Outcomes of congenital heart surgery patients after extracorporeal life support at Texas Children's Hospital.
Outcomes of congenital heart surgery patients after extracorporeal life support at Texas Children's Hospital.
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德克萨斯儿童医院先天性心脏病手术患者接受体外生命支持后的结果。
DOI：
10.1111/j.1525-1594.2004.07378.x
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发表时间：
2004
影响因子：
2.4
通讯作者：
C. Fraser
中科院分区：
文献类型：
--
作者：
A. Ündar;A. Ündar;E. McKenzie;E. Mckenzie;M. McGarry;W. R. Owens;Deborah L. Surprise;Vicki D. Kilpack;Maryann W. Mueller;S. Stayer;D. Andropoulos;J. Towbin;C. Fraser;C. Fraser
本研究的目的是调查在美国得克萨斯儿童医院接受体外生命支持 (ECLS) [左心室辅助装置 (LVAD) 或体外膜氧合 (ECMO)] 后需要暂时使用美国现有技术的各种病因心力衰竭儿童的结果。 1995年7月至2002年10月期间，德克萨斯儿童医院有2847名患者在体外循环的帮助下接受了先天性心脏病手术修复。在此期间，17 名患者需要使用 Biomedicus 离心泵 (n=8) 或 Thoratec LVAD (n=4) 和 ECMO (n=5) 进行慢性机械循环辅助。 17 名患者中有 6 名因心脏切开术后心力衰竭而需要 ECLS。 17名患者中，7名患有先天性心脏病，6名患有心肌病，3名患有心脏移植后晚期急性排斥反应，1名患有心肌梗死。十二名患者幸存，五名患者死亡。 12 名幸存者中有 6 名恢复了足够的心脏功能，可以移除装置；其余六名患者接受了心脏移植。五分之三的死亡是 ECMO 患者。在我们的机构中，先天性心脏病修复后需要 ECLS 的情况极为罕见。使用 ECMO 的要求会导致死亡率显着升高，这可能是由于相关的心肺衰竭所致。先天性心脏病似乎与显着较高的死亡率相关。
The objective of this study was to investigate the outcomes of children with heart failure of various etiologies requiring temporary use of currently available technology in the U.S.A. after extracorporeal life support (ECLS) [left ventricular assist device (LVAD) or extracorporeal membrane oxygenation (ECMO)] at Texas Children's Hospital. Between July of 1995 and October of 2002, 2847 patients underwent congenital heart surgical repairs with the aid of cardiopulmonary bypass at Texas Children's Hospital. During this period, 17 patients required chronic mechanical circulatory assistance with Biomedicus centrifugal pump (n=8) or Thoratec LVAD (n=4), and ECMO (n=5). Six out of 17 patients required ECLS for postcardiotomy heart failure. Seven of the 17 patients had congenital heart disease, six had cardiomyopathy, three had late acute rejection following heart transplantation, and one had myocardial infarction. Twelve patients survived and five patients expired. Six of 12 survivors recovered sufficient cardiac function to allow device removal; and the remaining six patients underwent heart transplantation. Three out of five deaths were ECMO patients. The need for ECLS following repair of congenital heart disease is extremely rare in our institution. The requirement for the use of ECMO confers a significantly higher mortality presumably because of associated combined cardiopulmonary failure. Congenital heart disease appears to be associated with significantly higher mortality.