Ventricular assist device support in neonates and infants with a failing functionally univentricular circulation
| Autor: | Susana Cruz Beltran, Joseph Philip, Jose F. Hernandez-Rivera, James C. Fudge, Kevin J. Sullivan, Mark S. Bleiweis, Giles Peek, Andrew D. Pitkin, Himesh V. Vyas, Jeffrey P. Jacobs |
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| Rok vydání: | 2022 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty business.industry medicine.medical_treatment Functionally univentricular heart medicine.disease Hypoplastic left heart syndrome Transplantation Standard Risk Internal medicine Ventricular assist device Cardiology Etiology Medicine Surgery Waitlist mortality business Hypoplastic right heart syndrome |
| Zdroj: | JTCVS Techniques. 13:194-204 |
| ISSN: | 2666-2507 |
| DOI: | 10.1016/j.xjtc.2021.09.056 |
| Popis: | Some neonates with functionally univentricular hearts are extremely high risk for conventional surgical palliation. Primary cardiac transplantation offers the best option for survival of these challenging neonates; however, waitlist mortality must be minimized. We have developed a comprehensive strategy for the management of neonates with functionally univentricular hearts that includes the selective use of conventional neonatal palliation in standard risk patients, hybrid approaches in neonates with elevated risk secondary to noncardiac etiology, and neonatal palliation combined with insertion of a single ventricular assist device (VAD) in neonates with elevated risk secondary to cardiac etiology. The purpose of this manuscript is to describe our selection criteria, technical details, management strategies, pitfalls, and current outcomes for neonates with functionally univentricular hearts supported with VAD. Our experience documents that extremely high-risk patients with functionally univentricular hearts who are poor candidates for conventional palliation can be successfully stabilized with concomitant palliation and pulsatile VAD insertion while awaiting transplantation. |
| Databáze: | OpenAIRE |
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