Mechanical circulatory support for end-stage heart failure in repaired and palliated congenital heart disease

Research output: Contribution to journalReview article

24 Citations (Scopus)

Abstract

Approximately one in one hundred children is born with congenital heart disease. Most can be managed with corrective or palliative surgery but a small group will develop severe heart failure, leaving cardiac transplantation as the ultimate treatment option. Unfortunately, due to the inadequate number of available donor organs, only a small number of patients can benefit from this therapy, and mortality remains high for pediatric patients awaiting heart transplantation, especially compared to adults. The purpose of this review is to describe the potential role of mechanical circulatory support in this context and to review current experience. For patients with congenital heart disease, ventricular assist devices are most commonly used as a bridge to cardiac transplantation, an application which has been shown to have several important advantages over medical therapy alone or support with extracorporeal membrane oxygenation, including improved survival to transplant, less exposure to blood products with less immune sensitization, and improved organ function. While these devices may improve wait list mortality, the chronic shortage of donor organs for children is likely to remain a problem into the foreseeable future. Therefore, there is great interest in the development of mechanical ventricular assist devices as potential destination therapy for congenital heart disease patients with end-stage heart failure. This review first discusses the experience with the currently available ventricular assist devices in children with congenital heart disease, and then follows to discuss what devices are under development and may reach the bedside soon.

Original languageEnglish (US)
Pages (from-to)102-109
Number of pages8
JournalCurrent Cardiology Reviews
Volume7
Issue number2
DOIs
StatePublished - May 1 2011

Fingerprint

Heart-Assist Devices
Heart Diseases
Heart Transplantation
Heart Failure
Tissue Donors
Equipment and Supplies
Extracorporeal Membrane Oxygenation
Mortality
Therapeutics
Palliative Care
Pediatrics
Transplants
Survival

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

@article{51f940f706c6445a989e3d34937924fa,
title = "Mechanical circulatory support for end-stage heart failure in repaired and palliated congenital heart disease",
abstract = "Approximately one in one hundred children is born with congenital heart disease. Most can be managed with corrective or palliative surgery but a small group will develop severe heart failure, leaving cardiac transplantation as the ultimate treatment option. Unfortunately, due to the inadequate number of available donor organs, only a small number of patients can benefit from this therapy, and mortality remains high for pediatric patients awaiting heart transplantation, especially compared to adults. The purpose of this review is to describe the potential role of mechanical circulatory support in this context and to review current experience. For patients with congenital heart disease, ventricular assist devices are most commonly used as a bridge to cardiac transplantation, an application which has been shown to have several important advantages over medical therapy alone or support with extracorporeal membrane oxygenation, including improved survival to transplant, less exposure to blood products with less immune sensitization, and improved organ function. While these devices may improve wait list mortality, the chronic shortage of donor organs for children is likely to remain a problem into the foreseeable future. Therefore, there is great interest in the development of mechanical ventricular assist devices as potential destination therapy for congenital heart disease patients with end-stage heart failure. This review first discusses the experience with the currently available ventricular assist devices in children with congenital heart disease, and then follows to discuss what devices are under development and may reach the bedside soon.",
author = "Clark, {Joseph B.} and Pauliks, {Linda B.} and Myers, {John L.} and Akif {\"U}ndar",
year = "2011",
month = "5",
day = "1",
doi = "10.2174/157340311797484222",
language = "English (US)",
volume = "7",
pages = "102--109",
journal = "Current Cardiology Reviews",
issn = "1573-403X",
publisher = "Bentham Science Publishers B.V.",
number = "2",

}

Mechanical circulatory support for end-stage heart failure in repaired and palliated congenital heart disease. / Clark, Joseph B.; Pauliks, Linda B.; Myers, John L.; Ündar, Akif.

In: Current Cardiology Reviews, Vol. 7, No. 2, 01.05.2011, p. 102-109.

Research output: Contribution to journalReview article

TY - JOUR

T1 - Mechanical circulatory support for end-stage heart failure in repaired and palliated congenital heart disease

AU - Clark, Joseph B.

AU - Pauliks, Linda B.

AU - Myers, John L.

AU - Ündar, Akif

PY - 2011/5/1

Y1 - 2011/5/1

N2 - Approximately one in one hundred children is born with congenital heart disease. Most can be managed with corrective or palliative surgery but a small group will develop severe heart failure, leaving cardiac transplantation as the ultimate treatment option. Unfortunately, due to the inadequate number of available donor organs, only a small number of patients can benefit from this therapy, and mortality remains high for pediatric patients awaiting heart transplantation, especially compared to adults. The purpose of this review is to describe the potential role of mechanical circulatory support in this context and to review current experience. For patients with congenital heart disease, ventricular assist devices are most commonly used as a bridge to cardiac transplantation, an application which has been shown to have several important advantages over medical therapy alone or support with extracorporeal membrane oxygenation, including improved survival to transplant, less exposure to blood products with less immune sensitization, and improved organ function. While these devices may improve wait list mortality, the chronic shortage of donor organs for children is likely to remain a problem into the foreseeable future. Therefore, there is great interest in the development of mechanical ventricular assist devices as potential destination therapy for congenital heart disease patients with end-stage heart failure. This review first discusses the experience with the currently available ventricular assist devices in children with congenital heart disease, and then follows to discuss what devices are under development and may reach the bedside soon.

AB - Approximately one in one hundred children is born with congenital heart disease. Most can be managed with corrective or palliative surgery but a small group will develop severe heart failure, leaving cardiac transplantation as the ultimate treatment option. Unfortunately, due to the inadequate number of available donor organs, only a small number of patients can benefit from this therapy, and mortality remains high for pediatric patients awaiting heart transplantation, especially compared to adults. The purpose of this review is to describe the potential role of mechanical circulatory support in this context and to review current experience. For patients with congenital heart disease, ventricular assist devices are most commonly used as a bridge to cardiac transplantation, an application which has been shown to have several important advantages over medical therapy alone or support with extracorporeal membrane oxygenation, including improved survival to transplant, less exposure to blood products with less immune sensitization, and improved organ function. While these devices may improve wait list mortality, the chronic shortage of donor organs for children is likely to remain a problem into the foreseeable future. Therefore, there is great interest in the development of mechanical ventricular assist devices as potential destination therapy for congenital heart disease patients with end-stage heart failure. This review first discusses the experience with the currently available ventricular assist devices in children with congenital heart disease, and then follows to discuss what devices are under development and may reach the bedside soon.

UR - http://www.scopus.com/inward/record.url?scp=80054104431&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=80054104431&partnerID=8YFLogxK

U2 - 10.2174/157340311797484222

DO - 10.2174/157340311797484222

M3 - Review article

C2 - 22548033

AN - SCOPUS:80054104431

VL - 7

SP - 102

EP - 109

JO - Current Cardiology Reviews

JF - Current Cardiology Reviews

SN - 1573-403X

IS - 2

ER -