Objectives: This retrospective study reviews our results regarding the long-term support with
Berlin Heart EXCOR system in pediatric patients with single- and two-ventricle physiology
between January 2008 and September 2016.
Methods: We implanted the Berlin Heart EXCOR in 36 patients (median age: 3.37 years; interquartile
range [IQR]: 0.2–16.5), median weight: 12.85 kg (IQR: 4.2–67.2). 29 patients (80.5%)
received a left ventricular assist device. Four patients (11.1%) had single-ventricle
physiology (two patients with bidirectional Glenn anastomosis and two patients with
total cavo-pulmonary connection). Two patients (5.5%) had mechanical mitral valve
prosthesis.
Results: The median support time was 96.5 days (IQR: 4–619), with 4,980 days of cardiac support.
22 patients (61.1%) were transplanted, eight patients (22.2%) recovered, three patients
(8.3%) are on support and three patients (8,3%) died on support. Survival rate was
91.7%. 21 blood pumps had been changed. Four patients (11.1%) had local signs of infection
but there was no mediastinitis. Four patients (11.1%) had neurological complication
but only one of them needed neurological rehabilitation. From the four patients with
single-ventricle physiology, three of them have been transplanted and one patient
is on device. There was no death after heart transplantation or after weaning from
device.
Conclusion: Excellent survival and a low rate of adverse events are possible after long term
mechanical circulatory support with Berlin Heart EXCOR system in patients with single-
and two-ventricle physiology. Early implantation decreases the need for right ventricular
mechanical support. Prolonged mechanical circulatory support increases the chance
for weaning in an era with dramatic organ shortage in young patients with signs of
myocardial recovery while on device.
