Korean J Thorac Cardiovasc Surg.  2000 May;33(5):385-390.

Postcardiotomy Mechanical Circulatory Support in Congenital Heart Diseases

• Kwon OC
• Lee YT

Abstract

BACKGROUND: To review the experience that used both ventricular assist device(VAD) and extracorporeal membrane oxygenation(ECMO) for children with congential heart disease requiring postcardiotomy mechanical circulatory support. MATERIAL AND METHOD: Between March 1993 and May 1995, we applied mechanical assist device using centrifugal pump to the 16 patients who failed to be weaned from cardiopulmonary bypass(n=15) or had been in cardiogenic shock in intensive care unit(n=1). The diagnosis were all congenital heart diseases and the ages of patients ranged from 20 days to 10 years (mean age=2.5+/-3.5 years). RESULT: The methods of mechanical circulatory support were LVAD(n=13), BVAD (n=1), and ECMO(n=2). The mean assist times were 54.0+/-23.7 hours. Post-assist complications were in orders: bleeding, acute renal failure, ventricular failure, respiratory failure, infection, and neurologic complication. It was possible for 9 patients(56.3%) to be weaned from assist device and 5 patients(31.3%) were discharged from hospital. There was no statistical significant between hospital discharged group and undischarged group by age, body weight, cardiopulmonary bypass time, and assist time.
CONCLUSIONS
The ventricular assist device is an effective modality in salvaging the patient who failed to be weaned from cardiopulmonary bypass, but multiple factors must be considered for improving the results of mechanical circulatory support ; such as patient selection, optimal time of starting the assist device, and prevention and management of the complications.

Keyword

Heart Assist device; Extracorporeal Membrane Oxygenation; Congenital Heart Disease

MeSH Terms

Acute Kidney Injury
Body Weight
Cardiopulmonary Bypass
Child
Diagnosis
Extracorporeal Membrane Oxygenation
Heart Defects, Congenital
Heart Diseases*
Heart*
Heart-Assist Devices
Hemorrhage
Humans
Critical Care
Membranes
Patient Selection
Respiratory Insufficiency
Shock, Cardiogenic