The Use of Ventricular Assist Device Support in Children: The State of the Art
The Use of Ventricular Assist Device Support in Children: The State of the Art
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DOI：
10.1111/aor.12439
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发表时间：
2015-01-01
影响因子：
2.4
通讯作者：
Mascio, Christopher E.
中科院分区：
文献类型：
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作者：
Mascio, Christopher E.
先天性心脏病患者的生存率、识别率和管理水平的提高增加了儿童心室功能障碍患者的数量。这些患者中的许多人需要机械支持来桥接移植或恢复。小儿心室辅助装置的开发落后于成人装置。直到最近，成人器械才用于儿科患者，在较小的患者人群中效果不佳。体外膜氧合可以挽救生命，但对于长期支持来说是一个糟糕的选择。柏林心脏EXCOR（柏林心脏股份公司，柏林，德国）是一种具有各种泵的旁路器械，适用于各种体型的患者。PumpKIN试验将在一项前瞻性随机研究中比较该器械与婴儿Jarvik 2000（Jarvik Heart，纽约，NY，USA）。单心室人群对辅助装置的放置和正常功能提出了独特的挑战。数据是轶事，死亡率很高。已经建立了一个登记册，以协助照顾这一具有挑战性的人口。
Improved survival, recognition, and management of patients with congenital heart disease have increased the number of pediatric patients with ventricular dysfunction. Many of these patients require mechanical support to bridge to transplant or recovery. Development of pediatric ventricular assist devices has lagged behind adult devices. Until recently, adult devices were used in pediatric patients, with suboptimal results in the smaller patient population. Extracorporeal membrane oxygenation can be life saving, but is a poor choice for long-term support. The Berlin Heart EXCOR (Berlin Heart AG, Berlin, Germany) is a paracorporeal device with a variety of pumps for patients of all sizes. The PumpKIN Trial will compare this device to the Infant Jarvik 2000 (Jarvik Heart, New York, NY, USA) in a prospective, randomized study. The single ventricle population presents unique challenges to placement and proper functioning of assist devices. Data are anecdotal and mortality is high. A registry has been developed to assist in caring for this challenging population.