Berlin Heart EXCOR Paediatric Ventricular Assist Device: Does Weight Matter?

Area of Science:

• Pediatric Cardiology
• Mechanical Circulatory Support
• Cardiac Surgery

Background:

• The Berlin Heart EXCOR (BH) ventricular assist device offers mechanical long-term circulatory support for children with end-stage heart failure, serving as a bridge to transplantation or recovery.
• Existing research on BH devices primarily originates from high-volume pediatric cardiac centers.

Purpose of the Study:

• To analyze the experiences with BH devices across three French centers.
• To compare these findings with existing published data on pediatric ventricular assist devices.

Main Methods:

• A retrospective observational study was conducted across three pediatric cardiac intensive care units.
• Data on morbidity, mortality, and risk factors were collected for all children supported with BH devices.

Main Results:

• Survival rate while on BH support was 73% among 54 pediatric patients.
• Dilated cardiomyopathy was the primary indication (61%), with bi-ventricular assist device use in 46% of cases.
• Key complications included renal dysfunction (57%), bleeding (41%), and infection (39%). A weight below 5 kg was significantly associated with increased mortality.

Conclusions:

• Body weight appears to be the most critical risk factor for mortality in pediatric patients requiring BH device support.
• These findings underscore the importance of considering patient weight in managing pediatric end-stage heart failure with mechanical circulatory support.