Pediatric ventricular assist devices

Lodge, Andrew J.; Antunez, Alexis G.; Jaquiss, Robert D.B.

doi:10.1016/j.ppedcard.2012.02.010

Cited by 4 publications

(3 citation statements)

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“…Together, these data would suggest that, while ECMO may prove a useful shortterm tool in the support of the failing myocardium, longer-term alternatives are needed, given wait times that currently far exceed 14 days. Consequently, despite a dramatic growth in numbers and improvement in techniques and outcomes of patients supported with ECMO for primary myocardial failure, the last several years have given rise to experience of alternative modalities of circulatory support intended for longer-term support of the failing myocardium [30][31][32]. Consequently, despite a dramatic growth in numbers and improvement in techniques and outcomes of patients supported with ECMO for primary myocardial failure, the last several years have given rise to experience of alternative modalities of circulatory support intended for longer-term support of the failing myocardium [30][31][32].…”

Section: Key Pointsmentioning

confidence: 99%

Cardiac critical care

Smith

Laussen²

2013

Current Opinion in Pediatrics

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Section: Key Pointsmentioning

confidence: 99%

Cardiac critical care

Smith

Laussen²

2013

Current Opinion in Pediatrics

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“…The use of computational engineering tools (computational fluid dynamics, SolidWorks) led to improvements in impeller and stator designs with higher mechanical efficiencies (19,20). Advances in manufacturing methods, reduced manufacturing tolerances, and impeller designs enabled further reduction in rotary blood pump size for adults (<50 g, <40 mL) and spawned the development of pediatric MCS devices with support from National Institutes of Health PUMPKIN development initiative (21,22). These smaller adult rotary blood pumps, which include Miniaturized Ventricular Assist Device (MVAD) (HeartWare), HeartMate X (Thoratec), Synergy (CircuLite, Saddle Brook, NJ, USA), and Jarvik 2000 (Jarvik Heart), operate at higher rotational speeds (up to 26 000 rpm) and may be implanted in the pericardial space using less invasive surgical procedures without the use of cardiopulmonary bypass to provide partial/full VAD support chronically (Table 2) (23–25).…”

Section: Pumpsmentioning

confidence: 99%

Miniaturization of Mechanical Circulatory Support Systems

et al. 2012

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Heart failure (HF) is increasing worldwide and represents a major burden in terms of health care resources and costs. Despite advances in medical care, prognosis with HF remains poor, especially in advanced stages. The large patient population with advanced HF and the limited number of donor organs stimulated the development of mechanical circulatory support (MCS) devices as a bridge to transplant and for destination therapy. However, MCS devices require a major operative intervention, cardiopulmonary bypass, and blood component exposure, which have been associated with significant adverse event rates, and long recovery periods. Miniaturization of MCS devices and the development of an efficient and reliable transcutaneous energy transfer system may provide the vehicle to overcome these limitations and usher in a new clinical paradigm in heart failure therapy by enabling less invasive beating heart surgical procedures for implantation, reduce cost, and improve patient outcomes and quality of life. Further, it is anticipated that future ventricular assist device technology will allow for a much wider application of the therapy in the treatment of heart failure including its use for myocardial recovery and as a platform for support for cell therapy in addition to permanent long-term support.

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“…However, for pediatric patients extracorporeal membrane oxygenation (ECMO) is usually the first choice for cardiac support [2]. The development of pediatric VAD circuits to deliver lower flows and pressures has been tentative due to complications from thrombosis, bleeding, and the complex anatomy of congenital heart disease [3,4]. Pediatric VADs currently require special equipment with expensive and intricate supplies to keep in stock.…”

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confidence: 99%