Mechanical ventricular circulatory support in children; Bad Oeynhausen experience.
BACKGROUND
Recently various mechanical circulatory support systems are being used all over the world, nevertheless the size of the devices limits the implantation in pediatric cases. Accordingly we report our experiences with assist devices applied for pediatric patients.


METHODS
Twenty-nine children underwent mechanical circulatory support implantation operation. The diagnoses of preoperation were dilated cardiomyopathy in 16, congenital heart disease in 12 and allograft dysfunction in 1.


RESULTS
From November 1987 to January 2004 we implanted 7 LVAD, 11 BVAD and 11 ECMO in pediatric patients. The 29 patients were supported from 11 to 231 days (mean 32.3 days). Three children were supported by Thoratec LVAD. Biventricular Thoratec VAD was used in 3 children. Three children were supported by Medos-HIA system LVAD, and 8 children by biventricular VAD using the Medos-HIA system. One child was supported by Novacor LVAD. Fourteen children were supported by ECMO. We succeeded in heart transplantation in 10 cases, but lost 16 children during the support. Bleeding occurred in 7 cases, thrombosis occurred in 6 cases, infection occurred in 8 cases, pneumothorax occurred in 3 cases and neurological deficit occurred in 2 cases.


CONCLUSIONS
The development of assist device for children which has long durability and small in size as a future subject is desired. Further clinical and experimental research and application of those assist devices for children are in progress.
Minami
Kazutomo
K
Department of Thoracic and Cardiovascular Surgery, Heart and Diabetes Center North Rhine-Westphalia, Ruhr University of Bochum, Bad Oeynhausen, Germany.
Knyphausen
Edzard von
Ev
Suzuki
Ryusuke
R
Blanz
Ute
U
Arusoglu
Latif
L
Morshuis
Michael
M
El-Banayosy
Aly
A
Körfer
Reiner
R
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D015199:Extracorporeal Membrane Oxygenation / Q000009:adverse effects / Q000295:instrumentation; D005260:Female; D016027:Heart Transplantation; D006353:Heart-Assist Devices / Q000009:adverse effects; D006801:Humans; D007223:Infant; D008297:Male; D019736:Prostheses and Implants; D014850:Waiting Lists