+ Resolve Article
+ Follow Us
Follow on FacebookFollow on Facebook
Follow on TwitterFollow on Twitter

+ Translate
+ Subscribe to Site Feed
GeoScience Most Shared ContentMost Shared Content

Bridging children of all sizes to cardiac transplantation: the initial multicenter North American experience with the Berlin Heart EXCOR ventricular assist device

, : Bridging children of all sizes to cardiac transplantation: the initial multicenter North American experience with the Berlin Heart EXCOR ventricular assist device. Journal of Heart and Lung Transplantation 30(1): 1-8

Beginning in 2000 and accelerating in 2004, the Berlin Heart EXCOR (Berlin Heart Inc Woodlands, TX) became the first pediatric-specific ventricular assist device (VAD) applied throughout North America for children of all sizes. This retrospective study analyzed the initial Berlin Heart EXCOR pediatric experience as a bridge to transplantation. Between June 2000 and May 2007, 97 EXCOR VADs were implanted in North America at 29 different institutions. The analysis is limited to 73 patients (75%) from 17 institutions, for which retrospective data were available. Median age and weight at VAD implant were 2.1 years (range, 12 days-17.8 years) and 11 kg (range, 3-87.6 kg), respectively. The primary diagnoses were dilated cardiomyopathy in 42 (58%), congenital heart disease in 19 (26%), myocarditis in 7 (10%), and other cardiomyopathies in 5 (7%). Pre-implant clinical condition was critical cardiogenic shock in 38 (52%), progressive decline in 33 (45%), or other in 2 (3%). Extracorporeal membrane oxygenation was used as a bridge to EXCOR in 22 patients (30%). Device selection was left VAD (LVAD) in 42 (57%) and biventricular assist devices (BiVAD) in 31 (43%). The EXCOR bridged 51 patients (70%) to transplant and 5 (7%) to recovery. Mortality on the EXCOR was 23% (n = 17) overall, including 35% (11 of 31) in BiVAD vs 14% (6 of 42) in LVAD patients (p = 0.003). Multivariate analysis showed younger age and BiVAD support were significant risk factors for death while on the EXCOR. This limited but large preliminary North American experience with the Berlin Heart EXCOR VAD as a bridge to cardiac transplantation for children of all ages and sizes points to the feasibility of this approach. The prospective investigational device evaluation trial presently underway will further characterize the safety and efficacy of the EXCOR as a bridge to pediatric cardiac transplantation.


PMID: 21145473

DOI: 10.1016/j.healun.2010.08.033

Other references

Jamieson, C.; Morosan, M.; Cameron, M., 2017: Crohn's disease: First diagnosis in pregnancy and management. This case addresses the difficulty in the initial diagnosis of severe Crohn's disease in pregnancy as well as the challenges of instituting remission therapy towards the end of second trimester. The patient's course was complicated by re...

Cazzola, G.A.; Valletta, E.A.; Mastella, G., 1989: Chronic suppurative bronchopathy and motility defect of neutrophils: evaluation of an immunomodulating treatment. Five patients with recurrent infections of the lower respiratory tract, chronic bronchial suppuration and significant defect of polymorphonuclear granulocyte (PMN) motility were studied. Clinical evaluation and in vitro studies of PMN motility wer...

Castle, W.E., 1942: Calendar Reform And The National Academy Of Sciences. Science 95(2460): 195-195

Strobino, R., 1976: Euchloe insularis Staudinger bora species, de Corse et Sardaigne. Etude comparative des especes franYaises du genre Euchloe. Entomops, 38: 203-210

Hrcek, L., 1972: Biological and technological properties of Furlanski Tokaj. The origin, distribution, biology, productivity and grape composition of this important white wine cv. are discussed.

Gibbons, D.W.; Bohan, D.A.; Rothery, P.; Stuart, R.C.; Haughton, A.J.; Scott, R.J.; Wilson, J.D.; Perry, J.N.; Clark, S.J.; Dawson, R.J.G.; Firbank, L.G., 2006: Weed seed resources for birds in fields with contrasting conventional and genetically modified herbicide-tolerant crops. The UK Farm Scale Evaluations (FSEs) have shown that the use of broad spectrum herbicides on genetically modified herbicide-tolerant (GMHT) crops can have dramatic effects on weed seed production compared to management of conventional varieties. H...

Daigeler, A.; Meyer, M.; Joneidi-Jafari, H.; Möcklinghoff, C.; Steinau, H-U.; Lehnhardt, M., 2007: Manifestations of scleroderma at the hand--options for hand surgery in an interdisciplinary concept. Clinical manifestations of scleroderma at the hand include Raynaud's phenomenon, calcinosis cutis, sclerodactylia and teleangiectasia. With the progression of the disease, cutaneous and joint contractions, acro-osteolysis, necrosis of the fin...

Ul' ko, V.N.; Semelyanskii, N.L.; Dumai, L.B.; Yanovskii, Y.S., 1977: Present and future prospects for mechanizing the unearthing of vines. Five tractor-mounted machines, designed to remove the soil with which the vines are covered for frost protection, are described and illustrated.

Mahmood, N.; Rudolf, N.D.M., 1992: Ongoing dimensional and fractal characterization of the human epileptiform EEG. Neurophysiologie Clinique 22(SUPPL 1): 125S

Day, E.Chan.; Li, Y.; Diez-Roux, A.; Kandula, N.; Moran, A.; Rosas, S.; Shlipak, M.G.; Peralta, C.A., 2011: Associations of acculturation and kidney dysfunction among Hispanics and Chinese from the Multi-Ethnic Study of Atherosclerosis (MESA). Acculturation affects health, but it has never been studied with kidney disease. We studied the association of language spoken at home, generation and birth place with kidney function among Hispanics and Chinese in the Multi-Ethnic Study of Athero...