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Mechanical Device Helps Kids Waiting for Heart Transplant
Date:8/8/2012

or neck, and an artery, he said. Blood is then circulated through an artificial lung and pumped back into the body. Infants and children on ECMO have to be in the intensive care unit, and they almost always have to be completely anesthetized and often are on a mechanical ventilator. Children on ECMO can't get up and move around, they can't do any physical therapy and they don't get normal nutrition.

At best, ECMO gives a child a few more weeks of survival, Fraser said. The hope is that during those few extra weeks, a donor heart will become available.

"Once you put a child on ECMO, the clock is ticking quickly," Fraser said. Unfortunately, the average time to transplant is 119 days for infants, according to background information in the study. Only between 40 percent and 60 percent of children on ECMO survive long enough to receive a transplant.

About 20 years ago, a device became available for adults with heart failure that helped them get extra time to wait for a transplant. Called the left ventricular assist device, it helped the patient's heart pump more efficiently. Although it has helped many adults, getting the device sized for children presented many challenges, Fraser said.

"Children aren't just scaled-down adults," he said. "The complexity of the engineering and the logistics and geography in the chest of a child are all different. Plus, they needed to size devices to work from newborn size and up."

The current trial included two groups of 24 children aged 16 and under who were in severe heart failure. Children in each group received the pediatric ventricular assist device. These groups were then compared to previous heart failure patients with similar disease severity who had received ECMO.

The average age was 1 year in the first group of children. The longest duration of support in this group for the pediatric ventricular assist device was 174 days, compared with 21 days for ECMO. At 21 days, 25 percent of the ch
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