title: Mechanical cardiac support in the young with the Berlin Heart EXCOR pulsatile ventricular assist device: 15 years' experience.
abstract: The pediatric-size pneumatically driven pulsatile extracorporeal ventricular assist device (VAD) Berlin Heart EXCOR (Berlin Heart Mediprodukt GmbH, Berlin, Germany) was introduced into clinical practice by the German Heart Institute Berlin in 1992. Until July 1, 2005, Berlin Heart EXCOR systems have been used for circulatory support in 68 children up to 18 years of age with severe circulatory failure resistant to pharmacologic therapy. These were patients suffering from cardiomyopathy, fulminant myocarditis, end-stage congenital cardiac defects, and acute heart failure following congenital heart surgery. Mean VAD support time was 35 days (range, 0 to 420 days). Forty-two patients (62%) survived to transplantation or after weaning; 37 patients (54%), including eight infants, were discharged home. These results in patients with very advanced disease have improved significantly in recent years because of technical developments and growing experience in the treatment of patients on the device, in postoperative care and optimal timing for VAD implantation. Timely implantation of the Berlin Heart EXCOR in the course of progressive heart failure now appears to be justified because the system has undergone the necessary modifications and the accumulation of clinical knowledge has made its use highly reliable and safe.
authors.affiliation: Deutsches Herzzentrum, Berlin, Germany.
authors.forename: Roland
authors.initials: R
authors.lastname: Hetzer
authors.forename: Vladimir
authors.initials: V
authors.lastname: Alexi-Meskishvili
authors.forename: Yuguo
authors.initials: Y
authors.lastname: Weng
authors.forename: Michael
authors.initials: M
authors.lastname: Hübler
authors.forename: Evgenij
authors.initials: E
authors.lastname: Potapov
authors.forename: Thorsten
authors.initials: T
authors.lastname: Drews
authors.forename: Ewald
authors.initials: E
authors.lastname: Hennig
authors.forename: Friedrich
authors.initials: F
authors.lastname: Kaufmann
authors.forename: Brigitte
authors.initials: B
authors.lastname: Stiller
mesh_terms: D000293:Adolescent; D000925:Anticoagulants / Q000627:therapeutic use; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D009202:Cardiomyopathies / Q000150:complications; D002648:Child; D002675:Child, Preschool; D020878:Device Removal; D005260:Female; D006330:Heart Defects, Congenital / Q000150:complications; D006331:Heart Diseases / Q000150:complications*; D006333:Heart Failure / Q000209:etiology / Q000601:surgery*; D016027:Heart Transplantation; D006353:Heart-Assist Devices; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009205:Myocarditis / Q000150:complications; D011182:Postoperative Care; D011183:Postoperative Complications; D011673:Pulsatile Flow; D012770:Shock, Cardiogenic / Q000209:etiology / Q000601:surgery*
chemical_list: D000925:Anticoagulants