Original articlePediatric cardiacBridge to Cardiac Transplant in Children: Berlin Heart versus Extracorporeal Membrane Oxygenation
Section snippets
Material and Methods
Permission to proceed with a retrospective review of anonymous patient data was granted by our Institutional Review Board, and the requirement for patient and parent written consent was waived. Between 2001 and November 2008, 42 consecutive patients who were not postcardiotomy required mechanical circulatory support for bridge to transplantation at Arkansas Children's Hospital. During the same period, 13 patients were supported postcardiotomy and were excluded from this analysis because we have
Results
A demographic comparison between the EXCOR and ECMO groups is reported in Table 1. In ECMO patients were slightly younger and smaller, although the differences were not statistically significant. The proportions of congenital heart defects, cardiomyopathy, and myocarditis were similar in both groups. Detailed data about diagnosis and support on each group are given in Table 2, Table 3.Table 4 summarizes the comparison of postsupport profiles, including complications.
Comment
This retrospective comparison of the outcomes for children receiving mechanical support with ECMO or the Berlin Heart EXCOR VAD as a bridge to cardiac transplantation suggests that the EXCOR allows for longer support times and better overall survival. Both support modalities were associated with a significant rate of neurologic complication, but these were less often fatal in the patients supported with VAD.
Since coming into widespread usage as the pediatric bridge modality in the 1990s, ECMO
References (21)
- et al.
Multicenter experience with the Thoratec ventricular assist device in children and adolescents
J Heart Lung Transplant
(2001) - et al.
Pediatric bridge to heart transplantation: application of the Berlin Heart, Medos and Thoratec ventricular assist devices
J Heart Lung Transplant
(2006) - et al.
Pneumatic paracorporeal ventricular assist device in infants and children: initial Stanford experience
J Heart Lung Transplant
(2008) - et al.
Beyond Berlin: heart transplantation in the “untransplantable.”
J Thorac Cardiovasc Surg
(2008) - et al.
Pediatric arteriovenous extracorporeal membrane oxygenation (ECMO) as a bridge to cardiac transplantation
J Heart Lung Transplant
(2003) - et al.
Beyond Berlin: heart transplantation in the “untransplantable.”
J Thorac Cardiovasc Surg
(2008) - et al.
Use of extracorporeal membrane oxygenation in pediatric thoracic organ transplantation
J Thorac Cardiovasc Surg
(2002) - et al.
The waiting game: bridging to paediatric heart transplantation
Lancet
(2003) - et al.
Use of extracorporeal life support as a bridge to pediatric cardiac transplantation
J Heart Lung Transplant
(2003) - et al.
Use of assist devices and ECMO to bridge pediatric patients with cardiomyopathy to transplantation
J Heart Lung Transplant
(2002)
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