What is the Berlin Heart?
When a donor heart is not available during the end stage of heart failure, implanting a mechanical pump is often the best way to keep a patient alive. A ventricular assist device takes over the function of the damaged ventricle of the heart to restore normal blood flow. Although there are many devices designed for adults, very few are available in the United States for children and infants. Fortunately, the "Berlin Heart" (manufactured in the German city) comes in various sizes for a range of children, from newborn babies to teens.
What does the Berlin Heart do?
The device, first used in the United States in 2000, takes over the heart's work of pumping blood. In a normal heart, blood moves from the right atrium into the right ventricle, which then pumps the blood through the pulmonary artery into the lungs. The blood then returns to the heart via the left atrium, then to the left ventricle and finally into the aorta, which carries the blood to the body. The Berlin Heart pumps can be used to pump blood to the body and/or the lungs. The blood is removed from inside the heart and then pumped directly into the blood vessels that go to the body and/or the lungs.
Most of the device is outside the body; only the tubes are implanted. They emerge from small openings in the skin to enter the pump, a small round chamber. The system consists of a pneumatic compressor that is run by a laptop computer.
The Berlin Heart is intended to be a bridge to recovery, or a temporary measure until a heart becomes available for transplant. In the past, each time it was used in the United States, doctors had to appeal to the Food and Drug Administration for permission, then have the device flown in from Germany. After the device is used on each child, it had to be returned.
The Berlin Heart is especially attractive for children awaiting heart transplantation because they can be removed from breathing machines and allowed to move and even walk. This allows them to be involved in at least some of their regular activities while they are waiting for a donor heart and be stronger when they are taken for transplantation.
How widely used is the device?
The FDA — in a case-by-case review — has allowed its "compassionate use." And thanks to a research study underway in this country, the device is now more readily available. In July 2008, Children's Memorial was one of 40 U.S. pediatric centers allowed compassionate use, and the first hospital in Illinois to implant the device.