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Erschienen in:

01.12.2023 | Cardiology/CT Surgery (K Gist, Section Editor)

Device Innovations in Pediatric Heart Failure

verfasst von: Tanya Perry, DO, Chet Villa, MD

Erschienen in: Current Treatment Options in Pediatrics | Ausgabe 4/2023

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Abstract

Purpose of Review

This review will discuss the evolving epidemiology of heart failure in children and young adults and the innovations/changes in mechanical circulatory support (MCS) over the last 2 decades.

Recent Findings

Maturation of pediatric MCS programs in conjunction with improvement in patient management have led to serial improvements in clinical outcomes for children requiring MCS. These improvements, in conjunction with the increasing burden of heart failure, have driven rapid evolution in the use of mechanical circulatory support for children and young adults with heart failure.

Summary

The number of children and young adults supported with MCS has increased significantly over the last 2 decades. This has been driven by increased willingness (and ability) to provide effective ventricular assist device (VAD) support in young children and patients with congenital heart disease. The increasing burden of disease, in conjunction with longer heart transplant wait times, has underscored the need for further innovation. In particular, there is a need for smaller, durable VAD options for pediatric patients who are not candidates for implantable, continuous flow VADs.
Literatur
1.
Zurück zum Zitat Blume ED, et al. Outcomes of children bridged to heart transplantation with ventricular assist devices: a multi-institutional study. Circulation. 2006;113(19):2313–9.PubMedCrossRef Blume ED, et al. Outcomes of children bridged to heart transplantation with ventricular assist devices: a multi-institutional study. Circulation. 2006;113(19):2313–9.PubMedCrossRef
2.
Zurück zum Zitat Almond CS, et al. Extracorporeal membrane oxygenation for bridge to heart transplantation among children in the United States: analysis of data from the Organ Procurement and Transplant Network and Extracorporeal Life Support Organization Registry. Circulation. 2011;123(25):2975–84.PubMedCrossRef Almond CS, et al. Extracorporeal membrane oxygenation for bridge to heart transplantation among children in the United States: analysis of data from the Organ Procurement and Transplant Network and Extracorporeal Life Support Organization Registry. Circulation. 2011;123(25):2975–84.PubMedCrossRef
3.
Zurück zum Zitat Burstein DS, et al. Significant mortality, morbidity and resource utilization associated with advanced heart failure in congenital heart disease in children and young adults. Am Heart J. 2019;209:9–19.PubMedCrossRef Burstein DS, et al. Significant mortality, morbidity and resource utilization associated with advanced heart failure in congenital heart disease in children and young adults. Am Heart J. 2019;209:9–19.PubMedCrossRef
5.
Zurück zum Zitat Williams RJ, et al. Pediatric heart transplant waiting times in the United States since the 2016 allocation policy change. Am J Transplant. 2022;22(3):833–42.PubMedPubMedCentralCrossRef Williams RJ, et al. Pediatric heart transplant waiting times in the United States since the 2016 allocation policy change. Am J Transplant. 2022;22(3):833–42.PubMedPubMedCentralCrossRef
8.
Zurück zum Zitat Rossano JW, et al. The International Thoracic Organ Transplant Registry of the International Society for Heart and Lung Transplantation: twenty-second pediatric heart transplantation report - 2019; Focus theme: donor and recipient size match. J Heart Lung Transplant. 2019;38(10):1028–41.PubMedPubMedCentralCrossRef Rossano JW, et al. The International Thoracic Organ Transplant Registry of the International Society for Heart and Lung Transplantation: twenty-second pediatric heart transplantation report - 2019; Focus theme: donor and recipient size match. J Heart Lung Transplant. 2019;38(10):1028–41.PubMedPubMedCentralCrossRef
