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עמוד בית
Wed, 09.10.24

ORIGINAL ARTICLES

IMAJ | volume 25

Journal 12, December 2023
pages: 819-825

Pediatric Mechanical Circulatory Support: Introduction and Schneider’s Experience

1 Pediatric Intensive Care Unit, Schneider Children's Medical Center, Petah Tikva, Israel 2 Pediatric Cardiac Intensive Care Unit, Schneider Children's Medical Center, Petah Tikva, Israel 3 Department of Pediatric and Congenital Cardiac Surgery, Schneider Children's Medical Center, Petah Tikva, Israel 4 Heart Institute, Schneider Children's Medical Center, Petah Tikva, Israel 5 Department of Hematology-Oncology, Schneider Children's Medical Center, Petah Tikva, Israel 6 Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

Summary

Background:

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.

Objectives:

To describe this life-saving technology and our experience with VAD implantation in children with heart failure, including characteristics and outcomes.

Methods:

We conducted a retrospective chart review of all patients who underwent VAD implantation at Schneider Children's Medical Center from 2018 to 2023.

Results:

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.

Conclusions:

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.

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