To assist the failing heart in infants and small children, mechanical circulatory support with a variety of devices has been routinely applied in pediatric patients with end-stage heart disease, aiming at bridge to transplantation or myocardial recovery. Although extracorporeal membrane oxygenation (ECMO) and centrifugal pumps have been widely and successfully used since the development of pediatric cardiac surgery, their applications are largely limited by the short-term support and

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... ion of the patient. Several adult-sized ventricular assist devices (VADs) could be implanted in larger adolescent patients, but they could not provide circulatory support in small children with weight less than 20 kg. Current experience with the use of pediatric-specific VADs in children is limited, and previous studies were mostly based on either adult-sized VADs or relatively small patient numbers. We describe our recent 10-year experience with long- term mechanical circulatory support in small children and young adolescents with intractable heart failure, using Berlin Heart EXCOR Pediatric VAD (Berlin Heart AG, Berlin, Germany), which is designed specifically for all age groups of the pediatric population, and further define the potential risk factors for postimplantation mortality in children. Methods: Between 01/1999 Jan and 12/2009 Dec, 73 children were implanted with the Berlin Heart EXCOR pediatric ventricular assist device at the Deutsches Herzzentrum Berlin. We conducted a retrospective, non-randomized study by obtaining patient data from the ventricular assist device registry database of our institution. The following clinical data were collected and analyzed: (1) patient characteristics: age, sex, body surface area, body length, weight, body mass index, temperature, pulse oxygen saturation, causes of heart failure, prior sternotomy, history of comorbidities, VAD type, year of implantation; (2) medical and device therapy for heart failure: preimplantation cardiac pulmonary resuscitation, intravenous [...]