Children may survive severe myocarditis with prolonged use of biventricular assist devices.

The outcome of acute myocarditis with cardiogenic shock is poor. In some children in whom aggressive medical treatment fails, artificial replacement of heart function may offer lifesaving support until the myocardium has recovered. Four previously healthy children (three boys aged 4, 6, and 1 years; one girl aged 5) developed acute myocarditis with ventricular failure and multiorgan dysfunction caused by low cardiac output.

Circulatory support with pneumatic paracorporeal ventricular assist device in infants and children.

Background: Mechanical circulatory support in intractable heart failure in children has been limited to centrifugal pumps and extracorporeal membrane oxygenation: Since 1990 small adult-size pulsatile air-driven ventricular assist devices "Berlin Heart" (VAD) and, since 1992 miniaturized pediatric VAD (12, 15, 25, 30 mL pumps), have been used in our institution. Since 1994 the blood-contacting surfaces of the device system have been heparin-coated. In this report the experiences with VAD support in 28 children are presented.

Soluble L-selectin plasma concentrations in infants undergoing heart surgery: no association with capillary leak syndrome or need for respiratory support.

Objective: In critical care patients at risk of developing the acute respiratory distress syndrome (ARDS), low soluble L-selectin (sCD62L) plasma concentrations have been shown to be associated with progression to ARDS and prolonged subsequent mechanical ventilation. This study aimed to determine the usefulness of sCD62L plasma concentrations to identify infants undergoing cardiovascular surgery who are at risk for postoperative pulmonary dysfunction and capillary leaks.

Design: Serial measurements of sCD62L plasma concentrations in a cohort of infants with congenital heart disease before, during, and after surgery for 4 consecutive days.

[Initial clinical results with the Amplatzer septal occluder--a self-centering double disc for occlusion of atrial septal defects].

Unlabelled: In recent years many different systems for transcatheter closure of an atrial septal defect (ASD) have been developed and tested. However, all systems presently available have some special disadvantages. The recently introduced Amplatzer Septal Occluder (ASO), though, appears promising.

Complement and contact activation during cardiovascular operations in infants.

Background: By comparing the results of cardiac operations with or without cardiopulmonary bypass (CPB) in infants in a prospective study, we sought to determine which part of the postoperative systemic inflammatory response was caused by CPB.

Methods: Thirty-five patients were divided into two groups: 11 infants operated on without CPB and 24 infants operated on with CPB. Blood samples were drawn before, during, and after the operation.

Anaphylatoxins in fresh-frozen plasma.

Background: Fresh-frozen plasma (FFP) is widely used in patients with coagulation disorders and simultaneous complement activation. Complement activation in FFP itself is poorly investigated.

Study Design And Methods: The concentration of anaphylatoxins C3a and C5a, the complement precursors C1q and factor B, and complement function were measured in 40 consecutively administered FFP units in two pediatric neonatal intensive care units.