Early Experience in Mechanical Cardiac Support as Bridge to Transplant in Pediatrics

  • Dr Horacio Vogelfang, Hospital de Pediatria"J.P.Garrahan"-Buenos Aires-Argentina, Argentina
  • Dr Gerardo Naiman, Hospital de Pediatria"J.P.Garrahan"-Buenos Aires-Argentina, Argentina
  • Dra Alejandra Villa, Hospital de Pediatria"J.P.Garrahan"-Buenos Aires-Argentina, Argentina
  • Dr Alberto Charroqui, Hospital de Pediatria"J.P.Garrahan"-Buenos Aires-Argentina, Argentina
  • Dr Guillermo Moreno, Hospital de Pediatria"J.P.Garrahan"-Buenos Aires-Argentina, Argentina
  • Dr Luis Quiroga, Hospital de Pediatria"J.P.Garrahan"-Buenos Aires-Argentina, Argentina
  • Tec Estela Carmona, Hospital de Pediatria"J.P.Garrahan"-Buenos Aires-Argentina, Argentina
  • Lic Maria de la Riba, Hospital de Pediatria"J.P.Garrahan"-Buenos Aires-Argentina, Argentina

    • Objetive: To describe the experience using a pulsatile electropneumatic assist device (Excor Berlin Heart ®) as bridge to transplantation.
    Methods: Since march 2006 till agoust 2008, 6 children had been supported. Age range: 31 to 126 months. Weight range: 10 to 31 kg.
    Results:Case I: 71 month, male, 19 kg. Dilated Cardiomyophaty with end stage cardiac dysfunction; no response to inotropes infusion; mechanical respiratory support. After biventricular device implant early improvement of systemic functions. Extubation 48 hs. after. Assistance:14 days. Transplantated.
    Case II: 31 month, female, 11 kg. Restrictive Cardiomyophaty and Systemic Pulmonary Hypertension. Severe heart failure. Biventricular Assistance. Extubation 72 hs after. Pulmonary Hypertension levels after 45 days: 50%. Assistance: 264 days. Transplantated.
    Case III: 56 month, female, 11 kg. Dilated Cardiomyophaty. Severe left ventricle dysfunction. Univentricular assistance. Extubated 10 days after. Assistance:147 days. Endochraneal bleeding.
    Case IV: 126 month, female, 31 kg. Dilated Cardiomyophaty. Severe left ventricle dysfunction. Univentricular assistance. Extubated 24 hs after. Assistance:70 days. Endochraneal bleeding.
    Case V: 46 month, female, 10 kg. Dilated Cardiomyophaty. Severe heart function deterioration; mechanical respiratory support. Univentricular assistance. Extubated 24 hs after. Assistance: 246 days. Transplantated.
    Case VI: 48 month, male, 18 kg. Dilated Cardiomyophaty. Severe left ventricle dysfunction. Univentricular assistance. Extubated 3 days after. Assistance: 96 days. Transplantated.
    Conclusions: Pulsatile electropneumatic assist device system seems to be a satisfactory device for bridging to transplantation infants and children in desperate heart failure condition. Decision for implantation in those early stage experience will largely depends on each institutional criteria.