Pediatric arteriovenous extracorporeal membrane oxygenation (ECMO) as a bridge to cardiac transplantation

Emprego do suporte cardiopulmonar com bomba centrífuga e oxigenador de membrana em cirurgia cardiovascular pediátrica

“…In our country, its development and clinical application are limited, being restricted to a few high-complexity centers 8 . Nevertheless, the use of the ECMO in the perioperative period of cardiovascular surgery is an effective method to control severe hemodynamic 9 or respiratory 10 alterations, allowing the recovery of targetorgans 11 or as bridge for transplant in selected cases [12][13][14] . The largest world experience with the method occurs in pediatric patients with respiratory failure.…”

Pediatric cardiomyopathies: A review of literature on clinical status and meta-analysis of diagnosis and clinical management methods

“…Sixteen (16) studies conducted between 1969 and 2013 meeting the inclusion criteria were included in this meta-analysis [63,[78][79][80][81][82][83][84][85][86][87][88][89][90][91][92]. The total pediatric patients in all the 16 studies was 1,021 with mean age 7.73 years and mean follow-up period of 6.8 months.…”

“…The most commonly studied phenotype of pediatric cardiomyopathy was DCM by 50% of the studies [63,79,85,86,[89][90][91][92] followed by RCM (37.5% of the studies) [81][82][83][85][86][87] and finally HCM (12.5% of the studies) [78,80]. Two studies did not specify the type of pediatric cardiomyopathy [84,88]. The dominant clinical management methods were heart transplantation assessed by 44% of the studies [63,[81][82][83][85][86][87] followed by pharmacotherapy, which was similarly assessed by 44% of the studies [63,79,80,[89][90][91][92] [78,84,88].…”

“…Two studies did not specify the type of pediatric cardiomyopathy [84,88]. The dominant clinical management methods were heart transplantation assessed by 44% of the studies [63,[81][82][83][85][86][87] followed by pharmacotherapy, which was similarly assessed by 44% of the studies [63,79,80,[89][90][91][92] [78,84,88]. The main clinical outcomes assessed in the studies was five-year survival rate and/or reported mortality rate but the period differed in individual studies.…”

“…Mechanical support using LVAD and ECMO conveys effective short-term circulatory support but the benefits wane for long-term support. However, they are an effective short-term bridge for pediatric patients waiting for heart transplantation [84,88]. Heart transplantation remains the most effective preventive therapy for pediatric patients with cardiomyopathy-related end-stage heart failure.…”