Fouilloux Virginie, El Louali Fedoua, Gran Célia, Henaine Roland, Roubertie François, Chenu Caroline, Fiorini Marion, Le Bel Stéphane, Mauriat Philippe, Neidecker Jean, Macé Loïc, Kreitmann Bernard, Ovaert Caroline
Department of Paediatric and Congenital Cardiac Surgery, Timone Hospital, Marseille, France; Faculty of Medicine, Aix-Marseille University, Marseille, France.
Department of Paediatric and Congenital Cardiology, Timone Hospital, Marseille, France.
Heart Lung Circ. 2021 Apr;30(4):585-591. doi: 10.1016/j.hlc.2020.08.012. Epub 2020 Sep 21.
Berlin Heart EXCOR (BH) ventricular assist devices provide mechanical long-term circulatory support in children with end-stage heart failure, as a bridge to transplantation or to recovery. Most studies are from large-volume paediatric cardiac centres.
The aim of this study was to analyse the experiences of three French centres and to compare these with available published data.
We performed a retrospective observational study of three paediatric cardiac intensive care units. All children supported with BH devices were included. Morbidity and mortality data were collected and risk factors analysed.
Fifty-four (54) patients (54% male) were included. Survival rate was 73% while on a BH device. Median age at BH device implantation was 17 months (range 2-180 months). The predominant indication was dilated cardiomyopathy (61%). Bi-ventricular assist device was used in 25 (46%) cases. The total length of long-term circulatory support was 3,373 days, with a mean length per patient of 62.5 days (range 5-267 days). Thirty-two (32) patients were transplanted (59%) and seven (13%) were successfully weaned. Type and length of support did not influence morbidity. Main complications were renal dysfunction (57%), bleeding (41%), and infection (39%). In multivariate analysis, a weight <5 kg was significantly associated with higher mortality.
The weight seems to be the most important risk factor of mortality in this precarious condition.
柏林心脏EXCOR（BH）心室辅助装置为终末期心力衰竭儿童提供长期机械循环支持，作为移植或恢复的桥梁。大多数研究来自大型儿科心脏中心。
本研究的目的是分析三个法国中心的经验，并与现有已发表数据进行比较。
我们对三个儿科心脏重症监护病房进行了一项回顾性观察研究。纳入所有接受BH装置支持的儿童。收集发病率和死亡率数据并分析危险因素。
纳入54例患者（54%为男性）。使用BH装置期间的生存率为73%。BH装置植入时的中位年龄为17个月（范围2 - 180个月）。主要适应证为扩张型心肌病（61%）。25例（46%）使用双心室辅助装置。长期循环支持的总时长为3373天，每位患者的平均时长为62.5天（范围5 - 267天）。32例（59%）患者接受了移植，7例（13%）成功撤机。支持类型和时长不影响发病率。主要并发症为肾功能不全（57%）、出血（41%）和感染（39%）。多因素分析显示，体重<5 kg与较高死亡率显著相关。
在这种危急情况下，体重似乎是最重要的死亡危险因素。
