Outcomes of Congenital Heart Surgery Patients After Extracorporeal Life Support at Texas Children's Hospital
: The objective of this study was to investigate the outcomes of children with heart failure of various etiologies requiring temporary use of currently available technology in the U.S.A. after extracorporeal life support (ECLS) [left ventricular assist device (LVAD) or extracorporeal membrane oxygen...
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Published in | Artificial organs Vol. 28; no. 10; pp. 963 - 966 |
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Main Authors | , , , , , , , , , , |
Format | Journal Article |
Language | English |
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Oxford, UK and Malden, USA
Blackwell Science Inc
01.10.2004
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Abstract | : The objective of this study was to investigate the outcomes of children with heart failure of various etiologies requiring temporary use of currently available technology in the U.S.A. after extracorporeal life support (ECLS) [left ventricular assist device (LVAD) or extracorporeal membrane oxygenation (ECMO)] at Texas Children's Hospital. Between July of 1995 and October of 2002, 2847 patients underwent congenital heart surgical repairs with the aid of cardiopulmonary bypass at Texas Children's Hospital. During this period, 17 patients required chronic mechanical circulatory assistance with Biomedicus centrifugal pump (n = 8) or Thoratec LVAD (n = 4), and ECMO (n = 5). Six out of 17 patients required ECLS for postcardiotomy heart failure. Seven of the 17 patients had congenital heart disease, six had cardiomyopathy, three had late acute rejection following heart transplantation, and one had myocardial infarction. Twelve patients survived and five patients expired. Six of 12 survivors recovered sufficient cardiac function to allow device removal; and the remaining six patients underwent heart transplantation. Three out of five deaths were ECMO patients. The need for ECLS following repair of congenital heart disease is extremely rare in our institution. The requirement for the use of ECMO confers a significantly higher mortality presumably because of associated combined cardiopulmonary failure. Congenital heart disease appears to be associated with significantly higher mortality. |
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AbstractList | The objective of this study was to investigate the outcomes of children with heart failure of various etiologies requiring temporary use of currently available technology in the U.S.A. after extracorporeal life support (ECLS) [left ventricular assist device (LVAD) or extracorporeal membrane oxygenation (ECMO)] at Texas Children's Hospital. Between July of 1995 and October of 2002, 2847 patients underwent congenital heart surgical repairs with the aid of cardiopulmonary bypass at Texas Children's Hospital. During this period, 17 patients required chronic mechanical circulatory assistance with Biomedicus centrifugal pump (n=8) or Thoratec LVAD (n=4), and ECMO (n=5). Six out of 17 patients required ECLS for postcardiotomy heart failure. Seven of the 17 patients had congenital heart disease, six had cardiomyopathy, three had late acute rejection following heart transplantation, and one had myocardial infarction. Twelve patients survived and five patients expired. Six of 12 survivors recovered sufficient cardiac function to allow device removal; and the remaining six patients underwent heart transplantation. Three out of five deaths were ECMO patients. The need for ECLS following repair of congenital heart disease is extremely rare in our institution. The requirement for the use of ECMO confers a significantly higher mortality presumably because of associated combined cardiopulmonary failure. Congenital heart disease appears to be associated with significantly higher mortality. The objective of this study was to investigate the outcomes of children with heart failure of various etiologies requiring temporary use of currently available technology in the U.S.A. after extracorporeal life support (ECLS) [left ventricular assist device (LVAD) or extracorporeal membrane oxygenation (ECMO)] at Texas Children's Hospital. Between July of 1995 and October of 2002, 2847 patients underwent congenital heart surgical repairs with the aid of cardiopulmonary bypass at Texas Children's Hospital. During this period, 17 patients required chronic mechanical circulatory assistance with Biomedicus centrifugal pump ( n = 8) or Thoratec LVAD ( n = 4), and ECMO ( n = 5). Six out of 17 patients required ECLS for postcardiotomy heart failure. Seven of the 17 patients had congenital heart disease, six had cardiomyopathy, three had late acute rejection following heart transplantation, and one had myocardial infarction. Twelve patients survived and five patients expired. Six of 12 survivors recovered sufficient cardiac function to allow device removal; and the remaining six patients underwent heart transplantation. Three out of five deaths were ECMO patients. The need for ECLS following repair of congenital heart disease is extremely rare in our institution. The requirement for the use of ECMO confers a significantly higher mortality presumably because of associated combined cardiopulmonary failure. Congenital heart disease appears to be associated with significantly higher mortality. : The objective of this study was to investigate the outcomes of children with heart failure of various etiologies requiring temporary use of currently available technology in the U.S.A. after extracorporeal life support (ECLS) [left ventricular assist device (LVAD) or extracorporeal membrane oxygenation (ECMO)] at Texas Children's Hospital. Between July of 1995 and October of 2002, 2847 patients underwent congenital heart surgical repairs with the aid of cardiopulmonary bypass at Texas Children's Hospital. During this period, 17 patients required chronic mechanical circulatory assistance with Biomedicus centrifugal pump (n = 8) or Thoratec LVAD (n = 4), and ECMO (n = 5). Six out of 17 patients required ECLS for postcardiotomy heart failure. Seven of the 17 patients had congenital heart disease, six had cardiomyopathy, three had late acute rejection following heart transplantation, and one had myocardial infarction. Twelve patients survived and five patients expired. Six of 12 survivors recovered sufficient cardiac function to allow device removal; and the remaining six patients underwent heart transplantation. Three out of five deaths were ECMO patients. The need for ECLS following repair of congenital heart disease is extremely rare in our institution. The requirement for the use of ECMO confers a significantly higher mortality presumably because of associated combined cardiopulmonary failure. Congenital heart disease appears to be associated with significantly higher mortality. |
Author | Stayer, Stephen A. Kilpack, Vicki D. Towbin, Jeffrey A. Fraser Jr, Charles D. McKenzie, E. Dean Surprise, Deborah L. Mueller, Maryann W. Andropoulos, Dean B. McGarry, Mary C. Owens, W. Richard Ündar, Akif |
Author_xml | – sequence: 1 givenname: Akif surname: Ündar fullname: Ündar, Akif email: aundar@psu.edu organization: Congenital Heart Surgery Service, Texas Children's Hospital – sequence: 2 givenname: E. Dean surname: McKenzie fullname: McKenzie, E. Dean organization: Congenital Heart Surgery Service, Texas Children's Hospital – sequence: 3 givenname: Mary C. surname: McGarry fullname: McGarry, Mary C. organization: Congenital Heart Surgery Service, Texas Children's Hospital – sequence: 4 givenname: W. Richard surname: Owens fullname: Owens, W. Richard organization: Congenital Heart Surgery Service, Texas Children's Hospital – sequence: 5 givenname: Deborah L. surname: Surprise fullname: Surprise, Deborah L. organization: Congenital Heart Surgery Service, Texas Children's Hospital – sequence: 6 givenname: Vicki D. surname: Kilpack fullname: Kilpack, Vicki D. organization: Congenital Heart Surgery Service, Texas Children's Hospital – sequence: 7 givenname: Maryann W. surname: Mueller fullname: Mueller, Maryann W. organization: Congenital Heart Surgery Service, Texas Children's Hospital – sequence: 8 givenname: Stephen A. surname: Stayer fullname: Stayer, Stephen A. organization: Division of Pediatric Cardiovascular Anesthesiology, Texas Children's Hospital/Baylor College of Medicine; and – sequence: 9 givenname: Dean B. surname: Andropoulos fullname: Andropoulos, Dean B. organization: Division of Pediatric Cardiovascular Anesthesiology, Texas Children's Hospital/Baylor College of Medicine; and – sequence: 10 givenname: Jeffrey A. surname: Towbin fullname: Towbin, Jeffrey A. organization: Pediatric Cardiology, Texas Children's Hospital/Baylor College of Medicine, Houston, TX, U.S.A – sequence: 11 givenname: Charles D. surname: Fraser Jr fullname: Fraser Jr, Charles D. organization: Congenital Heart Surgery Service, Texas Children's Hospital |
