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Mechanical circulatory support for infants and small children

Iki Adachi1, Charles D Fraser

  • 1Instructor, Division of Congenital Heart Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA.

Seminars in Thoracic and Cardiovascular Surgery. Pediatric Cardiac Surgery Annual
|March 30, 2011
PubMed

Insights

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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