Biventricular Assist Device by the Berlin Heart as Bridge to Transplant in a 9-Year-Old Boy with Dilated Cardiomyopathy and Multiorgan Failure

Abstract

We report on a 9-year-old boy who presented with end-stage heart failure due to idiopathic dilated cardiomyopathy 7 months after the initial diagnosis. On admission to the Pediatric Intensive Care Unit he showed massive right ventricular dilation with minimal contractility and severe left ventricular dysfunction in transthoracic echocardiography, permanent monomorphic ventricular tachycardia of 130/min, and an elevated BNP-level (887 pg/ml). Despite maximal medical treatment with amiodarone, diuretics, inotropes (dobutamine, milrinone, epinephrine, norepinephrine), and a course of thyrotardin and levosimendan the patient developed cardiogenic shock with multiorgan dysfunction syndrome (lactic acidosis, renal, respiratory and liver failure with coagulopathy and encephalopathy). Therefore a pulsatile paracorporeal biventricular assist device, the Berlin Heart pediatric®, was implanted under resuscitation.