Outcomes of congenital heart surgery patients after extracorporeal life support at Texas Children's Hospital.
The objective of this study was to investigate the outcomes of children with heart failure of various etiologies requiring temporary use of currently available technology in the U.S.A. after extracorporeal life support (ECLS) [left ventricular assist device (LVAD) or extracorporeal membrane oxygenation (ECMO)] at Texas Children's Hospital. Between July of 1995 and October of 2002, 2847 patients underwent congenital heart surgical repairs with the aid of cardiopulmonary bypass at Texas Children's Hospital. During this period, 17 patients required chronic mechanical circulatory assistance with Biomedicus centrifugal pump (n=8) or Thoratec LVAD (n=4), and ECMO (n=5). Six out of 17 patients required ECLS for postcardiotomy heart failure. Seven of the 17 patients had congenital heart disease, six had cardiomyopathy, three had late acute rejection following heart transplantation, and one had myocardial infarction. Twelve patients survived and five patients expired. Six of 12 survivors recovered sufficient cardiac function to allow device removal; and the remaining six patients underwent heart transplantation. Three out of five deaths were ECMO patients. The need for ECLS following repair of congenital heart disease is extremely rare in our institution. The requirement for the use of ECMO confers a significantly higher mortality presumably because of associated combined cardiopulmonary failure. Congenital heart disease appears to be associated with significantly higher mortality.
Undar
Akif
A
Congenital Heart Surgery Service, Texas Children's Hospital, Houston, TX, USA. aundar@psu.edu
McKenzie
E Dean
ED
McGarry
Mary C
MC
Owens
W Richard
WR
Surprise
Deborah L
DL
Kilpack
Vicki D
VD
Mueller
Maryann W
MW
Stayer
Stephen A
SA
Andropoulos
Dean B
DB
Towbin
Jeffrey A
JA
Fraser
Charles D
CD
D000293:Adolescent; D000328:Adult; D002315:Cardiopulmonary Bypass; D002648:Child; D002675:Child, Preschool; D015199:Extracorporeal Membrane Oxygenation; D006330:Heart Defects, Congenital / Q000401:mortality / Q000601:surgery* / Q000628:therapy; D006353:Heart-Assist Devices; D006776:Hospitals, Pediatric; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015996:Survival Rate; D013781:Texas; D016896:Treatment Outcome