Clinical Experience With Berlin Heart Excor in Pediatric Patients in Argentina: 1373 days of Cardiac Support
Clinical Experience With Berlin Heart Excor in Pediatric Patients in Argentina: 1373 days of Cardiac Support
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Berlin Heart Excor 在阿根廷儿科患者中的临床经验：1373 天的心脏支持
DOI：
10.1007/s00246-011-9949-0
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发表时间：
2011
影响因子：
1.6
通讯作者：
H. Vogelfang
中科院分区：
文献类型：
--
作者：
G. Moreno;A. Charroqui;M. L. Pilan;R. Magliola;Mariela Krynski;M. Althabe;L. Landry;G. Sciuccati;A. Villa;H. Vogelfang
本研究的目的是描述我们使用柏林心脏Excor（BH）心室辅助装置（VAD）作为终末期心肌病儿科患者心脏移植的桥接的经验（1373天的支持）。本研究涉及一个回顾性观察队列。审查了BH VAD支持的患者记录。收集有关年龄、性别、体重、诊断、术前状况、单心室与双心室支持、发病率和死亡率的数据。登记了单心室与双心室支持和重症监护室管理的标准。该程序得到了我们的机构伦理委员会的批准，并获得了知情同意书。2006年3月至2010年3月，12例诊断为扩张型（n = 10）和限制型（n = 2）心肌病的患者得到了支持。中位年龄为56.6个月（范围20.1-165.9）;平均体重为18.3 kg（范围8.5-45）; 9例患者为女性。所有患者均表现为药物治疗无效的严重心力衰竭。4例患者需要双心室支持。9例患者接受了心脏移植。没有儿童因为心肌恢复而停用BH VAD。平均支持时间为73天（范围3-331天），支持总天数为1 373天。3例患者出现致命性并发症：2例血栓性出血性卒中导致脑死亡，1例出现难治性血管麻痹性休克。BH VAD是治疗终末期心力衰竭患儿心脏移植桥接的一种有效、合理、安全的装置。团队经验导致发病率和死亡率降低，植入时间、外科手术、抗凝监测和患者护理得到改善。
The objective of this study was to describe our experience (1373 days of support) with the Berlin Heart Excor (BH) ventricular-assist device (VAD) as bridging to cardiac transplantation in pediatric patients with end-stage cardiomyopathy. This study involved a retrospective observational cohort. Records of patients supported with the BH VAD were reviewed. Data regarding age, sex, weight, diagnosis, preoperative condition, single versus biventricular support, morbidity, and mortality were collected. Criteria for single versus biventricular support and intensive care unit management were registered. The procedure was approved by our Institutional Ethics Committee, and informed consent was obtained. Between March 2006 and March 2010, 12 patients with diagnosis of dilated (n = 10) and restrictive (n = 2) cardiomyopathy were supported. Median age was 56.6 months (range 20.1–165.9); mean weight was 18.3 kg (range 8.5–45); and nine patients were female. Every patient presented with severe heart failure refractory to pharmacological therapy. Biventricular support was necessary in four patients. Nine patients underwent heart transplantation. No child was weaned off the BH VAD because of myocardial recovery. Mean length of support was 73 days (range 3–331), and the total number of days of support was 1373. Three patients had fatal complications: 2 had thrombo-hemorrhagic stroke leading to brain death, and one had refractory vasoplegic shock. The BH VAD is a useful and reasonable safe device for cardiac transplantation bridging in children with end-stage heart failure. Team experience resulted in less morbidity and mortality, and time for implantation, surgical procedure, anticoagulation monitoring, and patient care improved.