Temporary Circulatory Support in U.S. Children Awaiting Heart Transplantation

Abstract

The use of TCS devices in children as a bridge to transplant has risen rapidly in recent years, led by the growth of magnetically levitated centrifugal flow pumps. Compared with conventional ECMO, TCS durations are longer, and more importantly, patient survival is superior.

Commentary: Total artificial heart in the pediatric population…proceed with caution

“…Temporary circulatory devices have advantages over durable support and have been used more often in the current era. 2 Temporary devices are relatively easier to implant via either a percutaneous approach or less invasive surgical techniques and the management of these devices is also flexible and versatile. Temporary devices can be a better alternative tool to facilitate end organ recovery compared with traditional extracorporeal membrane oxygenation support, provided that pulmonary function is reasonable.…”

Evaluation of centrifugal blood pumps in term of hemodynamic performance using simulated neonatal and pediatric ECMO circuits

“…Additionally, the various centrifugal pump designs can have significant effects on hemodynamic performance . PediMag and CentriMag pumps have been successfully used in pediatric and adult patients requiring Ventricular Assist Device (VAD) and ECMO support . They have similar magnetically levitated, bearingless impellers and utilize the same hardware platform (motor and console) .…”

“…3,4 PediMag and CentriMag pumps have been successfully used in pediatric and adult patients requiring Ventricular Assist Device (VAD) and ECMO support. [5][6][7][8] They have similar magnetically levitated, bearingless impellers and utilize the same hardware platform (motor and console). 8 The PediMag pump has five impeller blades in a small pump housing (14 mL priming volume) with a 1/4-inch ID connections, while the CentriMag pump has eight impeller blades (four long blades, four short blades) in large pump housing (31 mL priming volume) with 3/8-inch connections.…”

First human implantation of a miniaturized axial flow ventricular assist device in a child with end-stage heart failure

“…Small children with end-stage heart failure who require left ventricular assist device (LVAD) support to heart transplant have limited device options, leading to high morbidity and mortality and are confined to the hospital until transplant. 1,2 The only Food and Drug Administration (FDA)approved durable LVAD for children is a paracorporeal pulsatile device that carries a high stroke risk and lacks portability, precluding hospital discharge. 1 Temporary paracorporeal continuous flow devices have also been used offlabel for bridge-to-transplant but carry higher mortality, require lengthy paracorporeal cannulas prone to circuit thrombus, and typically require children to remain in intensive care.…”

“…1 Temporary paracorporeal continuous flow devices have also been used offlabel for bridge-to-transplant but carry higher mortality, require lengthy paracorporeal cannulas prone to circuit thrombus, and typically require children to remain in intensive care. 2,3 Recently, a novel, durable, fully implantable, miniaturized axial flow pump similar to more contemporary adult LVADs has been developed, but it has never been used in a human. We present the case of a 4-year-old girl with dilated cardiomyopathy who underwent the world's first pump placement in Rome, Italy.…”