9.
Zurück zum Zitat Edelson JB, et al. The influence of mechanical circulatory support on post-transplant outcomes in pediatric patients: a multicenter study from the International Society for Heart and Lung Transplantation (ISHLT) Registry. J Heart Lung Transplant. 2021;40(11):1443–53.PubMedCrossRef Edelson JB, et al. The influence of mechanical circulatory support on post-transplant outcomes in pediatric patients: a multicenter study from the International Society for Heart and Lung Transplantation (ISHLT) Registry. J Heart Lung Transplant. 2021;40(11):1443–53.PubMedCrossRef
10.
Zurück zum Zitat Davies RR, et al. The use of mechanical circulatory support as a bridge to transplantation in pediatric patients: an analysis of the United Network for Organ Sharing database. J Thorac Cardiovasc Surg. 2008;135(2):421-427.e1.PubMedCrossRef Davies RR, et al. The use of mechanical circulatory support as a bridge to transplantation in pediatric patients: an analysis of the United Network for Organ Sharing database. J Thorac Cardiovasc Surg. 2008;135(2):421-427.e1.PubMedCrossRef
11.
Zurück zum Zitat Alghanem F, Balasubramanian S, Zampi JD. Impact of left atrial decompression on patient outcomes during pediatric venoarterial extracorporeal membrane oxygenation: a case-control study. Pediatr Cardiol. 2019;40(6):1266–74.PubMedCrossRef Alghanem F, Balasubramanian S, Zampi JD. Impact of left atrial decompression on patient outcomes during pediatric venoarterial extracorporeal membrane oxygenation: a case-control study. Pediatr Cardiol. 2019;40(6):1266–74.PubMedCrossRef
12.
Zurück zum Zitat Amancherla K, et al. Limited balloon atrial septostomy for left ventricular unloading in Peripheral extracorporeal membrane oxygenation. J Card Fail. 2021;27(4):501–4.PubMedCrossRef Amancherla K, et al. Limited balloon atrial septostomy for left ventricular unloading in Peripheral extracorporeal membrane oxygenation. J Card Fail. 2021;27(4):501–4.PubMedCrossRef
13.
Zurück zum Zitat Delmas C, et al. Use of percutaneous atrioseptotosmy for left heart decompression during veno-arterial extracorporeal membrane oxygenation support: an observational study. J Am Heart Assoc. 2022;11(17):e024642.PubMedPubMedCentralCrossRef Delmas C, et al. Use of percutaneous atrioseptotosmy for left heart decompression during veno-arterial extracorporeal membrane oxygenation support: an observational study. J Am Heart Assoc. 2022;11(17):e024642.PubMedPubMedCentralCrossRef
14.
Zurück zum Zitat Mlcek M, et al. Atrial septostomy for left ventricular unloading during extracorporeal membrane oxygenation for cardiogenic shock: animal model. JACC Cardiovasc Interv. 2021;14(24):2698–707.PubMedCrossRef Mlcek M, et al. Atrial septostomy for left ventricular unloading during extracorporeal membrane oxygenation for cardiogenic shock: animal model. JACC Cardiovasc Interv. 2021;14(24):2698–707.PubMedCrossRef
15.
Zurück zum Zitat Russo JJ, et al. Left ventricular unloading during extracorporeal membrane oxygenation in patients with cardiogenic shock. J Am Coll Cardiol. 2019;73(6):654–62.PubMedCrossRef Russo JJ, et al. Left ventricular unloading during extracorporeal membrane oxygenation in patients with cardiogenic shock. J Am Coll Cardiol. 2019;73(6):654–62.PubMedCrossRef
16.
