title: Mechanical circulatory support in pediatric patients with the MEDOS assist device.
abstract: 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.
authors.affiliation: Department Cardiac Surgery, University Hospital Grosshadern, Ludwig-Maximilians-University, Munich, Germany.
authors.forename: Ingo
authors.initials: I
authors.lastname: Kaczmarek
authors.forename: Joerg
authors.initials: J
authors.lastname: Sachweh
authors.forename: Jan
authors.initials: J
authors.lastname: Groetzner
authors.forename: Helmut
authors.initials: H
authors.lastname: Gulbins
authors.forename: Helmut
authors.initials: H
authors.lastname: Mair
authors.forename: Kozlik-Feldmann
authors.initials: KF
authors.lastname: Rainer
authors.forename: Stefanie
authors.initials: S
authors.lastname: Zysk
authors.forename: Bruno
authors.initials: B
authors.lastname: Reichart
authors.forename: Sabine
authors.initials: S
authors.lastname: Daebritz
mesh_terms: 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