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[Left ventricular assistance by postoperative mechanical devices in neonates]
1Service de chirurgie thoracique et cardiovasculaire, Hôpital cardiologique, Lyon.
Archives Des Maladies Du Coeur Et Des Vaisseaux
|May 1, 1997
Summary
This study demonstrates successful left ventricular assistance in neonates with d-transposition of the great arteries using the Biomedicus pump, leading to functional recovery. Despite challenges with decoagulation, the technique offers a viable option for critical pediatric cardiac support.
Area of Science:
- Pediatric Cardiology
- Cardiovascular Surgery
- Biomedical Engineering
Background:
- Circulatory assistance in neonates presents unique miniaturization challenges.
- Left ventricular assistance (LVA) is infrequently reported in pediatric populations.
Observation:
- Three neonates with d-transposition of the great arteries received LVA via Biomedicus centrifugal pump.
- Cannulation involved the left atrial appendage and ascending aorta.
- Assistance duration ranged from 53 to 120 hours.
Findings:
- Functional recovery and successful weaning from LVA were achieved in all three patients.
- Left ventricular recovery began between 24 and 70 hours of assistance.
- Decoagulation management was critical, with two patients requiring thrombus removal; however, no systemic embolism or pump thrombosis occurred.
Implications:
- This case series highlights the feasibility of Biomedicus pump LVA in neonates with complex congenital heart disease.
- Effective management of anticoagulation and close laboratory monitoring are crucial for successful outcomes.
- Requires specialized surgical infrastructure and neonatal intensive care support.