Kanaya Tomomitsu, Ueno Takayoshi, Taira Masaki, Kido Takashi, Okuda Naoki, Araki Kanta, Watanabe Takuji, Toda Koichi, Kuratani Toru, Sawa Yoshiki
Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine, Suita, Japan.
Osaka University, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.
Pediatr Cardiol. 2019 Aug;40(6):1126-1133. doi: 10.1007/s00246-019-02108-0. Epub 2019 May 24.
Berlin Heart EXCOR® (BHE) ventricular assist device (VAD) (Berlin Heart, Berlin Heart AG, Berlin, Germany) implantation is prevalent in patients with severe heart failure. However, clinical outcomes of pediatric patients on long-term BHE support remain mainly unknown. This study aimed to report our clinical experience with long-term support of pediatric patients with severe heart failure supported by BHE VAD. Clinical outcomes of 11 patients (median age 8.4 months; two male), who underwent LVAD implantation of the Berlin Heart EXCO® (BHE) VAD (Berlin Heart, Berlin Heart AG, Berlin, Germany) between 2013 and 2017 at our institution were reviewed. The median support period was 312 (range 45-661) days and five patients were supported for more than 1 year. The longest support duration was 661 days. No mortality occurred, and six patients were successfully bridged to heart transplantation, while three patients were successfully weaned off the device. Two patients are currently on BHE support while they await heart transplantation. Four patients had cerebral bleeding or infarction, but only one case of persistent neurological deficit occurred. No fatal device-related infection occurred during LVAD support. BHE VAD can provide long-term support for pediatric patients with severe heart failure with acceptable mortality and morbidity rates with long-term support.
柏林心脏EXCOR®(BHE)心室辅助装置(VAD)(德国柏林的柏林心脏公司)植入术在重度心力衰竭患者中很常见。然而,长期接受BHE支持的儿科患者的临床结局仍主要未知。本研究旨在报告我们对接受BHE VAD支持的重度心力衰竭儿科患者进行长期支持的临床经验。回顾了2013年至2017年在我们机构接受柏林心脏EXCO®(BHE)VAD(德国柏林的柏林心脏公司)左心室辅助装置植入术的11例患者(中位年龄8.4个月;2例男性)的临床结局。中位支持时间为312天(范围45 - 661天),5例患者接受支持超过1年。最长支持时间为661天。无死亡发生,6例患者成功过渡到心脏移植,3例患者成功撤机。2例患者目前在等待心脏移植期间接受BHE支持。4例患者发生脑出血或梗死,但仅1例出现持续性神经功能缺损。左心室辅助装置支持期间未发生与装置相关的致命感染。BHE VAD可为重度心力衰竭儿科患者提供长期支持,长期支持下的死亡率和发病率可接受。