Successful Use of the Toyobo Left Ventricular Assist Device in a 16-kg Girl Awaiting Cardiac Transplantation

Masuoka, Ayumu; Kobayashi, Toshiyuki; Asano, Haruhiko; Iwazaki, Mika; Matsuoka, Takahiro; Nishimura, Motonobu; Kyo, Shunei

doi:10.1016/j.athoracsur.2006.07.029

Cited by 4 publications

(4 citation statements)

References 5 publications

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“…This case demonstrates successful management of a subdural hematoma in a pediatric patient requiring LVAD support. Previous case reports of children managed with adult LVADs underline the difficulty in prevention of thromboembolism in this group of patients (4–6). Using adult LVADs provides effective mechanical support in pediatric patients awaiting heart transplant, but is associated with a high risk of clot formation in the LVAD chamber, especially in children weighing <17 kg or with less than 0.70‐m 2 body surface area (1, 3).…”

Section: Discussionmentioning

confidence: 96%

“…Our patient’s intermittent episodes of a negative flash test indicated that his LVAD was not emptying completely. Case reports indicate that a “full‐fill, full‐empty” mode can reduce the risk of chamber thrombus formation in children on adult LVADs, although this setting increases the risk of hypertension (4, 6). Although pediatric‐specific LVADs are available, they still pose some risks of thromboembolism, bleeding complications, and infection (8–10).…”

Section: Discussionmentioning

confidence: 99%

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Management of intracranial hemorrhage in a child with a left ventricular assist device

Haque¹,

Wojtasiewicz²,

Gerrah³

et al. 2012

Pediatric Transplantation

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Pediatric patients bridged to heart transplant with LVADs require chronic anticoagulation and are at increased risk of hemorrhagic complications, including intracranial hemorrhage. In this population, intracranial hemorrhage is often fatal. We report a case of successful management of a five-yr-old-boy with DCM on an LVAD who developed a subdural hematoma. We initially chose medical management, weighing the patient's high risk of thromboembolism from anticoagulation reversal against the risk of his chronic subdural hematoma. When head CT showed expansion of the hemorrhage with increasing midline shift, we chose prompt surgical evacuation of the hematoma with partial reversal of anticoagulation, given the increased risk of acute deterioration. The patient ultimately received an orthotopic heart transplant and was discharged with no permanent neurological complications. This represents a case of a pediatric patient on an LVAD who survived a potentially fatal subdural hematoma and was successfully bridged to cardiac transplantation.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Management of intracranial hemorrhage in a child with a left ventricular assist device

Haque¹,

Wojtasiewicz²,

Gerrah³

et al. 2012

Pediatric Transplantation

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“…We encountered similar problems when an adult-size Toyobo-NCVC LVAD was used in a 6-yearold girl (BSA 0.71 m 2 ), with cerebral infarction occurring when operating the pump in the half-fi ll half-empty mode. 6 Here, as a life-saving measure, we used an adultsize Toyobo-NCVC LVAD in a 3-year-old girl (BSA 0.66 m 2 ). The pump in the present patient was therefore operated in full-fi ll full-empty mode starting soon after LVAD operation, and the life of the patient was saved without thrombosis.…”

Section: Discussionmentioning

confidence: 99%

“…We speculated that reducing stroke volume of the pump might cause stagnation of the bloodstream in the pumping chamber, leading to thrombus formation. 6 To pump out almost all the blood in the pumping chamber on each stroke, the stroke volume of this pump needs to be >60 ml. As a consequence, the stroke rate had to be decreased to <45 strokes/min, and %systole was set at 50%.…”

Section: Case Reportmentioning

confidence: 99%

Bridge to transplantation with a Toyobo-NCVC left ventricular assist device in a 3-year-old girl

Masuoka

Kobayashi

Iwazaki

et al. 2008

Gen Thorac Cardiovasc Surg

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In Japan, no pulsatile ventricular assist devices are available specifically for use in children. Pumps designed for adults are thus often used in children. We report herein a case of end-stage heart failure in a 3-year old girl (height 100.4 cm; body weight 16.2 kg; body surface area 0.66 m2) who underwent implantation with an adult-sized Toyobo-NCVC left ventricular assist device (Toyobo-National Cardiovascular Center, Osaka, Japan) in our unit. We started with the driving mode to "full-fill, full-empty" mode. The problem was difficult-to-treat hypertension due to excessive stroke volume induced by the left ventricular assist device. Aggressive administration of antihypertensive therapy was needed. Successful heart transplantation was performed in Germany 5 months after beginning support with the Toyobo-NCVC left ventricular assist device.

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Prothrombin Complex Concentrate and Methylene Blue for Treatment of Coagulopathy and Vasoplegia in a Pediatric Heart Transplant Patient

Lee

Ing²

2016

A & A Case Reports

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Ventricular assist devices (VADs) are associated with conditions that may complicate the perioperative course of pediatric heart transplants. A 7-year-old girl with dilated cardiomyopathy supported by a Toyobo-NCVC left VAD (Toyobo-National Cardiovascular Center, Osaka, Japan), a pulsatile extracorporeal device, and preoperatively anticoagulated with warfarin presented for orthotopic heart transplant. The course was complicated by persistent bleeding treated with prothrombin complex concentrate and refractory postbypass vasoplegia treated with methylene blue. Preoperative anticoagulation and the presence of a VAD are associated with postbypass coagulopathy and vasoplegia. We describe a case in which these conditions were successfully treated with no thrombotic complications and minimal need of vasopressors for hemodynamic stability.

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Successful Use of the Toyobo Left Ventricular Assist Device in a 16-kg Girl Awaiting Cardiac Transplantation

Cited by 4 publications

References 5 publications

Management of intracranial hemorrhage in a child with a left ventricular assist device

Management of intracranial hemorrhage in a child with a left ventricular assist device

Bridge to transplantation with a Toyobo-NCVC left ventricular assist device in a 3-year-old girl

Prothrombin Complex Concentrate and Methylene Blue for Treatment of Coagulopathy and Vasoplegia in a Pediatric Heart Transplant Patient

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