Ventricular assist device implantation in the pediatric population: Does pump size selection and associated hemodynamics impact outcomes?

被引:5
作者
Husain, S. Adil [1 ,2 ]
Wallis, Gonzolo [1 ,2 ]
Fricker, Fredrick J. [1 ,2 ]
Bleiweis, Mark S. [1 ,2 ]
Staples, Edward D. [1 ,2 ]
Klodell, Charles T. [1 ,2 ]
Brown, John W. [3 ]
Turrentine, Mark W. [3 ]
机构
[1] Univ Florida, Coll Med, Dept Pediat, Congenital Heart Ctr, Gainesville, FL USA
[2] Univ Florida, Coll Med, Dept Surg, Congenital Heart Ctr, Gainesville, FL USA
[3] Indiana Univ, Sch Med, James Whitcomb Riley Hosp Children, Div Cardiothorac Surg, Indianapolis, IN USA
关键词
D O I
10.1097/MAT.0b013e3181888f2d
中图分类号
R318 [生物医学工程];
学科分类号
0831 ;
摘要
The use of pediatric ventricular assist devices (VADs) continues to evolve with the availability of smaller blood pumps. We examine the correlation of implanting appropriate sized blood pumps with a lower incidence of VAD related complications (VADRC). A 7-year retrospective review was undertaken for all pediatric VAD patients. Optimal VAD hemodynamics were defined as cardiac index of 2.7 L/m(2) and rate of 80 beats per minute (bpm) with complete fill/empty of the blood pump. Patient/blood pump size match, VAD rate and fill/empty ratios were calculated (optimum = 1.0) and then correlated with incidence of VADRC. The study included 22 patients, mean age 9.77 years (6 mo-18 yrs) and mean body surface area (BSA) of 1.14 m(2) (0.14 m(2) -2.32 m(2)), who underwent VAD implantation. VADRC included death while on support (n = 5), bleeding requiring reoperation (n = 8), hemolysis (n = 2), neurologic events (n = 2), thrombus formation (n = 3), and infection (n = 3). Six patients were bridged to transplant without any VADRC. This subset of patients had a mean blood pump size match ratio of 0.98, VAD rate ratio of 0.92 and fill/empty ratio of 1.00. Patients with VADRC (n = 16) were found to have a mean blood pump size match ratio of 0.72, VAD rate ratio of 0.72 and fill/empty ratio of 0.78. We report a series of pediatric patients with wide ranging BSA receiving VAD implantation. Selection of appropriate sized blood pumps can be correlated with decreased VADRC.
引用
收藏
页码:474 / 478
页数:5
相关论文
共 19 条
[1]  
Alexi-Meskishvili V, 2001, MECHANICAL SUPPORT FOR CARDIAC AND RESPIRATORY FAILURE IN PEDIATRIC PATIENTS, P287
[2]   Registry of the International Society for Heart and Lung Transplantation: Eighth official pediatric report - 2005 [J].
Boucek, MM ;
Edwards, LB ;
Keck, BM ;
Trulock, EP ;
Taylor, DO ;
Hertz, MI .
JOURNAL OF HEART AND LUNG TRANSPLANTATION, 2005, 24 (08) :968-982
[3]   The Registry of the International Society for Heart and Lung Transplantation: Sixth official pediatric report - 2003 [J].
Boucek, MM ;
Edwards, LB ;
Keck, BM ;
Trulock, EP ;
Taylor, DO ;
Mohacsi, PJ ;
Hertz, MI .
JOURNAL OF HEART AND LUNG TRANSPLANTATION, 2003, 22 (06) :636-652
[4]   FDA perspective [J].
Burlington, DB .
ANNALS OF THORACIC SURGERY, 1996, 61 (01) :482-484
[5]   Mechanical circulatory support for infants and children with cardiac disease [J].
Duncan, BW .
ANNALS OF THORACIC SURGERY, 2002, 73 (05) :1670-1677
[6]  
Fraser Charles D Jr, 2006, Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu, P109
[7]  
FRAZIER OH, 1989, TEX HEART I J, V16, P46
[8]  
Fuchs A., 2002, IMAGES PAEDIAT CARDI, V9, P24
[9]   Implantable left ventricular assist devices can successfully bridge adolescent patients to transplant [J].
Helman, DN ;
Addonizio, LJ ;
Morales, DLS ;
Catanese, KA ;
Flannery, MA ;
Quagebeur, JM ;
Edwards, NM ;
Galantowicz, ME ;
Oz, MC .
JOURNAL OF HEART AND LUNG TRANSPLANTATION, 2000, 19 (02) :121-126
[10]  
HENNIG E, 1991, ANN CONCERTED ACTION, P39