Pediatric Ventricular Assist Devices

Stiller, Brigitte; Adachi, Iki; Fraser, Charles D.

doi:10.1097/pcc.0b013e318292df5f

Cited by 24 publications

(21 citation statements)

References 35 publications

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“…Patients on LVAD undergo significant medical and surgical therapy for their disease. With increased durability of pumps, the life expectancy of patients on LVAD has increased (15). In fact, patients on LVAD may face many life-limiting health diseases other than cardiac failure (16).…”

Section: Discussionmentioning

confidence: 99%

Modes of Death in a Pediatric Cardiac ICU*

Polito

Garisto

Pezzella

et al. 2016

Pediatric Critical Care Medicine

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Section: Discussionmentioning

confidence: 99%

Modes of Death in a Pediatric Cardiac ICU*

Polito

Garisto

Pezzella

et al. 2016

Pediatric Critical Care Medicine

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“…Refixation of fractures may be a choice in younger populations with better bone quality and physical condition (5,6). In the elderly population, early weight bearing, ambulation, and rehabilitation can be achieved by conversion to hip arthroplasty with good reported clinical outcome (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20). Hip arthroplasty for failed intertrochanteric fractures is more technically demanding due to repeated surgery, poor bone stock, weak or loss of abduction mechanism, and…”

Section: Conflict Of Interestmentioning

confidence: 99%

Peripheral Veno‐Arterial Extracorporeal Membrane Oxygenation as a Bridge to Decision for Pediatric Fulminant Myocarditis

Okada¹,

Murayama²,

Hasegawa³

et al. 2016

Artificial Organs

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It is essential to establish an appropriate initial treatment strategy for pediatric fulminant myocarditis. We reviewed eight cases of pediatric fulminant myocarditis that required extracorporeal membrane oxygenation (ECMO) from 2012 to 2015. The median age was 8 years (range 3 months-13 years), and the median body surface area was 0.89 m(2) (range 0.35-1.34 m(2) ). Peripheral veno-arterial ECMO was initially applied, and we evaluated whether heart decompression was sufficient. If the pump flow was insufficient, central cannulation was performed via median sternotomy (central ECMO). The need for subsequent ventricular assist device (VAD) support was determined 72 h after ECMO initiation. Six patients were bridged to recovery using peripheral ECMO support only (for 3-11 days), whereas two required VAD support. One patient was switched to central ECMO before VAD implantation. Three patients died of multiorgan failure, even though cardiac function recovered in two of those patients. The duration from hospital arrival to ECMO initiation was shorter in the survival (3.3 ± 1.3 h; range 1.6-4.7 h) than in the nonsurvival group (32 ± 28 h; range 0.7-55 h). Peripheral ECMO can be useful as a bridge to decision for pediatric fulminant myocarditis, which is frequently followed by a successful bridge to recovery. It is important to determine whether ECMO support should be initiated before organ dysfunction advances to preserve organ function, which provides a better bridge to subsequent VAD therapy and heart transplant or recovery.

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“…Our current MCS strategy has been described elsewhere in detail [7]. In short, patients with heart failure requiring an inotrope will be evaluated for MCS if there is ongoing end-organ dysfunction (eg, neurologic, respiratory, gastrointestinal, liver, renal or musculoskeletal) due to suboptimal hemodynamics (eg, a requirement of a second inotrope or mixed venous saturation of < 60%).…”

Section: Mcs Strategy At Tchmentioning

confidence: 99%

“…Taking these considerations in mind, we sought to review our singlecenter experience with MCS used with "intention to transplant" at Texas Children's Hospital (TCH), one of the largest pediatric heart transplant centers [6]. The MCS program at TCH started in 1995 and has been evolving over the years, resulting now in a full armamentarium of MCS devices [7]. Our extensive experience with pediatric MCS and pediatric heart transplant should provide a unique opportunity to evaluate how the evolution of the pediatric MCS program impacts the outcome of pediatric heart transplant candidates.…”

mentioning

confidence: 99%