Pediatric ventricular assist device therapy for advanced heart failure-Hong Kong experience

We present a retrospective review of 13 consecutive children who underwent implantation of VAD between 2001 and 2018 in our center. The median age was 12  years (1–17 years), weight was 45 kg (10–82 kg). Etiologies of heart failure were dilated cardiomyopathy (CMP) (n = 8), myocarditis (n = 2), ischemic CMP (n = 1), restrictive CMP (n = 1) and congenital heart disease (n = 1). Pre-implantation ECMO was used in 5, mechanical ventilation in 4, renal replacement therapy in 2 and IABP in 1. Devices used were: Berlin Heart EXCOR left VAD (LVAD), biventricular VAD (BIVAD) (n = 5, 2), CentriMag LVAD, BIVAD (n = 1, 2), HeartWare (n = 2), HeartMate II (n = 1). Median duration of support was 45 days (3–823 days). Overall survival was 85%. Four patients were successfully bridged to transplantation, 2 died while on a device, 4 remain on support and 3 were weaned from VAD. Late death occurred in 2 transplanted patients. Complications included b leeding requiring reoperation in 1, neurologic events in 3, driveline infections and pericardial effusion in 2 each. In one patient, CentriMag BIVAD provided support for 235 days, which is longest reported duration on such a VAD in the Asia Pacific region. Survival for pediatric patients of all age s is excellent using VADs. Given the severity of illness in these children ...
Source: Journal of Artificial Organs - Category: Transplant Surgery Source Type: research

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AbstractIn humans, it is acknowledged that dilated cardiomyopathy is also caused by infection-induced myocarditis. To evaluate whether the occurrence of lesions of dilated cardiomyopathy in cattle may be triggered by myocarditis, an adult Holstein-Friesian dairy cow which showed dilated cardiomyopathy associated with myocarditis was examined by histopathology. Traumatic pericarditis or idiopathic congestive heart failure was clinically suspected, and the animal was culled because of unfavorable prognosis. Histopathological examination revealed an intrinsic cardiomyopathic lesion that overlapped with myocarditis. Cardiomyoc...
Source: Comparative Clinical Pathology - Category: Pathology Source Type: research
In this study we examined whether exposure to BPA for two weeks prior to viral infection and leading up to myocarditis at day 10 altered inflammation in female BALB/c mice housed in standard plastic cages/water bottles with soy-free food and bedding. We found that a human relevant dose of BPA (25µg/L) in drinking water, with an estimated exposure of 5µg BPA/kg BW, significantly increased myocarditis and pericarditis compared to control water without altering viral genome levels in the heart. BPA exposure activated ERa and ERb in the spleen 24 hours after infection and phosphorylated ERa and ERb during myocardit...
Source: Frontiers in Endocrinology - Category: Endocrinology Source Type: research
In conclusion, with study of the frailty syndrome still in its infancy, frailty analysis remains a major challenge. It is a challenge that needs to be overcome in order to shed light on the multiple mechanisms involved in the pathogenesis of this syndrome. Although several mechanisms contribute to frailty, immune system alteration seems to play a central role: this syndrome is characterized by increased levels of pro-inflammatory markers and the resulting pro-inflammatory status can have negative effects on various organs. Future studies should aim to better clarify the immune system alteration in frailty, and seek to esta...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
The innate immune cells called macrophages are vitally important to the health and function of tissues. They help to coordinate the intricate dance of stem cells, somatic cells, and immune cells that produces tissue regrowth and tissue maintenance. They destroy errant cells and pathogens. They have a variety of other roles as well. But where do macrophages come from? While some macrophages are generated within tissues, it is generally the case that in damaged or diseased tissues, most macrophages were originally monocytes. Circulating monocytes in the bloodstream enter tissues in response to chemical cues and then transfor...
Source: Fight Aging! - Category: Research Authors: Tags: Medicine, Biotech, Research Source Type: blogs
Abstract Hypereosinophilic syndrome is characterized by sustained and marked eosinophilia leading to tissue damage and organ dysfunction. Morbidity and mortality occur primarily due to cardiac and thromboembolic complications. Understanding the cause and mechanism of disease would aid in the development of targeted therapies with greater efficacy and fewer side effects. We discovered a spontaneous mouse mutant in our colony with a hypereosinophilic phenotype. Mice develop peripheral blood eosinophilia, infiltration of lungs, spleen and heart by eosinophils, and extensive myocardial damage and remodeling. This ulti...
Source: American Journal of Physiology. Heart and Circulatory Physiology - Category: Physiology Authors: Tags: Am J Physiol Heart Circ Physiol Source Type: research
Conclusions: We suggest some distinct molecular mechanisms for production of IL-1β in innate immune cells from patients with different clinical forms of Chagas disease. MMP-2 and MMP-9 gelatinases are associated with distinct disease outcomes and IL-1β production. Introduction Chagas disease, also known as American trypanosomiasis, is a neglected parasitic disease caused by the protozoan Trypanosoma cruzi (1), that affects millions of people in the world (2). During the acute phase, a diffuse and intense inflammation in the cardiomyocytes is observed, which is composed mainly of neutrophils, monocytes, and ...
Source: Frontiers in Immunology - Category: Allergy & Immunology Source Type: research
Discussion Barth syndrome is characterized by a dilated cardiomyopathy, proximal skeletal muscle weakness, neutropenia and short stature that usually presents at birth or soon after. It is a rare X-linked recessive disease process caused by mutations in the TAZ gene. The TAZ gene codes for tafazzin which alters cardiolipin in mitochondria. Characteristic facies can be seen especially in infancy including a tall and broad forehead, prominent chin and full cheeks, larger ears, and deep-set eyes. Most patients present at birth or soon afterwards but some may not until later in life. Life expectancy is reduced with many childr...
Source: PediatricEducation.org - Category: Pediatrics Authors: Tags: Uncategorized Source Type: news
In conclusion, prolonged AI and/or LS infusions in HF are safe and beneficial even in small infants, allowing stabilization and reasonable social and family life out of the hospital. It may provi de precious time for heart transplantation or myocardial remodeling, improvement, and possible discontinuation even after long periods of support.
Source: Pediatric Cardiology - Category: Cardiology Source Type: research
ConclusionHeart failure occurs at a younger age in Indians compared to the western countries. The most common etiology is DCM followed by VHD. Since this is a retrospective analysis and has its own limitations, community based heart failure study taking a clue from the present study can be done to achieve invaluable data.
Source: Journal of Indian College of Cardiology - Category: Cardiology Source Type: research
Conclusion Heart failure occurs at a younger age in Indians compared to the western countries. The most common etiology is DCM followed by VHD. Since this is a retrospective analysis and has its own limitations, community based heart failure study taking a clue from the present study can be done to achieve invaluable data.
Source: Journal of Indian College of Cardiology - Category: Cardiology Source Type: research
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