Mechanical circulatory support in pediatric patients with the MEDOS assist device.
Mechanical circulatory support is successfully applied to patients with low cardiac output. The MEDOS-System provides pulsatile ventricular assistance for patients of all age groups, including neonates. We report our experience with seven consecutive pediatric patients with the MEDOS-VAD. The indication was bridge to transplantation in all patients. Mean age was 7.3 +/- 6.5 years (range 0.75-16.9 years) and mean weight was 26.3 +/- 21.7 kg (range 5.9-60 kg). Perioperative survival was 100%; complications occurred in six patients (86%; two cerebral embolism/bleeding, two rethoracotomy, two exchange of pump chamber due to thrombus formation after 4 and 9 days). Mean duration of support was 20.4 +/- 10.8 days (range 6-38 days). Bilirubin decreased from 3.5 +/- 2.6 mg/d to 2.1 +/- 1.2 mg/d. Hospital mortality was three of seven patients who did not receive an organ offer in time. All patients who underwent subsequent heart transplantation (four of seven patients; 57%) were discharged from the hospital. Mechanical circulatory support with the MEDOS-System can be performed successfully in pediatric patients of any age. Secondary organ functions improve under this pulsatile circulatory assistance. Hemorrhage and thromboembolic events are the most frequent complications.
Kaczmarek
Ingo
I
Department Cardiac Surgery, University Hospital Grosshadern, Ludwig-Maximilians-University, Munich, Germany.
Sachweh
Joerg
J
Groetzner
Jan
J
Gulbins
Helmut
H
Mair
Helmut
H
Rainer
Kozlik-Feldmann
KF
Zysk
Stefanie
S
Reichart
Bruno
B
Daebritz
Sabine
S
D000293:Adolescent; D002303:Cardiac Output, Low / Q000628:therapy; D009202:Cardiomyopathies / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D005858:Germany; D016027:Heart Transplantation; D006353:Heart-Assist Devices / Q000009:adverse effects; D017052:Hospital Mortality; D006801:Humans; D007223:Infant; D008297:Male; D019563:Mechanics; D009205:Myocarditis / Q000628:therapy; D011183:Postoperative Complications; D012086:Reoperation / Q000401:mortality / Q000706:statistics & numerical data; D012189:Retrospective Studies; D015996:Survival Rate; D013923:Thromboembolism / Q000209:etiology; D013997:Time Factors; D016896:Treatment Outcome