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Mechanical Circulatory Support in the Patient with Congenital Heart Disease

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Heart Failure in Congenital Heart Disease:

Abstract

While conventional therapy with inotropic support and afterload reduction remains the mainstay of treatment for the failing heart, mechanical circulatory support is being increasingly used in the pediatric population.1–5 The majority of the pediatric experience consists of use of extracorporeal membrane oxygenation (ECMO). ECMO which is the use of mechanical devices to replace heart and lung function for cardiopulmonary failure was first used successfully for cardiac failure in a child in 1972, and respiratory failure in a neonate in 1975. In September 2004, the Extracorporeal Life Support Organization (ELSO) celebrated its 15th anniversary by honoring Dr. Robert Bartlett, the founding father of ECMO.

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References

  1. Kanter KR, Pennington DG, Weber TR et al. Extracorporeal membrane oxygenation for postoperative cardiac support in children. J Thorac Cardiovasc Surg. 1987;93:27–35.

    PubMed  CAS  Google Scholar 

  2. Nido PJ. Extracorporeal membrane oxygenation for cardiac support in children. Ann Thorac Surg. 1996;61:336–339.

    Article  PubMed  Google Scholar 

  3. Kulik TJ, Moler FW, Palmisano JM et al. Outcome-associated factors in pediatric patients treated with extracorporeal membrane oxygenator after cardiac surgery. Circulation. 1996;94: II63–II68.

    PubMed  CAS  Google Scholar 

  4. Aharon AS, Drinkwater DC, Churchwell KB et al. Extracorporeal membrane oxygenation in children after repair of congenital cardiac lesions. Ann Thorac Surg. 2001;72:2095–2101.

    Article  PubMed  CAS  Google Scholar 

  5. Kolovos NS, Bratton SL, Moler FW et al. Outcome of pediatric patients treated with extracorporeal life support after cardiac surgery. Ann Thorac Surg. 2003;76:1435–1441; discussion 1441–1442.

    Article  PubMed  Google Scholar 

  6. Bartlett RJ, Gazzaniga AB, Jefferies MR et al. Extracorporeal membrane oxygenation (ECMO) cardiopulmonary support in infancy. Trans Am Soc Artif Intern Organs. 1976;22:80–93.

    PubMed  CAS  Google Scholar 

  7. Dalton HJ, Rycus PT, Conrad SA. Update on extracorporeal life support 2004. Semin Perinatol. February 2005;29(1):24–33.

    Article  PubMed  Google Scholar 

  8. Duncan BW, Hraska V, Jonas RA et al. Mechanical circulatory support in children with cardiac disease. J Thorac Cardiovasc Surg. 1999;117:529–542.

    Article  PubMed  CAS  Google Scholar 

  9. Duncan BW. Mechanical circulatory support for infants and children with cardiac disease. Ann Thorac Surg. 2002;73:1670–1677.

    Article  PubMed  Google Scholar 

  10. Chang AC, McKenzie ED. Mechanical cardiopulmonary support in children and young adults: Extracorporeal membrane oxygenation, ventricular assist devices, and long-term support devices. Pediatr Cardiol. 2005;26:2–28.

    Article  PubMed  CAS  Google Scholar 

  11. Luciani GB, Chang AC, Starnes VA. Surgical repair of transposition of great arteries in neonates with persistent pulmonary hypertension. Ann Thorac Surg. 1996;61:800–805.

    Article  PubMed  CAS  Google Scholar 

  12. Walker GM, McLeod K, Brown KL et al. Extracorporeal life support as a treatment of supraventricular tachycardia in infants. Pediatr Crit Care Med. 2003;4:52–54.

    Article  PubMed  Google Scholar 

  13. Cohen MI, Gaynor JW, Ramesh V et al. Extracorporeal membrane oxygenation for patients with refractory ventricular arrhythmias. J Thorac Cardiovasc Surg. 1999;118:961–963.

    Article  PubMed  CAS  Google Scholar 

  14. di Russo GB, Clark BJ, Bridges ND et al. Prolonged extracorporeal membrane oxygenation as a bridge to cardiac transplantation. Ann Thorac Surg. 2000;69:925–927.

    Article  PubMed  CAS  Google Scholar 

  15. del Nido PJ, Duncan BW, Meyer JE et al. Left ventricular assist device improves survival in children with left ventricular dysfunction after repair of anomalous origin of the left coronary artery from the pulmonary artery. Ann Thorac Surg. 1999;67:169–172.

    Article  PubMed  CAS  Google Scholar 

  16. Del Nido PJ, Dalton HJ, Thomson AE, Siewers RD. Extracorporeal membrane oxygenator rescue in children during cardiac arrest after cardiac surgery. Circulation. 1992;86:II300–II304.

