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Ventricular assist devices in pediatric cardiac surgery
R J Costa1, R B Chard, G R Nunn
1Adolph Basser Institute of Cardiology, Royal Alexandra Hospital for Children, Sydney, Australia.
The Annals of Thoracic Surgery
|December 1, 1995
Summary
Pediatric ventricular assistance shows promise for critically ill children, with 7 of 13 patients surviving. This mechanical circulatory support offers a chance for survival in cases with otherwise certain mortality.
Area of Science:
- Pediatric cardiology
- Cardiothoracic surgery
- Biomedical engineering
Background:
- Pediatric ventricular assist devices (VADs) have demonstrated positive outcomes in prior studies.
- This study evaluates the initial experience with VADs at a specific children's hospital.
Purpose of the Study:
- To assess the safety and efficacy of ventricular assistance in pediatric patients.
- To report outcomes and complications associated with VAD use in critically ill children.
Main Methods:
- A prospective study of 13 pediatric patients who received ventricular assistance between January 1992 and September 1994.
- Patients' ages ranged from 4 days to 30 months, with weights from 2.9 to 17 kg.
Main Results:
- Ventricular assistance was used for durations ranging from 1.5 to 190 hours.
- Eight patients required support after congenital defect correction, and four needed post-operative support for low cardiac output; one patient received support after traumatic cardiogenic shock.
- Seven out of thirteen patients survived, with survivors remaining well at 3 to 32 months post-implantation. Mortality causes included neurological events, myocardial failure, and sepsis.
Conclusions:
- Ventricular assistance, despite associated mortality and complications like hemorrhage, tamponade, and circuit thrombosis, offers a life-saving option for pediatric patients facing certain death.
- The initial experience suggests that VADs are a viable, albeit complex, treatment modality for severe pediatric heart failure.