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Child-Size Heart Treatment Saves 5-Year-Old's Life

FDA Makes Exception on Pending Treatment to Save a Young Boy's Life

Synopsis
The FDA made an exception and permitted the use of the Berlin Heart pump, which is approved for use throughout Europe but not the United States, to keep 5-year-old Joseph Greenwood alive as he awaited a heart transplant.
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What happens when a child needs a new heart and there's no heart readily available to transplant? That was the dilemma for doctors treating 5-year-old Joseph Greenwood.

Jojo's Surgery
Joseph celebrates his sixth birthday, five days after undergoing a heart transplant at the Medical University of South Carolina's Children's Hospital.
(Brennan Wesley)

Before his medical problems began, Joseph was a happy, healthy child. Then in March, he unexpectedly collapsed.

Joseph's father performed CPR while frantically dialing 911. Shortly thereafter an ambulance arrived and rushed them to a hospital near their hometown of Florence, S.C. From there, a helicopter flew them to the Medical University of South Carolina in Charleston.

Doctors determined his heart had failed and diagnosed the problem as dilated cardiomyopathy. They suspected a virus that Joseph contracted a year ago had caused his immune system to attack and destroy his heart muscle. Gradually, his heart grew bigger and weaker until it finally stopped.

In Charleston, doctors put Joseph on a standard heart-lung machine. But these machines are not designed to keep a patient alive for more than a few days. Adults can get ventricular assist devices, or VADs, but there are no such devices in the United States designed for children.

Special Care for Young Patient

The standard heart-lung machine poses significant risks for children, who have on occasion developed strokes while on it. They can also develop renal and liver failure. In Joseph's case, his lungs started to fail, which worried his doctor. "Once his lungs start to suffer," Dr. T.Y. Hsia told ABC News, "the urgency really starts to rise. Because even if you get a good heart and the lungs don't work, you're still going to die."

Hsia and many other doctors believe there's a better life-support device, a German-built pump called the Berlin Heart that's made specifically to keep children alive while awaiting a heart transplant.

One child survived for more than 12 months on this device, which pumps like an actual heart with a pulse more natural to the body, while the standard heart-lung machine creates a steady flow of blood out, blood back into the body.

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