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Berlin Heart EXCOR sVAD upsizing and exchange technique.

Yuriy Stukov1, Jeffrey P Jacobs2, Breanne Collison2

  • 1Division of Thoracic Surgery, Department of Surgery, University of Florida, Gainesville, Florida, USA.

Multimedia Manual of Cardiothoracic Surgery : MMCTS
|November 4, 2024
PubMed
Summary

This case report details the technique for upsizing a Berlin Heart EXCOR ventricular assist device in a 5-kg infant. This procedure addresses increased cardiac output demands in growing pediatric patients requiring temporary circulatory support.

Keywords:
Atrioventricular septal defectBerlin Heart VAD implantationMechanical circulatory support

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Area of Science:

  • Pediatric Cardiology
  • Cardiovascular Surgery
  • Biomedical Engineering

Background:

  • The Berlin Heart EXCOR ventricular assist device provides temporary circulatory support for pediatric patients with ventricular failure.
  • Growing neonates, infants, and children supported by ventricular assist devices experience increased cardiac output demands.
  • Sequential device upsizing may be necessary to meet evolving circulatory needs during growth.

Discussion:

  • This report presents a step-by-step technique for exchanging and upsizing the Berlin Heart EXCOR single ventricle-ventricular assist device.
  • The procedure was performed on a 5-kg infant, highlighting the adaptability of the device for smaller patients.
  • Managing growing pediatric patients with ventricular assist devices requires careful consideration of device longevity and iterative adjustments.

Key Insights:

  • Successful upsizing of the Berlin Heart EXCOR device is feasible in very young and small pediatric patients.
  • This intervention can effectively manage increased cardiac output requirements in growing infants.
  • The technique described offers a potential solution for prolonged support in pediatric ventricular failure.

Outlook:

  • Further research should explore long-term outcomes and optimal timing for device exchanges in pediatric VAD patients.
  • Standardizing surgical techniques for VAD upsizing can improve outcomes and reduce complications.
  • Advancements in VAD technology may lead to devices with wider applicability and longer support durations for pediatric populations.