European Journal of Cardio-Thoracic Surgery, Vol 11, 965-972, Copyright © 1997 by European Association for Cardio-thoracic Surgery
Circulatory support with paracorporeal pneumatic ventricular assist device (VAD) in infants and children
K Ishino, M Loebe, F Uhlemann, Y Weng, E Hennig and R Hetzer
Department of Thoracic and Cardiovascular Surgery, German Heart Institute, Berlin.
OBJECTIVE: The feasibility and efficacy of the pneumatic 'Berlin Heart'
ventricular assist device (VAD) were evaluated in 14 pediatric patients
with profound cardiogenic shock refractory to conventional therapy.
METHODS: There were two patient groups. Eleven patients, aged 2 weeks 15
years and weighing 3.2-52 kg received a left ventricular assist device or a
biventricular assist device as a bridge to cardiac transplantation (bridge
group). Nine of them had liver, kidney, or lung dysfunction before device
implantation. Three patients were supported with a biventricular assist
device for myocardial recovery (recovery group): a 6-month-old girl for
postcardiotomy shock, a 10-month-old girl for allograft failure after
cardiac transplantation, and a 4-year- old boy with acute myocarditis.
RESULTS: In the bridge group, eight patients were transplanted after a
bridge duration of 6-98 days (mean, 32 days) with five long-term survivors.
Organ functions were normalized during bridging in all of the transplant
recipients. In the recovery group, the first patient was removed from
support after 2 days because of irreversible brain damage. The second
patient was weaned from biventricular support after 8 days, but suffered
from recurrent allograft failure. The third patient received biventricular
support for 21 days followed by extracorporeal membrane oxygenation and was
subsequently discharged from the hospital. CONCLUSIONS: The 'Berlin Heart'
VAD can keep selected infants and children with life-threatening heart
failure for weeks or months.
