From April 1989 to December 1993, total 39 patients who were unable to be weaned off CPB or expected fatal immediate-postoperatively, were treated with ventricular assist device(VAD) or extracorporeal membrane oxygenator(ECMO) at the Royal
Children's
Hospital, Melbourne. Ages ranged from 3 days to 19.4 years old and body weights from 2.0kg to 70kg. Twenty-seven(69.2%) of 39 patients were weaned to be decannulated successfully and sixteen(41.0%) survived to hospital discharge and late survival
rate
was twelve(30.8%) of 39 patients. The total follow-up period was 4 to 56 months(32.92*20.77 months) and most of the late survivals showed good myocardial recovery state. From the viewpoint of the assist modality, 29 patients were treated with VAD
and
among them, 23 were weaned from assist successfully, but among the 8 ECMO patients, only 3 could be weaned, and both modalities were performed to the 2 patients with one weaned. The total duration of assist was from 8 to 428 hours and there was a
significant difference between hospital discharged group and hospital death group, which were 83.13*31.29 hours vs 147.52*112.03 hours(P=0.032). Conclusively, at the critical postcardiotomy situation of the paediatrtc patients including various
congenital complex diseases and procedures, we can chose this VAD or ECMO treatment strategy as the reasonable life saving way except transplantation. (Korean J Thoracic Cardiovas Surg 1994; 27:977-83)
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