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 on Wednesday switched 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 Dr. Mark Bleiweis 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.”
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