Mechanical circulatory support in infants and adults with the MEDOS/HIA assist device.
Mechanical circulatory support is successfully applied to patients with low cardiac output. The MEDOS/HIA-System provides pulsatile ventricular assistance for pediatric and adult patients. Our experience with 13 consecutive patients with the MEDOS is reported. Perioperative survival was 84.6%, complications occurred in 61% (31% thrombembolism, 23% rethoracotomy, 7% infections). Mean duration of support was 17.6 +/- 14.6 days (1-45 days). Bilirubin decreased from 3.9 +/- 2.3 to 2.7 +/- 1.6 mg/dL; creatinine from 1.6 +/- 1 to 1.4 +/- 0.8 mg/dL; lactate from 5.8 +/- 4.2 to 1.7 +/- 1.5 (P = 0.027; Wilcoxon). All patients who underwent subsequent heart transplantation (6 of 13; 46%) were discharged from hospital. For 38.5% of the patients no organ offer was received. Mechanical circulatory support with the MEDOS/HIA-System can be performed successfully for bridging to transplantation. Secondary organ functions improve under this pulsatile circulatory assistance. Hemorrhage and thromboembolic events are the most frequent complications.
Kaczmarek
Ingo
I
Department of Cardiac Surgery, University Hospital Grasshadern, Ludwig-Maximilians-University, Munich, Germany. ingo.kaczmarek@med.uni-muenchen.de
Mair
Helmut
H
Groetzner
Jan
J
Sachweh
Joerg
J
Oberhoffer
Martin
M
Fuchs
Alexandra
A
Reichart
Bruno
B
Daebritz
Sabine
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D001663:Bilirubin / Q000032:analysis; D002648:Child; D002675:Child, Preschool; D003404:Creatinine / Q000032:analysis; D005260:Female; D006333:Heart Failure / Q000401:mortality / Q000628:therapy*; D016027:Heart Transplantation; D006353:Heart-Assist Devices; D006801:Humans; D007223:Infant; D019344:Lactic Acid / Q000032:analysis; D008297:Male; D008875:Middle Aged; D016019:Survival Analysis
D019344:Lactic Acid; D003404:Creatinine; D001663:Bilirubin