Ishino K, Loebe M, Uhlemann F, Weng Y, Hennig E, Hetzer R
Department of Thoracic and Cardiovascular Surgery, German Heart Institute, Berlin.
Eur J Cardiothorac Surg. 1997 May;11(5):965-72. doi: 10.1016/s1010-7940(97)01149-4.
The feasibility and efficacy of the pneumatic 'Berlin Heart' ventricular assist device (VAD) were evaluated in 14 pediatric patients with profound cardiogenic shock refractory to conventional therapy.
There were two patient groups. Eleven patients, aged 2 weeks 15 years and weighing 3.2-52 kg received a left ventricular assist device or a biventricular assist device as a bridge to cardiac transplantation (bridge group). Nine of them had liver, kidney, or lung dysfunction before device implantation. Three patients were supported with a biventricular assist device for myocardial recovery (recovery group): a 6-month-old girl for postcardiotomy shock, a 10-month-old girl for allograft failure after cardiac transplantation, and a 4-year-old boy with acute myocarditis.
In the bridge group, eight patients were transplanted after a bridge duration of 6-98 days (mean, 32 days) with five long-term survivors. Organ functions were normalized during bridging in all of the transplant recipients. In the recovery group, the first patient was removed from support after 2 days because of irreversible brain damage. The second patient was weaned from biventricular support after 8 days, but suffered from recurrent allograft failure. The third patient received biventricular support for 21 days followed by extracorporeal membrane oxygenation and was subsequently discharged from the hospital.
The 'Berlin Heart' VAD can keep selected infants and children with life-threatening heart failure for weeks or months.
评估气动“柏林心脏”心室辅助装置（VAD）在14例对传统治疗无效的严重心源性休克儿科患者中的可行性和疗效。
患者分为两组。11例年龄为2周至15岁、体重3.2至52千克的患者接受左心室辅助装置或双心室辅助装置作为心脏移植的过渡（过渡组）。其中9例在装置植入前存在肝、肾或肺功能障碍。3例患者接受双心室辅助装置以促进心肌恢复（恢复组）：一名6个月大的女孩用于心脏切开术后休克，一名10个月大的女孩用于心脏移植后同种异体移植失败，一名4岁男孩患有急性心肌炎。
在过渡组中，8例患者在过渡6至98天（平均32天）后接受了移植，5例长期存活。所有移植受者在过渡期间器官功能均恢复正常。在恢复组中，第一名患者因不可逆性脑损伤在2天后撤除支持。第二名患者在8天后撤离双心室支持，但出现同种异体移植反复失败。第三名患者接受双心室支持21天，随后接受体外膜肺氧合，随后出院。
“柏林心脏”VAD可使选定的患有危及生命的心力衰竭的婴幼儿维持数周或数月。
