Ventricular Assist Devices in Pediatric Cardiac Intensive Care

Abstract

The number of patients with advanced heart failure due to either acquired or congenital heart disease continues to increase, necessitating in some mechanical circulatory support and in others cardiac transplantation. With a limited cardiac donor pool, mechanical circulatory support is playing a greater role in the management of this population. The perioperative morbidity associated with mechanical circulatory support has lessened with improved postoperative management strategies.

Mechanical circulatory support using modified TandemHeart ventricular assist device in neonates with CHD

“…However, most ventricular assist devices do not support oxygenation or lower flow rates in younger children. 5 The TandemHeart (CardiacAssist, Pittsburgh, Pennsylvania, United States of America) ventricular assist device is a centrifugal pump traditionally used in adults with heart failure that requires a minimum revolutions per minute of 3500 or a minimum flow of 1 L/minute. In paediatrics, several reported circuit modifications provide lower flow including recirculation shunt, flow occlusion clamps, and, in some cases, an oxygenator.…”

“…– 4 Ventricular assist devices are increasingly being used for short-term extracorporeal support. However, most ventricular assist devices do not support oxygenation or lower flow rates in younger children 5 …”

Use of ECMO for Cardiogenic Shock in Pediatric Population

“…Byrnes at al. have described an algorithm that may help with this decision-making process at different time points [ 78 ].…”