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Published on: February 5, 2021
Mechanical circulatory support for infants and small children
1Instructor, Division of Congenital Heart Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA.
Summary
Mechanical circulatory support for pediatric heart failure lags adult options. The Berlin Heart EXCOR Pediatric is the sole long-term device for children awaiting transplants, with others years from clinical trials.
Area of Science:
- Pediatric cardiology
- Biomedical engineering
- Mechanical circulatory support
Background:
- Mechanical circulatory support (MCS) development for pediatric heart failure has historically lagged behind adult applications.
- Limited durable MCS options exist for infants and small children with acute heart failure.
- The United States saw minimal progress in pediatric MCS until the early 2000s.
Purpose of the Study:
- To review the current status of mechanical circulatory support devices for pediatric patients.
- To discuss therapy strategies for infants and small children with acute heart failure.
- To highlight the challenges and advancements in pediatric MCS.
Main Methods:
- Review of existing literature on pediatric mechanical circulatory support devices.
- Analysis of current therapeutic strategies for pediatric heart failure.
- Examination of the regulatory and clinical trial landscape for pediatric MCS.
Main Results:
- The Berlin Heart EXCOR Pediatric ventricular assist device is the only currently available long-term MCS for children awaiting cardiac transplantation.
- Access to the EXCOR Pediatric device is limited to compassionate use or investigational device exemption trials.
- Several other pediatric MCS devices are under development but require years for clinical trial testing.
Conclusions:
- Significant unmet needs exist for mechanical circulatory support in pediatric heart failure.
- The Berlin Heart EXCOR Pediatric represents a critical, albeit limited, option for critically ill children.
- Further research and development are essential to expand MCS options for infants and small children.
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