A six-year-old girl whose life was at risk due to failing heart pump function has regained her daily life after undergoing surgery to implant a left ventricular assist device (LVAD) at Severance Hospital. It is the first successful LVAD implantation in Korea's youngest and smallest end-stage heart failure patient.
According to Severance Hospital on Thursday, Professor Shin Yu-rim of the Division of Cardiovascular Surgery at the Cardiovascular Hospital performed Korea's youngest-ever LVAD surgery last month on Park Min-ji, a six-year-old girl suffering from severe heart failure. The previous youngest patient was 11 years old.
Park visited a hospital in December last year with symptoms of indigestion and vomiting, where she was diagnosed with cardiomyopathy. She received intravenous inotropic injections to boost cardiac contractility, but heart failure symptoms including dyspnea and vomiting worsened, making a transplant necessary.
Pediatric heart failure in Korea is estimated at approximately 200 to 470 cases per 100,000 population. As survival rates for children with congenital heart disease have improved, the number of patients requiring long-term treatment continues to rise. The medical team determined that implanting an LVAD to assist heart function was preferable to waiting indefinitely for a donor organ, given the severe shortage of brain-dead organ donors in Korea. However, no LVAD implantation had ever been performed in Korea on a patient as small as Park. At the time of surgery, Park weighed only 22 kilograms. The narrow space inside her chest and small cardiac structure made it difficult even to secure room for the device. Post-surgical blood flow adjustment also had to be calibrated to her small body, raising the difficulty of both the operation and ongoing management.
Professor Shin's team held pre-operative consultations with professors at Cincinnati Children's Hospital in the United States, who have extensive experience in pediatric surgery, and conducted three-dimensional simulations before the procedure. Professors from the departments of pediatric cardiology, cardiac anesthesiology, and cardiology also devoted intensive efforts to maintaining drug therapy until the optimal surgical timing and managing right ventricular function after the operation.
Min-ji's condition after surgery is stable, and she is set to be discharged next week. Intravenous treatment for infection and other complication management has also been completed, allowing her to begin school immediately after discharge. Going forward, the medical team plans to monitor her progress while pursuing a parallel treatment strategy of either proceeding with a heart transplant or maintaining the LVAD.
"This surgery demonstrated the possibility that pediatric patients with severe heart failure can return to daily life outside the hospital," Professor Shin said. "We will continue to develop treatment strategies that consider both children's growth and quality of life."