# Berlin Heart bridge to transplantation in an 18-month-old with septicaemia and thrombocytopenia: a case report and literature review

## TL;DR

An 18-month-old with heart failure, sepsis, and low platelets was successfully bridged to heart transplant using the Berlin Heart device, challenging current guidelines.

## Contribution

This case report demonstrates the use of the Berlin Heart device in a high-risk pediatric patient with sepsis and thrombocytopenia.

## Key findings

- The Berlin Heart EXCOR device was successfully used as a bridge to transplantation in a child with DCMP, sepsis, and thrombocytopenia.
- The case challenges existing guidelines and supports individualized assessments for VAD use in high-risk patients.
- Careful management of the device is crucial in such complex clinical scenarios.

## Abstract

Dilated cardiomyopathy (DCMP), a non-ischaemic heart disease involving ventricular enlargement, is the second most common cause of heart failure, with a prevalence of 1:2500. Few studies document the use of paediatric ventricular assist devices (VADs) such as the Berlin Heart EXCOR (BHE) device in those with sepsis. We report an 18-month-old patient, diagnosed with DCMP-induced refractory heart failure, causing septicaemia and thrombocytopenia. Despite this, BHE implantation was used as a last resort bridge to heart transplantation. Our case highlights the importance of carefully managing BHE in high-risk, compassionate-use patients, challenging existing guidelines and encouraging individualised assessments in VAD application.