Mechanical circulatory assistance in paediatric patients with cardiac failure.
Extracorporeal membrane oxygenation (ECMO) was initially developed for respiratory failure. Its use, however, has evolved into an excellent method of preoperative and postoperative support in the treatment of infants and children with acquired and congenital heart disease. Along with ECMO, the left ventricular assist device (LVAD) and the intraaortic balloon pump (IABP) have also found a place in the management of paediatric patients with heart failure. This report documents 15 patients who were treated with one or a combination of these mechanical devices, either preoperatively or postoperatively. There is a 74% survival rate and the long-term outcome has been excellent in most cases. The use of heparin-coated devices and tight regulation of heparin has allowed the transfer of infants and children from standard cardiopulmonary bypass to assist devices in the operating room. Mechanical devices are an essential adjunct for the preoperative and postoperative treatment of infants and children with cardiac disease.
Khan
A
A
Department of Cardiothoracic Surgery, University of California, Irvine Medical Center, Orange County 92668, USA.
Gazzaniga
A B
AB
D000925:Anticoagulants / Q000008:administration & dosage / Q000627:therapeutic use; D001243:Assisted Circulation / Q000009:adverse effects; D002303:Cardiac Output, Low / Q000628:therapy*; D002315:Cardiopulmonary Bypass; D002648:Child; D002675:Child, Preschool; D015199:Extracorporeal Membrane Oxygenation / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D006330:Heart Defects, Congenital / Q000628:therapy; D006331:Heart Diseases / Q000628:therapy; D006353:Heart-Assist Devices / Q000009:adverse effects; D006493:Heparin / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007423:Intra-Aortic Balloon Pumping / Q000009:adverse effects; D007430:Intraoperative Care; D008297:Male; D009873:Operating Rooms; D011182:Postoperative Care; D011300:Preoperative Care; D015996:Survival Rate; D016896:Treatment Outcome; D016277:Ventricular Function, Left
D000925:Anticoagulants; D006493:Heparin