Use of an Intrapericardial Continuous Flow Ventricular Assist Device in a 4-Year-Old Child Weighing 12 Kilograms

Area of Science:

• Cardiology
• Medical Devices
• Pediatric Surgery

Background:

• Intractable heart failure necessitates mechanical circulatory support, often as a bridge to cardiac transplantation.
• Ventricular assist devices (VADs) are crucial for supporting patients awaiting heart transplants.
• Pediatric patients, especially those with small body surface area (BSA), present unique challenges for VAD implantation.

Observation:

• A continuous flow ventricular assist device was successfully implanted intrapericardially in a petite child (BSA 0.56 m2).
• This intrapericardial placement utilized a centrifugal pump, demonstrating feasibility in a very small patient.
• The patient received the device as a bridge to cardiac transplantation.

Findings:

• The intrapericardial placement of a continuous flow VAD was technically feasible and successful in a low-weight pediatric patient.
• This approach supports the circulatory system mechanically, offering a potential solution for end-stage heart failure in children.
• The HeartWare system has shown acceptable results in smaller patients, with this case potentially representing the youngest recipient.

Implications:

• Intrapericardial VAD implantation is a viable option for pediatric patients with end-stage heart failure, particularly when donor organs are scarce.
• This strategy expands the potential use of VADs in pediatric cardiology, offering hope for improved outcomes.
• Further research into VADs for pediatric populations could lead to advancements in mechanical circulatory support and heart transplantation.