https://scholars.lib.ntu.edu.tw/handle/123456789/560040
標題: | Ventricular assist device application as a bridge to pediatric heart transplantation: A single center's experience | 作者: | Hsu K.H. SHU-CHIEN HUANG NAI-KUAN CHOU NAI-HSIN CHI Tsao C.I. Ko W.J. YIH-SHARNG CHEN CHUNG-I CHANG ING-SH CHIU SHOEI-SHEN WANG |
公開日期: | 五月-2012 | 卷: | 44 | 期: | 4 | 起(迄)頁: | 883 | 來源出版物: | Transplantation Proceedings | 摘要: | Objectives: There are limited options for mechanical circulatory support to treat end-stage heart failure in pediatric patients. Although extracorporeal membrane oxygenation is commonly used in infants and children, ventricular assist devices (VAD) provide a longer duration of support with fewer complications before recovery or as a bridge to heart transplantation (HTx), as described herein. Methods: This retrospective chart review of eight patients transplanted from April 2008 to December 2011, after left ventricular assist device (LVAD) implantation due to end-stage heart failure. Their mean age was 12 years (9-15 y) and mean body weight, 48 kg (20-78). All were New York Heart Association functional class IV with mean left ventricular ejection fractions less than 15%. Results: The six patients (75%) received HTx after a mean LVAD support duration of 43.2 days; 2 (25%) died before a suitable heart became available. Their mean duration of LVAD support was 30 days. There were 4 (50%) who experienced clinically evident thromboembolic events: 3 (37.5%) cerebrovascular with 1 mortality and 1 (12.5%) as acute limb ischemia. Transient hemodialysis was performed in 4 (50%). Bloodstream infection identified in 6 (75%) was controlled with intravenous antibiotics. Driveline infection identified in 4 (50%) was treated successfully with local wound dressing changes and intravenous antibiotics. One 9-year-old boy died of rejection at 16 months after transplantation. Conclusions: Because of the organ shortage, pediatric patients have a low chance to undergo HTx. VAD provides long-term support for children with end-stage heart failure before a suitable heart becomes available. A thromboembolic event remains a major complication influencing their survival. ? 2012 Elsevier Inc. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-84860778178&doi=10.1016%2fj.transproceed.2012.03.023&partnerID=40&md5=dc6b44cf8909f5da14ba8cd313fed12a https://scholars.lib.ntu.edu.tw/handle/123456789/560040 |
ISSN: | 0041-1345 | DOI: | 10.1016/j.transproceed.2012.03.023 | SDG/關鍵字: | antibiotic agent; ceftazidime; vancomycin; artery disease; bloodstream infection; body weight; brain disease; brain hemorrhage; cardiac graft rejection; cerebral artery disease; cerebrovascular accident; conference paper; heart failure; heart left ventricle ejection fraction; heart transplantation; hemodialysis; human; left ventricular assist device; leg ischemia; medical record review; medical society; mortality; pediatric surgery; postoperative complication; priority journal; resuscitation; surgical mortality; thrombectomy; thromboembolism; wound dressing; Adolescent; Child; Female; Graft Rejection; Heart Failure; Heart Transplantation; Heart-Assist Devices; Humans; Male; Prosthesis Design; Retrospective Studies; Taiwan; Thromboembolism; Time Factors; Tissue Donors; Treatment Outcome; Ventricular Function, Left; Waiting Lists |
顯示於: | 醫學系 |
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