HJAR May/Jun 2024

HEALTHCARE JOURNAL OF ARKANSAS I  MAY / JUN 2024 37 Lawrence Greiten, MD, MSc Pediatric Cardiothoracic Surgeon Arkansas Children’s Hospital including her age, size, and overall mental well-being. The VAD team trained her fam- ily and area medical staff should an emer- gency arise. It included in-person education to understand the meaning of the various alarms on her LVAD, how to stabilize her, and how to immediately get in touch with herACHVAD team, which consists of over 10 people. Realizing the importance of family and friends, the team even connected with medical personnel outside of Arkansas, so that Maddry could safely travel to watch her brother play soccer, attend family events, and even prepare for college admission. Forward-thinking VAD program Arkansas Children’s Heart Institute VAD program participates in a national registry for Pediatric MechanicallyAssisted Circula- tory Support (PediMACS) by entering, col- lecting, and analyzing data to help further technology, identify obstacles, and support clinical studies to improve VAD outcomes in children. They are also active in VADAC- TION (Advanced CardiacTherapies Improv- ing Outcomes Network), a conglomerate of providers that collaborate nationally and worldwide regarding VADs. Maddry’s case illustrates how, in Arkan- sas, we can work with community providers to care for these complex and complicated patients even from a distance. We are com- mitted to a future where more than a single device or pathway is used and continue uti- lizing new technologies. This allows Arkan- sas Children’s and other leading pediatric healthcare systems to explore ways to cus- tomize care to fit each patient’s needs. VADs are tailored to pediatric patients’special an- atomical and physiological conditions with continued support of each patient’s vitality while awaiting tomorrow’s successes. n Lawrence Greiten, MD, MSc, is a pediatric cardio- thoracic surgeon at Arkansas Children’s Hospital and assistant professor in the division of congeni- tal cardiac surgery at the University of Arkansas for Medical Sciences in Little Rock.He is board certified by the American Board of Surgery and the Ameri- can Board ofThoracic Surgery. Greiten is amember of the Society of Thoracic Surgeons, the American HeartAssociation,theAmericanAssociation ofTho- racic Surgery, and both the Southern and Eastern Cardiothoracic Surgery Societies. His clinical inter- ests include congenital malformations and surgical treatment,as well as thromboprophylaxis and quality improvement of postoperative care. in May 2021, she completed her chemother- apy treatments over the next four months at Arkansas Children’s Northwest (ACNW), closer to Bella Vista. Going home on a VAD As a result of a rare chemo side effect, Maddry became a heart patient at ACH. She was admitted toACH’s CVICU for a couple of weeks starting in October 2022, where she was diagnosed with dilated cardiomyopathy and end-stage heart failure. After discussion with all of her care teams, she was deemed an acceptable candidate for LVAD as a bridge to transplantation. The surgical team implanted Maddry’s LVAD in November 2022. They are the only medical experts in the state specially trained to implant VADs in pediatric patients. She went home in February 2023 and will be supported with an LVAD until she re- ceives a new heart. As of December, Maddry is undergoing a final orthopedic procedure to complete her recovery prior to being list- ed for heart transplant. The team weighed several factors when choosing for her to go home on an LVAD, Pictured MacKenzie Maddry