Cardiomyopathy, Heart Failure and Transplantation

Treatments We Offer

Comprehensive Child-Centered Advanced Care

If your child has been diagnosed with cardiomyopathy, our expert pediatric cardiologists will tailor your child’s treatment to the type and severity of the cardiomyopathy, the prognosis of the underlying disease, family preferences and your child’s overall health. Treatment is individualized and tailored to your child’s unique needs.  Our goal is to manage and monitor your child’s heart condition from diagnosis until adulthood, so that any disease progression can be treated quickly and effectively.

Medications

Medications can be very useful in treating cardiomyopathies and heart failure, especially in the early stages. Medications are also sometimes used in conjunction with surgery to correct heart abnormalities that can cause heart failure. Some of the medications currently used to treat heart failure include:

• Angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers and combination angiotensin receptor blocker/neprolysin inhibitors dilate the blood vessels in the body to make it easier for the heart to pump blood forward.
• Beta blockers slow down the heart rate and lower blood pressure, which allows the heart to pump more efficiently.
• Digoxin helps the heart muscle contract better and controls the rate and rhythm of the heart.
• Phosphodiesterase-5 inhibitors such as sildenafil and tadalafil dilate the body’s blood vessels with particular focus on the blood vessels in the lungs, and also help with relaxation of the ventricles.
• Aldosterone antagonists reduce the scar tissue of the heart muscle and helps the heart muscle recover.
• Diuretics help prevent the buildup of fluid or remove fluid from the body and can help ease breathing by reducing fluid in the lungs.  
• Intravenous inotropes (increases the heart’s ability to pump blood) and vasopressors (increases the blood pressure when it is too low) are used in cases of heart failure refractory to oral medication therapies.

Pacemakers and Defibrillators

Pacemakers and defibrillators are tiny devices that are implanted under your child’s skin, where they help monitor and control the heart’s rhythm. Your child may need a pacemaker or defibrillator if he or she has an certain type of abnormal heart rhythm (arrhythmia) that cannot be controlled with medication.  

Procedures That Treat Arrhythmias

These procedures, also called electrophysiology procedures, use long thin tubes called catheters, which are inserted through a tiny incision in the body and guided into the heart. They measure the electrical activity in the heart’s chambers to determine the origin of an abnormal rhythm, and sometimes can correct it. Radiofrequency ablation is a type of minimally invasive treatment in which a small, needle-like probe is inserted into the scarred tissue of the heart muscle, sending out radiofrequency waves that burns away the scar tissue causing the abnormal rhythm. It can be effective for some children with cardiomyopathy that is secondary to a long-standing arrhythmia. 

Ventricular Assist Devices (VADs)

Children experiencing advanced heart failure and are getting worse symptomatically despite the best oral and intravenous medications may be candidates for a ventricular assist device (VAD). A VAD is a specialized heart pump that maintains blood flow in people with serious heart failure. We currently use various devices to help left, right or biventricular heart failure in patients from infants to young adults. Our pediatric heart surgeons are at the forefront of developing and designing VADs for infants and small children as a bridge to transplantation. We also specialize in the use of durable VADs as a permanent option for patients unable to receive a heart transplant and the use of temporary devices as a bridge to recovery.

• As leaders in research into the use of mechanical circulatory support as a bridge to transplantation, we were among the first in the United States to implant a Berlin Heart EXCOR heart pump into a newborn and a Jarvik 2015 ventricular assist device in a toddler as a successful bridge to heart transplant.
• As a pioneer in the use of alternatives to transplant in pediatrics, we have successfully used the Heartmate 3 LVAD as destination therapy in several patients, including ones with Duchenne Muscular dystrophy.
• We recently became one of the first pediatric centers in the United States approved to use the Syncardia Total Artificial Heart
• We have extensive experience and expertise in the use of a multitude of permanent and temporary support devices including:
  • Berlin Heart EXCOR VAD
  • CentriMag and PediMag (Levitronix) continuous flow VADs
  • Heartmate 3 VAD
  • Jarvik 2015 VAD
  • Impella temporary assist devices