TY - JOUR
T1 - Indications and outcomes for temporary mechanical circulatory support in pediatric patients with cardiac failure
AU - Bearl, David W.
AU - Jaquiss, Robert D.B.
AU - Vesel, Travis P.
N1 - Publisher Copyright:
Copyright © 2018 by the ASAIO
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2019
Y1 - 2019
N2 - Temporary continuous-flow ventricular assist devices (cfVAD) and extracorporeal membrane oxygenation (ECMO) are options for temporary mechanical circulatory support in pediatric patients. Despite the increase in temporary cfVAD use, the literature describing its use in pediatrics is limited. This was a single-center retrospective review of temporary cfVAD and a cohort of similar ECMO patients between January 1, 2011, and June 30, 2016, in patients <19 years of age. Thirteen patients underwent temporary cfVAD placement and 11 patients underwent ECMO cannulation for similar indications during the study period. Precannulation data were not statistically different, except for higher lactate and lower pH in the ECMO cohort. Median length of cfVAD support was 20 days (range 6-227), compared with 9 days (range 1-15) on ECMO. Primary outcome for cfVAD patients was one decannulated with recovery, six transplanted, and six died, compared with ECMO patients with five decannulated with recovery, three transplanted after conversion to durable VAD, and three died. No patients were transplanted directly from ECMO. This review provides new evidence that temporary cfVAD use can be used to support pediatric patients more than longer periods of time compared with ECMO, with transition to durable VAD and transplant. ASAIO Journal 2019; 65:389-394.
AB - Temporary continuous-flow ventricular assist devices (cfVAD) and extracorporeal membrane oxygenation (ECMO) are options for temporary mechanical circulatory support in pediatric patients. Despite the increase in temporary cfVAD use, the literature describing its use in pediatrics is limited. This was a single-center retrospective review of temporary cfVAD and a cohort of similar ECMO patients between January 1, 2011, and June 30, 2016, in patients <19 years of age. Thirteen patients underwent temporary cfVAD placement and 11 patients underwent ECMO cannulation for similar indications during the study period. Precannulation data were not statistically different, except for higher lactate and lower pH in the ECMO cohort. Median length of cfVAD support was 20 days (range 6-227), compared with 9 days (range 1-15) on ECMO. Primary outcome for cfVAD patients was one decannulated with recovery, six transplanted, and six died, compared with ECMO patients with five decannulated with recovery, three transplanted after conversion to durable VAD, and three died. No patients were transplanted directly from ECMO. This review provides new evidence that temporary cfVAD use can be used to support pediatric patients more than longer periods of time compared with ECMO, with transition to durable VAD and transplant. ASAIO Journal 2019; 65:389-394.
KW - Heart failure
KW - Mechanical circulatory support
KW - Pediatric
KW - Ventricular assist device
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U2 - 10.1097/MAT.0000000000000819
DO - 10.1097/MAT.0000000000000819
M3 - Article
C2 - 30543528
AN - SCOPUS:85065402378
SN - 1058-2916
VL - 65
SP - 389
EP - 394
JO - ASAIO Journal
JF - ASAIO Journal
IS - 4
ER -