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Surgical therapy of end-stage heart failure in pediatric patients

F Ayik1, E Oguz, C Engin

  • 1Department of Cardiovascular Surgery, Ege University Medical Faculty, Izmir, Turkey.

Transplantation Proceedings
|April 14, 2011
PubMed

Insights

Pediatric ventricular assist device (VAD) implantation offers safe circulatory support for children with end-stage heart failure awaiting heart transplantation. This approach improves organ function and is recommended for hemodynamically unstable candidates.

Area of Science:

  • Pediatric Cardiology
  • Cardiovascular Surgery
  • Transplantation Medicine

Background:

  • End-stage heart failure in children presents significant challenges.
  • Pediatric heart transplantation is a critical treatment option.
  • Ventricular assist devices (VADs) can provide mechanical circulatory support.

Purpose of the Study:

  • To review the experience with VAD implantation and heart transplantation in pediatric patients.
  • To evaluate the safety and efficacy of VADs as a bridge to transplantation.
  • To assess the outcomes of heart transplantation in children.

Main Methods:

  • Retrospective review of pediatric patients undergoing VAD implantation or heart transplantation.
  • Study period from July 2005 to July 2010.
  • Inclusion of patients receiving Berlin Heart Excor VAD or heart transplant, with analysis of bridging strategies and follow-up.

Main Results:

  • No serious complications during VAD support.
  • Heart transplantation mortality rate was 9.1% (1/11).
  • VAD implantation improved end-organ function pre-transplant; 4/11 patients experienced controlled rejection episodes.

Conclusions:

  • Heart transplantation is highly effective for pediatric end-stage heart failure.
  • Pediatric VAD implantation provides safe and satisfactory support for critically ill children.
  • VADs should be considered for pediatric heart transplant candidates with poor hemodynamic status.
Abstract

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