Department of Cardiothoracic and Vascular Surgery, Cardio Centrum Berlin, Berlin, Germany.
Expert Rev Med Devices. 2020 Jan;17(1):57-74. doi: 10.1080/17434440.2020.1699404. Epub 2019 Dec 31.
: The development of ventricular assist devices (VADs) have enabled myocardial recovery and improved patient survival until heart transplantation. However, device options remain limited for children and lag in development.: This review focuses on the evolution of pediatric VADs in becoming to be an accepted treatment option in advanced heart failure, discusses the classification of VADs available for children, i.e. types of pumps and duration of support, and defines implantation indications and explantation criteria, describes attendant complications and long-term outcome of VAD support. Furthermore, we emphasize the key considerations and requirements in the application of these devices in infants, children and adolescents.: Increasing use of VADs has facilitated a leading edge in management of advanced heart failure either as a bridge to transplantation or as a bridge to myocardial recovery. In newborns and small children, the EXCOR Pediatric VAD remains the only reliable option. In some patients ventricular unloading may lead to complete myocardial recovery. There is a strong need for pumps that are fully implantable, suitable for single ventricle physiology, such as the right ventricle.
心室辅助装置（VAD）的发展使心肌得以恢复，提高了患者在心脏移植前的生存率。然而，儿童可用的设备选择仍然有限，并且在发展方面滞后。
本篇综述重点介绍了儿科 VAD 的发展历程，它已成为治疗晚期心力衰竭的一种可接受的治疗选择，讨论了适用于儿童的 VAD 的分类，即泵的类型和支持的持续时间，并定义了植入指征和取出标准，描述了伴随的并发症和 VAD 支持的长期结果。此外，我们强调了在婴儿、儿童和青少年中应用这些设备时的关键考虑因素和要求。
VAD 的广泛应用促进了晚期心力衰竭管理的前沿发展，无论是作为移植前的桥梁，还是作为心肌恢复的桥梁。在新生儿和小儿童中，EXCOR 儿科 VAD 仍然是唯一可靠的选择。在某些患者中，心室卸载可能导致完全的心肌恢复。我们非常需要完全可植入的、适合单心室生理的泵，如右心室。
