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Biventricular Assist Device Shows Promise in Children

Eight of nine children with heart failure survive wait for transplants using BiVADs

TUESDAY, Sept. 30 (HealthDay News) -- The use of biventricular assist devices may be an effective method for sustaining small children awaiting heart transplantation, according to research published Sept. 30 in a supplement issue of Circulation: Journal of the American Heart Association.

Sanjiv K. Gandhi, M.D., of Saint Louis Children's Hospital, and colleagues discuss the outcomes of nine pediatric heart transplant candidates, with ages ranging from 12 days to 17 years, who underwent placement of a Berlin Heart EXCOR biventricular assist device (BiVAD) on a compassionate-use basis. Heart failure was due to cardiomyopathy in seven children and complex congenital heart disease in two.

Eight of the nine patients survived to successful heart transplantation after a median length of 35 days of BiVAD support, the researchers report. Five patients required a total of 12 pump changes due to fibrin deposition or thrombus. None had acute neurological complications, thromboembolic events or bleeding complications, and after a median follow-up of 19 months, no additional deaths had occurred in the group after transplant, the report indicates.

"Our experience demonstrates the feasibility of BiVAD support in small children with low mortality and reasonable morbidity," the authors write. "The overall 89 percent survival rate in this series during circulatory support is favorable compared to other trials. Studies examining pediatric bridge to transplant experiences have reported bridging success rates between 51 percent to 78 percent and one-year survival post-transplant from 62 percent to 88 percent. Our post-transplant survival after ventricular assist device support has been excellent, with 100 percent of children alive to date."

Two of the study co-authors disclosed financial relationships, one with AGA Medical Corporation and another with Blue Cross/Blue Shield.

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