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Advanced Heart Failure in Special Population-Pediatric Age
Emanuele Monda1, Michele Lioncino1, Roberta Pacileo1
1Inherited and Rare Cardiovascular Diseases Unit, Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli", Monaldi Hospital, Via Leonardo Bianchi 1, 80131, Naples, Italy.
Heart Failure Clinics
|September 13, 2021
Summary
Pediatric heart failure (HF) requires advanced treatments like mechanical circulatory support when heart transplantation (HT) is not feasible due to donor limitations. This review covers HF management, focusing on advanced cases in children.
Area of Science:
- Pediatric Cardiology
- Cardiovascular Surgery
- Critical Care Medicine
Background:
- Pediatric heart failure (HF) presents significant morbidity and mortality.
- Advanced HF involves children with persistent symptoms despite optimal medical therapy.
- Current treatment options include inotropic therapy, mechanical circulatory support (MCS), and heart transplantation (HT).
Purpose of the Study:
- To review the epidemiology, causes, pathophysiology, clinical manifestations, and treatment of pediatric HF.
- To emphasize management strategies for advanced pediatric HF.
- To assess the role of MCS as an alternative to HT in pediatric advanced HF.
Main Methods:
- Comprehensive literature review of pediatric HF.
- Analysis of data concerning medical treatment, device therapy (MCS), and HT.
- Focus on outcomes and challenges in advanced pediatric HF cases.
Main Results:
- Heart transplantation (HT) is the gold standard for advanced pediatric HF.
- Limited donor availability leads to long waitlists and increased mortality.
- Mechanical circulatory support (MCS) is increasingly evaluated as a bridge to HT or as destination therapy.
Conclusions:
- Advanced pediatric HF necessitates specialized management strategies.
- Mechanical circulatory support (MCS) offers a viable alternative for children awaiting HT or ineligible for it.
- Further research and development in pediatric MCS are crucial for improving outcomes.
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