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Pediatric circulatory support systems
Amy L Throckmorton1, Paul E Allaire, Howard P Gutgesell
1Biomedical Engineering Department, Virginia Artificial Heart Center, University of Virginia, Charlottesville 22903-2442, USA.
Insights
Ventricular assist devices (VADs) offer a promising solution for pediatric heart failure, supporting patients as a bridge to transplantation. Clinical success suggests long-term VAD support may be achievable for children.
Area of Science:
- Pediatric Cardiology
- Biomedical Engineering
- Mechanical Circulatory Support
Background:
- Ventricular assist devices (VADs) are crucial for pediatric patients experiencing myocardial failure or severe heart defects.
- Current clinical experience primarily focuses on short-term VAD support for children weighing over 6 kg.
- VADs have demonstrated significant potential in reversing cardiac failure and supporting patients awaiting heart transplantation.
Purpose of the Study:
- To evaluate the efficacy and potential of various VADs for pediatric circulatory support.
- To review existing VAD systems used in pediatric cases and assess their success.
- To explore the feasibility of long-term VAD support in pediatric patients.
Main Methods:
- Review of clinical data and experimental outcomes for pediatric VAD implementations.
- Analysis of specific VAD systems including Medos-HIA, Berlin Heart, Medtronic Bio-Medicus, Abiomed BVS 5000, Toyobo-Zeon, Hemopumps, Jarvik 2000, and Pierce-Donachy.
- Assessment of VAD performance in reversing cardiac failure and providing circulatory support.
Main Results:
- Several VAD systems have shown success in providing short-term circulatory support for pediatric patients.
- Devices like the Jarvik 2000 and Pierce-Donachy pediatric system indicate potential for pediatric use.
- VAD implementation has shown promise in reversing cardiac failure and supporting patients as a bridge to transplantation.
Conclusions:
- VADs are a viable option for pediatric circulatory support, particularly for those with myocardial failure or heart defects.
- The success of various VADs in short-term support encourages the development and investigation of long-term pediatric VAD solutions.
- Continued research and clinical application of VADs hold promise for improving outcomes in pediatric heart failure management.
Abstract:
Ventricular assist devices (VADs) are a valid option for long term circulatory support in pediatric patients with postoperative myocardial failure or debilitating heart defects. Most clinical experience to date has involved the short-term support of patients weighing 6 kg and larger. For cases of VAD implementation in pediatric patients, the assist device showed tremendous promise in reversing cardiac failure and providing adequate support as a bridge to cardiac transplantation. The Medos-HIA system, Berlin Heart, Medtronic Bio-Medicus Pump, Abiomed BVS 5000, Toyobo-Zeon pumps, and Hemopumps have proven successful for short-term circulatory support for the pediatric population. The Jarvik 2000 and Pierce-Donachy pediatric system further demonstrate the potential to be used for pediatric circulatory support. The clinical and experimental success of these support systems provide encouragement to believe that long-term support is possible.