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Neurological Complications During Pulsatile Ventricular Assistance With the B erlin H eart EXCOR in Children: Incidence and Risk Factors
Author(s) -
Polito Angelo,
Netto Roberta,
Soldati Massimiliano,
Brancaccio Gianluca,
Grutter Giorgia,
Amodeo Antonio,
Ricci Zaccaria,
Morelli Stefano,
Cogo Paola
Publication year - 2013
Publication title -
artificial organs
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.684
H-Index - 76
eISSN - 1525-1594
pISSN - 0160-564X
DOI - 10.1111/aor.12075
Subject(s) - medicine , ventricular assist device , incidence (geometry) , stroke (engine) , extracorporeal membrane oxygenation , heart transplantation , heart disease , prospective cohort study , cardiomyopathy , heart failure , etiology , cardiology , surgery , mechanical engineering , physics , optics , engineering
The aim of this study is to describe the incidence of brain injury ( BI ) in children with end‐stage cardiac failure who were supported with the B erlin H eart EXCOR ventricular assist device ( VAD ) as a bridge to heart transplantation. Between J anuary 2002 and J anuary 2012, all patients <18 years of age who underwent the implantation of the B erlin H eart EXCOR at B ambino G esú C hildren's H ospital were included. A total of 25 patients were included in this study. Median age and weight at implantation were 22.4 months (range 3.6–154.2) and 10 kg (range 4.5–36), respectively. Diagnosis included cardiomyopathy ( n = 20) and congenital heart disease ( n = 5). Eleven patients received atrial cannulation. Nine patients underwent biventricular assist device support. Seven patients underwent extracorporeal membrane oxygenation before the implantation of the EXCOR VAD . Median duration of VAD support was 51 days (range 2–167). Nine patients had evidence of acute BI including intracranial hemorrhage ( n = 5) and cerebral ischemia ( n = 4). Freedom from BI at 30, 60, and 90 days from VAD implantation was 80.7, 69.9, and 43.3%, respectively. Weight <10 kg at implantation was significantly associated with BI . BI is a frequent complication among children supported with EXCOR VAD and is associated with lower weight at implantation. However, our data do not support the association between size and BI . Future prospective multicenter studies are warranted to further help understand the etiology and the impact of BI and to improve functional outcomes for children undergoing EXCOR VAD mechanical support.