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

ildren on ECMO had died after coming off the device. At 174 days, 88 percent of the children on the assist device were able to survive to transplantation or be weaned off the machine.

The average age in the second group of children was about 9 years old. The longest duration of support with the pediatric ventricular assist device was 192 days, compared with 28 days for ECMO. At 30 days, 33 percent of children on ECMO had died; at 192 days, only 8 percent of children on the assist device had died.

The pediatric ventricular assist device isn't a panacea. It carries significant risks of major bleeding, infection and strokes, according to the study.

"This is definitely not something to be undertaken with light consideration," Fraser said. "But for those desperate children who likely wouldn't survive to transplant, clearly the benefits of the device outweigh the risks."

Fraser added that children who receive the pediatric ventricular assist device can usually be taken off mechanical ventilation. They can typically get out of bed and move around, take part in physical therapy and eat normally. All of these things help make them stronger and healthier before surgery.

"This device is designed to rescue children whose hearts are failing so severely that the benefits outweigh the risk," said Dr. Daphne Hsu, chief of pediatric cardiology at Children's Hospital at Montefiore, in New York City.

She has experience with the device, and said "it's wonderful that there is a device to treat children now. There has not been much emphasis on treating heart failure in children."

The only drawback for the new device compared to ECMO is cost, she said. Although she didn't know the exact figures, she thought the new device initially cost about $50,000, compared with several thousand dollars for ECMO. But, she said, the cost of the assist device may have already come down, and might come down further as it gains more widespread use.

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