Circulatory support with pneumatic paracorporeal ventricular assist device in infants and children Roland Hetzer, MD, PhD, Matthias Loebe, MD, Evgenij.

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Presentation transcript:

Circulatory support with pneumatic paracorporeal ventricular assist device in infants and children Roland Hetzer, MD, PhD, Matthias Loebe, MD, Evgenij V Potapov, MD, Yuguo Weng, MD, Brigitte Stiller, MD, Ewald Hennig, MD, Vladimir Alexi-Meskishvili, MD, PhD, Peter E Lange, MD, PhD The Annals of Thoracic Surgery Volume 66, Issue 5, Pages 1498-1505 (November 1998) DOI: 10.1016/S0003-4975(98)00914-X

Fig 1 Adult size (80 mL) pump with titanium connectors (left), polyurethane ports including polyurethane trileaflet valves (center) and 12 mL pump with polyurethane ports and valves (right) (bottom) and a spectrum of available atrial cannulae (left) arterial cannulua (center) with different angles and pediatric cannulae (right) (top). The Annals of Thoracic Surgery 1998 66, 1498-1505DOI: (10.1016/S0003-4975(98)00914-X)

Fig 2 Pediatric assist systems, pumps, and cannulae. Thirty-milliliter pump (top) with cannula showing Dacron-velour surface around central portion of skin tunnel. Miniaturized (12 mL) system with inlet port reservoir (center). Same system with reservoir equipped with smallest, infant-type cannulae (no Dacron-velour). The Annals of Thoracic Surgery 1998 66, 1498-1505DOI: (10.1016/S0003-4975(98)00914-X)

Fig 3 Pediatric cannulae close-up. Flat metal tip “press-button” type arterial cannula with sewing ring (far left), small infant-type atrial cannula (center left), pair of cannulae tips for small children (right). The Annals of Thoracic Surgery 1998 66, 1498-1505DOI: (10.1016/S0003-4975(98)00914-X)

Fig 4 Drive systems available for “Berlin Heart” assist device. The IKUS 2000 driver (left) is preferred in small children because it can generate high positive and negative pressures and a variety of driving modes. The lighter Heimes HD-7 driver (right) allows for a somewhat greater mobility. The Annals of Thoracic Surgery 1998 66, 1498-1505DOI: (10.1016/S0003-4975(98)00914-X)

Fig 5 Child with cardiomyopathy on a biventricular system with a 25 mL pump (right) and a 30 mL pump (left) early after assist implantation. The Annals of Thoracic Surgery 1998 66, 1498-1505DOI: (10.1016/S0003-4975(98)00914-X)

Fig 6 The same child as in Figure 5, extubated and gradually being mobilized at a later stage of support. The Annals of Thoracic Surgery 1998 66, 1498-1505DOI: (10.1016/S0003-4975(98)00914-X)

Fig 7 Infant on a biventricular assist system with 12 mL pump (right heart) and 15 mL (left heart) early after assist implantation. The Annals of Thoracic Surgery 1998 66, 1498-1505DOI: (10.1016/S0003-4975(98)00914-X)