Issue |
J Extra Corpor Technol
Volume 35, Number 2, June 2003
|
|
---|---|---|
Page(s) | 115 - 120 | |
DOI | https://doi.org/10.1051/ject/2003352115 | |
Published online | 11 August 2023 |
Original Articles
Pulsatile Mechanical Cardiac Assistance in Pediatric Patients with the Berlin Heart Ventricular Assist Device
1
Academy for Perfusion, Deutsches Herzzentrum Berlin, Germany
2
Department of Thoracic and Cardiovascular Surgery, Deutsches Herzzentrum Berlin, Germany
3
Department of Pediatric Cardiology, Deutsches Herzzentrum Berlin, Germany
* Address correspondence to: Frank Merkle, ECCP, Deutsches Herzzentrum Berlin, Academy for Perfusion, Augustenburger Platz 1, 13353 Berlin, Germany. E-mail: merkle@dhzb.de
Received:
21
March
2002
Accepted:
2
December
2002
Mechanical cardiac assistance for neonates, infants, children and adolescents may be accomplished with pulsatile ventricular assist devices (VAD) instead of extracorporeal membrane oxygenation or centrifugal pumps. The Berlin Heart VAD consists of extracorporeal, pneumatically driven blood pumps for pulsatile univentricular or biventricular assistance for patients of all age groups. The blood pumps are heparin-coated. The stationary driving unit (IKUS) has the required enhanced compressor performance for pediatric pump sizes. The Berlin Heart VAD was used in a total number of 424 patients from 1987 to November 2001 at our institution. In 45 pediatric patients aged 2 days–17 years the Berlin Heart VAD was applied for long-term support (1–111 days, mean 20 days). There were three patient groups: Group I: "Bridge to transplantation" with various forms of cardiomyopathy (N = 21) or chronic stages of congenital heart disease (N = 9); Group II: "Rescue" in intractable heart failure after corrective surgery for congenital disease (N = 7) or in early graft failure after heart transplantation (N = 1); and Group III: “Acute myocarditis” (N = 7) as either bridge to transplantation or bridge to recovery. Seventeen patients were transplanted after support periods of between 4 and 111 days with 12 long-term survivors, having now survived for up to 10 years. Five patients (Groups I and III) were weaned from the system with four long-term survivors. In Group II only one patient survived after successful transplantation. Prolonged circulatory support with the Berlin Heart VAD is an effective method for bridging until cardiac recovery or transplantation in the pediatric age group. Extubation, mobilization, and enteral nutrition are possible. For long-term use, the Berlin Heart VAD offers advantages over centrifugal pumps and ECMO in respect to patient mobility and safety.
Key words: ventricular assist device / pediatric heart surgery / mechanical cardiac assistance / pulsatile cardiac assist
© 2003 AMSECT
Current usage metrics show cumulative count of Article Views (full-text article views including HTML views, PDF and ePub downloads, according to the available data) and Abstracts Views on Vision4Press platform.
Data correspond to usage on the plateform after 2015. The current usage metrics is available 48-96 hours after online publication and is updated daily on week days.
Initial download of the metrics may take a while.