    CAS  Google Scholar 

  17. Duncan BW, Ibrahim AE, Hraska V et al. Use of rapid-deployment extracorporeal membrane oxygenation for the resuscitation of pediatric patients with heart disease after cardiac arrest. J Thorac Cardiovasc Surg. 1998;116:305–311.

    Article  PubMed  CAS  Google Scholar 

  18. Jacobs JP, Ojito JW, McConaghey TW et al. Rapid cardiopulmonary support for children with complex congenital heart disease. Ann Thorac Surg. 2000;70:742–750.

    Article  PubMed  CAS  Google Scholar 

  19. Hetzer R, Loebe M, Potapov EV et al. Circulatory support with pneumatic paracorporeal ventricular assist device in infants and children. Ann Thorac Surg. 1998;66:1498–1506.

    Article  PubMed  CAS  Google Scholar 

  20. Koenig PR, Ralston MA, Kimball TR et al. Balloon atrial septostomy for left ventricular decompression in patients receiving extracorporeal membrane oxygenation for myocardial failure. J Pediatr. 1993;122:S95–S99.

    Article  PubMed  CAS  Google Scholar 

  21. Dominguez TE, Mitchell M, Friess SH et al. Use of recombinant factor VIIa for refractory hemorrhage during extracorporeal membrane oxygenation. Pediatr Crit Care Med. 2005;6: 348–351.

    Article  PubMed  CAS  Google Scholar 

  22. Haines NM, Rycus PT, Zwischenberger JB et al. Extracorporeal Life Support Registry Report 2008: neonatal and pediatric cardiac cases. ASAIO J. 2009;55:111–116.

    Article  PubMed  Google Scholar 

  23. Morris MC, Ittenbach RF, Godinez RI et al. Risk factors for mortality in 137 pediatric cardiac intensive care unit patients managed with extracorporeal membrane oxygenation. Crit Care Med. 2004;32:1061–1069.

    Article  PubMed  Google Scholar 

  24. Thiagarajan RR, Laussen PC, Rycus PT et al. Extracorporeal membrane oxygenation to aid cardiopulmonary resuscitation in infants and children. Circulation. 2007;116:1693–1700.

    Article  PubMed  Google Scholar 

  25. Thuys CA, Mullaly RJ, Horton SB et al. Centrifugal ventricular assist in children under 6 kg. Euro J Cardiothorac Surg. 1998;13:130–134.

    Article  CAS  Google Scholar 

  26. Karl TR, Horton SB. Centrifugal pump VAD in pediatric cardiac surgery. In: Duncan BW, ed. Mechanical Circulatory Support for Pediatric Cardiac Patients. New York, NY: Marcel Dekker; 2001:21–48.

    Google Scholar 

  27. Wieselthaler GM, Schima H, Hiesmayr M et al. First clinical experience with the DeBakey VAD continuous-axial-flow pump for bridge to transplantation. Circulation. 2000;101:356–359.

    PubMed  CAS  Google Scholar 

  28. Konertz W, Hotz H, Schneider M et al. Clinical experience with the MEDOS HIA-VAD system in infants and children. Ann Thorac Surg. 1997;63:1138–1144.

    Article  PubMed  CAS  Google Scholar 

  29. Ishino K, Loebe M, Uhlemann F et al. Circulatory support with paracorporeal pneumatic ventricular assist device (VAD) in infants and chidren. Euro J Cardiothorac Surg. 1997;11: 965–972.

    Article  CAS  Google Scholar 

  30. Hetzer R, Potapov, Stiller B et al. Improvement in survival after mechanical circulatory support with pneumatic pulsatile ventricular assist devices in pediatric patients. Ann Thorac Surg. 2006;82:917–925.

    Article  PubMed  Google Scholar 

  31. Reinhartz O, Hill JD, Al-Khaldi A et al. Thoratec ventricular assist devices in pediatric patients: update on clinical results. ASAIO J. 2005;51:501–503.

    Article  PubMed  Google Scholar 

  32. Reinhartz O, Copeland JG, Farrar DJ. Thoratec ventricular assist devices in children with less than 1.3 m2 of body surface area. ASAIO J. 2003;49:727–730.

    Article  PubMed  Google Scholar 

  33. Blume ED, Naftel DC, Bastardi HJ et al. Pediatric Heart Transplant Study Investigators. Outcomes of children bridged to heart transplantation with ventricular assist devices: a multi-institutional study. Circulation. 2006;113:2313–2319.

    Article  PubMed  Google Scholar 

  34. O’Connor MJ, Menteer J, Chrisant MR et al. Ventricular assist device-associated anti-human leukocyte antigen antibody sensitization in pediatric patients bridged to heart transplantation. J Heart Lung Transplant. 2010;29:109–116.

