Pediatric Mechanical Circulatory Support: Introduction and Schneider's Experience

Ventricular assist devices (VADs) play a critical and increasing role in treating end-stage heart failure in pediatric patients. A growing number of patients are supported by VADs as a bridge to heart transplantation. Experience with VADs in the pediatric population is limited, and experience in Isr...

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Published in:The Israel Medical Association journal 2023-12, Vol.25 (12), p.819-825
Main Authors: Soffair, Niv, Shostak, Eran, Dagan, Ovadia, Manor-Shulman, Orit, Feinstein, Yael, Amir, Gabriel, Frenkel, Georgy, Rotstein, Amichai, Dvir-Orgad, Merav, Birk, Einat, Yacobovich, Joanne, Schiller, Ofer
Format: Article
Language:English
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Summary:Ventricular assist devices (VADs) play a critical and increasing role in treating end-stage heart failure in pediatric patients. A growing number of patients are supported by VADs as a bridge to heart transplantation. Experience with VADs in the pediatric population is limited, and experience in Israel has not been published. To describe this life-saving technology and our experience with VAD implantation in children with heart failure, including characteristics and outcomes. We conducted a retrospective chart review of all patients who underwent VAD implantation at Schneider Children's Medical Center from 2018 to 2023. We analyzed results of 15 children who underwent VAD implantation. The youngest was 2.5 years old and weighed 11 kg at implantation. In eight patients, HeartMate 3, a continuous-flow device, was implanted. Seven patients received Berlin Heart, a pulsatile-flow device. Three children required biventricular support; 11 underwent heart transplants after a median duration of 169 days. Two patients died due to complications while awaiting a transplant; two were still on VAD support at the time of submission of this article. Successful VAD support was achieved in 86.6% of patients. In the last 5 years,79% of our heart transplant patients received VAD support prior to transplant. Circulatory assist devices are an excellent bridge to transplantation for pediatric patients reaching end-stage heart failure. VADs should be carefully selected, and implantation techniques tailored to patient's weight and diagnosis at a centralized pediatric cardiac transplantation center. Israeli healthcare providers should be cognizant of this therapeutic alternative.
ISSN:1565-1088