Original Article

Ventricular Assist in the Infant

Sharp Memorial Hospital, UCSD Medical Center, Cardiovascular Perfusion, Inc., San Diego, CA

^* Address correspondence to: Susan C. Ratty, Cardiovascular Perfusion, Inc., 7910 Frost St., Suite 204, San Diego, CA 92123

Abstract

Two cases are described in which the Bio-Medicus centrifugal pump is used to support ventricular failure post CPB in the infant patient. The first patient (5 kg) was diagnosed with anomalous left coronary artery and pre-operative myocardial infarction. This patient required left ventricular assist support for 70 hours following surgical repair and failure to wean from CPB. The second patient (5 kg) presented 12 days status post mustard procedure with post operative ECMO support, for resuscitative CPB following an acute cardiac arrest incident. The patient could not be weaned from CPB with adequate cardiac output and required systemic ventricular support for 24 hours. Both patients were cannulated from left atrium to ascending aorta. The circuit consisted of 1/4" tubing an electromagnetic flow probe, and a pediatric bio-pump head connected to the Bio-Medicus centrifugal pump. High flows and minimal anticoagulation were maintained and both patients were successfully weaned from the left ventricular assist device. The text will describe the details of perfusion management and patient outcomes. We conclude that ventricular assist is a viable adjunct to the care of infants unable to be weaned from CPB.