Long-Term Mechanical Circulatory Support in Pediatric Patients

Area of Science:

• Pediatric Cardiology
• Cardiovascular Surgery
• Biomedical Engineering

Background:

• Mechanical circulatory support (MCS) is crucial for pediatric patients with end-stage heart failure.
• Ventricular assist devices (VADs) offer a bridge to transplant or recovery.
• Evaluating long-term outcomes of different VADs in pediatric populations is essential.

Purpose of the Study:

• To review the long-term outcomes of pediatric patients supported by two different VAD systems: Berlin Heart EXCOR and HeartWare.
• To compare the efficacy, survival rates, and adverse events associated with each VAD system.

Main Methods:

• Retrospective study of pediatric patients implanted with Berlin Heart EXCOR (n=29) and HeartWare (n=9) systems between January 2008 and April 2014.
• Analysis of patient demographics, support duration, transplant status, recovery, mortality, and complications.
• Inclusion of patients with biventricular and single-ventricle physiology.

Main Results:

• Berlin Heart EXCOR group: 65.5% transplanted, 20.7% recovered, 89.7% survival rate. Complications included pump exchanges, infection (13.8%), and neurological events (10.3%).
• HeartWare group: 88.9% transplanted, 88.9% survival rate. Complications included infection (44.4%) and neurological events (33.3%).
• Both systems demonstrated excellent survival possibilities in pediatric patients, including those with single-ventricle physiology.

Conclusions:

• Long-term mechanical circulatory support is a viable option for pediatric patients with two- and single-ventricle physiology.
• Both Berlin Heart EXCOR and HeartWare systems can achieve excellent survival rates with manageable adverse event profiles.
• Further research into optimizing VAD therapy in pediatric populations is warranted.