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Eur J Cardiothorac Surg 2001;20:811-815
© 2001 Elsevier Science NL

Post-cardiotomy mechanical circulatory support using a conventional bypass circuit in children

Department of Cardiac Surgery, Alder Hey Children's Hospital, Eaton Road, Liverpool L12 2AP, UK

Received 31 January 2001; received in revised form 25 June 2001; accepted 26 June 2001.

Corresponding author. Tel.: +44-151-228-4811, ext. 2715; fax: +44-151-252-5643
e-mail: mpozzi75{at}hotmail.com

Objective: Mechanical circulatory support (MCS) is increasingly used after cardiotomy in children when conventional medical treatment fails. Poor overall survival and long-term outcome have been reported. We report our experience of post-cardiotomy MCS using a conventional bypass circuit. Methods: Over a 4 year and 6 month period 10 patients, with a median age of 16 days (range 5 days to 16 years) required MCS. Eight patients required support for failure to wean from cardiopulmonary bypass during primary correction. Two patients required support for cardiac arrest or poor cardiac output in the postoperative period. Results: The median duration of support was 43 h (range 26–146 h). Seven hospital survivors were alive and well at median follow-up of 18 months (range 4–36 months). One patient could not be weaned off support. Two more patients died after successful weaning from support. Complications in nine patients who could be weaned off support included renal failure (n=6), cerebrovascular events (n=3) and mediastinitis (n=2). Conclusions: Overall long-term survival (70%) and quality of recovery is usually good even though initial mortality and complication rates may be high. We think that post cardiotomy mechanical circulatory bypass using a conventional bypass circuit can offer a favourable outcome to selected patients.

Key Words: Post-cardiotomy mechanical circulatory support • Conventional bypass circuit • Children

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