available means of support is the ECMO, a very complex device that forces children to remain completely immobile and that can be used only for a few weeks,” said Harvey Borovetz, director of the University of Pittsburgh’s Bioengineering Department and head of the research trial, “not to mention that this system also implies extremely high complication and mortality rates.”

The researchers’ goal is to develop a device capable not only of enabling children “to reach transplantation in good health conditions”, but also of representing a decisive therapy that may allow the cardiac muscle to recover completely, in order to avoid transplantation.

At present, ISMETT’s plans do not include pediatric cardiac surgery, but Medical Director Bruno Gridelli assured the Istituto is committed to provide the artificial heart to the Italian centers that will need it, once the device will be ready. “Newborns affected by severe cardiac failure, who fortunately are few,” said Gridelli, “currently have only one option to survive: extracorporeal circulation. But this requires sedation for several days or weeks, until a heart becomes available for transplantation (and it’s not easy to find donors among newborns) or until a corrective surgery is performed, or until the cardiac muscle damage recovers.”

When will the small artificial heart be available in Italy? “We don’t know that yet. It will depend on the experimentation’s outcomes.”

Files: Un_cuore_artificiale_p16.pdf

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