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Postoperative support with the centrifugal pump ventricular assist device (VAD)
Tom R Karl1, Stephen B Horton, Christian Brizard
1Pediatric Cardiac Surgery, University of California-San Francisco, 513 Parnassus Ave, S-549, San Francisco, CA 94143, USA. karlt@surgery.ucsf.edu
Summary
Centrifugal pump left ventricular assist devices offer effective circulatory support in pediatric cardiac surgery, serving as a bridge to recovery or transplantation. While not universally applicable like ECMO, they are highly effective in selected pediatric patients.
Area of Science:
- Pediatric Cardiac Surgery
- Mechanical Circulatory Support
Background:
- Centrifugal pump left ventricular assist devices (LVADs) are increasingly utilized in pediatric cardiac surgery.
- Their role as a bridge to recovery or transplantation is well-established.
- Standardized technology and documented advantages support their use.
Purpose of the Study:
- To discuss the indications and case selection for centrifugal pump LVADs in pediatric patients.
- To review the technical aspects of circuit management.
- To present clinical management strategies and outcomes.
Main Methods:
- Review of clinical data and surgical techniques for centrifugal pump LVADs.
- Discussion of patient selection criteria.
- Analysis of circuit configuration and management protocols.
Main Results:
- Centrifugal pump LVADs demonstrate significant efficacy in properly selected pediatric cardiac surgery patients.
- Comparison with extracorporeal membrane oxygenation (ECMO) highlights comparable or superior outcomes in specific cases.
- Long-term results since 1989 are presented, showcasing the device's utility.
Conclusions:
- Centrifugal pump LVADs are a valuable tool in pediatric cardiac surgery, offering effective circulatory support.
- Careful patient selection and management are crucial for optimal outcomes.
- The technology provides a viable alternative or adjunct to other support methods.