CLINICAL-EXPERIENCE WITH THE MEDOS HIA-VAD SYSTEM IN INFANTS AND CHILDREN - A PRELIMINARY-REPORT

Background. The need of pediatric cardiac assist is growing because of the complexity of the congenital conditions operated on and the incre asing number of pediatric transplantations. We evaluated the newly dev eloped pediatric MEDOS HIA-VAD ventricular assist device. Methods. The pneumatic paracorporeal ventricular assist device has three left vent ricular sizes (10-, 25-, and 60-mL maximum stroke volume) and three ri ght ventricular sizes (9, 22.5, and 54 mL) and can be operated effecti vely with up to 180 cycles/min. We used this device in 6 consecutive p ediatric patients. Intention of treatment was to bridge to transplanta tion in 3 patients and to aid in recovery from a cardiac operation in 3. Age ranged from 5 days to 8 years. Results. Two children died durin g assist, 2 were weaned from the system and discharged home, and 2 had successful transplantation. During assist, laboratory variables indic ative of impaired renal, hepatic, or pulmonary function normalized or showed a trend toward normalization. Both deaths were related to infec tion. Conclusions. With the new MEDOS HIA-VAD ventricular assist devic e system, pediatric mechanical cardiac assist can be performed success fully. It requires timely implantation, careful monitoring, and adequa te size-matched devices. (C) 1997 by The Society of Thoracic Surgeons.