Use of extracorporeal life support in patients with congenital heart disease.
OBJECTIVE
To review a large experience with extracorporeal life support in patients with congenital heart disease. To determine the major causes of mortality and morbidity in order to improve the results of using this technology in this patient population.


METHODS
Retrospective chart review.


METHODS
Twenty-five patients between the ages of 1 day and 8 yrs. These patients had congenital heart disease and were clinically felt to be at high risk for death caused by cardiac failure or by respiratory failure complicated by congenital heart disease.


METHODS
All patients in this report were placed on extracorporeal life support to allow recovery of myocardial or pulmonary function.


RESULTS
Of these 25 patients, 52% were weaned from bypass support and 40% survived to discharge. Patients who were not weaned from extracorporeal life support characteristically suffered from irreversible neurologic injury, multiple organ failure, or bleeding complications. Only one patient died of irreversible cardiac failure.


CONCLUSIONS
Extracorporeal life support can be useful in supporting patients with congenital heart disease with life-threatening cardiac or pulmonary failure. Improvements in limiting neurologic and bleeding complications may lead to improvements in the use of extracorporeal life support for this indication. However, prospective, randomized studies are needed to appreciate the role of extracorporeal life support in these patients.
Delius
R E
RE
Department of Surgery, University of Michigan Medical Center, Ann Arbor 48109-0331.
Bove
E L
EL
Meliones
J N
JN
Custer
J R
JR
Moler
F W
FW
Crowley
D
D
Amirikia
A
A
Behrendt
D M
DM
Bartlett
R H
RH
D002648:Child; D002675:Child, Preschool; D004868:Equipment Failure; D015199:Extracorporeal Membrane Oxygenation / Q000009:adverse effects / Q000295:instrumentation / Q000706:statistics & numerical data; D005260:Female; D006330:Heart Defects, Congenital / Q000150:complications / Q000401:mortality / Q000628:therapy*; D006470:Hemorrhage / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008020:Life Support Care / Q000379:methods / Q000706:statistics & numerical data; D008021:Life Support Systems / Q000706:statistics & numerical data; D008297:Male; D008824:Michigan; D009422:Nervous System Diseases / Q000453:epidemiology / Q000209:etiology; D012189:Retrospective Studies; D013673:Technology Assessment, Biomedical; D015300:Ventilator Weaning / Q000401:mortality / Q000706:statistics & numerical data