Excerpt reprinted from the Catalyst Online Friday, April 27, 2007. In addition to the skilled cardiovascular surgeons, cardiologists and nurses involved in the first Berlin Heart implantation in South Carolina April 4, the MUSC Cardiovascular Perfusion Program assisted in placing the device in a 5-year-old patient with congestive heart failure. This ventricular assist device is the only one available for pediatric patients, and it is not approved by the Food and Drug Administration in the U.S. despite being widely used in Europe since the early 1990s. It can only be implanted after getting approval from the FDA and the hospital IRB for “compassionate use.”
The young patient marked the 88th time the device has been implanted in this country.
“I think this was a great team effort on the part of all the physicians, nurses, perfusionists and pharmacists,” said Joe Sistino, College of Health Professions’ Cardiovascular Perfusion Program director and one of the lead perfusionists during the surgery. “There were many people who contributed from the ECMO team, the Berlin Heart implant team, and the heart transplant team. Dr. T.Y. Hsia did a wonderful job coordinating the effort and everyone felt part of the team and that their contributions were greatly appreciated. ...The pediatric cardiologists also were very receptive to suggestions made by Berlin Heart on how to manage the patient, and I think that everyone learned a great deal from this experience.”
To prepare for implantation of a device that few in the U.S. have experience with, the clinical specialist from Berlin Heart, Bob Kroslowitz, met with and trained all of the nurses, perfusionists and surgeons involved with the procedure early the day before. MUSC perfusionists learned many things for the first time, including how to do “platelet mapping” to assist with the anticoagulation of the patient following the implant. Seventy percent platelet inhibition is the key to long term success of the device, as with too little platelet activity the patient bleeds, and with too much the pumps develop clots which can cause strokes.
“Bob works with many large cardiac centers and told me about a very well known pediatric cardiac center where he had to sit down and remind the cardiac surgeons and cardiologists there that they must work together if they want to have a successful outcome,” said Sistino. “On the other hand, Bob was very complimentary regarding the relationships and communication that he witnessed at MUSC. Based on that, he said that he expected an excellent outcome at MUSC because of the high quality of care, and especially the teamwork he observed here. We should all be very proud of this accomplishment.”
Catalyst Online is published weekly, updated as needed and improved from time to time by the MUSC Office of Public Relations for the faculty, employees and students of the Medical University of South Carolina. Catalyst Online editor, Kim Draughn, can be reached at 792-4107 or by email, catalyst@musc.edu. |
