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When a donor heart is not available during the end stage of heart failure, the implantation of a ventricular assist device is the only therapeutic alternative. Many such devices are designed to provide circulatory support to adults, but very few are available for children and infants, especially in the United States. In children, implantation of ventricular assist devices that are designed for adults carries a high risk of complications, because the low stroke volumes that must be used can result in inadequate pump washout and excessive thromboembolic risk. Herein, we report the case of an 11-year-old boy with congenital heart defects who experienced acute myocardial infarction. Prolonged support with the Berlin Heart excor Pediatric ventricular assist device served as a bridge to recovery. The period after device implantation was challenging, because of the need for prolonged inotropic support, continuous mechanical ventilation, the number of reoperations, and the occurrence of sepsis. Nevertheless, after 29 days, the patient's heart recovered, and the device was explanted. He was discharged from the hospital, in good condition, 30 days after removal of the excor device.

作者:Alexander, Tschirkov;Dimitar, Nikolov;Vassil, Papantchev

来源:Texas Heart Institute journal 2007 年 34卷 4期

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作者:
Alexander, Tschirkov;Dimitar, Nikolov;Vassil, Papantchev
来源:
Texas Heart Institute journal 2007 年 34卷 4期
标签:
Assisted circulation/methods child circulatory assist devices device removal equipment design heart failure heart-assist devices myocardial infarction/complications postoperative complications prosthesis design treatment outcome ventricular dysfunction, left/therapy
When a donor heart is not available during the end stage of heart failure, the implantation of a ventricular assist device is the only therapeutic alternative. Many such devices are designed to provide circulatory support to adults, but very few are available for children and infants, especially in the United States. In children, implantation of ventricular assist devices that are designed for adults carries a high risk of complications, because the low stroke volumes that must be used can result in inadequate pump washout and excessive thromboembolic risk. Herein, we report the case of an 11-year-old boy with congenital heart defects who experienced acute myocardial infarction. Prolonged support with the Berlin Heart excor Pediatric ventricular assist device served as a bridge to recovery. The period after device implantation was challenging, because of the need for prolonged inotropic support, continuous mechanical ventilation, the number of reoperations, and the occurrence of sepsis. Nevertheless, after 29 days, the patient's heart recovered, and the device was explanted. He was discharged from the hospital, in good condition, 30 days after removal of the excor device.