Pediatric mechanical circulatory support in the United States: past, present, and future.

Mechanical support of the failing myocardium has become standard therapy for adults who fail medical management. Historically, there have been fewer options for children with heart failure. Extracorporeal membrane oxygenation and centrifugal pump-based ventricular assist devices have been the most commonly used circulatory support modalities for pediatrics in the United States. During the last few years, substantial advances in pediatric circulatory support have been made, with greater availability of a number of devices suitable for pediatrics. For example, there has been increasing experience using the DeBakey VAD Child and the Berlin Heart VAD to provide circulatory support for children during this period. A number of innovative devices under development supported by the Pediatric Circulatory Support Program of the National Heart, Lung, and Blood Institute hold great promise for expanded options for pediatric mechanical circulatory support in the future.