Ventricular assist devices for children

Infants and children may experience such severe heart failure that circulatory support is required as a bridge to recovery, transplantation, or until other surgical intervention can be performed. While older children may be supported by devices designed for use in adults, historically, options for pediatric circulatory support have been limited to extracorporeal membrane oxygenators (ECMO), short-term centrifugal pump-based ventricular assist devices (VADs), and paracorporeal VADs. However, these devices present substantial risk for adverse events in the pediatric population. To address the need for improved circulatory support devices for the youngest pediatric patients, new devices specifically targeted to this vulnerable population are being developed. These include implantable rotary blood pumps, compact cardiopulmonary assist systems, and extracorporeal pulsatile and rotary pumps for acute and chronic support. Several devices are expected to be available for clinical evaluation soon. These devices will hopefully provide solutions for challenges that are unique to pediatric circulatory support, such as the anticipated growing population of failing single ventricle patients who have previously undergone a Fontan procedure. (C) 2005 Elsevier Ireland Ltd. All rights reserved.