Faculty Collaboration Database

Ventricular Assist Device Outcomes in Infants and Children With Stage 1 Single Ventricle Palliation. ASAIO J 2022 Nov 01;68(11):e188-e195

Date

11/04/2022

Pubmed ID

36326704

DOI

10.1097/MAT.0000000000001817

Scopus ID

2-s2.0-85141890016 (requires institutional sign-in at Scopus site)

Abstract

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.

Author List

Joong A, Maeda K, Peng DM, ACTION Learning Network Investigators, ACTION Learning Network Investigators:, ACTION Learning Network Investigators and ACTION Learning Network Investigators:

Author

Steven J. Kindel MD Associate Professor in the Pediatrics department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Child
Child, Preschool
Heart Failure
Heart-Assist Devices
Humans
Infant
Infant, Newborn
Palliative Care
Retrospective Studies
Stroke
Treatment Outcome