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Extracorporeal circulatory support in pediatric cardiac patients — The Berlin Experience

  • Conference paper
Mechanical Circulatory Support

Abstract

The institution of extracorporeal circulatory support in the pediatric population has been limited due to the scarcity of suitable devices. Although the successful use of miniaturized intra-aortic balloon pumps in children has been reported occasionally (23, 34), providing intra-aortic balloon pump support in this cohort has been hampered by difficulties associated with inserting cannulas into small vessels and synchronizing the device to a rapid heart rate. Its efficacy has further been questioned in small children because of increased aortic compliance. Over the last decade circulatory support in pediatric surgery has most commonly been provided through extracorporeal membrane oxygenation (ECMO)(14, 17, 25, 36). The capability of ECMO to provide biventricular as well as respiratory support may be beneficial in maintaining circulation in children, especially those with congenital heart defects. Some recent reports have described the successful use of a centrifugal ventricular assist device (VAD) in children for cardiogenic shock after cardiac surgery (6, 15), for donor heart failure, and as a bridge to cardiac transplantation (26). However, the impossibility of mobilizing the patient, generating a pulseless flow, and the short durability of the components are critical disadvantages for long-term support with ECMO or centrifugal VADs.

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Authors and Affiliations

  1. Department of Cardiothoracic and Vascular Surgery, German Heart Institute Berlin, Augustenburger Platz 1, D-13353, Berlin-Buch, Germany

    V. Alexi-Meskishvili M.D., R. Hetzer, Y. Weng, K. Ishino, E. Potapov, M. Loebe, E. Hennig, F. Uhlemann & P. E. Lange

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  1. V. Alexi-Meskishvili M.D.
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  2. R. Hetzer
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  3. Y. Weng
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  4. K. Ishino
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  5. E. Potapov
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  6. M. Loebe
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  7. E. Hennig
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  8. F. Uhlemann
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  9. P. E. Lange
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  1. German Heart Institute Berlin, Augustenburger Platz 1, 13353, Berlin, Germany

    R. Hetzer , E. Hennig  & M. Loebe ,  & 

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© 1997 Dr. Dietrich Steinkopff Verlag GmbH & Co. KG, Darmstadt

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Alexi-Meskishvili, V. et al. (1997). Extracorporeal circulatory support in pediatric cardiac patients — The Berlin Experience. In: Hetzer, R., Hennig, E., Loebe, M. (eds) Mechanical Circulatory Support. Steinkopff. https://doi.org/10.1007/978-3-642-95984-4_4

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  • DOI: https://doi.org/10.1007/978-3-642-95984-4_4

  • Publisher Name: Steinkopff

  • Print ISBN: 978-3-642-95986-8

  • Online ISBN: 978-3-642-95984-4

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