Language
English
Publication Date
7-1-2023
Journal
The Journal of Thoracic and Cardiovascular Surgery
DOI
10.1016/j.jtcvs.2022.10.041
PMID
36494210
Abstract
Background: There are scarce data describing outcomes of pediatric temporary ventricular assist device support.
Methods: A retrospective single-center study was conducted to review clinical outcomes of all consecutive patients with temporary ventricular assist device between 1996 and 2021. Given the complex clinical course in some patients requiring multiple temporary ventricular assist device runs, outcome analysis was based on "encounters" (hospitalizations with temporary ventricular assist device, regardless of the number of devices used).
Results: In total, 126 temporary ventricular assist devices were implanted in 108 patients, resulting in a total of 114 encounters: 70 (61%) extracorporeal centrifugal pumps and 44 (39%) catheter-based axial pumps. The median (range) age and weight at temporary ventricular assist device implant were 10.1 years (1 day to 42.8 years) and 33.6 (2.5-128) kg, respectively. Underlying etiologies of cardiac dysfunction were cardiomyopathy (34, 30%), cardiac transplant graft dysfunction (29, 25%), congenital heart disease (23, 20%; 9 single ventricle), myocarditis (22, 19%), and other (6, 5%). Interagency Registry for Mechanically Assisted Circulatory Support Profile was 1 in 75 (66%) and 2 in 39 (34%). Support configuration was left ventricular assist device (104, including 9 systemic ventricular assist devices), right ventricular assist device (5), and biventricular assist device (5). The median (range) support duration was 6 (1-61) days. Overall, 97 (85%) encounters reached a positive primary end point: bridge-to-recovery (55), bridge-to-bridge (31), and bridge-to-transplant directly with temporary ventricular assist device (11). Seventeen (15%) encounters resulted in death during temporary ventricular assist device support: multiorgan failure (12), stroke (4), and cardiac arrest (1). The 6-month survivals with catheter-based axial pumps and extracorporeal centrifugal pumps were 84% (95% confidence interval, 74-96) and 67% (95% confidence interval, 57-79), respectively (P = .08). The 1- and 5-year survivals of 82 hospital survivors were 90% and 84%, respectively.
Conclusions: This study suggests temporary ventricular assist device support is feasible in children with favorable outcomes.
Keywords
Child, Humans, Heart-Assist Devices, Heart Failure, Retrospective Studies, Treatment Outcome, Time Factors, heart failure, mechanical circulatory support, outcomes, temporary support, ventricular assist device
Published Open-Access
yes
Recommended Citation
Cho, Junsang; Fuentes-Baldemar, Andres A; Tunuguntla, Hari P; et al., "Outcomes of Temporary Ventricular Assist Device: A Pediatric Institutional Experience Over 25 Years" (2023). Faculty and Staff Publications. 4251.
https://digitalcommons.library.tmc.edu/baylor_docs/4251