Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Schrempf, J.
Erfahrungen mit dem Berlin Heart Excor als biventrikuläres Herzunterstützungssystem im Kindesalter
[ Diplomarbeit ] Medical University of Graz; 2013. pp. 66
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- Autor*innen der Med Uni Graz:
- Betreuer*innen:
- Knez Igor
- Schweiger Martin
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- Abstract:
- Background. In children diagnosed with chronic cardiomyopathy (CMP) mechanical circulatory support (MCS) plays an increasingly important role, especially because the shortage of suitable donor hearts leads to increased waiting times on the transplant waiting-list. We report our experiences with the paracorporal Berlin Heart EXCOR® (Berlin Heart AG, Berlin, Germany) used as biventricuclar assist device (BVAD). Method. Between 2006 and 2012 9 BVAD Excors were implanted at the Medical University Graz; 4 of them in children (6a, 14a, 14a, 17a, all of them male). Underlying diseases were: postcardiotomy failure n:1, dilatative cardiomyopathy n:2, heart failure of unknown origin n:1. The analysis was done retrospectively, exclusion criteria have been defined as age over 18 years, LVADs and non Excor BVADs. Results. 30 day mortality was 25% (n:1, hemorrhage), another child died after 84 days on BVAD support because of brain hemorrhage (INR 5.5; T-ASS). Mean duration time of BVAD support were 223.75 days (4 days, 84 days, 262 days, 545 days). In two children pump head replacement was needed because of thrombus formation: after 109 days (left chamber) and after 185 days (right chamber). One patient had a fractional rupture of the membrane surface of the right chamber that required pump head exchange after 298 days. Further severe complications in the long-term course were two drive-line infections, which required i.v. antibiosis, as well as recurring epistaxis in three children, treated conservatively. Two children were successfully transplanted. Waiting time on high urgent list was: 480 and 242 days. Both were discharged successfully. Follow up time is 1.9 (715days) and 2.3 (850days) years after HTX. Discussion. The occurrence of frequent complications, like thrombus formation and hemorrhage complications as well as drive-line infections should be reduced in order to enhance quality of life and survival after BVAD implantation.