innovative heart failure devices offer treatment options for children living with advanced heart disease
left ventricular assist devices (lvad) can give kids and teens with advanced heart disease a new lease on life
4 minute read
“it can dramatically improve the life of the child and the family,” says cardiologist dr. holger buchholz. “they can travel again; they can go back to school." jason franson
this story is sponsored by
abbott canada
this story was created by content works, postmedia’s commercial content division, on behalf of a client.
while advanced heart failure is a condition associated with adults, it also impacts children and adolescents, many of whom require a heart transplant or mechanical device implant to survive. these children may need to spend an immense amount of time at the hospital, miss school and are often not able to run and play with their peers in the same way.
advanced heart failure, which affects approximately 75,000 canadians, is a condition where the heart becomes weak and is not able to pump enough blood throughout the body. in adults, some of the most common symptoms include breathlessness, fatigue and swelling in the legs, but the disease can present very differently in children.
heart failure in children
“it’s not uncommon for a child to end up in the emergency room because the family thinks they have a gastrointestinal bug,” says dr. holger buchholz, a cardiac surgeon and director of the pediatric and adult artificial heart program at the stollery children’s hospital and mazankowski alberta heart institute in edmonton, alberta.
other symptoms include cough, fatigue and loss of appetite. because these symptoms are similar to less serious pediatric illnesses, kids with advanced heart failure have the potential to be misdiagnosed, leading to delayed diagnosis and treatment.
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the underlying cause of advanced heart failure is another point of differentiation; damage to the vessels around the heart — most commonly driven by diabetes, hypertension, high lipid levels or obesity — is the major cause in adults, while common causes in children are infection and congenital heart defects.
dr. buchholz says that asking parents about their child’s behaviour can also help identify whether the child might be in heart failure, particularly when they haven’t experienced symptoms in the past.
“if you ask them what their child is like, they often describe them as a perfect child,” he says. “it means that they’re very quiet, don’t really play sports, like to read, like to stay with their parents. combined with other symptoms, that can be a sign that they have heart failure, because the kids are avoiding stressful situations.”
because heart failure is a complex, progressive disease, it can be difficult to diagnose and then manage. for this reason, ongoing communication with your healthcare professional team is critical.
new treatment options for children with heart failure
dr. buchholz notes treatment options for advanced heart failure include oral medications and diuretics to help the kidneys flush out excess fluids. “patients are normally on a variety of medications or diuretics, including ones that control blood pressure and help keep the heart working,” he says.
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but as the disease progresses, medications alone may not be enough and other therapeutic options may be needed to increase chances of survival. for several years in canada, adults living with advanced heart failure have had the option of receiving a left ventricular assist device (lvad), which is a small implantable pump designed to help the heart pump blood.
lvads have a strong survival rate, comparable to higher-risk transplant patients five years after surgery.
until recently, canadian pediatric patients didn’t have the same options. fortunately, lvads are now an option authorized by health canada for use in kids with advanced heart failure who are waiting for a heart transplant or who are otherwise not eligible to receive a transplant. this provides an additional treatment option beyond current options, while also reducing the amount of time they may need to be in hospital.
“children and teens with advanced heart failure previously had to stay in the hospital for months — or years — to receive continuous medical care. now there is an option that allows the patient to go home while they wait for a heart transplant.
“it can dramatically improve the life of the child and the family,” says dr. buchholz. “they can travel again; they can go back to school. that’s a big advantage.”
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dr. buchholz adds, “if the device is implanted at the ideal time, before other organs are severely damaged, many symptoms of heart failure can be almost completely eliminated.”
living with an lvad
there are limitations that children and their caregivers have to learn to navigate while using an lvad. “you have batteries, you have dressing changes, and you have to take medications,” dr. buchholz says. for many of his patients, the quality-of-life benefits of the device outweigh the limitations they learn to live with after the device is implanted.
“we have pediatric patients who went to disneyland,” he adds. “others go to summer camps and are enjoying sports again. we had a patient who is playing hockey again. while this isn’t true of all kids with an lvad, if they and their families learn to focus on the things they can do, they can have improved outcomes and better quality of life.”
to learn more, speak with your healthcare professional.
this story was created by healthing content works, healthing.ca’s commercial content division, on behalf of abbott canada.
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