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Pneumatic paracorporeal ventricular assist device as bridge to transplant in children ≤ 20 kg: Krakow experience

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Indian Journal of Thoracic and Cardiovascular Surgery Aims and scope Submit manuscript

Abstract

Purpose

Pulsatile mechanical ventricular assist devices (VADs) of various designs and functional principles have been in use in adult patients for long-term support of the failing heart. Despite the remarkable advances with the use of VAD, its support in children is still limited. We report on our experience in the paediatric population. The aim is either recovery of the heart or, more often, to keep the patient alive until later transplantation.

Methods

We retrospectively study of children ≤ 20 kg, who were mechanically bridged to heart transplantation using the Berlin Heart (BH) Excor VAD at our hospital. The period of review was from November 2009 to March 2017.

Results

A total eight patients were included in this analysis, with these patients weighing < 20 kg. The study included three boys and five girls, with a mean weight of 10.55 kg (5.30–20 kg) and mean age of 20.69 months (4.5 to 60 months). Eight patients were supported with the Berlin Excor VAD, and six patients were supported with a left-sided ventricular assist device (LVAD) and two patients were supported with biventricular assist device (BVAD). Three of eight patients (38%) have been successfully bridged to heart transplant.

Conclusions

Insertion of pulsatile paracorporeal VADs in children with end-stage heart failure is an effective strategy as a bridge to heart transplantation. This study demonstrates VAD support had serious ceribrovascular complications, and implantation BVAD support results were not satisfactory.

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Funding

There was no grant or other funding obtained for this work.

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Authors and Affiliations

  1. Department of Pediatric Cardiac Surgery, Jagiellonian University Children’s Hospital, Krakow, Poland

    Vivek Rai, Marcin Gładki, Mirosława Dudyńska, Jarosz Jery, Tomasz Mroczek, Jacek Kołcz & Janusz Skalski

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  1. Vivek Rai
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  2. Marcin Gładki
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  3. Mirosława Dudyńska
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  4. Jarosz Jery
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  5. Tomasz Mroczek
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  7. Janusz Skalski
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Correspondence to Vivek Rai.

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Ethical approval

For retrospective studies ‘For this type of study formal consent is not required.’

According to the Polish law, approval from the Ethics Committee was not required for retrospective data analysis, since this kind of study did not violate human rights. All parents of those children provided written informed consent for device implantation.

Conflict of interest

The authors declare that they have no conflicts of interest.

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Rai, V., Gładki, M., Dudyńska, M. et al. Pneumatic paracorporeal ventricular assist device as bridge to transplant in children ≤ 20 kg: Krakow experience. Indian J Thorac Cardiovasc Surg 34, 19–24 (2018). https://doi.org/10.1007/s12055-017-0583-1

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  • DOI: https://doi.org/10.1007/s12055-017-0583-1

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