Australian experience with VAD as a bridge to paediatric cardiac transplantation

Heart Lung Circ. 2010 Jan;19(1):26-30. doi: 10.1016/j.hlc.2009.07.002. Epub 2009 Nov 13.

Abstract

The Royal Children's Hospital, Melbourne is the National Paediatric Heart Transplant Centre of Australia. A variety of ventricular assist devices (VADs) have been used effectively as a bridge to heart transplantation in adult patients, however, the experience in the paediatric population is limited. We present our initial experience using the Thoratec and Medos VAD systems as a bridge to heart transplantation in the designated centre for paediatric cardiac transplantation in Australia. The medical records of all patients supported with a Thoratec or Medos VAD at the RCH from July 2005 to July 2007 were retrospectively reviewed. Seven patients between 5 and 16 years of age were supported with the Thoratec or Medos VAD during the period of study. All of the patients were supported with a left sided ventricular assist device (LVAD). The length of time supported ranged from 6 to 230 days, with a median of 22 days. Co-morbidities included surgical re-exploration for bleeding, cannula site wound infections and thromboembolic events. Two patients died before a donor heart became available. From our limited experience, the use of a VAD as a bridge to heart transplantation is a feasible option for children with end stage cardiac failure.

MeSH terms

  • Adolescent
  • Age Factors
  • Australia
  • Child
  • Child, Preschool
  • Equipment Design
  • Equipment Failure
  • Female
  • Heart Transplantation*
  • Heart-Assist Devices*
  • Humans
  • Male
  • Pediatrics
  • Retrospective Studies