CIRCULATORY SUPPORT WITH PARACORPOREAL PNEUMATIC VENTRICULAR ASSIST DEVICE (VAD) IN INFANTS AND CHILDREN

Objective: The feasibility and efficacy of the pneumatic 'Berlin Heart ' ventricular assist device (VAD) were evaluated in 14 pediatric patie nts with profound cardiogenic shock refractory to conventional therapy . Methods: There were two patient groups. Eleven patients, aged 2 week s-15 years and weighing 3.2-52 kg received a left ventricular assist d evice or a biventricular assist device as a bridge to cardiac transpla ntation (bridge group). Nine of them had liver, kidney, or lung dysfun ction 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. Results: In the bridge group, eight patients w ere 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, t he first patient was removed from support after 2 days because of irre versible brain damage. The second patient was weaned from biventricula r 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 discharge d from the hospital. Conclusions: The 'Berlin Heart' VAD can keep sele cted infants and children with life-threatening heart failure for week s or months. (C) 1997 Elsevier Science B.V.