[AJS-02] Experience in Choice of Mechanical Support in Pediatric Group and the Result of Transplantation for Complex Congential Heart Disease
Severe congestive heart failure (CHF) is a devastating situation in managing the patients with heart disease, especially for those with congenital heart problem. The condition is associated with a high rate of morbidity and mortality and places a significant burden on families of affected children and to society as a whole. Pharmacological therapy was limited for children or neonates with severe CHF. Heart transplantation is the treatment of choice, however, the in-time donor heart supply is most impossible. Mechanical support is the only way to keep CHF patients alive for further possibility for heart transplantation. The mechanical support for the pediatric group is not well developed because the coagulation issue and the size of the device. Extracorporeal membrane oxygenation seems to be the fast and simple device for short-term survival. It can be applied for the emergency setting, even under resuscitation. The predominant role of these devices has been as a bridge to heart transplantation, and excellent results are currently achieved for most children with cardiomyopathies. There is an ongoing investigation to improve outcomes in high-risk populations, such as small infants and those with complex congenital heart disease, including patients with functionally univentricular hearts.
Since 1989, we started our pediatric heart transplantation program (< 18 years old), and we had 55 pediatric patients undergoing 57 transplantation. Five patients received biological bridge procedure and 7 of them received either ECMO or VAD support for severe CHF status. One-third patients received transplantation under UNOS status I. Two patients required re-transplantation due to vasculopathy. Twenty-two patients died during the follow-up period.
Mechanical support is mandatory for pediatric group patients requiring heart transplantation, especially they are under critical status. Donor shortage is till the key issue for better survival in those under mechanical support.
Since 1989, we started our pediatric heart transplantation program (< 18 years old), and we had 55 pediatric patients undergoing 57 transplantation. Five patients received biological bridge procedure and 7 of them received either ECMO or VAD support for severe CHF status. One-third patients received transplantation under UNOS status I. Two patients required re-transplantation due to vasculopathy. Twenty-two patients died during the follow-up period.
Mechanical support is mandatory for pediatric group patients requiring heart transplantation, especially they are under critical status. Donor shortage is till the key issue for better survival in those under mechanical support.