Mechanical Circulatory Support: Strategies and Outcomes in Pediatric Congenital Heart Disease
Abstract Patients with acute or progressive heart failure in the setting of congenital heart disease may need mechanical circulatory support (MCS) to enhance survival while awaiting cardiac transplantation. Because the majority of MCS devices are implanted after prior cardiac operations, special pre...
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| Veröffentlicht in: | Seminars in thoracic and cardiovascular surgery. Pediatric cardiac surgery annual 2014, Vol.17 (1), p.62-68 |
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| container_title | Seminars in thoracic and cardiovascular surgery. Pediatric cardiac surgery annual |
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| creator | Kirklin, James K Bennett Pearce, F Dabal, Robert J Carlo, Waldemar F |
| description | Abstract Patients with acute or progressive heart failure in the setting of congenital heart disease may need mechanical circulatory support (MCS) to enhance survival while awaiting cardiac transplantation. Because the majority of MCS devices are implanted after prior cardiac operations, special precautions are necessary at the time of implant. MCS in single ventricle patients usually requires ventricular and aortic cannulation, with a systemic to pulmonary artery shunt for pulmonary blood flow. Limited outcomes data is available, with less than 15% of pediatric MCS patients having congenital heart disease. The Berlin EXCOR is the only durable device currently available for infants. Neurologic complications are the major cause of mortality, and survival during support is poor for infants |
| doi_str_mv | 10.1053/j.pcsu.2014.01.007 |
| format | Article |
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Because the majority of MCS devices are implanted after prior cardiac operations, special precautions are necessary at the time of implant. MCS in single ventricle patients usually requires ventricular and aortic cannulation, with a systemic to pulmonary artery shunt for pulmonary blood flow. Limited outcomes data is available, with less than 15% of pediatric MCS patients having congenital heart disease. The Berlin EXCOR is the only durable device currently available for infants. Neurologic complications are the major cause of mortality, and survival during support is poor for infants <5 kg. Patients post-Fontan with acute cardiac failure and/or respiratory failure are at high risk for death before transplant and should be considered for MCS therapy. Several emerging miniature continuous flow devices will soon broaden the landscape of available pediatric devices.</description><identifier>ISSN: 1092-9126</identifier><identifier>DOI: 10.1053/j.pcsu.2014.01.007</identifier><identifier>PMID: 24725719</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Cardiothoracic Surgery ; Child ; Child, Preschool ; Disease Progression ; Heart Defects, Congenital - complications ; Heart Defects, Congenital - surgery ; Heart Failure - etiology ; Heart Failure - surgery ; Heart Transplantation ; Heart-Assist Devices ; Humans ; Infant ; Infant, Newborn ; Pediatrics ; Prosthesis Design ; Reoperation</subject><ispartof>Seminars in thoracic and cardiovascular surgery. Pediatric cardiac surgery annual, 2014, Vol.17 (1), p.62-68</ispartof><rights>Elsevier Inc.</rights><rights>2014 Elsevier Inc.</rights><rights>Copyright © 2014 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c326t-ce680f3e47ba432c5af95d39e083fac94d81b6b0d1d4548bf1af73030cc160e13</citedby><cites>FETCH-LOGICAL-c326t-ce680f3e47ba432c5af95d39e083fac94d81b6b0d1d4548bf1af73030cc160e13</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S1092912614000088$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,4010,27900,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24725719$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kirklin, James K</creatorcontrib><creatorcontrib>Bennett Pearce, F</creatorcontrib><creatorcontrib>Dabal, Robert J</creatorcontrib><creatorcontrib>Carlo, Waldemar F</creatorcontrib><title>Mechanical Circulatory Support: Strategies and Outcomes in Pediatric Congenital Heart Disease</title><title>Seminars in thoracic and cardiovascular surgery. Pediatric cardiac surgery annual</title><addtitle>Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu</addtitle><description>Abstract Patients with acute or progressive heart failure in the setting of congenital heart disease may need mechanical circulatory support (MCS) to enhance survival while awaiting cardiac transplantation. Because the majority of MCS devices are implanted after prior cardiac operations, special precautions are necessary at the time of implant. MCS in single ventricle patients usually requires ventricular and aortic cannulation, with a systemic to pulmonary artery shunt for pulmonary blood flow. Limited outcomes data is available, with less than 15% of pediatric MCS patients having congenital heart disease. The Berlin EXCOR is the only durable device currently available for infants. Neurologic complications are the major cause of mortality, and survival during support is poor for infants <5 kg. Patients post-Fontan with acute cardiac failure and/or respiratory failure are at high risk for death before transplant and should be considered for MCS therapy. Several emerging miniature continuous flow devices will soon broaden the landscape of available pediatric devices.