Long-term outcomes after transplantation after support with a pulsatile pediatric ventricular assist device

Jeewa, Aamir; Imamura, Michiaki; Canter, Charles; Niebler, Robert A.; VanderPluym, Christina; Rosenthal, David N.; Kirklin, James K.; Cantor, Ryan S.; Tresler, Margaret; McMullan, D. Michael; Morell, Victor O.; Turrentine, Mark A.; Ameduri, Rebecca; Nguyen, Khanh; Kanter, Kirk R.; Conway, Jennifer; Gajarski, Robert J.; Fraser, Charles D.

doi:10.1016/j.healun.2018.10.005

Cited by 8 publications

(16 citation statements)

References 16 publications

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“…With the aim of delaying or, if possible, avoiding the need for HT, we propose a novel, integrated surgical program, comprising PAB for LV rehabilitation and long‐term MCS. Our experience shows that selected patients can benefit from such a patient‐tailored protocol, which can provide satisfactory early and medium‐term results, with an overall 5‐year survival rate of 74.1% (Figure 3), which is similar to the international standard of care 5‐11 . Noticeably, PAB strategy permitted survival without MCS and myocardial recovery avoiding HT in selected infants.…”

Section: Discussionmentioning

confidence: 63%

Surgical strategies for the management of end‐stage heart failure in infants and children: A 15‐year experience with a patient‐tailored approach

et al. 2021

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End‐stage heart failure (ESHF) in pediatric age is an ongoing challenge. Heart transplantation is the final option, but its long‐term outcomes are still suboptimal in children. An alternative patient‐tailored surgical protocol to manage ESHF in children is described. Retrospective, single‐center analysis of pediatric patients admitted to our institution between April 2004 and February 2021 for ESHF. Our current protocol is as follows: (a) Patients <1 year with isolated left ventricular dysfunction due to dilated cardiomyopathy underwent pulmonary artery banding (PAB). (b) Patients <10 years and <20 kg, who did not meet previous criteria were managed with Berlin Heart EXCOR. (c) Patients >10 years or >20 kg, underwent placement of intracorporeal Heartware. Primary outcomes were survival, transplant incidence, and postoperative adverse events. A total of 24 patients (mean age 5.3 ± 5.9 years) underwent 26 procedures: PAB in 6 patients, Berlin Heart in 11, and Heartware in 7. Two patients shifted from PAB to Berlin Heart. Overall survival at 1‐year follow‐up and 5‐year follow‐up was 78.7% (95%CI = 62%‐95.4%) and 74.1% (95%CI = 56.1%‐92.1%), respectively. Berlin Heart was adopted in higher‐risk settings showing inferior outcomes, whereas a PAB enabled 67% of patients to avoid transplantation, with no mortality. An integrated, patient‐tailored surgical strategy, comprehensive of PAB and different types of ventricular assist devices, can provide satisfactory medium‐term results for bridging to transplant or recovery. The early postoperative period is critical and requires strict clinical vigilance. Selected infants can benefit from PAB that has demonstrated to be a safe bridge to recovery.

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Section: Discussionmentioning

confidence: 63%

Surgical strategies for the management of end‐stage heart failure in infants and children: A 15‐year experience with a patient‐tailored approach

et al. 2021

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“…Furthermore, patients supported with ECMO had significantly lower survival compared with patients supported with VAD and non-MCS. 35 There was no significant difference in rejection, infection, posttransplant lymphoproliferative disorder, or renal function between VAD and non-MCS groups. 36 Adachi et al published their single-center outcomes utilizing a protocol of CF-VAD support in children prior to listing for heart transplantation.…”

Section: Ventricular Assist Devices In Congenital Cardiac Diseasementioning

confidence: 78%

“…34 Jeewa et al conducted a retrospective study comparing the posttransplant outcomes of children with a history of MCS with the Berlin Heart EXCOR versus those treated with medical therapy alone. 35 The Berlin Heart EXCOR is the first pediatric specific VAD to obtain FDA approval. The researchers utilized the Berlin Heart EXCOR Investigational Device Exemption Trial and matched these 83 patients to 166 nonmechanically supported patients using the Pediatric Heart Transplant Study database.…”

Section: Ventricular Assist Devices In Congenital Cardiac Diseasementioning

confidence: 99%

The Year in Review: Anesthesia for Congenital Heart Disease 2019

Houska

Schwartz

2020

Semin Cardiothorac Vasc Anesth

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“…Although the total number of transplantations has not increased, the number of pediatric heart transplantations that are bridged with ventricular assist devices is increasing worldwide [5,6]. Post-transplant outcomes in patients after ventricular assist device support are similar to those of medically supported patients and are superior to that of patients treated with ECMO [7]. In Korea, the number of pediatric heart transplantations remains low, with less than 20 transplants a year, and the frequency of transplantations in young children and infants is especially low [8].…”

Section: Discussionmentioning

confidence: 99%

The First Pediatric Heart Transplantation Bridged by a Durable Left Ventricular Assist Device in Korea

Shin

Park

Jung

et al. 2020

Korean J Thorac Cardiovasc Surg

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Treatment options for children with end-stage heart failure are limited. We report the first case of a successful pediatric heart transplantation bridged with a durable left ventricular assist device in Korea. A 10-month-old female infant with dilated cardiomyopathy and left ventricular non-compaction was listed for heart transplantation. During the waiting period, the patient's status deteriorated. Therefore, we decided to provide support with a durable left ventricular assist device as a bridge to transplantation. The patient was successfully bridged to heart transplantation with effective support and without any major adverse events.

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Long-term outcomes after transplantation after support with a pulsatile pediatric ventricular assist device

Cited by 8 publications

References 16 publications

Surgical strategies for the management of end‐stage heart failure in infants and children: A 15‐year experience with a patient‐tailored approach

Surgical strategies for the management of end‐stage heart failure in infants and children: A 15‐year experience with a patient‐tailored approach

The Year in Review: Anesthesia for Congenital Heart Disease 2019

The First Pediatric Heart Transplantation Bridged by a Durable Left Ventricular Assist Device in Korea

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