Successful biventricular assist device Berlin heart implantation leading to heart transplant in a complicated pediatric case: an experience from a single center

Authors

  • Kashif Rizvi Perfusion Services Heart Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
  • Felix W. Tsai Department of Pediatrics Surgery, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
  • Emad Hakami Clinical Specialist Heart Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
  • Ghada Aldabaan Perfusion Services Heart Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
  • Majid Ali Pediatric Intensivist, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia

DOI:

https://doi.org/10.18203/2349-3291.ijcp20243479

Keywords:

BIVAD, Plakophilin-2 gene, Berlin Heart, Kawasaki disease, Heart transplant, Ventricular assist device, Dilated cardiomyopathy

Abstract

The use of the Berlin heart EXCOR ventricular assist device (VAD) as a bridge to heart transplantation in pediatric patients has become increasingly widespread. This case report presents a detailed account of the successful implantation of a biventricular assist device (BIVAD) Berlin heart device in a complex pediatric case at the esteemed King Faisal Specialist Hospital and Research Center. The patient, diagnosed with dilated cardiomyopathy (DCM) and Kawasaki disease, underwent a series of interventions and treatments before requiring extracorporeal membrane oxygenation (ECMO) support and subsequently receiving the Berlin heart device. The post-implantation period was marked by significant challenges, including instances of bleeding and clot formation, necessitating multiple interventions and careful management. Ultimately, a heart transplant was performed; however, the patient encountered humoral rejection, leading to additional targeted treatment. Despite these intricate complications, the patient exhibited substantial improvement in left ventricular ejection fraction (LVEF) following the transplant, indicating a positive outcome. This case underscores the successful use of a BIVAD Berlin heart device as a viable bridge to heart transplantation in a complicated pediatric case, highlighting the crucial role of a multidisciplinary approach and meticulous management of complications throughout the entire treatment process.

References

Blume ED, VanderPluym C, Lorts A, Baldwin JT, Rossano JW, David LS, et al. Pedimacs Investigators. Second annual Pediatric Interagency Registry for Mechanical Circulatory Support (Pedimacs) report: Pre-implant characteristics and outcomes. J Heart Lung Transplant. 2018;37:38-45.

Miera O, Germann M, Cho MY, Photiadis J, Walter EM, Hetzer R, et al. Bridge to recovery in children on ventricular assist devices-protocol, predictors of recovery, and long-term follow-up. J Heart Lung Transplant. 2018;37:1459-66.

Ozen S, Ruperto N, Dillon MJ, Bagga A, Barron K, Davin JC, et al. EULAR/PRES endorsed consensus criteria for the classification of childhood vasculitides. Ann Rheumat Dis. 2005;65(7):936-41.

Ramphul K, Mejias SG. Kawasaki disease: a comprehensive review. Arch Med Sci Atheroscler Dis. 2018;3:e41-5.

Torpoco Rivera DM, Schneider J, Lawrence D, Dentel J, Sehgal S. Successful Explantation of Berlin Heart Excor in Two Young Children. ASAIO J. 2023;69(2):e100-5.

Burns JC, Capparelli EV, Brown JA, Newburger JW, Glode MP. Intravenous gamma-globulin treatment and retreatment in Kawasaki disease. US/Canadian Kawasaki Syndrome Study Group. Pediatr Infect Dis J. 1998;17(12):1144-8.

Fernandez-Cooke E, Barrios Tascón A, Sánchez-Manubens J, Antón J, Grasa Lozano CD, Aracil Santos J, et al. KAWA-RACE study group. Epidemiological and clinical features of Kawasaki disease in Spain over 5 years and risk factors for aneurysm development. (2011-2016): KAWA-RACE study group. PLoS One. 2019;14(5):e0215665.

Lardhi AA. Kawasaki disease: A university hospital experience. Saud J Med Med Sci. 2013;1(1):35.

Truby LK, Rogers JG. Advanced heart failure. JACC: Heart Failure. 2020;8(7):523-36.

Zafar F, Castleberry C, Khan MS, Mehta V, Bryant R, Lorts A. Pediatric heart transplant waiting list mortality in the era of ventricular assist devices. J Heart Lung Transplant. 2015;34(1):82-8.

Downloads

Published

2024-11-25

Issue

Section

Case Reports