Neonatal mechanical bridging to total orthotopic heart transplantation.
BACKGROUND
Until recently, newborns with medically intractable cardiac failure caused by congenital malformations were mostly doomed to death because of the severity of the disease, which precludes a palliative operation, or because of fatal deterioration before availability of a suitable donor heart.


METHODS
The recently developed paracorporeal pneumatically driven Medos HIA ventricular assist device offers a therapeutic option for these small infants because it is manufactured in various sizes and is even suitable for cardiac assistance in neonates with a body surface area less than 0.3 m2.


RESULTS
We report our initial experience with this device, which we used for univentricular bridging to total orthotopic cardiac transplantation in 3 infants. The device was inserted to support the left ventricle in two instances and to support the right heart in one. Successful bridging to transplantation was achieved in 2 infants for periods of 2 and 7 weeks.


CONCLUSIONS
Our experience demonstrates the feasibility of univentricular mechanical support followed by successful cardiac transplantation in infants and newborns.
Weyand
M
M
Department of Cardiothoracic Surgery, Westfalian Wilhelms University, Münster, Germany.
Kececioglu
D
D
Kehl
H G
HG
Schmid
C
C
Loick
H M
HM
Vogt
J
J
Scheld
H H
HH
D001024:Aortic Valve Stenosis / Q000151:congenital; D004437:Ebstein Anomaly / Q000601:surgery; D004695:Endocardial Fibroelastosis / Q000601:surgery; D006330:Heart Defects, Congenital / Q000601:surgery / Q000628:therapy*; D016027:Heart Transplantation; D006353:Heart-Assist Devices; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D013997:Time Factors