This patient's story is out of the ordinary. He came to the Lausanne University Hospital at the age of three, in the early summer of 2022, to be treated for cancer. A few weeks after his hospitalization, he developed severe heart failure as a result of an infection. Due to his oncological treatment, the child could not be put on the waiting list for a heart transplant. As his heart was no longer supplying his body with sufficient blood, the boy received a biventricular heart assist device (BVAD) - Berlin Heart EXCOR.
The pediatric cardiac surgery team at the Lausanne University Hospital implanted EXCOR as a BVAD to support the heart with a potential transplant in mind.
This little boy was hospitalized on our unit for a year," says Dr. Maria-Helena Perez, Head Physician of the Lausanne University Hospital's Pediatric Intensive and Intermediate Care Units. “Over time, we developed a strong bond with him and his family. To give them more freedom, we taught the parents how to familiarize themselves with the machine. Thanks to this, they could leave the unit while remaining within the perimeter of the Lausanne University Hospital."
Signs that the heart was recovering
A few months after the EXCOR implantation, the team and the parents saw signs that the heart was recovering. "During a check-up ultrasound, I saw that a competition was developing between the heart and the machine. That's when the idea of weaning the child off life support, without the need for a transplant, began to germinate," explains Dr. Stefano Di Bernardo, pediatric cardiologist and head physician of the Woman-Mother-Child Department at Lausanne University Hospital. The parents agreed to try to wean the BIVAD support.
CHUV activates its network for a challenging operation
“We decided to remove the machine and keep the native heart," explains Prof. Reza Hosseinpour, chief physician and pediatric cardiac surgeon at Lausanne University Hospital.
To carry out the bi-ventricular weaning operation in the Lausanne University Hospital's operating theatre, Prof. Hosseinpour was accompanied by surgeon Fabrizio De Rita, a specialist from Newcastle (England) who is very familiar with the procedure. "His presence was a great help. He accompanied me and showed me the pitfalls to avoid, but none of this would have been possible without the help of the whole OR team, the anesthetists, perfusionists, instrument technicians and ward assistants", says Prof. Hosseinpour.
The operation lasted an entire morning and was a success. The child was able to leave intensive care just a few days after the operation and return home a month later. In remission from his cancer, he is now being treated as an outpatient at the Lausanne University Hospital. “We went through a terrible rollercoaster, but we kept our faith and fought through it all," says his dad. When we got home, our son went straight to his room and started playing with his train, as if he'd left it the day before."
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From left to right: Dr Sylvain Mauron (Associate Pediatric Anesthesiologist), M. Guillaume Besse (Berlin Heart Clinical Specialist), Dr. Maria-Helena Perez (Head Physician Pediatric Intensive and Intermediate Care Units), Dr Fabrizio De Rita (Pediatric Cardiac Surgeon), Prof. Reza Hosseinpour (Senior Physician, Head of Pediatric Cardiac Surgery), Dr Stefano Di Bernardo (pediatric cardiologist and head physician of the Woman-Mother-Child Department) and Mr Philipp Zrunek (Berlin Heart Clinical Specialist).