title: First pediatric transatlantic air ambulance transportation on a Berlin Heart EXCOR left ventricular assist device as a bridge to transplantation.
abstract: BACKGROUND
  Mechanical circulatory devices are indicated in patients with refractory cardiac failure as a bridge to recovery or to transplantation. Whenever required, transportation while on mechanical support is a challenge and still limited by technical restrictions or distance.
  
  
  METHODS
  We report the first pediatric case of transatlantic air transportation on a Berlin Heart EXCOR ventricular assist device (Berlin Heart, Berlin, Germany) of a 13-yr-old American female who presented in cardiogenic shock with severe systolic dysfunction while vacationing in France. Rapid hemodynamic deterioration occurred despite maximal medical treatment, and she was supported initially with extracorporeal membrane oxygenation converted to a Berlin Heart EXCOR left ventricular assist device. Long-distance air transportation of the patient was accomplished 3 wks after implantation from Marseille, France, to Denver, Colorado. No adverse hemodynamic effects were encountered during the 13.5-hr flight (8770 km). The patient did not recover sufficient cardiac function and underwent successful orthotopic heart transplantation 3 months after the initial event.
  
  
  CONCLUSIONS
  Our experience suggests that long-distance air transportation of pediatric patients using the Berlin Heart EXCOR mobile unit as a bridge to recovery or transplantation is feasible and appears safe.
authors.affiliation: The Children's Hospital, The Heart Institute, Denver, CO, USA. cecile.tissot@hotmail.com
authors.forename: Cecile
authors.initials: C
authors.lastname: Tissot
authors.forename: Holger
authors.initials: H
authors.lastname: Buchholz
authors.forename: Max B
authors.initials: MB
authors.lastname: Mitchell
authors.forename: Eduardo
authors.initials: E
authors.lastname: da Cruz
authors.forename: Shelley D
authors.initials: SD
authors.lastname: Miyamoto
authors.forename: Bill A
authors.initials: BA
authors.lastname: Pietra
authors.forename: Arnaud
authors.initials: A
authors.lastname: Charpentier
authors.forename: Olivier
authors.initials: O
authors.lastname: Ghez
mesh_terms: D000293:Adolescent; D017732:Air Ambulances; D015199:Extracorporeal Membrane Oxygenation / Q000295:instrumentation*; D005260:Female; D005602:France; D016027:Heart Transplantation; D006353:Heart-Assist Devices; D006801:Humans; D038622:Internationality; D012720:Severity of Illness Index; D012770:Shock, Cardiogenic / Q000503:physiopathology; D014195:Travel; D014481:United States; D018487:Ventricular Dysfunction, Left / Q000628:therapy*