Andersons pediatric cardiology 1754
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ChronicMechanicalCirculatory
Support
JosephW.Rossano,KyleW.Riggs,KelleyD.Miller,DavidL.S.Morales
Introduction
Theuseoflong-termmechanicalcirculatorysupport(MCS),predominatelyin
theformofventricularassistdevices(VADs),hasundergoneamajor
transformationinthepast15years.Intheearly2000s,deviceusewas
uncommon.Supportwastypicallyforshortduration,inpatientswith
cardiogenicshock,andpediatric-specificdeviceuse,especiallyintheUnited
States,wasexceptionallyrare.IntheinitialreportonVADsfromthePediatric
HeartTransplantStudydatabase,coveringchildrenlistedforheart
transplantationfrom1993to2003,only4%ofpatientsweresupportedwitha
VADandonlyoneBerlinHeartEXCORVADwasused.1Thisisincontrastto
thecurrentstatewherenearly50%ofpediatricpatientswithdilated
cardiomyopathy(DCM)intheInternationalSocietyforHeartandLung
TransplantationRegistryarebridgedtotransplantwithaVAD.2Inmost
pediatrictransplantcenters,VADswouldcurrentlybeconsideredastandardpart
ofadvancedheartfailuremanagement,predominatelybeingusedasabridgeto
transplant.