Zurück zum Zitat • Sperotto F, et al. Left atrial decompression in pediatric patients supported with extracorporeal membrane oxygenation for failure to wean from cardiopulmonary bypass: a propensity-weighted analysis. J Am Heart Assoc. 2022;11(23):e023963. This article describes the potential utility of left atrial decompression in pediatric patients on ECMO.PubMedPubMedCentralCrossRef • Sperotto F, et al. Left atrial decompression in pediatric patients supported with extracorporeal membrane oxygenation for failure to wean from cardiopulmonary bypass: a propensity-weighted analysis. J Am Heart Assoc. 2022;11(23):e023963. This article describes the potential utility of left atrial decompression in pediatric patients on ECMO.PubMedPubMedCentralCrossRef
17.
Zurück zum Zitat Yarlagadda VV, et al. Temporary circulatory support in U.S. children awaiting heart transplantation. J Am Coll Cardiol. 2017;70(18):2250–60.PubMedCrossRef Yarlagadda VV, et al. Temporary circulatory support in U.S. children awaiting heart transplantation. J Am Coll Cardiol. 2017;70(18):2250–60.PubMedCrossRef
18.
Zurück zum Zitat Lorts A, et al. Outcomes of children supported with devices labeled as “temporary” or short term: a report from the Pediatric Interagency Registry for Mechanical Circulatory Support. J Heart Lung Transplant. 2018;37(1):54–60.PubMedCrossRef Lorts A, et al. Outcomes of children supported with devices labeled as “temporary” or short term: a report from the Pediatric Interagency Registry for Mechanical Circulatory Support. J Heart Lung Transplant. 2018;37(1):54–60.PubMedCrossRef
19.
Zurück zum Zitat Almond CS, et al. Berlin Heart EXCOR pediatric ventricular assist device for bridge to heart transplantation in US children. Circulation. 2013;127(16):1702–11.PubMedCrossRef Almond CS, et al. Berlin Heart EXCOR pediatric ventricular assist device for bridge to heart transplantation in US children. Circulation. 2013;127(16):1702–11.PubMedCrossRef
20.
Zurück zum Zitat Weinstein S, et al. The use of the Berlin Heart EXCOR in patients with functional single ventricle. J Thorac Cardiovasc Surg. 2014;147(2):697–704 (discussion 704-5).PubMedCrossRef Weinstein S, et al. The use of the Berlin Heart EXCOR in patients with functional single ventricle. J Thorac Cardiovasc Surg. 2014;147(2):697–704 (discussion 704-5).PubMedCrossRef
21.
Zurück zum Zitat • Zafar F, et al. Berlin Heart EXCOR and ACTION post-approval surveillance study report. J Heart Lung Transplant. 2021;40(4):251–9. This article describes evolving outcomes on the Berlin, noting the relationship to evolving use of bivalirudin.PubMedCrossRef • Zafar F, et al. Berlin Heart EXCOR and ACTION post-approval surveillance study report. J Heart Lung Transplant. 2021;40(4):251–9. This article describes evolving outcomes on the Berlin, noting the relationship to evolving use of bivalirudin.PubMedCrossRef
22.
Zurück zum Zitat Lorts A, et al. ISHLT consensus statement for the selection and management of pediatric and congenital heart disease patients on ventricular assist devices endorsed by the American Heart Association. J Heart Lung Transplant. 2021;40(8):709–32.PubMedCrossRef Lorts A, et al. ISHLT consensus statement for the selection and management of pediatric and congenital heart disease patients on ventricular assist devices endorsed by the American Heart Association. J Heart Lung Transplant. 2021;40(8):709–32.PubMedCrossRef
23.
Zurück zum Zitat Ricci M, et al. Initial experience with the TandemHeart circulatory support system in children. ASAIO J (Am Soc Artif Intern Organs: 1992). 2008;54(5):542–5.CrossRef Ricci M, et al. Initial experience with the TandemHeart circulatory support system in children. ASAIO J (Am Soc Artif Intern Organs: 1992). 2008;54(5):542–5.CrossRef
24.
Zurück zum Zitat Dimas VV, et al. A multicenter study of the impella device for mechanical support of the systemic circulation in pediatric and adolescent patients. Catheter Cardiovasc Interv. 2017;90(1):124–9.PubMedPubMedCentralCrossRef Dimas VV, et al. A multicenter study of the impella device for mechanical support of the systemic circulation in pediatric and adolescent patients. Catheter Cardiovasc Interv. 2017;90(1):124–9.PubMedPubMedCentralCrossRef
