Caring for Pediatric Heart Failure Patients With Long-Term Mechanical Circulatory Support

2018 ◽  
Vol 38 (5) ◽  
pp. 44-56
Author(s):  
Kari Hyotala

Pediatric cardiac failure is a significant problem that may be caused by cardiomyopathy, myocarditis, or congenital defects that cannot be surgically repaired. Long-term mechanical circulatory support (LTMCS) devices provide hemodynamic support for patients in heart failure as a bridge to heart transplant and, sometimes, cardiac recovery or destination therapy. Critical care nurses must have a comprehensive understanding of LTMCS device function and keen assessment skills to detect signs of impaired perfusion and device failure. Nurses should anticipate postoperative interventions, prevent adverse events, and be prepared to respond during emergencies. Patient care should be family centered and nurses must strive to maximize patients’ quality of life throughout device implantation. This article provides a basic guide to caring for pediatric patients receiving LTMCS, including specific information regarding 4 devices that are often used for pediatric heart failure: Berlin Heart EXCOR, SynCardia Total Artificial Heart, HeartWare HVAD, and HeartMate II.

2020 ◽  
Vol 28 (S1) ◽  
pp. 115-121
Author(s):  
S. E. A. Felix ◽  
N. de Jonge ◽  
K. Caliskan ◽  
O. Birim ◽  
K. Damman ◽  
...  

Circulation ◽  
2004 ◽  
Vol 109 (20) ◽  
pp. 2423-2427 ◽  
Author(s):  
Ronald M. Lazar ◽  
Peter A. Shapiro ◽  
Brian E. Jaski ◽  
Michael K. Parides ◽  
Robert C. Bourge ◽  
...  

Author(s):  
Stephan M. Ensminger ◽  
Gino Gerosa ◽  
Jan F. Gummert ◽  
Volkmar Falk

Because the first generation of pulsatile-flow devices was primarily used to bridge the sickest patients to transplantation (bridge-to-transplant therapy), the current generation of continuous-flow ventricular assist devices qualifies for destination therapy for patients with advanced heart failure who are ineligible for transplantation. The first-generation devices were associated with frequent adverse events, limited mechanical durability, and patient discomfort due device size. In contrast, second-generation continuous-flow devices are smaller, more quiet, and durable, thus resulting in less complications and significantly improved survival rates. Heart transplantation remains an option for a limited number of patients only, and this fact has also triggered the discussion about the optimal timing for device implantation. The increasing use of continuous-flow devices has resulted in new challenges, such as adverse events during long-term support, and high hospital readmission rates. In addition, there are a number of device-related complications including mechanical problems such as device thrombosis, percutaneous driveline damage, as well as conditions such as hemolysis, infection, and cerebrovascular accidents. This review provides an overview of the evolution of mechanical circulatory support systems from bridge to transplantation to destination therapy including technological advances and clinical improvements in long-term patient survival and quality of life. In addition, recent changes in device implant strategies and current trials are reviewed and discussed. A brief glimpse into the future of mechanical circulatory support therapy will summarize the innovations that may soon enter clinical practice.


2013 ◽  
Vol 15 (10) ◽  
pp. 1185-1193 ◽  
Author(s):  
Akan Emin ◽  
Chris A. Rogers ◽  
Jayan Parameshwar ◽  
Guy MacGowan ◽  
Rhiannon Taylor ◽  
...  

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