1. Pediatric Mechanical Circulatory Support: Introduction and Schneider's Experience.
- Author
-
Soffair N, Shostak E, Dagan O, Manor-Shulman O, Feinstein Y, Amir G, Frenkel G, Rotstein A, Dvir-Orgad M, Birk E, Yacobovich J, and Schiller O
- Subjects
- Child, Humans, Child, Preschool, Retrospective Studies, Treatment Outcome, Heart, Heart Failure surgery, Heart Transplantation, Heart-Assist Devices
- Abstract
Background: Ventricular assist devices (VADs) play a critical and increasing role in treating end-stage heart failure in pediatric patients. A growing number of patients are supported by VADs as a bridge to heart transplantation. Experience with VADs in the pediatric population is limited, and experience in Israel has not been published., Objectives: To describe this life-saving technology and our experience with VAD implantation in children with heart failure, including characteristics and outcomes., Methods: We conducted a retrospective chart review of all patients who underwent VAD implantation at Schneider Children's Medical Center from 2018 to 2023., Results: We analyzed results of 15 children who underwent VAD implantation. The youngest was 2.5 years old and weighed 11 kg at implantation. In eight patients, HeartMate 3, a continuous-flow device, was implanted. Seven patients received Berlin Heart, a pulsatile-flow device. Three children required biventricular support; 11 underwent heart transplants after a median duration of 169 days. Two patients died due to complications while awaiting a transplant; two were still on VAD support at the time of submission of this article. Successful VAD support was achieved in 86.6% of patients. In the last 5 years,79% of our heart transplant patients received VAD support prior to transplant., Conclusions: Circulatory assist devices are an excellent bridge to transplantation for pediatric patients reaching end-stage heart failure. VADs should be carefully selected, and implantation techniques tailored to patient's weight and diagnosis at a centralized pediatric cardiac transplantation center. Israeli healthcare providers should be cognizant of this therapeutic alternative.
- Published
- 2023