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| Single Center Experience in Treatment of Cardiogenic Shock of any Etiology in Children by Pediatric Ventricular Assist Devices | |
Roland Hetzer, Evgenij V. Potapov, Oliver Miera, Yu-Guo Weng, Michael Hübler, Felix Berger; DHZB, Berlin, Germany
Methods: Since 1990 and as of October 1, 2008, 95 pediatric Berlin Heart Excor systems have been implanted in patients below 18 years of age at our institution. The patients were divided into two groups according to the period of treatment: period I - devices implanted between 1990 and 2002 (n=45) and period II - devices implanted since 2002 (n=50). We compared our experience during the earlier and later periods. Results: There were no significant differences in the preoperative patient data between the two periods except for time of support (median 10, range 0-111 days vs. 37, range 1-420 days, p<0.001). In period I more patients were supported with a biventricular VAD (64% vs. 26%, p<0.001). In period II more children were extubated on the VAD (38% vs. 62%, p=0.018). Discharge from hospital following either weaning from the system or heart transplantation was achieved in 49% in period I and in 70% in period II (p=0.035). Whereas in period I 8% of children younger than 1 year old were discharged home, in period II it increased to 44% (p= 0.088). There was a significant improvement in the discharge rate in period II in patients with postcardiotomy heart failure (17% vs. 80% p=0.028). Conclusion: Earlier implantation of VAD, substantial modifications in cannula and pump design, improvement in anticoagulation and the coagulation monitoring regime have led to a significant increase in the survival and discharge rate, especially in children under 1 year of age. Now, the pediatric Berlin Heart Excor VAD is an established treatment for children suffering from cardiogenic shock of any etiology. Back to 2009 Annual Meeting Back to Program Outline Back to Main Program |
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