VENTRICULAR ASSIST DEVICES IN PEDIATRIC CARDIAC-SURGERY

Background. Early experience in other centers with pediatric assist de vices has been favorable. Methods. Prospectively we examined our first 13 patients between January 1992 and September 1994. Results. Thirtee n children underwent ventricular assistance at Royal Alexandra Hospita l for Children. Age ranged from 4 days to 30 months, weight from 2.9 k g to 17 kg. Ventricular assistance was employed from 1.5 hours to 190 hours. Of 12 surgical patients, 8 required left ventricular assistance to be weaned from cardiopulmonary bypass after correction of congenit al defects, and 4 required support in the postoperative period for ref ractory low cardiac output. A child was supported after a kick to the chest by a horse caused cardiogenic shock. All 13 patients initially r esponded to ventricular assistance and 7 remain alive. Of the deaths, 2 were neurologic, 2 due to myocardial failure, and 2 to sepsis. The m ajor complications in the first days were hemorrhage and tamponade. La ter problems included thrombosis of the circuit despite systemic hepar inization, and a cannula-related tear to the anterior mitral leaflet. The 7 survivors are well after 3 to 32 months. Conclusions. Despite th e mortality and complications, we are encouraged by these results, in the light of almost certain death for all 13 patients without ventricu lar assistance.