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Dell Children’s surgeons perform rare pediatric partial heart transplant

In a historic first for Texas, surgeons and staff at Dell Children’s Medical Center, part of Ascension Texas, and UT Health Austin recently performed a partial heart transplant on an 11-month-old boy. It was the seventh known pediatric partial heart transplant in the world.

The landmark surgery was performed on June 23 at The Texas Center for Pediatric and Congenital Heart Disease at Dell Children’s, in partnership with UT Health Austin, the clinical practice of Dell Medical School at The University of Texas at Austin.

In a partial heart transplant, valves are procured from a donor heart that was not suitable for full transplantation. The goal is to allow the harvested living valves to grow with the pediatric patient over time, potentially increasing life expectancy.

“Our team is excited about this procedure, it has the potential to change the paradigm of valve surgery in pediatric heart disease. This potentially lifesaving surgery can make use of a donated heart that would otherwise not be transplantable,” said Carlos Mery, MD, MPH, surgical director of the Heart Transplant Program at Dell Children’s and Associate Professor in the Departments of Pediatrics and Surgery and Perioperative Care at Dell Med.

The 11-hour surgery was performed on 11-month-old Elias Robinson-Rodriquez. Baby Elias was born with a congenital heart defect condition called transposition of the great arteries with obstruction of the part of the heart that pumps blood to the body. Despite prior surgery on the valve, the valve between the lower left heart chamber and the body’s main artery (aorta) was narrowed and didn’t open fully. This reduced or blocked blood flow from the heart to the aorta and to the rest of the body. Following the surgery, Elias is showing remarkable improvement and his outlook remains strong. This was the third open heart surgery for Elias.

“This is a milestone procedure. A partial transplant allows surgeons to tap into a supply of donor hearts that go unused due to deficiencies. We are thrilled with Elias’ progress and we are hopeful this will eliminate the need for future surgeries,” said Chesney Castleberry, MD, Medical Director of the Pediatric Heart Failure and Transplant Program and Associate Professor in the Department of Pediatrics at Dell Med. Only three other institutions in the U.S. have performed partial pediatric heart transplants in the past: Duke University, Columbia University and Medical University of South Carolina.

“Our ability to perform this surgery is a major step in Dell Children’s effort to provide innovative, life-changing care for the most complex cardiac cases in the region,” said Charles Fraser Jr., MD, Chief of Pediatric and Congenital Heart Surgery, Texas Center for Pediatric and Congenital Heart Disease. “This groundbreaking surgery provides hope for thousands of babies with congenital heart defects and amplifies the way we can use the gift of organ donation to save more lives,” said Fraser, Professor in the Departments of Pediatrics and Surgery and Perioperative Care at Dell Med.

The Texas Center for Pediatric and Congenital Heart Disease at Dell Children’s was established in 2018 and is led by Dr. Fraser. The program, which has strategically recruited new physicians to the Austin area to increase access to world-class providers and specialists, includes the integration of clinical academics and research-driven initiatives through an exclusive collaboration between Dell Medical School at The University of Texas at Austin and UT Health Austin. The program was recently recognized by the Society of Thoracic Surgeons as one of the few programs in the nation with significantly better outcomes after congenital heart surgery than a national benchmark. The capability of the Heart Transplant Program is enriched by Dell Children’s depth and breadth of expertise in numerous subspecialities as the only Level 1 Pediatric Trauma Center in Central Texas.

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