Patient Stories

Arkansas Children’s Hospital, First to Successfully Bridge Patient From New Heart Pump to New Heart

Travis was a high risk candidate for this but he had no other options. The DeBakey VAD Child allowed Travis’ organs time to recover from heart failure, allowing his body to be more prepared for transplant, once a heart became available.

Travis’ heart history began when he was born. The major arteries leading to his heart were reversed, better known as transposition of the great vessels. It’s a condition that’s not uncommon in infants, and can be repaired with a surgical procedure. Travis, however, was on his second pacing system and required surgery on his primary arteries and mitral valve.

Rick and Shari Marcus of Cabot have watched the hours pass, the days dwindle, and the weeks wander on, since the beginning of September. That’s when Travis was first brought to Arkansas Children’s Hospital for what they thought was a failed pacemaker. They soon learned it was the left side of Travis’ heart that failed him, and time was a leading factor in saving his life. The best they could hope for was a new heart that would come quickly.

Travis was immediately placed on the list for transplant, but his health declined very rapidly. The only option to keep him alive was to be placed on a heart/lung bypass machine. This would keep him alive, but his time was limited because his body was sick and the bypass machine would take its toll after several weeks.

Travis didn’t have several weeks; he possibly didn’t even have several days. He needed another option. That option – was sitting just down the hall from him and had been used in only one other child in the world. It is easier on the body, can be implanted inside a patient and will allow some children mobility and less stress on their bodies, while awaiting transplant.

“The biggest thing in my mind was, I hope it works – and it has,” says Rick Marcus, just weeks after the new heart pump was implanted. “The VAD gives us the opportunity to wait for a heart and the opportunity to be selective. This way we can be sure we get the right heart and don’t have to take the chances of a mismatch.”

The Marcus family was used to doctors, used to hospitals, used to waiting, but this time the wait was different. There were no definite answers and no time to spare. Finally, nine weeks, and what seemed like nine lives later, they got the call on the morning of November 11.

“Our daughter, Tonya, and Rick and I were in the waiting room sleeping, when our nurse, Lori, who’s been wonderful, came in and started shaking us to wake us up. I jumped up immediately and said ‘Is it a heart?’ and she just said ‘Come with me!’”, remembers Shari. “I barreled out of the waiting room and into Travis’ room and that’s when his surgeon told us we had a heart.” Shari’s first reaction was an embracing hug to the doctor, and a ‘thank you’ full of more gratitude than she could express. It was time to tell Travis.

“He was very excited and put his hands up over his eyes,” says Rick. “He sees visions of getting home.” After a few tears of relief, Travis wanted more information. He couldn’t speak because he was on a ventilator, so he quickly penciled questions inquiring about everything, from which family members were making the trip south from Wisconsin and Minnesota – to whether or not he was going to get a cheese-head cap from a recent Packers game. Once the excitement of the moment began to settle in, it was time for everyone to get ready. Rick and Shari returned to Cabot to check their other son and daughter out of school, while the surgeon got ready for a trip out of state. He would harvest the donor heart himself.

“He called me on my cell phone and told me he was flying out to get the heart himself and he’d be back early in the afternoon,” remembers Rick. “It just goes to show how involved he is – start to finish – with his children.”

“The chief heart surgeon understands everybody’s involved in this together, including him,” says Shari. “He takes a family and makes them part of his family.” As other relatives and friends trickled in by car and by plane, the excitement was building. This date would forever be remembered, not only because Travis was getting a heart, but because it was Shari’s late mother’s birthday as well.

“I don’t know what has kept me strong through this because I cry every day,” says Shari. “We’ve just gotten continuous support from our family, the hospital staff and new friends we’ve gotten to know in Arkansas in a very short time.”

Just after 4:00pm, wheels were down at Adams Field and Travis’ new heart was less than 15 minutes away from being carried into the operating room.

“I was relieved to get the heart back here safely and in a safe amount of time for the transplant procedure. There was also relief in knowing the heart team was progressing well with Travis and ready for the next step,” said the chief heart surgeon. Surgery to remove Travis’ failing heart and the revolutionary pump that kept him alive began within minutes. The procedure would last more than 10 hours in its entirety.

“The implantation was quite difficult and we expected that,” said the physician. “It’s not uncommon to have this degree of difficulty, but the task was more complex due to the fact that Travis has had so many surgeries in the past.” This would be the first time in the world a pediatric patient has been taken off the DeBakey VAD Child pump to receive a new heart. The first patient implanted with the device earlier this year, died after only 14 days. Rick and Shari Marcus know it saved their son’s life.

“We are so grateful that Dr. DeBakey developed this pump and that it was developed in time to save Travis,” says Rick. “He spent 56 days on the DeBakey and there’s no way he would have made it on ECMO that long; he might have lasted two or three weeks at the most.”

Although this technology buys time for children who are very sick and waiting on a transplant, it can’t replace their failing heart. Each year there are approximately 2,000 heart donors in the United States, meeting the needs of little more than half of the 3,300 patients (pediatric and adult) who are currently on the list for transplant. Approximately one in 24 patients on the waiting list will receive a heart.

“I believe the DeBakey VAD Child will be more widely applied once it becomes widely available because it gives us the opportunity to bridge more candidates to transplant freely,” said the chief surgeon. “But it doesn’t get away from the fact that we’ve got a shortage of donor organs, that’s the bottom line. My nightmare is that we’ve got all these children on these devices and they’re backed up like an assembly line because there’s no available organ and no where to go.”

“There are a lot of children waiting, we waited a long time ourselves,” says Rick. “Our children will all be donors and so will we.” Once Travis recovers from surgery, he is expected to return home where he will more than likely catch up on the Green Bay Packers’ season. He already has a Brett Favre street sign decorating his hospital door and should receive that Packers’ cheese cap before long. Although his family has lived in Arkansas only a few months, it wouldn’t be surprising if this young football fan is soon calling the Hogs.

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