TY - JOUR
T1 - Ventricular Assist Device Outcomes in Infants and Children With Stage 1 Single Ventricle Palliation
AU - Joong, Anna
AU - Maeda, Katsuhide
AU - Peng, David M.
AU - Absi, Mohammed
AU - Armstrong, Blake P.N.
AU - Bansal, Neha
AU - Bearl, David W.
AU - Bleiweis, Mark S.
AU - Brickler, Molly
AU - Buchholz, Holger
AU - Chen, Sharon
AU - Conway, Jennifer
AU - Do, Nhue L.
AU - Esteso, Paul
AU - Friedland-Little, Joshua
AU - Griffiths, Eric R.
AU - Hsu, Daphne T.
AU - Kindel, Steven J.
AU - Lorts, Angela
AU - Martinez, Hugo R.
AU - Michael Mcmullan, David
AU - Mehegan, Mary
AU - Mokshagundam, Deepa
AU - Morales, David L.S.
AU - Philip, Joseph
AU - Ploutz, Michelle
AU - Rosenthal, David N.
AU - Shezad, Muhammad F.
AU - Sparks, Joshua
AU - Ventresco, Courtney
AU - Villa, Chet
AU - Wilkens, Sarah
AU - Zafar, Farhan
N1 - Funding Information:
Disclosure: ACTION receives funding from Berlin Heart Inc, Abbott Laboratories, and Medtronic. Dr. Buchholz is a consultant for Abbott Laboratories. Dr. Conway has an unrestricted education grant from Abbott and is a medical monitor for the PumpKIN (Pumps for Kids, Infants, and Neonates) trial. Dr. Lorts is a consultant for Berlin Heart Inc, Abbott Laboratories, and Medtronic. Dr. Maeda is a consultant for Berlin Heart Inc. Dr. Morales is a consultant, proctor, and educator for SynCardia and Abbott Laboratories and a consultant for Medtronic and Berlin Heart Inc. Dr. Rosenthal is a consultant for Abbott Laboratories. The remaining authors have no conflicts of interest to declare.
Publisher Copyright:
© 2022 Lippincott Williams and Wilkins. All rights reserved.
PY - 2022/11/1
Y1 - 2022/11/1
N2 - Data on ventricular assist device (VAD) outcomes in infants with stage 1 single ventricle (SV) palliation are limited. We examined the Advanced Cardiac Therapies Improving Outcomes Network (ACTION) registry for outcomes of pre/poststage 1 SV patients undergoing VAD implantation between March 2018 and October 2020. Data are collected from 32 centers and major adverse events undergo central adjudication. During the study period, 30 stage 1 SV patients underwent VAD implant with median age of 0.9 months (range 0.1-25) and weight 3.7 kg (2.4-17). Preimplant illness severity was high: ventilator support (90%), ECMO (30%), prior cerebral vascular accident (CVA, 23%), and dialysis (13%). Devices used included paracorporeal pulsatile (50%), paracorporeal continuous-flow (37%), and multiple devices (13%). Median support duration was 56 days (range 3-246). A positive clinical outcome (transplanted or weaned) was attained in 63% (63% transplanted, 37% mortality, 0% weaned). VAD adverse events included: major infection (43%), neurologic dysfunction (any = 30%; CVA = 20%), major bleeding (17%), renal dysfunction (13%), and device malfunction (3%). In conclusion, stage 1 SV patients undergoing VAD support have high preimplant illness severity and complexity, as well as significant morbidity and mortality postimplant. A variety of devices and strategies are employed by centers to support this challenging population.
AB - Data on ventricular assist device (VAD) outcomes in infants with stage 1 single ventricle (SV) palliation are limited. We examined the Advanced Cardiac Therapies Improving Outcomes Network (ACTION) registry for outcomes of pre/poststage 1 SV patients undergoing VAD implantation between March 2018 and October 2020. Data are collected from 32 centers and major adverse events undergo central adjudication. During the study period, 30 stage 1 SV patients underwent VAD implant with median age of 0.9 months (range 0.1-25) and weight 3.7 kg (2.4-17). Preimplant illness severity was high: ventilator support (90%), ECMO (30%), prior cerebral vascular accident (CVA, 23%), and dialysis (13%). Devices used included paracorporeal pulsatile (50%), paracorporeal continuous-flow (37%), and multiple devices (13%). Median support duration was 56 days (range 3-246). A positive clinical outcome (transplanted or weaned) was attained in 63% (63% transplanted, 37% mortality, 0% weaned). VAD adverse events included: major infection (43%), neurologic dysfunction (any = 30%; CVA = 20%), major bleeding (17%), renal dysfunction (13%), and device malfunction (3%). In conclusion, stage 1 SV patients undergoing VAD support have high preimplant illness severity and complexity, as well as significant morbidity and mortality postimplant. A variety of devices and strategies are employed by centers to support this challenging population.
KW - congenital heart disease
KW - mechanical circulatory support
KW - pediatrics
KW - single ventricle
KW - ventricular assist device
UR - http://www.scopus.com/inward/record.url?scp=85141890016&partnerID=8YFLogxK
U2 - 10.1097/MAT.0000000000001817
DO - 10.1097/MAT.0000000000001817
M3 - Article
C2 - 36326704
AN - SCOPUS:85141890016
SN - 1058-2916
VL - 68
SP - E188-E195
JO - ASAIO Journal
JF - ASAIO Journal
IS - 11
ER -