초록접수 현황
| 17F-278 | 포스터 발표 |
Ventricular Assist Device is a Feasible Option for Cardiac Support in Patients with Systemic Arterial or Venous Blood as a Major Source for Pulmonary Blood flow
Young Hwa Lee, Hye Jin Park, So Yeon Park, Won Kyun Park, Won Young Lee, Chun Soo Park, Tae-Jin Yun
Division of Pediatric Cardiac Surgery, Asan Medical Center, Ulsan University College of Medicine, Seoul, Republic of Korea
Purpose : In palliated circulation with systemic arterial or venous blood as a major source for pulmonary blood flow (PBF), ventricular assist device (VAD) can be used for cardiac support with adequate oxygen saturation, if it is certain that lung condition is adequate and atrial mixing is sufficient. This study will analyze the outcome of VAD compared with that of ECMO in above-mentioned condition.
Methods : From Mar. 2002 to Apr. 2016, post-sternotomy cardiac support is required in 45 patients whose source for PBF is systemic-to-pulmonary arterial shunt (SPS), bidirectional Glenn shunt (BDG), or banded bilateral pulmonary arteries (bPAB). Their median age and weight were 41 days (8-4327days) and 3.46 kg (2.38-27.2kg). Source of PBF was SPS in 31 patients, BDG in 8 patients and bPAB in 6 patients.
Results : Initial choice was VAD in 9 patients and ECMO in 36 patients. During support, mode of support was converted in 5 patients (1 : VAD to ECMO, 4: ECMO to VAD). Final mode of support was VAD in 12 patients and ECMO in 33 patients. Weaning success was accomplished in 8 patients in final VAD group (8/12, 66.7%) and 7 patients in final ECMO group (7/33, 21.2%) (p=0.01). Survive-to-discharge could be achieved in 3 patients in final ECMO group (3/33, 9.1%) and 4 patients in final VAD group (4/12, 33.3%) (p=0.069).
Conclusion : VAD can be feasible for cardiac support in palliated circulation with systemic arterial or venous blood as a major source for PBF in children and might be better in selected patients compared with ECMO.
Methods : From Mar. 2002 to Apr. 2016, post-sternotomy cardiac support is required in 45 patients whose source for PBF is systemic-to-pulmonary arterial shunt (SPS), bidirectional Glenn shunt (BDG), or banded bilateral pulmonary arteries (bPAB). Their median age and weight were 41 days (8-4327days) and 3.46 kg (2.38-27.2kg). Source of PBF was SPS in 31 patients, BDG in 8 patients and bPAB in 6 patients.
Results : Initial choice was VAD in 9 patients and ECMO in 36 patients. During support, mode of support was converted in 5 patients (1 : VAD to ECMO, 4: ECMO to VAD). Final mode of support was VAD in 12 patients and ECMO in 33 patients. Weaning success was accomplished in 8 patients in final VAD group (8/12, 66.7%) and 7 patients in final ECMO group (7/33, 21.2%) (p=0.01). Survive-to-discharge could be achieved in 3 patients in final ECMO group (3/33, 9.1%) and 4 patients in final VAD group (4/12, 33.3%) (p=0.069).
Conclusion : VAD can be feasible for cardiac support in palliated circulation with systemic arterial or venous blood as a major source for PBF in children and might be better in selected patients compared with ECMO.
첨부파일 : 흉부외과추계 초록.pptx
책임저자: Chun Soo Park
Division of Pediatric Cardiac Surgery, Asan Medical Center, Ulsan University College of Medicine, Seoul, Republic of Korea
발표자: Yeong Hwa Lee, E-mail : hopang1974@hanmail.net