Nadja, two years old, from Tennessee, is seriously ill. Your heart is no longer working properly. Your only chance to bridge the waiting period before a donor organ is transplanted is to implant a cardiac assist system. Berlin Heart GmbH specializes in such systems, and its Excor Pediatric cardiac support system is the only one approved for children and infants.
“Our systems support about 200 children a year,” says Natalie Taylor, Marketing Director of Berlin Heart. It works closely with 180 heart transplant centers in more than 40 countries on all five continents. In these patients are cared for who are on a waiting list for a donor organ. About 12 percent of the implantations of Excor-Pediatric systems are carried out in German hospitals. According to Berlin Heart, the market is quite stable.
There are 500 cardiac catheter laboratories in Germany, but only 78 centers that also implanted cardiac support systems, so-called VADs, explains Taylor. And only three centers performed more than 200 such interventions on adults and children each year.
Always the ultimate ratio
In the German Heart Center Berlin (DHZB) alone, a good 200 Excor pediatric implants have been implanted, according to Christian Maier, head of the Communication and Marketing department at the DHZB. “This is how we performed most of the Excor-Pediatric systems in the German Heart Center Berlin,” says Maier. “Because we have the world’s greatest expertise in this field, parents even came to us with their children from Excor Pediatric with the ambulance jet,” he continues.
The implantation of a cardiac support system is necessary, for example, in the case of severe heart failure. Maier explains that it is always the ultimate ratio, since such an operation is stressful for the children. The cause of heart failure can be a heart defect with which a child of one hundred is born, according to a study by the German Society for Pediatric Cardiology in 2013. If heart failure can no longer be adequately treated with medication, the implantation of a support system is considered. “This system always saves lives,” says Maier.
Excor Pediatric is implanted if the patient would otherwise have no chance of survival, as Maier describes. The duration of treatment with the system varies greatly, since there are only few donor organs available for children, and ranges from a few weeks to several years, according to the German Heart Center Berlin. As Taylor from Berlin Heart explains, the system is approved for one year. The blood pumps would then have to be changed, but this can be done without surgery if the blood circulation is briefly stopped.
Open heart surgery
As described by Taylor, the Excor product consists of one or two blood pumps that are located outside the body. The pumps are connected to the patient’s heart and vessels using two silicone cannulas. They are divided into a blood chamber and an air chamber. These are separated from each other by a triple membrane. Air is pumped into and out of the air chambers via a connection to the drive unit using a pneumatic drive. This causes the membrane to move in a pulsed manner, causing the blood to be pumped into and out of the body. The implantation takes place through open heart surgery.
According to the Federal Gazette, Berlin Heart GmbH’s turnover in 2017 was 17.5 million euros. According to the company, which has 240 employees, sales and market share have remained stable. In order to offer the children more opportunities to move, play and learn, Berlin Heart has developed a mobile drive unit, Excor Active. It has hand luggage size, weighs only 15 kilograms and offers a battery life of at least seven hours.
After four months, Nadja from Tennessee successfully transplanted a donor organ with Excor Pediatric.
The article comes from the student project “Jugend und Wirtschaft”, which the F.A.Z. organized together with the Federal Association of German Banks.