Paediatric heart failure research: role of the National Heart, Lung, and Blood Institute

The National Heart, Lung, and Blood Institute, of the National Institutes of Health, is committed to supporting research in paediatric heart failure. The Institute’s support of paediatric heart failure research includes both investigator-initiated grants and Institute initiatives. There were 107 funded grants in paediatric heart failure over the past 20 years in basic, translational and clinical research, technology development, and support of registries. Such research includes a broad diversity of scientific topics and approaches. The Institute also supports several initiatives for paediatric heart failure, including the Pediatric Circulatory Support Program, the Pumps for Kids, Infants, and Neonates (PumpKIN) Program, PediMACS, and the Pediatric Heart Network. This review article describes the National Heart, Lung, and Blood Institute’s past, present, and future efforts to promote a better understanding of paediatric heart failure, with the ultimate goal of improving outcomes.

A Comprehensive Flow Study of the 12 cc Penn State Pulsatile Pediatric Ventricular Assist Device

While medical options for children born with congenital heart defects include transplantation, the amount of available organs remains limited. This lack of donors led to the development of the National Institute of Health’s National Heart, Lung and Blood Institute Pediatric Circulatory Support Program. Contracts have been awarded to five teams with the task of creating novel support systems for children, ranging from 2 to 25 kg [1]. As part of this program, Penn State has developed a 12 cc pulsatile pediatric ventricular assist device (PVAD), based on the successful 70 cc Pierce-Donachy adult assist device. During the process of reducing the volume of the device for pediatric use, changes were made to the design including altering the angles of the inlet and outlet ports. Previous two-dimensional flow visualization in the PVAD by Manning et al. had shown that these changes led to an increased three-dimensionality of the flow, the influence of which required further investigation [2]. It is important to characterize the fluid dynamics of the flow field inside assist devices such as the PVAD because certain characteristics including high blood residence time, stagnant flow and wall shear rates below 500 s−1 can lead to an increased propensity of thrombus deposition [3,4].