title: Long-term paracorporeal ventricular support systems: a single-center experience.
abstract: BACKGROUND
  The Berlin Heart EXCOR is a first-generation paracorporeal, pneumatic ventricular assist device that creates pulsatile flow. It can be used for long-term support of the left and/or right ventricule during end-stage heart failure. The aim of this study was to share our clinical experience in 54 patients.
  
  
  METHODS
  Between April 2007 and August 2012, 54 patients with end-stage heart failure underwent Berlin Heart EXCOR ventricular assist device implantation, including 5 females and 9 children. Twenty-four patients (44%) were in Intermacs level 1, 11 (21%) in level 2, and 19 (35%) in level 3. Biventricular support was applied to 13 patients. Device implantation was performed with an "on pump" beating heart technique while 6 other patients underwent intervention operations while the aortic valve has under cross-clamp. Tricuspid annuloplasty was performed in 6 patients.
  
  
  RESULTS
  There was no peroperative death. Nine patients (17%) underwent re-exploration because of hemorrhage in the early postoperative period. Heart transplantation was performed in 32 patients (59%), while 10 (19%) are still under pump support with a mean follow-up of 13 months. Although 1 was successfully weaned from the system, 11 patients (20%) died during the support. Pump-head exchange was required 19 times in 17 patients because of visible thrombus or fibrin deposit in the pump head or due to membrane rupture.
  
  
  CONCLUSIONS
  The use of long-term paracorporeal assist devices has decreased in recent years because of the increased popularity of implantable devices that permit longer survival and a better quality of life. We believe that the Berlin Heart EXCOR has a special role because it can be used in pediatric patients and especially in critical conditions like Intermacs levels 1 and 2.
authors.affiliation: Departments of Cardiovascular Surgery and Cardiology, Ege University Medical Faculty, Izmir, Turkey.
authors.forename: M
authors.initials: M
authors.lastname: Ozbaran
authors.forename: T
authors.initials: T
authors.lastname: Yagdi
authors.forename: C
authors.initials: C
authors.lastname: Engin
authors.forename: S
authors.initials: S
authors.lastname: Erkul
authors.forename: O
authors.initials: O
authors.lastname: Balcioglu
authors.forename: B
authors.initials: B
authors.lastname: Baysal
authors.forename: S
authors.initials: S
authors.lastname: Nalbantgil
authors.forename: S
authors.initials: S
authors.lastname: Ertugay
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D006353:Heart-Assist Devices / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007362:Intensive Care Units; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D055815:Young Adult