BACKGROUND: Pediatric ventricular assist devices may be superior to extracorporeal membrane oxygenation in some respects, especially for medium- and long-term cardiac support. We present our nearly 20-year experience with pediatric ventricular assist devices. METHODS: Between 1990 and April 2009, Berlin Heart EXCOR (Berlin Heart AG, Berlin, Germany) was implanted in 94 children. Patients were compared according to period of treatment: group I, implantation between 1990 and 2001 (n = 45), and group II, implantation since 2002 (n = 49). RESULTS: Preoperative serum creatinine (1.2 vs 0.7 mg/dL, P = .002) and bilirubin (1.5 vs 1 mg/dL, P = .002) were lower in period II, and fewer patients were artificially ventilated before surgery (26 vs 13, P = .002). In period I, more patients were supported with biventricular assist devices (64% vs 22.5%, P < .001). Median time on support was shorter in period I (10 vs 40 days, P < .001). Success (weaning from system or heart transplant) was achieved in 49% and 69%, respectively (P = .043). Whereas in period I 17% of children younger than 1 year were discharged home after transplant or weaning, rate during period II was 93% (P < .001), in particular because of improvement in discharge rate of patients with postcardiotomy heart failure (13% vs 50%). Rates of pump exchange for thrombus formation were 0.029/d in period I and 0.014/d in period II (P = 0.003). CONCLUSIONS: Recent results show significant improvements in survival and discharge rate, especially for children younger than 1 year. Pediatric Berlin Heart EXCOR ventricular assist device may provide a safe mechanical support strategy in children with cardiogenic shock.
BACKGROUND: Pediatric ventricular assist devices may be superior to extracorporeal membrane oxygenation in some respects, especially for medium- and long-term cardiac support. We present our nearly 20-year experience with pediatric ventricular assist devices. METHODS: Between 1990 and April 2009, Berlin Heart EXCOR (Berlin Heart AG, Berlin, Germany) was implanted in 94 children. Patients were compared according to period of treatment: group I, implantation between 1990 and 2001 (n = 45), and group II, implantation since 2002 (n = 49). RESULTS: Preoperative serum creatinine (1.2 vs 0.7 mg/dL, P = .002) and bilirubin (1.5 vs 1 mg/dL, P = .002) were lower in period II, and fewer patients were artificially ventilated before surgery (26 vs 13, P = .002). In period I, more patients were supported with biventricular assist devices (64% vs 22.5%, P < .001). Median time on support was shorter in period I (10 vs 40 days, P < .001). Success (weaning from system or heart transplant) was achieved in 49% and 69%, respectively (P = .043). Whereas in period I 17% of children younger than 1 year were discharged home after transplant or weaning, rate during period II was 93% (P < .001), in particular because of improvement in discharge rate of patients with postcardiotomy heart failure (13% vs 50%). Rates of pump exchange for thrombus formation were 0.029/d in period I and 0.014/d in period II (P = 0.003). CONCLUSIONS: Recent results show significant improvements in survival and discharge rate, especially for children younger than 1 year. Pediatric Berlin Heart EXCOR ventricular assist device may provide a safe mechanical support strategy in children with cardiogenic shock.
Authors: Christos P Kyriakopoulos; Chris J Kapelios; Elizabeth L Stauder; Iosif Taleb; Rana Hamouche; Konstantinos Sideris; Antigone G Koliopoulou; Michael J Bonios; Stavros G Drakos Journal: J Clin Med Date: 2022-06-20 Impact factor: 4.964
Authors: Eva Maria Javier Delmo; Mariano Francisco Del Maria Javier; Dietmar Böthig; Andre Rüffer; Robert Cesnjevar; Michael Dandel; Roland Hetzer Journal: Cardiovasc Diagn Ther Date: 2021-02