Q&A: Caring for kids with advanced heart failure is transplant cardiologist Nathan Rodgers’ mission
While heart failure in kids is fortunately rare, it can occur from a variety of causes, including congenital heart disease that doesn’t respond to surgery or a virus that leads to inflammation of the heart muscle. For kids who face it, we’re there to help, from before they’re born through young adulthood.
For children with advanced heart failure, the Pediatric Heart Center at M Health Fairview Masonic Children’s Hospital is home to an Advanced Cardiac Therapies (ACT) team. This multidisciplinary group of specialists provides dedicated expertise and a range of treatment options — including heart transplant — for patients with the most complex heart conditions.
As a transplant cardiologist, Nathan Rodgers, MD, MHA, specializes in working with infants, children, and teens with advanced heart failure. Rodgers became the medical director of our pediatric heart transplant program this spring, after serving two years as interim medical director. In this role, he helps lead our ACT team in caring for some of our hospital’s most critically ill patients.
We sat down with Rodgers, who is also an assistant professor at University of Minnesota Medical School, to discuss our care for advanced heart failure and what inspired him to work with children with complex heart conditions.
What should people know about the ACT team?
Our team brings together pediatric cardiologists and heart surgeons to care for infants, children, and teens with the most advanced heart disease — particularly heart failure. We also have a dedicated team of advanced practice providers, pediatric nurses, and a nurse care coordinator to support families along their care journey. We collaborate with a large, multidisciplinary team at our children’s hospital. This includes certified child life specialists, social workers, pharmacists, and other pediatric specialists who help us evaluate and care for patients.
What inspired you to specialize in pediatric heart transplant?
When I was going through my fellowship in pediatric cardiology, I gravitated toward working with kids with the most serious or complex heart conditions. At the same time, there were several new advanced therapies coming out for heart failure. I drew inspiration from my patients and from these new advances in treatment.
When a child has heart failure, you’re not only dealing with one specific part of the heart, or even just with the heart itself. Heart failure affects the whole patient. In a way, as a transplant cardiologist, you become the primary care provider for that child. I always enjoyed pediatrics and caring for the whole child. That’s a big part of advanced cardiac care, as well. We’re there for them before, during, and after transplant, caring not just for their physical well-being, but their social and developmental well-being.
What treatments do we offer for advanced heart failure?
We’re able to offer several ventricular assist devices, which provide mechanical support to help the heart continue pumping blood. These can help children with advanced heart failure, either as a bridge to recovery or to transplant. There’s a growing array of options in heart failure treatment, particularly when it comes to mechanical support, and we’re able to offer these devices to an ever-expanding range of patients. We can now provide ventricular assist devices to children who might not have been candidates for that type of support in the past. Our team has the capability and know-how to deliver these treatments, giving families in Minnesota more options right here at home.
When a patient is referred to our team, we do a comprehensive evaluation and spend a lot of time with the family, educating them on their child’s condition and treatment options. If the child is a good candidate for transplant, it's critical that they understand heart transplant and what it will look like for them going forward. Even after transplant, the new heart requires lifelong management, and the child may need to have another transplant in the future as their transplanted heart ages. It’s also important that our team fully understands the patient’s unique heart anatomy and medical history, since many of our patients have had previous heart surgeries that can affect how we approach transplant.
