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Thoratec ventricular assist devices in pediatric patients: update on clinical results

Olaf Reinhartz1, J Donald Hill, Abdulaziz Al-Khaldi

  • 1Stanford University, Department of Cardiothoracic Surgery, 300 Pasteur Drive, Stanford, CA 94605, USA.

ASAIO Journal (American Society for Artificial Internal Organs : 1992)
|December 3, 2005
PubMed

Insights

Mechanical circulatory support using Thoratec ventricular assist devices (VAD) in pediatric patients shows a 68% survival rate. Survival is lower for congenital heart disease patients, especially in smaller children.

Area of Science:

  • Pediatric cardiology
  • Mechanical circulatory support
  • Cardiothoracic surgery

Background:

  • Mechanical circulatory support (MCS) in pediatric patients presents unique clinical challenges.
  • The Thoratec ventricular assist device (VAD) is a key technology in pediatric MCS.

Purpose of the Study:

  • To analyze the Stanford experience and worldwide data on Thoratec VAD use in pediatric and adolescent patients.
  • To evaluate survival rates and identify factors influencing outcomes in this population.

Main Methods:

  • Retrospective analysis of 209 pediatric patients (age 5-18) who received Thoratec VAD support up to January 2005.
  • Data included patient demographics, primary diagnosis, duration of support, and survival outcomes.
  • Subanalysis of small children (body surface area < 1.3 m2) was performed.

Main Results:

  • Overall survival to transplantation or device explantation was 68%.
  • Higher survival rates were observed for cardiomyopathies (74%) and acute myocarditis (86%) compared to congenital heart disease (27%).
  • Small children (< 1.3 m2 BSA) had a higher incidence of congenital heart disease and lower survival (52%).

Conclusions:

  • Thoratec VAD support offers a survival benefit in pediatric patients, particularly for cardiomyopathies and myocarditis.
  • Congenital heart disease remains a significant challenge, with poorer outcomes in smaller pediatric patients.
  • Specific management strategies are crucial for optimizing outcomes in small children requiring VAD support.

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