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Ventricular Assist Devices in Pediatric Cardiac Intensive Care

Byrnes, Jonathan MD; Villa, Chet MD; Lorts, Angela MD

doi: 10.1097/PCC.0000000000000757
Organ Systems: Cardiopathophysiology and Disorders

Objectives: The objectives of this review are to discuss the process of patient and mechanical device selection, operative management, and postoperative care with a focus on the management of right ventricular failure, anticoagulation strategies, device-related infections and neurologic sequelae.

Data Sources: MEDLINE, PubMed.

Conclusion: The number of patients with advanced heart failure due to either acquired or congenital heart disease continues to increase, necessitating in some mechanical circulatory support and in others cardiac transplantation. With a limited cardiac donor pool, mechanical circulatory support is playing a greater role in the management of this population. The perioperative morbidity associated with mechanical circulatory support has lessened with improved postoperative management strategies.

All authors: Department of Pediatrics, Section of Cardiology, Cincinnati College of Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH.

Dr. Byrnes disclosed off-label product use (Outside of Berlin EXCOR, no other ventricular assist devices have Food and Drug Administration approval for children. The use of these other devices is disclosed in the manuscript). Dr. Villa disclosed off-label product use (The article describes off-label use of ventricular assist devices that were approved for patients with a body surface area > 1.5 m2 and > 18 years old). Dr. Lorts disclosed that she does not have any potential conflicts of interest.

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©2016The Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies