Results of pediatric mechanical assist for postcardiotomy ventricular failure and cardiac arrest

OpenAlex İngilizce

Background: This study aims to evaluate the results of pediatric mechanical assist device use for postcardiotomy ventricular failure and cardiac arrest in the intensive care unit. Methods: Between February 2000 and February 2012, 1800 patients underwent pediatric cardiac operation in our department. Among these patients 10 (5 boys, 5 girls; median age 3 months; range 2.5 month to 4.5 years) needed mechanical assist devices for postcardiotomy cardiac failure and cardiopulmonary failure in the intensive care unit. In four patients, roller pump support with left atrial appendage and ascending aorta cannulation was used for temporary left ventricle support. In six patients, extracorporeal membrane oxygenation (ECMO) was used for temporary cardiac and pulmonary support. Results: Three patients in the roller pump support group (75%) and three patients in the ECMO support group (50%) were successfully weaned from the mechanical assist. The longest mechanical support with the roller pump for left ventricle dysfunction was 160 hours in a seven-month-old infant after arterial switch operation. Mechanical support was required in two patients in the roller support group including one (4 years old) after arterial switch operation and one (2.5 months old) due to the left ventricular dysfunction after surgery for anomalous left coronary artery from pulmonary artery. Both patients were successfully weaned from the roller pump support after 48 hours. In two patients ECMO support was necessary for cardiac arrest due to pulmonary hypertensive crisis in the intensive care unit following the ventricular septal defect closure and ECMO was successfully weaned off after 12 and 48 hours. Conclusion: Pediatric mechanical circulatory support is a life-saving procedure for patients who develop cardiopulmonary failure after cardiac surgery and are unresponsive to the conventional resuscitative efforts. Conventional roller pump support is an alternative method for temporary left ventricle dysfunction in selected cases.