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Cites_doi | 10.1097/01.MAT.0000093965.33300.83 10.1016/S0003-4975(01)03027-2 10.1016/S0003-4975(99)01194-7 10.1177/039139889802100709 10.1016/S0003-4975(03)00898-1 10.1016/S0003-4975(98)00914-X 10.1055/s-2007-1013802 10.1016/0003-4975(95)00991-4 10.1016/S0003-4975(97)00063-5 |
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Notes | Presented at the 11th Congress of the International Society for Rotary Blood Pumps, August 31-September 2, 2003, held in Bad Oeynhausen, Germany. ArticleID:AOR7378 istex:F1B354106C36C00D63838A78C9C668E09A9DDAD7 ark:/67375/WNG-92NXRT61-L Presented at the 11th Congress of the International Society for Rotary Blood Pumps, August 31–September 2, 2003, held in Bad Oeynhausen, Germany. ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 23 ObjectType-Article-1 ObjectType-Feature-2 |
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References_xml | – volume: 61 start-page: 437 year: 1996 end-page: 43 article-title: Pierce–Donachy pediatric VAD: progress in development publication-title: Ann Thorac Surg – volume: 73 start-page: 1670 year: 2002 end-page: 7 article-title: Mechanical circulatory support for infants and children with cardiac disease publication-title: Ann Thorac Surg – volume: 69 start-page: 186 year: 2000 end-page: 92 article-title: Long‐term follow‐up of pediatric cardiac patients requiring mechanical circulatory support publication-title: Ann Thorac Surg – volume: 49 start-page: 727 year: 2003 end-page: 30 article-title: Thoratec ventricular assist devices in children with less than 1.3 m of body surface area publication-title: ASAIO J – start-page: 37 year: 2000; end-page: 62 – volume: 21 start-page: 417 year: 1998 end-page: 24 article-title: Development and initial in vivo testing of a new hydraulic drive system (Paedipump) for circulatory support publication-title: Int J Artif Organs – volume: 43 start-page: 313 year: 1995 end-page: 19 article-title: Left‐ventricular unloading with a new pulsatile assist device: the HIA‐VAD system and its influence on myocardial stunning publication-title: Thorac Cardiovasc Surg – volume: 66 start-page: 1498 year: 1998 end-page: 506 article-title: Circulatory support with pneumatic paracorporeal ventricular assist device in infants and children publication-title: Ann Thorac Surg – volume: 63 start-page: 1138 year: 1997 end-page: 44 article-title: Clinical experience with the MEDOS HIA‐VAD system in infants and children publication-title: Ann Thorac Surg – volume: 76 start-page: 1435 year: 2003 end-page: 42 article-title: Outcome of pediatric patients treated with extracorporeal life support after cardiac surgery publication-title: Ann Thorac Surg – ident: e_1_2_6_6_2 doi: 10.1097/01.MAT.0000093965.33300.83 – ident: e_1_2_6_2_2 doi: 10.1016/S0003-4975(01)03027-2 – ident: e_1_2_6_3_2 doi: 10.1016/S0003-4975(99)01194-7 – ident: e_1_2_6_10_2 doi: 10.1177/039139889802100709 – ident: e_1_2_6_5_2 doi: 10.1016/S0003-4975(03)00898-1 – start-page: 37 volume-title: Cardiac Assist Devices year: 2000 ident: e_1_2_6_4_2 contributor: fullname: Karl TR – ident: e_1_2_6_9_2 doi: 10.1016/S0003-4975(98)00914-X – ident: e_1_2_6_11_2 doi: 10.1055/s-2007-1013802 – ident: e_1_2_6_7_2 doi: 10.1016/0003-4975(95)00991-4 – ident: e_1_2_6_8_2 doi: 10.1016/S0003-4975(97)00063-5 |
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Snippet | : The objective of this study was to investigate the outcomes of children with heart failure of various etiologies requiring temporary use of currently... The objective of this study was to investigate the outcomes of children with heart failure of various etiologies requiring temporary use of currently available... |
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SubjectTerms | Adolescent Adult Biomedicus centrifugal left ventricular assist device Cardiopulmonary Bypass Child Child, Preschool Extracorporeal Membrane Oxygenation Heart Defects, Congenital - mortality Heart Defects, Congenital - surgery Heart Defects, Congenital - therapy Heart-Assist Devices Hospitals, Pediatric Humans Infant Infant, Newborn Neonates and infants Pediatric extracorporeal life support systems Survival Rate Texas Thoratec left ventricular assist device Treatment Outcome |
Title | Outcomes of Congenital Heart Surgery Patients After Extracorporeal Life Support at Texas Children's Hospital |
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