The first successful use of the Levitronix PediMag ventricular support device as a biventricular bridge to transplant in an infant.

摘要

Continuous improvements in the outcomes for children undergoing heart transplant have increased the number of neonates and infants listed for transplant. The number of available donor organs remains static, however, increasing the need for bridging to transplant. Recent enthusiasm for mechanical ventricular assistance in this age group has disclosed significant challenges with respect to adequate anticoagula-tion and consequent thrombotic or bleeding complications during the course of device support.1"2 We report here the first successful use of the Levitronix PediMag ventricular assist device (Levitronix, LLC Waltham, Mass) both as biventricular support as a bridge to transplant, and also for extracorporeal membrane oxygenation (ECMO) after transplant. This circuit is particularly attractive because of its small priming volume, ease of use, ready availability, and flexibility of application. In this setting, we endorse the use of a limited circuit length, of heparin-coated tubing and connectors, and of a simplified circuit in an effort to reduce the likelihood of thrombotic events.