AI Article Synopsis
- Mechanical circulatory support systems are increasingly used in pediatric patients, but their size limits their deployment for smaller children; this report discusses implantation experiences with such devices.
- A total of 29 pediatric patients received various mechanical support devices (including LVAD, BVAD, and ECMO) over a period from 1987 to 2004, with support durations averaging 32.3 days; although 10 children successfully underwent heart transplants, there were significant complications and 16 fatalities during support.
- There is a need for the development of smaller, more durable assist devices for children, as ongoing research and clinical applications continue in this area.
Article Abstract
Introduction: Recently various mechanical circulatory support systems are being used all over the world, nevertheless the size of the devices limits the implantation in pediatric cases. Accordingly we report our experiences with assist devices applied for pediatric patients.
Patients And Methods: Twenty-nine children underwent mechanical circulatory support implantation operation. The diagnoses of preoperation were dilated cardiomyopathy in 16, congenital heart disease in 12 and allograft dysfunction in 1.
Results: From November 1987 to January 2004 we implanted 7 LVAD, 11 BVAD and 11 ECMO in pediatric patients. The 29 patients were supported from 11 to 231 days (mean 32.3 days). Three children were supported by Thoratec LVAD. Biventricular Thoratec VAD was used in 3 children. Three children were supported by Medos-HIA system LVAD, and 8 children by biventricular VAD using the Medos-HIA system. One child was supported by Novacor LVAD. Fourteen children were supported by ECMO. We succeeded in heart transplantation in 10 cases, but lost 16 children during the support. Bleeding occurred in 7 cases, thrombosis occurred in 6 cases, infection occurred in 8 cases, pneumothorax occurred in 3 cases and neurological deficit occurred in 2 cases.
Conclusion: The development of assist device for children which has long durability and small in size as a future subject is desired. Further clinical and experimental research and application of those assist devices for children are in progress.
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