Pulsatile Pediatric Ventricular Assist Devices: Current Results for Bridge to Transplantation

Hetzer, Roland; Loebe, Matthias; Weng, Yuguo; Alexi-Meskhishvili, V.; Stiller, Brigitte

doi:10.1016/s1092-9126(99)70017-7

Cited by 33 publications

(17 citation statements)

References 45 publications

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“…Heart transplantation is a well-established treatment option for infants and children with end-stage heart failure due to complex congenital cardiac defects or cardiomyopathy [4,[11][12][13][14]. We report our 23-year single-center experience in HTx in children under the age of 18 years.…”

Section: Discussionmentioning

confidence: 99%

Pediatric heart transplantation: 23-year single-center experience

Huebler

Schubert

Lehmkuhl

et al. 2011

European Journal of Cardio-Thoracic Surgery

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Section: Discussionmentioning

confidence: 99%

Pediatric heart transplantation: 23-year single-center experience

Huebler

Schubert

Lehmkuhl

et al. 2011

European Journal of Cardio-Thoracic Surgery

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“…This system consists of a paracorporeal, pneumatic compressor-operated diaphragm pump with polyurethane valves (10, 15, 25 or 30 mL stroke volume) and silicon cannulae (4,8,11). The larger pumps (50, 60 and 80 mL) are equipped with mechanical valves (Sorin, Milan, Italy).…”

Section: Berlin Germany)mentioning

confidence: 99%

“…Though he was supported with an adult-sized VAD, he made it to heart transplantation ( Figure 1) (1). This successful event catalyzed the Berlin group to eventually innovate miniaturized pump systems appropriate for infants and children (2) and initiated further improvements and advances in heart failure therapy for this population (3)(4)(5)(6). The ensuing decades have seen the increased application of Berlin Heart EXCOR assist device in children in profound heart failure as a bridge to transplantation or as a bridge to myocardial recovery (7)(8)(9).…”

Section: Introductionmentioning

confidence: 99%

Role of paediatric assist device in bridge to transplant

Hetzer¹,

Mfdm²,

2018

Ann. Cardiothorac. Surg.

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“…[1][2][3][4][5][6][7][8][9][10][11][12] For Ͼ2 decades, extracorporeal membrane oxygenation (ECMO) has served as the clinical standard of care for children requiring mechanical circulatory support as a bridge to heart transplantation but has been associated with mixed results. 1,[3][4][5][6][7][8][9][10] In recent years, a number of novel miniaturized pediatric ventricular assist devices (VADs) have emerged as alternatives to ECMO, [12][13][14][15][16][17] marking what many believe to be a new era in pediatric mechanical circulatory support. 1,5,7-11,18 -20 …”

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confidence: 99%

Extracorporeal Membrane Oxygenation for Bridge to Heart Transplantation Among Children in the United States

et al. 2011

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Background-Extracorporeal membrane oxygenation (ECMO) has served for Ͼ2 decades as the standard of care for US children requiring mechanical support as a bridge to heart transplantation. Objective data on the safety and efficacy of ECMO for this indication are limited. We describe the outcomes of ECMO as a bridge to heart transplantation to serve as performance benchmarks for emerging miniaturized assist devices intended to replace ECMO. Methods and Results-Data from the Extracorporeal Life Support Organization Registry and the Organ ProcurementTransplant Network database were merged to identify children supported with ECMO and listed for heart transplantation from 1994 to 2009. Independent predictors of wait-list and posttransplantation in-hospital mortality were identified. Objective performance goals for ECMO were developed. Of 773 children, the median age was 6 months (interquartile range, 1 to 44 months); 28% had cardiomyopathy; and in 38%, a bridge to transplantation was intended at ECMO initiation. Overall, 45% of subjects reached transplantation, although one third of those transplanted died before discharge; overall survival to hospital discharge was 47%. Wait-list mortality was independently associated with congenital heart disease, cardiopulmonary resuscitation before ECMO, and renal dysfunction. Posttransplantation mortality was associated with congenital heart disease, renal dysfunction, ECMO duration of Ͼ14 days, and initial ECMO indication as a bridge to recovery. In the objective performance goal cohort (nϭ485), patients with cardiomyopathy had the highest survival to hospital discharge (63%), followed by patients with myocarditis (59%), 2-ventricle congenital heart disease (44%) and 1-ventricle congenital heart disease (33%). Conclusion-Although ECMO is effective for short-term circulatory support, it is not reliable for the long-term circulatory support necessary for children awaiting heart transplantation. Fewer than half of patients bridged with ECMO survive to hospital discharge. More effective modalities for chronic circulatory support in children are urgently needed. (Circulation. 2011;123:2975-2984.)

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Pulsatile Pediatric Ventricular Assist Devices: Current Results for Bridge to Transplantation

Cited by 33 publications

References 45 publications

Pediatric heart transplantation: 23-year single-center experience

Pediatric heart transplantation: 23-year single-center experience

Role of paediatric assist device in bridge to transplant

Extracorporeal Membrane Oxygenation for Bridge to Heart Transplantation Among Children in the United States

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