| Centrifugal ventricular assist in children under 6 kg. | |
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MedLine Citation:
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PMID: 9583817 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: The clinical application of centrifugal ventricular assist devices (VAD) has generally been limited to adults and large paediatric patients. In our experience neonates and small paediatric patients requiring ventricular support post-cardiopulmonary bypass are well supported by VAD. In this study we analyse our experience. METHODS: We have examined the records of our VAD patients who weighed less than 6 kg. Thirty-four patients, ranging in age from 2 to 258 days (median 60 days) and weight from 1.9 to 5.98 kg (median 3.7 kg), underwent 35 VAD procedures. One patient was supported on VAD twice. RESULTS: All patients had congenital heart lesions and were placed on VAD either because they could not be weaned from cardiopulmonary bypass after repair or palliation of the lesion (71.5%), or for support in the post-operative period due to refractory low cardiac output (28.5%). Twenty-two of the 35 VAD procedures (0.63, 95% CI: 0.45-0.78) resulted in successful weaning and decannulation, this was similar to the weaning probability for patients greater than 6 kg (P = 0.07). There were 10 late deaths in this group, with a 1-year KM survival of 0.31 (95% CI: 0.17-0.47). Most late deaths were related to irreversible cardiac disease processes as were the elective discontinuance of VAD outcomes. Neither weight, age, VAD duration, CPB duration, X clamp duration, univentricular anatomy or TGA anatomy predicted successful discharge from hospital (P > 0.05)--Weight P = 0.576; Age P = 0.532; VAD duration P = 0.181; CBP duration P = 0.549; X clamp duration P = 0.984; Univentricular anatomy P = 0.481; TGA anatomy P = 0.099. CONCLUSION: We believe centrifugal ventricular assist is a realistic option in very small patients who require post-cardiopulmonary bypass support. It is relatively easy to establish and manage, the results, although showing no factors predictive of successful discharge, are encouraging. |
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Authors:
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C A Thuys; R J Mullaly; S B Horton; E B O'Connor; A D Cochrane; C P Brizard; T R Karl |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery Volume: 13 ISSN: 1010-7940 ISO Abbreviation: Eur J Cardiothorac Surg Publication Date: 1998 Feb |
Date Detail:
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Created Date: 1998-07-01 Completed Date: 1998-07-01 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 8804069 Medline TA: Eur J Cardiothorac Surg Country: NETHERLANDS |
Other Details:
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Languages: eng Pagination: 130-4 Citation Subset: IM |
Affiliation:
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Victorian Paediatric Cardiac Surgical Unit, Royal Children's Hospital, Melbourne, Australia. thuysc@cryptic.rch.unimelb.edu.au |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Cardiopulmonary Bypass Heart Defects, Congenital / surgery* Heart-Assist Devices* Humans Infant Infant, Newborn Postoperative Period Ventilator Weaning |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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