Division of Pediatric Cardiology, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, Washington.
Division of Pediatric Cardiology, University of Texas Southwestern Medical Center, Dallas, Texas.
Catheter Cardiovasc Interv. 2019 Oct 1;94(4):618-624. doi: 10.1002/ccd.28456. Epub 2019 Aug 19.
To define patient and ventricular size parameters to guide Impella device (Abiomed, Inc., Danvers, MA) placement for mechanical circulatory support (MCS) in small pediatric patients (10-30 kg).
There are few options for MCS in children, and there are no data on minimum patient size requirements for placement of the Impella 2.5 device.
This was a multicenter study of echocardiographic and magnetic resonance imaging (MRI) derived dimensions of the left ventricle (LV) length and ascending aorta used to define minimum size parameters that are necessary for the placement of the Impella catheter.
Data were collected from 44 cardiac MRIs conducted in healthy pediatric patients and 39 echocardiograms performed in pediatric patients with cardiomyopathy prior to surgical ventricular assist device (VAD) placement. The Impella 2.5 catheter is 7.5 cm from the pigtail to the aortic annulus marker, thus requiring an LV apical length of 7.5 cm to allow the device to function in an unconstrained fashion. In the cohort of patients undergoing consideration for VAD placement, a minimum LV length of 7.5 cm corresponded to a height of 122 cm, weight of 23 kg, and body surface area (BSA) of 0.89 m . In the MRI cohort, this corresponded to a height of 121 cm, weight of 23.9 kg, and BSA of 0.89 m .
MCS with Impella devices is feasible in pediatric patients. This study defines anthropomorphic and anatomic measurements to guide providers in patient selection for MCS using the Impella devices.
确定患者和心室大小参数，以指导在小儿科患者（10-30kg）中使用 Impella 装置（Abiomed，Inc.，Danvers，MA）进行机械循环支持（MCS）。
儿童的 MCS 选择有限，并且没有关于放置 Impella 2.5 装置的最小患者尺寸要求的数据。
这是一项多中心研究，使用超声心动图和磁共振成像（MRI）得出的左心室（LV）长度和升主动脉尺寸，以确定放置 Impella 导管所需的最小尺寸参数。
从 44 例健康儿科患者的心脏 MRI 和 39 例心肌病儿科患者术前放置外科心室辅助装置（VAD）前的超声心动图中收集数据。Impella 2.5 导管从猪尾到主动脉瓣环标记物长 7.5cm，因此需要 LV 心尖长度为 7.5cm，以使装置能够自由工作。在接受 VAD 放置考虑的患者队列中，最小 LV 长度为 7.5cm 对应于身高 122cm、体重 23kg 和体表面积（BSA）为 0.89m。在 MRI 队列中，这对应于身高 121cm、体重 23.9kg 和 BSA 为 0.89m。
Impella 装置在儿科患者中进行 MCS 是可行的。本研究定义了人体测量和解剖学测量，以指导提供者在使用 Impella 装置进行 MCS 时选择患者。
