title: Long-Term Mechanical Circulatory Support in Pediatric Patients.
abstract: This retrospective study reviews our results regarding the long-term support in pediatric patients using two ventricular assist systems between January 2008 and April 2014. We implanted the Berlin Heart EXCOR in 29 patients (median age 3.4 years [interquartile range (IQR) 0.2-16.5], median weight 13 kg [IQR 4.2-67.2]). Twenty-two patients (75.8%) received a left ventricular assist device. Three patients (10.3%) had single-ventricle physiology. One patient (3.4%) had mechanical mitral valve prosthesis. The HeartWare System was implanted in nine patients. The median age was 15.6 years (IQR 12.2-17.9), and the median weight was 54.9 kg (IQR 27.7-66). In the Berlin Heart group, the median support time was 65 days (IQR 4-619), with 3647 days of cardiac support. Nineteen patients (65.5%) were transplanted, six patients (20.7%) recovered, one patient (3.4%) is on support, and three patients (10.3%) died on support. Survival rate was 89.7%. Fourteen blood pumps had been exchanged. Four patients (13.8%) had local signs of infection, and three patients (10.3%) had neurological complications. In the HeartWare group, the median support time was 180 days (IQR 1-1124), with 2839 days of cardiac support. Four patients (44.4%) had local signs of infection, and three (33.3%) had neurological complications. Eight patients (88.9%) have been transplanted, and one patient (11.1%) died on support. Survival rate was 88.9%. Excellent survival is possible after long-term mechanical circulatory support in patients with two- and single-ventricle physiology with a low rate of adverse events.
authors.affiliation: Department of Surgery for Congenital Heart Defects, Heart and Diabetes Centre NRW, Bad Oeynhausen, Germany.
authors.forename: Eugen
authors.initials: E
authors.lastname: Sandica
authors.affiliation: Department of Surgery for Congenital Heart Defects, Heart and Diabetes Centre NRW, Bad Oeynhausen, Germany.
authors.forename: Ute
authors.initials: U
authors.lastname: Blanz
authors.affiliation: Department of Surgery for Congenital Heart Defects, Heart and Diabetes Centre NRW, Bad Oeynhausen, Germany.
authors.forename: Lotfi Ben
authors.initials: LB
authors.lastname: Mime
authors.affiliation: Department of Surgery for Congenital Heart Defects, Heart and Diabetes Centre NRW, Bad Oeynhausen, Germany.
authors.forename: Ursula
authors.initials: U
authors.lastname: Schultz-Kaizler
authors.affiliation: Department of Paediatric Cardiology and Congenital Heart Defects, Heart and Diabetes Centre NRW, Bad Oeynhausen, Germany.
authors.forename: Deniz
authors.initials: D
authors.lastname: Kececioglu
authors.affiliation: Department of Paediatric Cardiology and Congenital Heart Defects, Heart and Diabetes Centre NRW, Bad Oeynhausen, Germany.
authors.forename: Nikolaus
authors.initials: N
authors.lastname: Haas
authors.affiliation: Department of Paediatric Cardiology and Congenital Heart Defects, Heart and Diabetes Centre NRW, Bad Oeynhausen, Germany.
authors.forename: Guenther
authors.initials: G
authors.lastname: Kirchner
authors.affiliation: Department of Paediatric Cardiology and Congenital Heart Defects, Heart and Diabetes Centre NRW, Bad Oeynhausen, Germany.
authors.forename: Edzard
authors.initials: E
authors.lastname: zu Knyphausen
authors.affiliation: Department of Thoracic and Cardiac Surgery, Heart and Diabetes Centre NRW, Bad Oeynhausen, Germany.
authors.forename: Volker
authors.initials: V
authors.lastname: Lauenroth
authors.affiliation: Department of Thoracic and Cardiac Surgery, Heart and Diabetes Centre NRW, Bad Oeynhausen, Germany.
authors.forename: Michiel
authors.initials: M
authors.lastname: Morshuis
mesh_terms: D000293:Adolescent; D000925:Anticoagulants / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D005260:Female; D006353:Heart-Assist Devices / Q000009:adverse effects; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D007223:Infant; D008297:Male; D019919:Prosthesis Implantation / Q000009:adverse effects; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D000925:Anticoagulants; D006493:Heparin
keywords: Destination therapy; Heart transplantation; Pediatric; Ventricular assist device