日本小児循環器学会雑誌 Pediatric Cardiology and Cardiac Surgery

The three major types of assisted circulation for severe heart failure in children are as follows: (1) extracorporeal membrane oxygenation (ECMO), (2) extracorporeal ventricular assist device, and (3) implantable ventricular assist device. Of these, ECMO is generally limited to approximately 1 month of assistance, whereas the ventricular assist device can be used for a longer term. The EXCOR® Pediatric external ventricular assist device can be used in neonates weighing as little as 3 kg and is primarily used as a bridge to heart transplantation. In some cases, an implantable artificial heart is indicated for relatively large children, so they can be discharged from the hospital and go back to school. In Japan, very few heart transplants have been conducted for congenital heart disease, with less than 10 cases by 2022, and approximately 4% of the patients are on the waiting list. In the future, the demand for artificial hearts and transplants for congenital heart disease is expected to increase, requiring treatment strategies for these diseases.