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Stollery Children's Hospital performs first pediatric mechanical heart procedure in Western Canada

In May 2005, eight-year-old Brandon Shapland became the first child in Western Canada to receive an artificial heart, thanks to doctors at the Stollery Children’s Hospital in Edmonton. The mechanical heart, known as the Berlin Heart, can keep a failing heart beating, while a patient waits for a donor heart transplant. Brandon suffered from cardiomyopathy, a disease that reduces the heart muscle’s ability to pump. When Brandon arrived in Edmonton from Kenora, Ontario, the only answer was a transplant. However, pediatric donor hearts are in short supply. Unlike adult hearts, children’s hearts are growing, and a heart that is just right for a baby or a toddler won’t help an eightyear- old boy. As a first step, Brandon was attached to Extracorporeal Membrane Oxygenation (ECMO), a heart-lung machine that pumps for the heart and gives the heart and lungs a rest. But ECMO is a short-term solution. Patients can only stay on ECMO for a few weeks. Any longer, and they risk bleeding, clotting and infection. The latest innovation is the artificial heart. Artificial hearts actually date back to the 1980s. However, these early renditions were large and cumbersome. Today, adult devices and the Berlin Heart are comfortable, light-weight and less risky. Patients can wear these devices for months, while they wait for a transplant. "Initially we thought that it would be a number of weeks until a donor heart would become available,” says Dr. Ivan Rebeyka, pediatric cardiac surgeon at the Stollery Children’s Hospital, adding that the Berlin Heart made it possible for Brandon to wait. Fortunately, Brandon had a very short wait. Three days after receiving a Berlin Heart, pediatric cardiac surgeons Dr. David Ross and Dr. Rebeyka implanted Brandon’s donor heart.

Last year, the Stollery Children’s Hospital performed eight heart transplants and has already performed 16 in 2005. In Edmonton, about four to six pediatric patients will receive an artificial Capital Health has made it possible for the Royal Alexandra and University of Alberta Hospitals to perform an additional 880 angiograms and angioplasties every year. During the fiscal year ending March 31, 2005, Capital Health completed 6,432 angiograms and 2,666 angioplasties. “Since extending hours in February 2004, we have performed approximately 475 additional procedures at both University of Alberta Hospital and Royal Alexandra Hospital,” says Dr. William Hui, chief of Cardiac Services at the Royal Alexandra Hospital. “As of the end of October 2005, the regional waitlist had decreased by approximately 260 patients since implementation of the expanded hours. Average wait times are less than two days for urgent inpatients. For outpatients, wait times have dropped from an average of 81 days in March 2004 to an average of 50 days. For angioplasties, wait times have dropped from an average 43 days to an average of eight days in October 2005.” The Mazankowski Alberta Heart Institute, which opens in 2007, will add a fifth cardiac catheterization laboratory to the region. This new lab will be specifically equipped for children and will significantly increase access to both adult and pediatric procedures. An angiogram is a diagnostic test that shows cardiologists if one or more arteries are blocked. An angioplasty is a nonsurgical procedure to open a blocked blood vessel. Patients with blocked heart every year, a figure likely to increase due to a continued shortage of donor hearts. “It is still rather rare for children to have heart transplants, and until now no one was manufacturing mechanical hearts, for children,” says Dr. Rebeyka, Berlin Heart AG, based out of Germany, is the first company to manufacture mechanical hearts in various sizes for children of different ages. And Edmonton is the first centre to offer mechanical hearts to both adults and children.

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