Sanford teen awaiting heart transplant after receiving temporary total artificial heart
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A 16-year-old girl in severe multi-organ system and heart failure is the first in Florida to receive the SynCardia temporary Total Artificial Heart, the only approved mechanical device that eliminates the symptoms and source of heart failure.
University of Florida Health surgeons implanted the device in early June in an effort to stabilize Sanford, Fla., teenager Nalexia “Lexi” Henderson so she would be healthy enough to survive transplant when a donor heart becomes available.
UF Health Shands Hospital is the first in Florida to become a SynCardia certified center. Certification requirements include SynCardia training and lectures, preparing to perform an implant, and actually performing the first implant with a surgeon in the operating room who is experienced in placing the SynCardia Heart.The SynCardia and UF Health care teams soon hope to switch Lexi to the Freedom Portable Driver, a wearable power supply for the SynCardia heart. The driver is the first wearable power supply for the SynCardia heart and is undergoing a Food and Drug Administration investigational device exemption clinical study in the United States.
UF Health cardiothoracic surgeon Mark Bleiweis, M.D., and his team removed Lexi’s own failing atria and ventricles and implanted the SynCardia temporary Total Artificial Heart, which is powered by an external machine nicknamed “Big Blue.” At 418 pounds and the size of a washing machine, Big Blue provides pneumatic power to the heart, but it isn’t conducive to patient mobility. The portable driver will allow Lexi to walk around the hospital more freely instead of being confined mostly to the pediatric intensive care unit.
“I feel like my normal self,” Lexi said, despite having tubes exiting from her upper abdomen that connect her artificial heart to her external driver. “You get used to them. There’s nothing bad about the SynCardia Heart; you got life.”
When Lexi arrived at UF Health Shands Children’s Hospital in mid-May, she thought she just had a very bad stomach virus. She’d had relentless stomach pains and had been throwing up for several days. It was much worse than that, however. She was diagnosed with severe cardiac allograft vasculopathy, a condition in which the coronary arteries are severely damaged by risk factors associated with a heart transplant.
Lexi received her first heart transplant at UF Health Shands Hospital in 2007, after developing dilated cardiomyopathy — her heart became enlarged and weakened — for an unknown reason.
In May, she was in severe heart failure again; her heart could no longer pump enough blood throughout her body to keep her other organs functioning. Her body was shutting down.
Her cardiac care team initially tried using extracorporeal membrane oxygenation, or ECMO, a method of providing cardiac and respiratory support to patients whose heart and lungs can no longer function.
“Lexi was clearly in shock; she was really sick,” said Bleiweis, director and principal cardiothoracic surgeon for the UF Health Congenital Heart Center. “We supported her with ECMO for a short period, but her previous transplant was failing. She was in deep trouble, with multiorgan dysfunction.”
While UF Health offers pediatric and adult cardiac patients a variety of ventricular assist devices, the primary devices for children are the SynCardia temporary Total Artificial Heart and the Berlin Heart. In 2006, UF Health Shands was the first in Florida to use the Berlin Heart, an external device specifically designed for children that connects to the patient’s own heart.
The SynCardia heart was a better choice for Lexi, who is nearly adult-sized, because it is a larger device and can pump more blood than the Berlin Heart.
Without devices like the SynCardia heart there are limited options, Bleiweis said.
“We choose a machine to help the heart because we feel medication alone won’t be enough for them to survive until transplant,” he said. “With the SynCardia heart, Lexi’s other organs have completely recovered. She’s now an excellent candidate for transplant.”
June 3, 2013: UF Health became the first pediatric heart center in Florida to use the SynCardia temporary Total Artificial Heart.
Nov. 20, 2013: Nalexia “Lexi” Henderson is transferred from the 418-pound “Big Blue” external device to the Freedom Portable Driver, a 13½-pound, backpack-sized power supply for the SynCardia heart.
According to the Organ Procurement and Transplant Network website at optn.transplant.hrsa.gov, as of Nov. 18, 2013:
- There were 27 pediatric patients (ages 0-17) who are heart transplant candidates with UF Health Shands Children’s Hospital.
- There were 315 pediatric patients in the United States, awaiting a heart transplant.
According to www.organdonor.gov, 18 people die each day waiting for an organ.
Fast facts about the UF Health Congenital Heart Center:
- Ranked by U.S. News & World Report as one of the Top 50 pediatric cardiology and heart surgery programs in the country;
- In 2012, the UF Health Congenital Heart Center performed 15 heart transplants. So far in 2013, it has performed 14 heart transplants.
- Heart transplant survival rates are better than expected and national survival rates for 1-month, 1-year and 3-year. Its survival rate at 1 month is 100 percent, compared with a national average of 94 percent; 1 year is 90 percent for the center compared to 89 percent nationally; and 92 percent at 3 years, compared to 83 percent nationally. (July 2011 report from Scientific Registry of Transplant Recipients)
- Only center in North Florida region that has experts specializing in cardiac care for unborn babies, newborns (including premature and low-birth-weight babies), children, adolescents and adults
UF Health and its Congenital Heart Center are the first in Florida to perform:
- 1986: pediatric heart transplant
- 1993: infant heart transplant
- 1999: pediatric heart/lung transplant
- 2006: Berlin Heart implant as bridge to transplant
- 2013: heart/lung transplant in youngest infant
- 2013: SynCardia Total Artificial Heart implant as bridge to transplant
- Multi-media: www.syncardia.com/media/multimedia-library-dp1.html