The use of Berlin Heart EXCOR VAD in children less than 10kg: a single center experience
Objective: Despite the improvement in ventricular assist device (VAD) therapy in adults and in adolescents, in infant population only Berlin Heart EXCOR (BHE) is licensed as long term VAD to bridge children to Heart Transplantation (HTx). Particularly demanding in terms of morbidity and mortality ar...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2016-12-01
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| Series: | Frontiers in Physiology |
| Subjects: | |
| Online Access: | http://journal.frontiersin.org/Journal/10.3389/fphys.2016.00614/full |
| _version_ | 1819206643532955648 |
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| author | Arianna Di Molfetta Fabrizio Gandolfo Sergio Filippelli Gianluigi Perri Luca Di Chiara Roberta Iacobelli Rachele Adorisio Isabella Favia Alessandra Rizza Giuseppina Testa Matteo Di Nardo Antonio Amodeo |
| author_facet | Arianna Di Molfetta Fabrizio Gandolfo Sergio Filippelli Gianluigi Perri Luca Di Chiara Roberta Iacobelli Rachele Adorisio Isabella Favia Alessandra Rizza Giuseppina Testa Matteo Di Nardo Antonio Amodeo |
| author_sort | Arianna Di Molfetta |
| collection | DOAJ |
| description | Objective: Despite the improvement in ventricular assist device (VAD) therapy in adults and in adolescents, in infant population only Berlin Heart EXCOR (BHE) is licensed as long term VAD to bridge children to Heart Transplantation (HTx). Particularly demanding in terms of morbidity and mortality are smallest patients namely the ones implanted in the first year of life or with a lower body surface area. This work aims at retrospective reviewing a single centre experience in using BHE in children with a body weight under 10kg. Methods: Data of all pediatric patients under 10kg undergoing BHE implantation in our institution from March 2002 to March 2016 were retrospectively reviewed Results: Of the 30 patients enrolled in the study, 53% were male, 87% were affected by a dilated cardiomyopathy with an average weight and age at the implantation of 6.75±2.16Kg and 11.57±10.12 months, respectively. Three patients (10%) required a BIVAD implantation. After the implantation, 7 patients (23%) required re-intervention for bleeding and 9 patients (30%) experienced BHE cannulas infection. A total of 56 BHE pump were changed for thrombus formation (1.86 BHE pump for patient). The average duration of VAD support was 132.8±94.4 days. Twenty patients (67%) were successfully transplanted and 10 patients (33%) died: 7 for major neurological complication and 3 for sepsis. Conclusion: Mechanical support in smaller children with end stage heart failure is an effective strategy for bridging patients to HTx. The need for BIVAD was relegated, in the last years, only to restrictive cardiomiopathy. Further efforts are required in small infants to improve anticoagulation strategy to reduce neurological events and BHE pump changes. |
| first_indexed | 2024-12-23T05:10:52Z |
| format | Article |
| id | doaj.art-cfaa79c6e0004ee6afbd865a29d1dbda |
| institution | Directory Open Access Journal |
| issn | 1664-042X |
| language | English |
| last_indexed | 2024-12-23T05:10:52Z |
| publishDate | 2016-12-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Physiology |
| spelling | doaj.art-cfaa79c6e0004ee6afbd865a29d1dbda2022-12-21T17:58:58ZengFrontiers Media S.A.Frontiers in Physiology1664-042X2016-12-01710.3389/fphys.2016.00614227530The use of Berlin Heart EXCOR VAD in children less than 10kg: a single center experienceArianna Di Molfetta0Fabrizio Gandolfo1Sergio Filippelli2Gianluigi Perri3Luca Di Chiara4Roberta Iacobelli5Rachele Adorisio6Isabella Favia7Alessandra Rizza8Giuseppina Testa9Matteo Di Nardo10Antonio Amodeo11Pediatric Hospital Bambino GesùPediatric Hospital Bambino GesùPediatric Hospital Bambino GesùPediatric Hospital Bambino GesùPediatric Hospital Bambino GesùPediatric Hospital Bambino GesùPediatric Hospital Bambino GesùPediatric Hospital Bambino GesùPediatric Hospital Bambino GesùPediatric Hospital Bambino GesùPediatric Hospital Bambino Gesù,Pediatric Hospital Bambino GesùObjective: Despite the improvement in ventricular assist device (VAD) therapy in adults and in adolescents, in infant population only Berlin Heart EXCOR (BHE) is licensed as long term VAD to bridge children to Heart Transplantation (HTx). Particularly demanding in terms of morbidity and mortality are smallest patients namely the ones implanted in the first year of life or with a lower body surface area. This work aims at retrospective reviewing a single centre experience in using BHE in children with a body weight under 10kg. Methods: Data of all pediatric patients under 10kg undergoing BHE implantation in our institution from March 2002 to March 2016 were retrospectively reviewed Results: Of the 30 patients enrolled in the study, 53% were male, 87% were affected by a dilated cardiomyopathy with an average weight and age at the implantation of 6.75±2.16Kg and 11.57±10.12 months, respectively. Three patients (10%) required a BIVAD implantation. After the implantation, 7 patients (23%) required re-intervention for bleeding and 9 patients (30%) experienced BHE cannulas infection. A total of 56 BHE pump were changed for thrombus formation (1.86 BHE pump for patient). The average duration of VAD support was 132.8±94.4 days. Twenty patients (67%) were successfully transplanted and 10 patients (33%) died: 7 for major neurological complication and 3 for sepsis. Conclusion: Mechanical support in smaller children with end stage heart failure is an effective strategy for bridging patients to HTx. The need for BIVAD was relegated, in the last years, only to restrictive cardiomiopathy. Further efforts are required in small infants to improve anticoagulation strategy to reduce neurological events and BHE pump changes.http://journal.frontiersin.org/Journal/10.3389/fphys.2016.00614/fullPediatric heart failureBerlin HeartPediatric VADLow weight LVADSurvival on pediatric LVAD |
| spellingShingle | Arianna Di Molfetta Fabrizio Gandolfo Sergio Filippelli Gianluigi Perri Luca Di Chiara Roberta Iacobelli Rachele Adorisio Isabella Favia Alessandra Rizza Giuseppina Testa Matteo Di Nardo Antonio Amodeo The use of Berlin Heart EXCOR VAD in children less than 10kg: a single center experience Frontiers in Physiology Pediatric heart failure Berlin Heart Pediatric VAD Low weight LVAD Survival on pediatric LVAD |
| title | The use of Berlin Heart EXCOR VAD in children less than 10kg: a single center experience |
| title_full | The use of Berlin Heart EXCOR VAD in children less than 10kg: a single center experience |
| title_fullStr | The use of Berlin Heart EXCOR VAD in children less than 10kg: a single center experience |
| title_full_unstemmed | The use of Berlin Heart EXCOR VAD in children less than 10kg: a single center experience |
| title_short | The use of Berlin Heart EXCOR VAD in children less than 10kg: a single center experience |
| title_sort | use of berlin heart excor vad in children less than 10kg a single center experience |
| topic | Pediatric heart failure Berlin Heart Pediatric VAD Low weight LVAD Survival on pediatric LVAD |
| url | http://journal.frontiersin.org/Journal/10.3389/fphys.2016.00614/full |
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