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)   11 Citations

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

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