Year 2019, Volume 58, Issue 1, Pages 52 - 54 2019-03-14

Continuous flow ventricular assist device implantation in pediatrics: Single center experience
Pediyatrik vakalarda sürekli akım sağlayan ventrikül destek cihazi implantasyonu: Tek merkez deneyimi

Pelin Öztürk [1] , Osman Nuri Tuncer [2]

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Aim: Heart transplantation is the gold standard of treatment for patients with medical therapy resistant end-stage heart failure. Particularly in the pediatric age group use of ventricular asist device (VAD) is mandatory, due to donor organ limitation and prolonged waiting lists.

Materials and Methods: This retrospective review of fourteen patients under 19 years of age who underwent continuous flow left VAD implantation between August 2012 and March 2018. All patients have met the criteria for heart transplantation. HeartWare (HeartWare Inc. Medtronic) HVAD was implanted to all patients.

Results: There were eight girls and six boys with a mean overall age of 15.4 (minimum11-maximum 18) years and mean body weight of 42.4 kg and body surface area (BSA) is 1.4 kg/cm². The mean follow-up was 549 days. Survival rate at six months was 90%. Six patients (42.9%) are still waiting for transplantation on VAD support. Six patients (42.9%) underwent heart transplantation successfully. Two patients died while they were waiting for transplantation on device support.

Conclusion: The use of continuous flow ventricular assist devices became more popular because reduced dimensions along with technological advances. In this article, we wanted to share our experience about continuous flow ventricular assist device implantation as bridge to transplantation in pediatric patients.

Amaç: Kalp transplantasyonu medikal tedaviye dirençli hastalarda altın standart tedavi yöntemidir. Tüm dünyada olduğu gibi ülkemizde de özellikle pediatrik yaş grubunda donör organ kısıtlılığı ve uzayan bekleme listeleri ventrikül destek sistemlerinin kullanımını zorunlu kılmıştır.

Gereç ve Yöntem: Bu çalışmada, kliniğimizde Ağustos 2012 ile Mart 2108 tarihleri arasında 19 yaş altı olgularda devamlı akım sağlayan ventriküler destek cihazı implante edilmiş olgular retrospektif olarak değerlendirildi. Hastaların tümü kalp nakli kriterlerine uygundu. Tüm hastalara HeartWare (HeartWare inc. Medtronic) HVAD cihazı implante edildi.

Bulgular: Yaş ortalaması 15.4 (minimum11-maksimum 18) olan 8 kız, 6 erkek olgunun, ortalama kilosu 42.4 kg, vücut yüzey alanı ise 1.4 kg/cm², ortalama takip süresi 549 gün, 6 aylık survi %90 olarak değerlendirildi. Altı (%42.9) olgu halen destek altında takibimizde iken, 6 olguya başarılı şekilde kalp transplantasyonu yapıldı. Destek altında iken 2 olgu kaybedildi.

Sonuç: Teknolojik ilerlemeler ile büyük ve pulsatil akım sağlayan pompalardan sonra son yıllarda boyutları oldukça küçülen sürekli akım sağlayan ventrikül destek sistemlerinin kullanımı yaygınlık kazanmıştır. Bu yazımızda kliniğimizde pediatrik yaş grubunda nakile köprü amaçlı sürekli akım sağlayan ventrikül destek cihazı implantasyonu deneyimlerimiz paylaşılacaktır.

  • Masarone D, Valente F, Rubino M, et al. Pediatric heart failure: A practical guide to diagnosis and management. Pediatr Neonatol 2017;58(4):303-12.
  • Almond CSD, Thiagarajan RR, Piercey GE, et al. Waiting list mortality among children listed for heart transplantation in the United States. Circulation 2009;119(5):717-27.
  • Hsu KH, Huang SC, Chou NH, et al. Ventricular assist device application as a bridge to pediatric heart transplantation: A single center's experience. Transplant Proc 2012;44(4):883-5.
  • Chambers DC, Yusen RD, Cherikh WS, et al. The Registry of the International Society for Heart and Lung Transplantation: Thirty-fourth Adult Lung And Heart-Lung Transplantation Report-2017; Focus Theme: Allograft ischemic time. J Heart Lung Transplant 2017;36(10):1047-59.
  • Blume ED, VanderPluym C, Lorts A, et al. Second annual Pediatric Interagency Registry for Mechanical Circulatory Support (Pedimacs) report: Pre-implant characteristics and outcomes. J Heart Lung Transplant 2018;37(1):38-45.
Primary Language en
Subjects Health Care Sciences and Services
Journal Section Research Articles
Authors

Orcid: 0000-0002-7962-4363
Author: Pelin Öztürk (Primary Author)
Institution: Ege University Faculty of Medicine, Department of Cardiovascular Surgery, İzmir
Country: Turkey


Orcid: 0000-0001-6495-1639
Author: Osman Nuri Tuncer
Institution: Ege University Faculty of Medicine, Department of Cardiovascular Surgery, İzmir
Country: Turkey


Bibtex @research article { etd418041, journal = {Ege Tıp Dergisi}, issn = {1016-9113}, eissn = {2147-6500}, address = {Ege University}, year = {2019}, volume = {58}, pages = {52 - 54}, doi = {10.19161/etd.418041}, title = {Continuous flow ventricular assist device implantation in pediatrics: Single center experience}, key = {cite}, author = {Öztürk, Pelin and Tuncer, Osman Nuri} }
APA Öztürk, P , Tuncer, O . (2019). Continuous flow ventricular assist device implantation in pediatrics: Single center experience. Ege Tıp Dergisi, 58 (1), 52-54. DOI: 10.19161/etd.418041
MLA Öztürk, P , Tuncer, O . "Continuous flow ventricular assist device implantation in pediatrics: Single center experience". Ege Tıp Dergisi 58 (2019): 52-54 <http://dergipark.org.tr/etd/issue/43429/418041>
Chicago Öztürk, P , Tuncer, O . "Continuous flow ventricular assist device implantation in pediatrics: Single center experience". Ege Tıp Dergisi 58 (2019): 52-54
RIS TY - JOUR T1 - Continuous flow ventricular assist device implantation in pediatrics: Single center experience AU - Pelin Öztürk , Osman Nuri Tuncer Y1 - 2019 PY - 2019 N1 - doi: 10.19161/etd.418041 DO - 10.19161/etd.418041 T2 - Ege Tıp Dergisi JF - Journal JO - JOR SP - 52 EP - 54 VL - 58 IS - 1 SN - 1016-9113-2147-6500 M3 - doi: 10.19161/etd.418041 UR - https://doi.org/10.19161/etd.418041 Y2 - 2018 ER -
EndNote %0 Ege Journal of Medicine Continuous flow ventricular assist device implantation in pediatrics: Single center experience %A Pelin Öztürk , Osman Nuri Tuncer %T Continuous flow ventricular assist device implantation in pediatrics: Single center experience %D 2019 %J Ege Tıp Dergisi %P 1016-9113-2147-6500 %V 58 %N 1 %R doi: 10.19161/etd.418041 %U 10.19161/etd.418041
ISNAD Öztürk, Pelin , Tuncer, Osman Nuri . "Continuous flow ventricular assist device implantation in pediatrics: Single center experience". Ege Tıp Dergisi 58 / 1 (March 2019): 52-54. https://doi.org/10.19161/etd.418041