TY - JOUR
T1 - Outpatient management of intra-corporeal left ventricular assist device system in children
T2 - A multi-center experience
AU - Schweiger, M.
AU - Vanderpluym, C.
AU - Jeewa, A.
AU - Canter, C. E.
AU - Jansz, P.
AU - Parrino, P. E.
AU - Miera, O.
AU - Schmitto, J.
AU - Mehegan, M.
AU - Adachi, I.
AU - Hübler, M.
AU - Zimpfer, D.
N1 - Publisher Copyright:
© Copyright 2015 The American Society of Transplantation and the American Society of Transplant Surgeons.
PY - 2015/2/1
Y1 - 2015/2/1
N2 - Little is known about the outcomes of children supported on intracorporeal left ventricular assist device (HVAD), and the feasibility of outpatient management. All centers with pediatric patients discharged from the hospital on the device were identified using company database. A total of 14 centers were contacted, with 9 centers, contributing data retrospectively. From 2011 to 2013, 12 pediatric patients (7 females), mean aged 11.9 ± 2.3 years (range 8-15), mean weight 43 ± 19 kg (range 18-81), mean body surface area 1.3 ± 0.3 m2 (range 0.76-1.96) were identified. Diagnosis included: dilated cardiomyopathy (CMP) (n = 5), noncompaction CMP (n = 4), toxic CMP (n = 2) and viral CMP (n = 1). Indications for support were permanent support (n = 1), bridge to recovery (n = 1) and bridge to transplantation (n = 10). Prior to HVAD implantation, all patients received intravenous inotropes and two patients were on temporary mechanical support. Overall mortality was 0%. Mean duration of inpatient and outpatient support were 56 (range: 19-95 days) and 290 days (range: 42-790), respectively. Mean readmission rate was 0.02 per patient month (2.1 per patient). No adverse events involving emergency department occurred. Eight children resumed local schooling. Home discharge of children supported on HVAD is feasible and safe. School integration can be achieved. There is wide center variability to discharge practice for children.
AB - Little is known about the outcomes of children supported on intracorporeal left ventricular assist device (HVAD), and the feasibility of outpatient management. All centers with pediatric patients discharged from the hospital on the device were identified using company database. A total of 14 centers were contacted, with 9 centers, contributing data retrospectively. From 2011 to 2013, 12 pediatric patients (7 females), mean aged 11.9 ± 2.3 years (range 8-15), mean weight 43 ± 19 kg (range 18-81), mean body surface area 1.3 ± 0.3 m2 (range 0.76-1.96) were identified. Diagnosis included: dilated cardiomyopathy (CMP) (n = 5), noncompaction CMP (n = 4), toxic CMP (n = 2) and viral CMP (n = 1). Indications for support were permanent support (n = 1), bridge to recovery (n = 1) and bridge to transplantation (n = 10). Prior to HVAD implantation, all patients received intravenous inotropes and two patients were on temporary mechanical support. Overall mortality was 0%. Mean duration of inpatient and outpatient support were 56 (range: 19-95 days) and 290 days (range: 42-790), respectively. Mean readmission rate was 0.02 per patient month (2.1 per patient). No adverse events involving emergency department occurred. Eight children resumed local schooling. Home discharge of children supported on HVAD is feasible and safe. School integration can be achieved. There is wide center variability to discharge practice for children.
KW - artificial organs
KW - education
KW - health services and outcomes research
KW - heart disease: congenital, outpatient care
KW - heart transplantation/cardiology
KW - quality of life (QOL)
KW - support devices: heart
KW - ventricular assist devices
UR - http://www.scopus.com/inward/record.url?scp=84921492333&partnerID=8YFLogxK
U2 - 10.1111/ajt.13003
DO - 10.1111/ajt.13003
M3 - Article
C2 - 25612114
AN - SCOPUS:84921492333
SN - 1600-6135
VL - 15
SP - 453
EP - 460
JO - American Journal of Transplantation
JF - American Journal of Transplantation
IS - 2
ER -