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Mechanical Circulatory Support in Children: Strategies, Challenges and Future Directions

dc.contributor.authorAbreu, S
dc.contributor.authorBrandão, C
dc.contributor.authorTrigo, C
dc.contributor.authorRodrigues, R
dc.contributor.authorPinto, F
dc.contributor.authorFragata, J
dc.date.accessioned2023-12-12T15:43:14Z
dc.date.available2023-12-12T15:43:14Z
dc.date.issued2022
dc.description.abstractIntroduction: The use of mechanical circulatory support (MCS) in the pediatric population has evolved significantly in the past 20 years, but its management still poses several challenges. We aim to describe patient characteristics, outcomes, and morbidity associated with different modalities of MCS, in a tertiary center. Methods: Retrospective analysis of data from all the children who underwent MCS between 2002 and 2018 at a pediatric cardiology unit. Results: Between 2002 and 2018, 22 devices were implanted in 20 patients. Patients were divided into three groups: Group A (n=11) extracorporeal membrane oxygenator (ECMO); Group B (n=8) pulsatile paracorporeal ventricular assist device (VAD) and group C (n=3) paracorporeal continuous flow VAD. The median age was similar in groups A and B (18 and 23 months, respectively), and higher in group C (13 years). ECMO patients were cannulated mainly as a bridge to recovery (post cardiotomy- 8) while group B and C patients were bridged to transplantation. The most frequent complications were bleeding (group A - 36%, group C - 66.6%) and thromboembolic events (group B - 50%, group C - 33.3%). As for outcomes, in group A the majority of patients (54.5%) were weaned and 27.3% died. Half of group B and all of group C patients underwent transplantation. Conclusion: Bleeding and thromboembolic events were the main complications observed. Group B showed the highest mortality, probably related to the low weight of the patients. Overall, outcomes and complications are related to the type of device and patient status and characteristics.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationRev Port Cardiol . 2022 May;41(5):371-378.pt_PT
dc.identifier.doi10.1016/j.repc.2021.03.011pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/4760
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherElsevier Españapt_PT
dc.subjectHSM CAR PEDpt_PT
dc.subjectHSM CCTpt_PT
dc.subjectBridge to Transplantpt_PT
dc.subjectBridge-to-Bridgept_PT
dc.subjectHeart Transplantpt_PT
dc.subjectECMOpt_PT
dc.subjectMechanical Circulatory Supportpt_PT
dc.subjectParacorporeal Pulsatile Ventricular Assist Devicespt_PT
dc.subjectShort Term Ventricular Assist Devicespt_PT
dc.subjectPediatricpt_PT
dc.titleMechanical Circulatory Support in Children: Strategies, Challenges and Future Directionspt_PT
dc.title.alternativeAssistência Circulatória Mecânica em Crianças: Estratégias, Desafios e Direção para o Futuropt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage378pt_PT
oaire.citation.issue5pt_PT
oaire.citation.startPage371pt_PT
oaire.citation.titleRevista Portuguesa de Cardiologiapt_PT
oaire.citation.volume41pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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