Purpose. The development of pediatric ventricular assist device (VAD) circuits withlower flow ranges for infants and small children is ongoing. We present our results withmodifying a readily available adult VAD to support the pediatric population.
Description. The TandemHeart VAD (CardiacAssist, Pittsburgh, PA) circuit was modifiedto include a variable restrictive recirculation shunt to permit lower flow ranges in smallpediatric patients.
Evaluation. Initial benchtop flow rates and pressures were studied. Hemolysis trials wereperformed using whole bovine blood to compare plasmaEvaluation. Initial benchtop flow rates-free hemoglobin levels betweenmodified and unmodified VAD circuits. The modified VAD was surgically implanted in 7piglets (6 to 14 kg) and which supported them for 4 hours. Levels of hemolysis did notincrease and full hemodynamic support was achieved. The modified TandemHeart VADwith a recirculation shunt was subsequently implanted in 2 pediatric patients who werebridged to transplant successfully.
Conclusions. Because of its simplicity, availability, low prime volume, greater patientflow range, and lower cost, the modified TandemHeart VAD with a recirculation shuntshould be considered as an alternative to extracorporeal membrane oxygenation and otherpulsatile VADs in children.
ASJC Scopus subject areas
- Pulmonary and Respiratory Medicine
- Cardiology and Cardiovascular Medicine