26.
Zurück zum Zitat Fraser CD Jr, et al. Prospective trial of a pediatric ventricular assist device. N Engl J Med. 2012;367(6):532–41.PubMedCrossRef Fraser CD Jr, et al. Prospective trial of a pediatric ventricular assist device. N Engl J Med. 2012;367(6):532–41.PubMedCrossRef
27.
Zurück zum Zitat Eghtesady P, et al. Post-transplant outcomes of children bridged to transplant with the Berlin Heart EXCOR Pediatric ventricular assist device. Circulation. 2013;128(11 Suppl 1):S24-31.PubMed Eghtesady P, et al. Post-transplant outcomes of children bridged to transplant with the Berlin Heart EXCOR Pediatric ventricular assist device. Circulation. 2013;128(11 Suppl 1):S24-31.PubMed
28.
Zurück zum Zitat O’Connor MJ, et al. Early experience with the HeartMate 3 continuous-flow ventricular assist device in pediatric patients and patients with congenital heart disease: a multicenter registry analysis. J Heart Lung Transplant. 2020;39(6):573–9.PubMedCrossRef O’Connor MJ, et al. Early experience with the HeartMate 3 continuous-flow ventricular assist device in pediatric patients and patients with congenital heart disease: a multicenter registry analysis. J Heart Lung Transplant. 2020;39(6):573–9.PubMedCrossRef
29.
Zurück zum Zitat Rossano JW, et al. Outcomes of pediatric patients supported with continuous-flow ventricular assist devices: a report from the Pediatric Interagency Registry for Mechanical Circulatory Support (PediMACS). J Heart Lung Transplant. 2016;35(5):585–90.PubMedCrossRef Rossano JW, et al. Outcomes of pediatric patients supported with continuous-flow ventricular assist devices: a report from the Pediatric Interagency Registry for Mechanical Circulatory Support (PediMACS). J Heart Lung Transplant. 2016;35(5):585–90.PubMedCrossRef
30.
Zurück zum Zitat Jordan LC, et al. Neurological complications and outcomes in the Berlin Heart EXCOR(R) pediatric investigational device exemption trial. J Am Heart Assoc. 2015;4(1):e001429.PubMedPubMedCentralCrossRef Jordan LC, et al. Neurological complications and outcomes in the Berlin Heart EXCOR(R) pediatric investigational device exemption trial. J Am Heart Assoc. 2015;4(1):e001429.PubMedPubMedCentralCrossRef
31.
Zurück zum Zitat Rosenthal DN, et al. Impact of a modified anti-thrombotic guideline on stroke in children supported with a pediatric ventricular assist device. J Heart Lung Transplant. 2017;36(11):1250–7.PubMedCrossRef Rosenthal DN, et al. Impact of a modified anti-thrombotic guideline on stroke in children supported with a pediatric ventricular assist device. J Heart Lung Transplant. 2017;36(11):1250–7.PubMedCrossRef
32.
Zurück zum Zitat Hetzer R, et al. Improvement in survival after mechanical circulatory support with pneumatic pulsatile ventricular assist devices in pediatric patients. Ann Thorac Surg. 2006;82(3):917–24 (discussion 924-5).PubMedCrossRef Hetzer R, et al. Improvement in survival after mechanical circulatory support with pneumatic pulsatile ventricular assist devices in pediatric patients. Ann Thorac Surg. 2006;82(3):917–24 (discussion 924-5).PubMedCrossRef
33.
Zurück zum Zitat Byrnes JW, et al. Incremental reduction in the incidence of stroke in children supported with the Berlin EXCOR ventricular assist device. Ann Thorac Surg. 2013;96(5):1727–33.PubMedCrossRef Byrnes JW, et al. Incremental reduction in the incidence of stroke in children supported with the Berlin EXCOR ventricular assist device. Ann Thorac Surg. 2013;96(5):1727–33.PubMedCrossRef
34.
Zurück zum Zitat Villa CR, VanderPluym CJ, Investigators* A. ABCs of stroke prevention: improving stroke outcomes in children supported with a ventricular assist device in a quality improvement network. Circ Cardiovasc Qual Outcomes. 2020;13(12):e006663. Villa CR, VanderPluym CJ, Investigators* A. ABCs of stroke prevention: improving stroke outcomes in children supported with a ventricular assist device in a quality improvement network. Circ Cardiovasc Qual Outcomes. 2020;13(12):e006663.
