ABSTRACT
CASE: An 8-year-old girl was diagnosed with osteosarcoma of the distal femur. She underwent chemotherapy and wide resection with implantation of a noninvasive electromagnetic expandable distal femur prosthesis. Ninety-three days after chemotherapy, she developed anthracycline-induced cardiomyopathy with heart failure for which a ventricular assist device was placed. Device compatibility was tested, and she was successfully lengthened. CONCLUSION: Expandable prostheses allow limb length maintenance in skeletally immature patients who undergo limb salvage. Chemotherapy for osteosarcoma involves anthracyclines with a dose-dependent side effect of cardiotoxicity. Patients can be successfully and safely lengthened with expandable electromagnetic prostheses with in situ ventricular assist devices.
Subject(s)
Bone Neoplasms , Heart-Assist Devices , Bone Neoplasms/surgery , Child , Electromagnetic Phenomena , Female , Heart-Assist Devices/adverse effects , Humans , Prosthesis Design , Prosthesis ImplantationABSTRACT
We report a 6-year-old with single ventricle physiology secondary to tricuspid atresia who had cardiorespiratory failure who was not a candidate for further single ventricle palliation. The patient underwent planned staged left pneumonectomy for recurrent pneumonias secondary to bronchomalacia followed by orthotopic heart transplantation. This aggressive approach improved the patient candidacy for heart transplantation by removing the source of recurrent infection and respiratory failure (left lung).
Subject(s)
Heart Failure , Heart Transplantation , Univentricular Heart , Child , Heart Transplantation/adverse effects , Heart Ventricles/diagnostic imaging , Heart Ventricles/surgery , Humans , Pneumonectomy/adverse effectsABSTRACT
HeartMate III is an emerging, small-sized centrifugal ventricular assist device. Its lower pump thrombosis and stroke rates make it favorable for use in pediatrics. We report the use of HeartMate III as a bridge to transplantation in an adolescent with failed Fontan circulation. (Level of Difficulty: Advanced.).