Surgeon Implants Diaphragm Pacemaker in Pediatric Patient
Source Newsroom: WVU Medicine
Newswise — MORGANTOWN, W.Va. – A surgeon for WVU Healthcare has implanted a diaphragmatic pacemaker in a pediatric patient, making West Virginia University’s medical center only the second in the country to use this device on a young patient, after Case-Western Reserve University in Cleveland.
Meg Throckmorton, 16, of Waynesburg, Pa., received the device after sustaining a high cervical spine injury resulting in quadriplegia while practicing for a dance competition.
Jennifer Knight, M.D., a trauma surgeon at WVU Healthcare’s Jon Michael Moore Trauma Center, was on call the evening of Friday, April 13, when Meg arrived in Morgantown after her injury, and was brought in to consult on the case. She also is the same surgeon who was first in the state to implant a diaphragmatic pacemaker in an adult patient.
An upper spinal cord injury breaks the connection between the brain and the diaphragm – the brain can no longer tell the diaphragm to contract. But for some people who suffer this type of spinal cord injury, a pacemaker for the diaphragm can be put into place to help them breathe. Just as a pacemaker for the heart helps to control the heartbeat, a diaphragmatic pacemaker stimulates the diaphragm to contract, allowing the patient to breathe.
The device, NeuRx DPS is currently being used in less than 35 cities nationwide, according to its manufacturer, Synapse Biomedical. WVU is the only center using the device in West Virginia.
The pacemaker is approved by the U.S. Food and Drug Administration for use in patients 18 years old and older. Meg is 16. Dr. Knight and others on her care team believed that she would greatly benefit from the pacemaker. The procedure won swift approval after an emergency assessment by WVU’s Institutional Review Board and from WVU Healthcare’s chief of staff, Michael Hurst, M.D., D.D.S. They determined that the two-year age difference did not put Meg at any significant risk.
Following surgery to implant the pacemaker on Friday, April 20, Meg returned to the Pediatric Intensive Care Unit at WVU Children’s Hospital. When the device was turned on, she was able to spend a full 12 hours off the ventilator. Since the surgery, she has been able to come off the ventilator for periods of time every day. Though she is not yet off the ventilator completely, Knight said Meg will eventually get to that point.
Meg’s surgery is also the earliest after injury that the device has ever been implanted.
“There are two reasons for that,” Knight said. “The first is that Meg was taken to a trauma center that does the procedure, and the second is that we started planning for the surgery almost immediately after she arrived. Everyone involved in Meg’s care worked very hard to make this happen as quickly as possible. And, it worked perfectly. Everyone did exactly what they were supposed to do to get it done.”
Now, Meg will spend the next several weeks in Atlanta, Ga., at the Shepherd Center, a private, not-for-profit hospital specializing in medical treatment, research and rehabilitation for people with spinal cord injury and brain injury. The Shepherd Center staff are trained to treat diaphragmatic pacemaker patients.
“She will live a pretty normal life with some limitations,” Knight said. “She’s a fighter, and her family is very strong.”