35.
Zurück zum Zitat Niebler RA, et al. Stroke in pediatric ventricular assist device patients-a pedimacs registry analysis. J Heart Lung Transplant. 2021;40(7):662–70.PubMedCrossRef Niebler RA, et al. Stroke in pediatric ventricular assist device patients-a pedimacs registry analysis. J Heart Lung Transplant. 2021;40(7):662–70.PubMedCrossRef
36.
Zurück zum Zitat • Rottermann K, et al. Mobility and freedom of movement: a novel out-of-hospital treatment for pediatric patients with terminal cardiac insufficiency and a ventricular assist device. Front Cardiovasc Med. 2022;9:1055228. This article describes the potential for discharge on the Berlin Heart with a portable driver.PubMedPubMedCentralCrossRef • Rottermann K, et al. Mobility and freedom of movement: a novel out-of-hospital treatment for pediatric patients with terminal cardiac insufficiency and a ventricular assist device. Front Cardiovasc Med. 2022;9:1055228. This article describes the potential for discharge on the Berlin Heart with a portable driver.PubMedPubMedCentralCrossRef
37.
Zurück zum Zitat Birks EJ, et al. A prospective multicentre study of myocardial recovery using left ventricular assist devices (RESTAGE-HF [Remission from Stage D Heart Failure]): Medium-Term and Primary End Point Results. Circulation 2020;142(21):2016–2028. Birks EJ, et al. A prospective multicentre study of myocardial recovery using left ventricular assist devices (RESTAGE-HF [Remission from Stage D Heart Failure]): Medium-Term and Primary End Point Results. Circulation 2020;142(21):2016–2028.
38.
Zurück zum Zitat Javier Delmo EM, et al. Heart failure in the young: Insights into myocardial recovery with ventricular assist device support. Cardiovasc Diagn Ther. 2021;11(1):148–63.PubMedPubMedCentralCrossRef Javier Delmo EM, et al. Heart failure in the young: Insights into myocardial recovery with ventricular assist device support. Cardiovasc Diagn Ther. 2021;11(1):148–63.PubMedPubMedCentralCrossRef
39.
Zurück zum Zitat Miera O, et al. Pump size of Berlin Heart EXCOR pediatric device influences clinical outcome in children. J Heart Lung Transplant. 2014;33(8):816–21.PubMedCrossRef Miera O, et al. Pump size of Berlin Heart EXCOR pediatric device influences clinical outcome in children. J Heart Lung Transplant. 2014;33(8):816–21.PubMedCrossRef
40.
Zurück zum Zitat Philip J, et al. Hybrid procedure with pulsatile ventricular assist device for hypoplastic left heart syndrome awaiting transplantation. J Thorac Cardiovasc Surg. 2019;158(2):e59–61.PubMedCrossRef Philip J, et al. Hybrid procedure with pulsatile ventricular assist device for hypoplastic left heart syndrome awaiting transplantation. J Thorac Cardiovasc Surg. 2019;158(2):e59–61.PubMedCrossRef
41.
Zurück zum Zitat Auerbach SR, Simpson KE, Action Learning Network I. HVAD usage and outcomes in the current pediatric ventricular assist device field: an advanced cardiac therapies improving outcomes network (ACTION) analysis. ASAIO J. 2021;67(6):675–680. Auerbach SR, Simpson KE, Action Learning Network I. HVAD usage and outcomes in the current pediatric ventricular assist device field: an advanced cardiac therapies improving outcomes network (ACTION) analysis. ASAIO J. 2021;67(6):675–680.
42.
Zurück zum Zitat Burstein DS, et al. Variation in cardiac rehabilitation for pediatric ventricular assist device recipients across North America. ASAIO J. 2021;67(9):1045–50.PubMedCrossRef Burstein DS, et al. Variation in cardiac rehabilitation for pediatric ventricular assist device recipients across North America. ASAIO J. 2021;67(9):1045–50.PubMedCrossRef
43.
