title: Clinical outcomes of pediatric ventricular assist device implantation: a single-institute report from Japan.
abstract: OBJECTIVE
  Numerous difficulties remain associated with pediatric heart transplantation. Therefore, the development of a ventricular assist device (VAD) specific to these cases is extremely important for therapeutic effectiveness. We present 5 cases of severe heart failure that were managed by ventricular assist device implantation, as a bridge to transplantation.
  
  
  METHODS
  We examined the clinical course of 5 patients (4 boys, 1 girl; mean age, 10.6 ± 1.5 years; range, 8-12 years) who underwent implantation of a pneumatic extracorporeal ventricular assist device between February 2004 and May 2009. Four patients had dilated cardiomyopathy and one had corrected transposition of the great arteries.
  
  
  RESULTS
  The mean period between onset of heart failure and ventricular assist device implantation was 594 ± 750 days (range, 94-1702 days), and the mean duration of ventricular assist support was 112 ± 98 days (range, 44-284 days). Four patients underwent heart transplantation overseas and one died of cerebral hemorrhage.
  
  
  CONCLUSIONS
  Careful management of pediatric VAD patients and development of a device designed specifically for pediatric patients are essential for improving clinical outcomes in the future.
authors.affiliation: Department of Cardiovascular Surgery, Tokyo Women's Medical University, Tokyo - Japan.
authors.forename: Masahide
authors.initials: M
authors.lastname: Komagamine
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Nishinaka
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Iwata
authors.forename: Yuki
authors.initials: Y
authors.lastname: Tsukui
authors.forename: Satoshi
authors.initials: S
authors.lastname: Saito
authors.forename: Kenji
authors.initials: K
authors.lastname: Yamazaki
mesh_terms: D000367:Age Factors; D002648:Child; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D016027:Heart Transplantation; D006353:Heart-Assist Devices; D006801:Humans; D007564:Japan; D008297:Male; D011474:Prosthesis Design; D012720:Severity of Illness Index; D013997:Time Factors; D061665:Time-to-Treatment; D016896:Treatment Outcome; D016277:Ventricular Function, Left