Preliminary Data on the Clinical Use of Infant Jarvik 2015 in Children with Dilated Cardiomyopahty; Recovery Will Be the New Therapeutic Goal?

Abstract

Continuous flow and intra-corporeal ventricular assist devices (VAD) in children has becoming attractive for their potential benefit in pediatric population. CF VAD for children less than 20 kg are still challenging population. We reported the effect of CF VAD in small children with dilated cardiomyopathy refractory to conventional pharmacological treatment. We implanted CF VAD type Infant Jarvik 2015 (Infant Jarvik 2015 Jarvik Heart, Inc., New York, NY) in 3 consecutive pediatric affected by dilated cardiomyopathy with refractory symptoms of heart failure. The mean weight at implantation was 11 kgs. Primary diagnosis was dilated cardiomyopathies in all. All 3 children survived. In one patient we changed the vad for pump thromboses. The mean time on VAD was 336,7± 105,4 days. All patients were treated with heart failure therapies. In all patient we obtain a significant recovery of LV function with significant reduction of SD LVEDD and increase of ejection fraction more than 45%. One patient was discharged home and is waiting for vad removal. In 2 patients the vad was removed and the mean follow up after removal was 120 ± 63,3 days. No acute episode of heart failure during follow up were recorded. Infant Jarvik 2015 LVAD, the smallest pump available conceived for children, can be successfully implanted in children. The use of continuous flow intracorporeal is feasible in children and from these preliminary results seem to be effective to induce recovery in small children with dilated cardiomyopathy. These data should be validated in future trial.