Toggle Main Menu Toggle Search

Open Access padlockePrints

An Extended Role of Continuous Flow Device in Pediatric Mechanical Circulatory Support

Lookup NU author(s): Dr John O'Sullivan, Dr Guy MacGowanORCiD


Full text for this publication is not currently held within this repository. Alternative links are provided below where available.


Background. Mechanical circulatory support in the pediatric population is currently limited to pulsatile ventricular assist devices (VAD). In recent years, the use of durable, newer generation, continuous flow devices have increased substantially among adults with end-stage heart failure. We examined the extended role of this device in the pediatric population (aged less than 18 years).Methods. Between 2010 and 2015, 12 patients (median age 7.1 years; range, 3.7 to 17.0; one third of patients were aged 5 years or less) received a HeartWare ventricular assist device (HVAD; HeartWare, Framingham, MA), 11 for cardiomyopathy and 1 for posttransplant rejection. Right VAD support (n = 5; 42%) was provided by a short-term device (Levitronix, Zurich, Switzerland).Results. Overall, 1 patient died (day 638), 8 patients (67%) underwent transplantation, 1 patient (8.3%) recovered, and 2 patients (17%) remain on HVAD. The mean length of support was 150 days (range, 16 to 638). Four patients (33.3%) were discharged home (all left VAD). In the left VAD group (n = 7), 3 patients subsequently received transplants (days 185, 201, and 234, respectively), 1 recovered (day 149), 1 died (day 638), 1 remained on HVAD (day 198), and 1 needed conversion to biventricular assist device (BIVAD [day 73]). In the BIVAD group (n = 5), right VAD was weaned in 3 (60%), all subsequently received transplants, and 2 remained on BIVAD support until transplant (days 16 and 17, respectively). One BIVAD patient required conversion to central cannulation for longer-term support. Four BIVAD patients (80%) were in Interagency Registry for Mechanically Assisted Circulatory Support level 1 before VAD compared with 2 (29%) in the left VAD group (p = not significant). The actuarial survival rate was 100% at 1 year with no neurologic events.Conclusions. The third-generation, continuous flow device can provide durable support in the pediatric population. The selection strategy for patients who benefit most from the device continues to evolve. It is anticipated that a smaller design in the future will benefit an even wider pediatric population with heart failure. (C) 2016 by The Society of Thoracic Surgeons

Publication metadata

Author(s): Peng E, Kirk R, Wrightson N, Duong P, Ferguson L, Griselli M, Butt T, O'Sullivan JJ, MacGowan GA, Crossland D, Schueler S, Hasan A

Publication type: Article

Publication status: Published

Journal: Annals of Thoracic Surgery

Year: 2016

Volume: 102

Issue: 2

Pages: 620-627

Print publication date: 01/08/2016

Online publication date: 26/04/2016

Acceptance date: 01/02/2016

ISSN (print): 0003-4975

ISSN (electronic): 1552-6259

Publisher: Elsevier


DOI: 10.1016/j.athoracsur.2016.02.013


Altmetrics provided by Altmetric