</description><subject>Cardiothoracic Surgery</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Disease Progression</subject><subject>Heart Defects, Congenital - complications</subject><subject>Heart Defects, Congenital - surgery</subject><subject>Heart Failure - etiology</subject><subject>Heart Failure - surgery</subject><subject>Heart Transplantation</subject><subject>Heart-Assist Devices</subject><subject>Humans</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>Pediatrics</subject><subject>Prosthesis Design</subject><subject>Reoperation</subject><issn>1092-9126</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kUuLFDEUhbNQnLH1D7iQWrrp8t6kniKCtI8RRkZoXUpI3bo1pq2ulElK6H9vyh5duDCbEDjng3xHiCcIOUKpnh_ymcKSS8AiB8wB6nviEqGV2xZldSEehnAAUDVIeCAuZFHLssb2Unz9yPTNTJbMmO2sp2U00flTtl_m2fn4IttHbyLfWg6ZmfrsZonkjulhp-wT99ZEbynbuemWJxsT5IqNj9kbG9gEfiTuD2YM_Pju3ogv795-3l1tr2_ef9i9vt6SklXcElcNDIqLujOFklSaoS171TI0ajDUFn2DXdVBj31RFk03oBlqBQqIsAJGtRHPztzZux8Lh6iPNhCPo5nYLUFjiZVqG5l4GyHPUfIuBM-Dnr09Gn_SCHpVqQ96ValXlRpQJ5Wp9PSOv3RH7v9W_nhMgZfnAKdf_rTsdSDLEyVDninq3tn_81_9U6fR_h7lO584HNzip-RPow5Sg96vw667YgHpNI36BdMGnLE</recordid><startdate>2014</startdate><enddate>2014</enddate><creator>Kirklin, James K</creator><creator>Bennett Pearce, F</creator><creator>Dabal, Robert J</creator><creator>Carlo, Waldemar F</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>2014</creationdate><title>Mechanical Circulatory Support: Strategies and Outcomes in Pediatric Congenital Heart Disease</title><author>Kirklin, James K ; Bennett Pearce, F ; Dabal, Robert J ; Carlo, Waldemar F</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c326t-ce680f3e47ba432c5af95d39e083fac94d81b6b0d1d4548bf1af73030cc160e13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Cardiothoracic Surgery</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Disease Progression</topic><topic>Heart Defects, Congenital - complications</topic><topic>Heart Defects, Congenital - surgery</topic><topic>Heart Failure - etiology</topic><topic>Heart Failure - surgery</topic><topic>Heart Transplantation</topic><topic>Heart-Assist Devices</topic><topic>Humans</topic><topic>Infant</topic><topic>Infant, Newborn</topic><topic>Pediatrics</topic><topic>Prosthesis Design</topic><topic>Reoperation</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kirklin, James K</creatorcontrib><creatorcontrib>Bennett Pearce, F</creatorcontrib><creatorcontrib>Dabal, Robert J</creatorcontrib><creatorcontrib>Carlo, Waldemar F</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Seminars in thoracic and cardiovascular surgery. Pediatric cardiac surgery annual</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kirklin, James K</au><au>Bennett Pearce, F</au><au>Dabal, Robert J</au><au>Carlo, Waldemar F</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Mechanical Circulatory Support: Strategies and Outcomes in Pediatric Congenital Heart Disease</atitle><jtitle>Seminars in thoracic and cardiovascular surgery. Pediatric cardiac surgery annual</jtitle><addtitle>Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu</addtitle><date>2014</date><risdate>2014</risdate><volume>17</volume><issue>1</issue><spage>62</spage><epage>68</epage><pages>62-68</pages><issn>1092-9126</issn><abstract>Abstract Patients with acute or progressive heart failure in the setting of congenital heart disease may need mechanical circulatory support (MCS) to enhance survival while awaiting cardiac transplantation. Because the majority of MCS devices are implanted after prior cardiac operations, special precautions are necessary at the time of implant. MCS in single ventricle patients usually requires ventricular and aortic cannulation, with a systemic to pulmonary artery shunt for pulmonary blood flow. Limited outcomes data is available, with less than 15% of pediatric MCS patients having congenital heart disease. The Berlin EXCOR is the only durable device currently available for infants. Neurologic complications are the major cause of mortality, and survival during support is poor for infants <5 kg. Patients post-Fontan with acute cardiac failure and/or respiratory failure are at high risk for death before transplant and should be considered for MCS therapy. Several emerging miniature continuous flow devices will soon broaden the landscape of available pediatric devices.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>24725719</pmid><doi>10.1053/j.pcsu.2014.01.007</doi><tpages>7</tpages></addata></record> |
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| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | Cardiothoracic Surgery Child Child, Preschool Disease Progression Heart Defects, Congenital - complications Heart Defects, Congenital - surgery Heart Failure - etiology Heart Failure - surgery Heart Transplantation Heart-Assist Devices Humans Infant Infant, Newborn Pediatrics Prosthesis Design Reoperation |
| title | Mechanical Circulatory Support: Strategies and Outcomes in Pediatric Congenital Heart Disease |
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