Welcome to

The Pediatric Heart Center


Perfusion Services / ECMO

Cardiopulmonary bypass (CPB), also known as the heart-lung machine, is used to support heart and lung functions during open cardiac surgery. This sophisticated technology is also used to support patients requiring mechanical assistance, for both cardiac and pulmonary disease. Montefiore Medical Center has one of the most progressive cardiovascular perfusion teams in the tri-state area. Their expertise is particularly important at the Children's Hospital at Montefiore (CHAM), where some patients weigh as little as six pounds and some as much as 160 pounds.

Cardiovascular perfusion at Montefiore plays a vital role in supporting the cardiac and pulmonary mechanical assist programs. Since 2006, Montefiore has implanted over 150 ventricular assist devices in infants, children and adults. "Our extensive experience with device implantation for the treatment of heart failure distinguishes Montefiore from other centers in the region," says Kenneth Shann, Assistant Director, Perfusion Services. "We have experience with the Thoratec HeartMate II, HeartWare, Abiomed, TandemHeart and the Berlin Heart."

Nicholas Mellas, CCP, Director, Cardiovascular Perfusion, has worked with our surgical staff to create a bloodless surgical program that will allow for pediatric cardiac repairs to be done without the need for a blood transfusion. This approach is used for all of our patients and is particularly suited for families who, for religious or other reasons, may want to avoid blood transfusions.

The perfusion team's protocols and practice are driven by the latest research. "Our perfusionists are currently participating in both basic science and clinical research, including stem cell therapy for heart transplantation, kidney injury during heart surgery, and pulsatile perfusion strategies," says Kenneth Shann.


For patients who have succumbed to a temporary failure of the lung from significant pneumonia, overwhelming infection or other diseases, such as congenital diaphragmatic hernia or meconium aspiration, Montefiore's mechanical support team offers extracorporeal membrane oxygenation (ECMO). ECMO is an artificial lung that delivers oxygen to a child who is nonresponsive to conventional respiratory therapy, allowing the lung more time to be treated. Samuel Weinstein, MD, Director, ECMO, says that in 2010, "Montefiore's success with ECMO for pulmonary disease was 100 percent, considerably exceeding national benchmarks."

Monitored by a dedicated perfusionist, ECMO supports long-term lung function and recovery during and after heart surgery. ECMO support is similar to cardiopulmonary bypass, in which the patient's blood is circulated through an artificial lung and back into the bloodstream. Performing over 1,000 bypass procedures each year, our perfusionists bring their extensive experience to the patients in our intensive care unit and are integrally involved in patient care. This model of ECMO management allows for superior expertise at the bedside, while allowing the other members of the clinical team, including physicians and nurses, to focus all of their attention on the care of the patient. We feel that this collaboration leads to an environment of safety that minimizes complications and translates to our superior results.