Experience with Temporary Centrifugal Pump Bi-ventricular Assist Device for Pediatric Acute Heart Failure: Comparison with ECMO

Autor: Gi Beom Kim, Jooncheol Min, Hye Won Kwon, Jeong Ryul Lee, Jae Gun Kwak, Jae Hong Lim, Eun Jung Bae, Woong Han Kim, Mi Kyung Song
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Cardiomyopathy
Dilated
Male
medicine.medical_specialty
Myocarditis
medicine.medical_treatment
030204 cardiovascular system & hematology
03 medical and health sciences
0302 clinical medicine
Extracorporeal Membrane Oxygenation
parasitic diseases
medicine
Humans
Respiratory function
cardiovascular diseases
Child
Retrospective Studies
Heart transplantation
Pediatric
Heart Failure
business.industry
Infant
Dilated cardiomyopathy
medicine.disease
Cardiac surgery
Surgery
Transplantation
surgical procedures
operative
Treatment Outcome
030228 respiratory system
Ventricular assist device
Heart failure
Child
Preschool
Pediatrics
Perinatology and Child Health
Heart Transplantation
Original Article
Female
Heart-Assist Devices
biological phenomena
cell phenomena
and immunity
Cardiology and Cardiovascular Medicine
business
Zdroj: Pediatric Cardiology
ISSN: 1432-1971
0172-0643
Popis: Though ventricular assist devices (VADs) are an important treatment option for acute heart failure, an extracorporeal membrane oxygenator (ECMO) is usually used in pediatric patients for several reasons. However, a temporary centrifugal pump-based Bi-VAD might have clinical advantages versus ECMO or implantable VADs. From January 2000 to July 2018, we retrospectively reviewed 36 pediatric patients who required mechanical circulatory support (MCS) for acute heart failure. Cases with postoperative MCS were excluded. Since 2016, we have tried to immediately add a right VAD rather than ECMO, when the patients begin to present features of right heart failure after left VAD support started in cases that the patients’ respiratory function did not require an oxygenator. Original diagnoses included dilated cardiomyopathy (n = 18), myocarditis (n = 11), and others (n = 7). Eleven patients were supported by Bi-VAD, and 25 patients were supported by ECMO; of these. Four patients were successfully weaned from VAD, and 10 patients were weaned from ECMO. Eleven patients underwent heart transplantation. Overall, we have 15 (41.7%) early mortalities. There were no significant differences in early mortality, morbidity, and weaning rate between the Bi-VAD group and the ECMO group. During the support, patients with Bi-VADs significantly required fewer platelets and showed less hemolysis than ECMO patients. Patients with myocarditis were successfully weaned from Bi-VAD support and bridged to transplantation thereafter. A temporary centrifugal pump-based Bi-VAD was clinically comparable to ECMO for pediatric patients with acceptable pulmonary function.
Databáze: OpenAIRE
Externí odkaz: