Mechanical circulatory support in pediatric cardiomyopathy

Mechanical circulatory support (MCS) plays a critical role in the support of children with a failing heart. The last three decades have witnessed a remarkable advance in the science of MCS for children. Over 20% of children undergoing heart transplantation receive some form of mechanical support while on the wait list. Extracorporeal membrane oxygenation (ECMO) provides comprehensive cardiac and pulmonary support, but is limited by a vexing pro-inflammatory and thrombogenic cascade after days or weeks of support. Ventricular assist devices on the other hand can provide durable support for as long as a year. MCS continues to evolve with smaller devices and the use of more biocompatible materials.