Supporting pediatric patients with short-term continuous-flow devices
Section snippets
Methods
The local Research Ethics Board approved the study protocol, and the requirement for individual patient consent was waived.
Demographics and clinical outcomes
From 2005 to 2014, 27 children (15 girls [56%]) were supported with a STCF-VAD with a total of 33 runs in 28 separate hospital admissions (Table 1), comprising 85% (n = 23) with 1 run, 7% (n = 2) experienced 2, and an additional 7% (n = 2) were supported on three occasions. At the time of implant, the patients were a median age of 1.7 years (IQR 0.1, 4.1 years) with a median weight of 8.9 kg (IQR 3.7, 18 kg). The most common reason for implantation during the 33 runs was congenital heart
Discussion
Acute heart failure occurs in a number of different settings in pediatrics. STCF-VAD support permits time for decisions to be made about the potential for myocardial recovery and allows for a detailed assessment of end-organ function. ECMO is another option for short-term support for acute cardiopulmonary failure, but survival to hospital discharge remains a challenge, with reports of 32% to 73% in single centers studies8, 9, 10, 11, 12, 13 and 40% to 50% for pediatric cardiac ECMO from the
Conclusions
STCF-VADs can successfully bridge pediatric patients to recovery, a long-term device, or transplant in most cases, with an acceptable complication rate. Although these devices are designed for short-term support, longer support is possible and may be an alternative support strategy for patients who are not suitable for the current long-term devices. Further studies are required to better understand the complication profile and the ideal management strategy, including anti-coagulation, for
Disclosure statement
None of the authors has a financial relationship with a commercial entity that has an interest in the subject of the presented manuscript or other conflicts of interest to disclose.
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