title: Mechanical circulatory support in pediatrics.
abstract: End-stage heart failure affects thousands of children yearly and mechanical circulatory support is used at many points in their care. Extracorporeal membrane oxygenation supports both the failing heart and lungs, which has led to its use as an adjunct to cardiopulmonary resuscitation as well as in post-operative cardiogenic shock. Continuous-flow ventricular assist devices (VAD) have replaced pulsatile-flow devices in adults and early studies have shown promising results in children. The Berlin paracorporeal pulsatile VAD recently gained U.S. Food and Drug Administration approval and remains the only VAD approved in pediatrics. Failing univentricular hearts and other congenitally corrected lesions are new areas for mechanical support. Finding novel uses, improving durability, and minimizing complications are areas of growth in pediatric mechanical circulatory support.
authors.affiliation: a Department of Thoracic and Cardiovascular Surgery , Heart and Vascular Institute, Cleveland Clinic , Cleveland , OH , USA.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Steffen
authors.affiliation: a Department of Thoracic and Cardiovascular Surgery , Heart and Vascular Institute, Cleveland Clinic , Cleveland , OH , USA.
authors.forename: Kyle G
authors.initials: KG
authors.lastname: Miletic
authors.affiliation: a Department of Thoracic and Cardiovascular Surgery , Heart and Vascular Institute, Cleveland Clinic , Cleveland , OH , USA.
authors.forename: Dean P
authors.initials: DP
authors.lastname: Schraufnagel
authors.affiliation: a Department of Thoracic and Cardiovascular Surgery , Heart and Vascular Institute, Cleveland Clinic , Cleveland , OH , USA.
authors.forename: Patrick R
authors.initials: PR
authors.lastname: Vargo
authors.affiliation: b Department of Biomedical Engineering , Lerner Research Institute, Cleveland Clinic , Cleveland , OH , USA.
authors.forename: Kiyotaka
authors.initials: K
authors.lastname: Fukamachi
authors.affiliation: a Department of Thoracic and Cardiovascular Surgery , Heart and Vascular Institute, Cleveland Clinic , Cleveland , OH , USA.
authors.forename: Robert D
authors.initials: RD
authors.lastname: Stewart
authors.affiliation: a Department of Thoracic and Cardiovascular Surgery , Heart and Vascular Institute, Cleveland Clinic , Cleveland , OH , USA.
authors.forename: Nader
authors.initials: N
authors.lastname: Moazami
mesh_terms: D015199:Extracorporeal Membrane Oxygenation; D006353:Heart-Assist Devices; D006801:Humans; D010372:Pediatrics; D016276:Ventricular Function
keywords: Mechanical circulatory support; bridge-to-transplant; congenital heart disease; heart failure; pediatrics