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Ventricular assist device (VAD) implantation is a widely used procedure in children with cardiac failure refractory to medical therapy as a long-term bridge to recovery or transplant. This strategy has proved to be of an enormous advantage in the cure of these children. The aim of this review is to evaluate the current strategies used for clinical monitoring of paediatric patients with a VAD, focusing on the management of several aspects such as anticoagulant and antiplatelet therapy, haemorrhagic and thrombotic complications, as well as the effects that VADs have on the exposure, effectiveness and the safety of drugs. The sources used for this research are MEDLINE, PubMed and Cochrane Library. The use of key words such as "paediatric ventricular assist device", "clinical management", "anticoagulant therapy" and "infections" retrieved 146 papers. With the application of the inclusion criteria, 42 articles have been selected, but following further analysis, only 21 were eligible. The post-implant process is still complicated due to the lack of guidelines regarding clinical management and for the frequent occurrence of adverse events including bleeding, infection and thromboembolic episodes. From these findings, we can highlight the importance of establishing a suitable antithrombotic therapy, as well as ensuring that the prevention and treatment of infection are paramount during the management of these patients. The clinical management of VAD paediatric children is complex and challenging. At the moment, there are no guidelines regarding strategies to adopt, but from the analysed surveys, it has been possible to highlight a relative coherence between adopted therapies in different centres worldwide.
This article was published in the following journal.
Name: Heart failure reviews
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Small pumps, often implantable, designed for temporarily assisting the heart, usually the left ventricle, to pump blood; they consist of a pumping chamber and a power source, which may be partially or totally external to the body and activated by electromagnetic motors; the devices are used after myocardial infarction or to wean the repaired heart from the heart-lung machine after open-heart surgery.
Occlusion of the outflow tract in either the LEFT VENTRICLE or the RIGHT VENTRICLE of the heart. This may result from CONGENITAL HEART DEFECTS, predisposing heart diseases, complications of surgery, or HEART NEOPLASMS.
A congenital heart defect characterized by the narrowing or complete absence of the opening between the RIGHT VENTRICLE and the PULMONARY ARTERY. Lacking a normal PULMONARY VALVE, unoxygenated blood in the right ventricle can not be effectively pumped into the lung for oxygenation. Clinical features include rapid breathing, CYANOSIS, right ventricle atrophy, and abnormal heart sounds (HEART MURMURS).
A congenital heart defect characterized by downward or apical displacement of the TRICUSPID VALVE, usually with the septal and posterior leaflets being attached to the wall of the RIGHT VENTRICLE. It is characterized by a huge RIGHT ATRIUM and a small and less effective right ventricle.
A congenital cardiovascular malformation in which the AORTA arises entirely from the RIGHT VENTRICLE, and the PULMONARY ARTERY from the LEFT VENTRICLE. Consequently, the pulmonary and the systemic circulations are parallel and not sequential, so that the venous return from the peripheral circulation is re-circulated by the right ventricle via aorta to the systemic circulation without being oxygenated in the lungs. This is a potentially lethal form of heart disease in newborns and infants.
Cardiology is a specialty of internal medicine. Cardiac electrophysiology : Study of the electrical properties and conduction diseases of the heart. Echocardiography : The use of ultrasound to study the mechanical function/physics of the h...
Congenital conditions are those which are present from birth. They include structural deformities or loss of function in organs such as the <!--LGfEGNT2Lhm-->heart, gut or skeletal system. They can be corrected by <!--LGfEGNT2Lhm-->surgery, m...
Cardiovascular disease (CVD)
Acute Coronary Syndromes (ACS) Blood Cardiovascular Dialysis Hypertension Stent Stroke Vascular Cardiovascular disease (CVD) includes all the diseases of the heart and circulation including coronary heart disease (angina...