Mechanical circulatory support in failing single-ventricle physiology

Ryan L. Kobayashi MD, Christina J. VanderPluym MD
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Abstract

The use of ventricular assist device (VAD) therapy for advanced heart failure in infants and children with single-ventricle (SV) congenital heart disease (CHD) has expanded rapidly. However, issues pertaining to patient size, developmental hemostasis, device availability, complicated anatomy, and complex modes of hemodynamic/circulatory failure associated with each stage of SV palliation make VAD support particularly challenging in this population. Over the last 20 years, there has been significant improvement in support outcomes for this complex population; however, survival and rates of adverse events still lag behind children with other diagnoses. Herein, we review current mechanical circulatory support approaches, ongoing challenges, and outcomes for patients with SV CHD.
机械循环支持在衰竭单心室生理学中的应用
在患有单心室(SV)先天性心脏病(CHD)的婴儿和儿童中,使用心室辅助装置(VAD)治疗晚期心力衰竭已经迅速扩大。然而,与患者大小、发育性止血、器械可用性、复杂的解剖结构以及与SV缓和的每个阶段相关的复杂的血液动力学/循环衰竭模式有关的问题使得VAD支持在这一人群中特别具有挑战性。在过去的20年里,对这一复杂人群的支持结果有了显著改善;然而,生存率和不良事件发生率仍然落后于其他诊断的儿童。在此,我们回顾了目前的机械循环支持方法、持续的挑战和SV冠心病患者的结果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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