The Pediatric Heart Institute at Monroe Carell Jr. Children’s Hospital at Vanderbilt has grown accustomed to caring for the sickest children in the region.
For decades the program, led by some of the most experienced pediatric heart surgeons in the country, has pioneered innovative heart procedures.
During a recent case, the team explored a nontraditional therapy to give a dying 13-year-old patient the best chance at making it to heart transplant.
Today Van Sung, a rising eighth grader, is recovering at home with her family, who credits the team at Monroe Carell with giving their daughter a new lease on life.
Born with hypoplastic left heart syndrome, a congenital heart defect, Sung had undergone a series of surgeries to repair the flaw. The final repair, called a Fontan procedure, was done in 2013 when she was 2 years old.
For more than a decade all was well.
In December 2024 her parents noticed facial puffiness and weight gain that was uncharacteristic of their daughter. They learned she was in heart failure.
“When we came to the hospital, we were hopeful that she would get the needed treatment,” said Sung’s mother, Rem Kumthar, through an interpreter. “At one point, we were worried that we would lose her. We had become hopeless.”
Sung’s heart failure worsened, making her critically ill.
“Time was of the essence,” said Rachel Harris, DO, assistant professor of Pediatrics in the Division of Pediatric Cardiology at Monroe Carell. “She began having life-threatening arrhythmias, which reflected just how sick her heart was, and so she needed more support to safely get her to transplant.”
The medical team was concerned that Sung wouldn’t tolerate open-heart surgery to implant a ventricular assist device (VAD), a mechanical pump that helps the heart pump blood. The team questioned using extracorporeal membrane oxygenation (ECMO), a life-sustaining mechanical system that temporarily takes over for the heart and lungs of critically ill patients.
Both choices were considered high risk for Sung, said Garrett Coyan, MD, assistant professor of Cardiac Surgery in the Division of Pediatric Cardiac Surgery at Monroe Carell. The team has been exploring options on how to adapt newer, innovative heart pumps designed for adults to help smaller patients. Sung seemed to be a candidate.
“It was very intense planning. We thought hard on how best to get her the support she needed,” Coyan said. “Using a new access technique, we were able to implant the device into her left carotid artery. It was the first time we had done this in a Fontan patient and one so small.”
The team decided on an Impella, a catheter-based miniature VAD. According to the team, it offered the best chance of getting Sung to transplant without catastrophic complications associated with ECMO or surgically implanting a VAD.
“Having access to these types of therapies means we are able to help patients who traditionally would be too ill to get to a lifesaving transplant,” said Coyan. “The ability to offer newer upcoming therapeutics like Impella is a testament to how dedicated we are to caring for very ill children.”
Feb. 17 was a day the medical team and family will remember.
“The family was questioning if she was suffering while waiting on a heart,” recalled Harris. “It was hard having these conversations about end of life. But on that very same day, we received an offer of a heart,” she said. “It was just remarkable.”
One month later, Sung was discharged from the hospital (March 17). And one month after that, she was released home.
“We explained it all to her,” said her mother. “We told her she was in bad condition, but the doctors found a heart. We remind her that the doctors say she has a bright future. We are so overjoyed.”
Sung has hopes of using her health journey to help others.
“This was hard,” she said softly. “I know God led me through it, and I want to get stronger so that I can help others who need transplants. I want to help them stay positive and not be scared.”
