Mechanical circulatory support for adolescent patients: the Ottawa Heart Institute experience.

摘要

BACKGROUND: Mechanical circulatory support devices may be used for patients with end-stage heart failure for bridging either to cardiac transplant or to recovery of the native heart. While less common in adolescents, fulminant heart failure may be rapidly fatal in these patients unless circulatory support can be instituted. OBJECTIVES: To assess the outcomes and the utility of mechanical circulatory assist devices for children. METHODS: A retrospective review of pediatric patients (18 years of age or younger) who underwent circulatory support at the Ottawa Heart Institute, Ottawa, Ontario, from 1992 to 2001 was performed using chart audits. RESULTS: Seven patients (four boys, three girls) with a mean age of 14.9 +/- 0.9 years were supported with Thoratec ventricular assist devices (n=6) or a CardioWest total artificial heart (n=1). Preoperatively, the cardiac index was 1.64 +/- 0.2 L/min/m2 on one or two inotropes with ejection fractions of 11 +/- 2.2%. Mean duration of circulatory support was 59.3 +/-17.2 days with a hospital length of stay of 89.6 +/- 12.8 days. All seven patients underwent successful transplantation and were discharged home. CONCLUSIONS: Pediatric patients with fulminant heart failure may be bridged to cardiac transplant successfully with mechanical circulatory support devices.