    Article  PubMed  Google Scholar 

  35. Helman DN, Addonizio LJ, Morales DLS et al. Implantable left ventricular assist devices can successfully bridge adolescent patients to transplant. J Heart Lung Transplant. 2000;19:121–126.

    Article  CAS  Google Scholar 

  36. Chai PJ, Williamson A, Lodge AJ et al. Effects of ischemia on pulmonary dysfunction after cardiopulmonary bypass. Ann Thorac Surg. 1999;69:731–735.

    Article  Google Scholar 

  37. Jaggers JJ, Forbess J, Shah A et al. Extracorporeal membrane oxygenation (ECMO) for post-cardiotomy failure in children: significance of shunt management in the single ventricle. Ann Thorac Surg. 2000; 69:1476–1483.

    Article  PubMed  CAS  Google Scholar 

  38. Hintz SR, Benitz WE, Colby CE et al. Utilization and outcomes of neonatal cardiac extracorporeal life support: 1996–2000. Pediatr Crit Care Med. 2005;6:33–38.

    Article  PubMed  Google Scholar 

  39. Ravishankar C, Dominguez TE, Kreutzer J et al. Extracorporeal membrane oxygenation after the Norwood Operation for hypoplastic left heart syndrome. Pediatr Crit Care Med. 2006;7:319–323.

    Article  PubMed  Google Scholar 

  40. Allan CK, Thiagarajan RR, del Nido PJ et al. Indication for initiation of mechanical circulatory support impacts survival of infants with shunted single-ventricle circulation supported with extracorporeal membrane oxygenation. J Thorac Cardiovasc Surg. 2007;133:660–667.

    Article  PubMed  Google Scholar 

  41. Ungerleider RM, Shen I, Yeh T et al. Routine mechanical ventricular assist following the Norwood procedure-improved neurologic outcome and excellent hospital survival. Ann Thorac Surg. 2004; 77:18–22.

    Article  PubMed  Google Scholar 

  42. Booth KL, Roth SJ, Thiagarajan RR et al. Extracorporeal membrane oxygenation support of the Fontan and bidirectional Glenn circulations. Ann Thorac Surg. 2004;77:1341–1348.

    Article  PubMed  Google Scholar 

  43. Myers CD, Mattix K, Presson RG Jr et al. Twenty-four hour cardiopulmonary stability in a model of assisted newborn Fontan circulation. Ann Thorac Surg. 2006;81:264–270.

    Article  PubMed  Google Scholar 

  44. Throckmorton AL, Kishore RA. Design of a protective cage for an intravascular axial flow blood pump to mechanically assist the failing Fontan. Artif Organ. 2009;33:611–621.

    Article  Google Scholar 

  45. Lacour-Gayet FG, Lanning CJ, Stoica S et al. An artificial right ventricle for failing fontan: in vitro and computational study. Ann Thorac Surg. 2009;88:170–176.

    Article  PubMed  Google Scholar 

  46. Ibrahim AE, Duncan BW, Blume ED et al. Long-term follow-up of pediatric cardiac patients requiring mechanical circulatory support. Ann Thorac Surg. 2000;69:186–192.

    Article  PubMed  CAS  Google Scholar 

  47. Rockett SR, Bryant JC, Morrow WR et al. Preliminary single center North American experience with the Berlin Heart pediatric EXCOR device. ASAIO J. 2008;54:479–482.

    Article  PubMed  Google Scholar 

  48. Russo P, Wheeler A, Russo J, Tobias JD. Use of a ventricular assist device as a bridge to transplantation in a patient with single ventricle physiology and total cavopulmonary anastomosis. Paediatr Anaesth. 2008;18:320–324.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Pediatrics, The Children’s Hospital of Philadelphia Civic Center Boulevard, Philadelphia, PA, 19104-4399, USA

    Chitra Ravishankar

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  1. Chitra Ravishankar
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  2. Troy E. Dominguez
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  3. Tami M. Rosenthal
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  4. J. William Gaynor
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Correspondence to Chitra Ravishankar .

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  1. Children's Hospital of Philadelphia, South 34th Street, Philadelphia, 19151, Pennsylvania, USA

    Robert. E Shaddy

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Ravishankar, C., Dominguez, T.E., Rosenthal, T.M., Gaynor, J.W. (2010). Mechanical Circulatory Support in the Patient with Congenital Heart Disease. In: Shaddy, R. (eds) Heart Failure in Congenital Heart Disease:. Springer, London. https://doi.org/10.1007/978-1-84996-480-7_7

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  • DOI: https://doi.org/10.1007/978-1-84996-480-7_7

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