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Mechanical circulatory support in children: bridge to transplant versus recovery
John L Jefferies1, David L Morales
1The Heart Institute, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, MLC 2003, Cincinnati, OH 45229, USA. john.jefferies@cchmc.org
Insights
Pediatric heart failure is rising, necessitating advanced therapies like mechanical circulatory support (MCS). New pediatric ventricular assist devices (VADs) offer promising options beyond traditional bridge-to-transplant strategies.
Area of Science:
- Pediatric Cardiology
- Cardiovascular Surgery
- Biomedical Engineering
Background:
- Increasing incidence of heart failure in children and adolescents.
- Mechanical circulatory support (MCS) as a critical advanced therapy.
- Growing need for pediatric-specific ventricular assist devices (VADs).
Purpose of the Study:
- Review current mechanical circulatory support (MCS) approaches in pediatric heart failure.
- Discuss the development and clinical use of pediatric ventricular assist devices (VADs).
- Explore emerging and future MCS options for pediatric patients.
Main Methods:
- Literature review of existing clinical data on pediatric MCS.
- Analysis of current trends in VAD development for children.
- Discussion of potential future MCS technologies and strategies.
Main Results:
- Mechanical circulatory support (MCS) is increasingly utilized in pediatric heart failure.
- Existing adult devices are adapted, and pediatric-specific VADs are under development.
- Bridge-to-transplant, bridge-to-recovery, and bridge-to-destination are viable MCS strategies in select pediatric cases.
Conclusions:
- Mechanical circulatory support (MCS) plays a vital role in managing pediatric heart failure.
- Pediatric-specific VADs are crucial for optimizing outcomes.
- Future MCS innovations hold promise for improving care for children with advanced heart disease.
Abstract:
The number of children and adolescents suffering from heart failure is increasing dramatically. Some of these patients will progress to need advanced therapies in the form of mechanical circulatory support (MCS). Over the past few years, increased attention has been focused on clinical use of existing devices as well the development of pediatric-specific ventricular assist devices (VADs). As in adult populations, these devices offer unique opportunities to successfully support children as a bridge-to-transplant, but increasing data suggest that bridge-to-recovery and bridge-to-destination are also viable options in select pediatric populations. Herein, we will review existing approaches as well describe future potential MCS options.
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