Zurück zum Zitat Riggs KW, et al. Optimizing postcardiac transplantation outcomes in children with ventricular assist devices: how long should the bridge be? ASAIO J. 2020;66(7):787–95.PubMedCrossRef Riggs KW, et al. Optimizing postcardiac transplantation outcomes in children with ventricular assist devices: how long should the bridge be? ASAIO J. 2020;66(7):787–95.PubMedCrossRef
44.
Zurück zum Zitat Butto A, et al. Relationship of ventricular assist device support duration with pediatric heart transplant outcomes. J Heart Lung Transplant. 2022;41(1):61–9.PubMedCrossRef Butto A, et al. Relationship of ventricular assist device support duration with pediatric heart transplant outcomes. J Heart Lung Transplant. 2022;41(1):61–9.PubMedCrossRef
45.
Zurück zum Zitat Cedars A, et al. Systemic ventricular assist device support in Fontan patients: a report by ACTION. J Heart Lung Transplant. 2021;40(5):368–76.PubMedCrossRef Cedars A, et al. Systemic ventricular assist device support in Fontan patients: a report by ACTION. J Heart Lung Transplant. 2021;40(5):368–76.PubMedCrossRef
46.
Zurück zum Zitat Bedzra EKS, et al. Systemic ventricular assist device support of the Fontan circulation yields promising outcomes: an analysis of The Society of Thoracic Surgeons Pedimacs and Intermacs Databases. J Thorac Cardiovasc Surg. 2022;164(2):353–64.PubMedCrossRef Bedzra EKS, et al. Systemic ventricular assist device support of the Fontan circulation yields promising outcomes: an analysis of The Society of Thoracic Surgeons Pedimacs and Intermacs Databases. J Thorac Cardiovasc Surg. 2022;164(2):353–64.PubMedCrossRef
47.
Zurück zum Zitat Rossano JW, et al. Fifth annual pediatric interagency registry for mechanical circulatory support (Pedimacs) report. Ann Thorac Surg. 2021;112(6):1763–74.PubMedCrossRef Rossano JW, et al. Fifth annual pediatric interagency registry for mechanical circulatory support (Pedimacs) report. Ann Thorac Surg. 2021;112(6):1763–74.PubMedCrossRef
49.
Zurück zum Zitat Moore RA, et al. Virtual implantation evaluation of the total artificial heart and compatibility: beyond standard fit criteria. J Heart Lung Transplant. 2014;33(11):1180–3.PubMedCrossRef Moore RA, et al. Virtual implantation evaluation of the total artificial heart and compatibility: beyond standard fit criteria. J Heart Lung Transplant. 2014;33(11):1180–3.PubMedCrossRef
50.
Zurück zum Zitat Moore RA, et al. Virtual implantation of the 50cc SynCardia total artificial heart. J Heart Lung Transplant. 2016;35(6):824–7.PubMedCrossRef Moore RA, et al. Virtual implantation of the 50cc SynCardia total artificial heart. J Heart Lung Transplant. 2016;35(6):824–7.PubMedCrossRef
51.
Zurück zum Zitat Morales DLS, et al. Third annual pediatric interagency registry for mechanical circulatory support (Pedimacs) report: preimplant characteristics and outcomes. Ann Thorac Surg. 2019;107(4):993–1004.PubMedCrossRef Morales DLS, et al. Third annual pediatric interagency registry for mechanical circulatory support (Pedimacs) report: preimplant characteristics and outcomes. Ann Thorac Surg. 2019;107(4):993–1004.PubMedCrossRef
52.
Zurück zum Zitat Arabia FA, et al. Interagency registry for mechanically assisted circulatory support report on the total artificial heart. J Heart Lung Transplant. 2018;37(11):1304–12.PubMedCrossRef Arabia FA, et al. Interagency registry for mechanically assisted circulatory support report on the total artificial heart. J Heart Lung Transplant. 2018;37(11):1304–12.PubMedCrossRef
Metadaten
Titel
Device Innovations in Pediatric Heart Failure
verfasst von
Tanya Perry, DO
Chet Villa, MD
Publikationsdatum
01.12.2023
Verlag
Springer International Publishing
Erschienen in
Current Treatment Options in Pediatrics / Ausgabe 4/2023
Elektronische ISSN: 2198-6088
DOI
https://doi.org/10.1007/s40746-023-00276-z

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