Pediatric Mechanical Circulatory Support Systems in Latin America

Canêo, Luiz Fernando; Jatene, Marcelo Biscegli

doi:10.1111/aor.12816

Cited by 8 publications

(7 citation statements)

References 12 publications

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“…Pediatric and congenital HTx programs have an intrinsic complexity that mixes elective dilated cardiomyopathy patients with cardiogenic shock and complicated congenital hearts. Besides that, waiting time on list tends to be a lot longer than that for bigger patients, due to the donor scarcity [ 8 , 16 ] .…”

Section: Discussionmentioning

confidence: 99%

“…The use of mechanical circulatory support (MCS) systems as a bridge to transplantation or bridge to recovery are the main indications in infants and children [ 8 - 11 ] . Recently published data from the International Society for Heart and Lung Transplantation reported that approximately 25% of pediatric patients receive some kind of MCS before HTx [ 12 ] .…”

Section: Introductionmentioning

confidence: 99%

“…The waiting list time in Latin America is three times higher than in United States of America (USA) and two times higher than in Europe [ 8 ] . Mean waiting list time for transplantation in Brazil is 6 months, but in patients less than 5 kg this period is greater than 10 months [ 8 ] .…”

Section: Introductionmentioning

confidence: 99%

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Rational Use of Mechanical Circulatory Support as a Bridge to Pediatric and Congenital Heart Transplantation

Miana¹,

Silva²,

Canêo³

et al. 2018

Braz J Cardiovasc Surg

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IntroductionDonor shortage and organ allocation is the main problem in pediatric heart transplant. Mechanical circulatory support is known to increase waiting list survival, but it is not routinely used in pediatric programs in Latin America.MethodsAll patients listed for heart transplant and supported by a mechanical circulatory support between January 2012 and March 2016 were included in this retrospective single-center study. The endpoints were mechanical circulatory support time, complications, heart transplant survival and discharge from the hospital.ResultsTwenty-nine patients from our waiting list were assessed. Twelve (45%) patients were initially supported by extracorporeal membrane oxygenation (ECMO) and a centrifugal pump was implanted in 17 (55%) patients. Five patients initially supported by ECMO were bridged to another device. One was bridged to a centrifugal pump and four were bridged to Berlin Heart Excor®. Among the 29 supported patients, 18 (62%) managed to have a heart transplant. Thirty-day survival period after heart transplant was 56% (10 patients). Median support duration was 12 days (interquartile range [IQR] 4 - 26 days) per run and the waiting time for heart transplant was 9.5 days (IQR 2.5-25 days). Acute kidney injury was identified as a mortality predictor (OR=22.6 [CI=1.04-494.6]; P=0.04).ConclusionMechanical circulatory support was able to bridge most INTERMACS 1 and 2 pediatric patients to transplant with an acceptable complication rate. Acute renal failure increased mortality after mechanical circulatory support in our experience.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Rational Use of Mechanical Circulatory Support as a Bridge to Pediatric and Congenital Heart Transplantation

Miana¹,

Silva²,

Canêo³

et al. 2018

Braz J Cardiovasc Surg

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“…17,18 The Latin American Transplant Association reported that heart transplantation in the paediatric population is performed in Brazil, Argentina, Colombia, Chile, and Paraguay. 19 About 50% of all cardiac transplants are performed in three centres: The Heart Institute at the University of São Paulo in Brazil, the Hospital Garrahan in Argentina, and the Fundación Cardiovascular in Colombia. However, due to the scarcity of transplantation centers and the lack of a strong transplant legislation and culture, the waiting list for cardiac transplantation in Latin America is two times higher than in the United States and one time higher than in Europe.…”

mentioning

confidence: 99%

“…However, due to the scarcity of transplantation centers and the lack of a strong transplant legislation and culture, the waiting list for cardiac transplantation in Latin America is two times higher than in the United States and one time higher than in Europe. 19 For these reasons and considering the lack of available studies regarding the incidence and epidemiological characteristics of paediatric cardiomyopathies in Latin America, a better understanding of the epidemiology and clinical characteristics of these pathologies would facilitate planning and provision of medical services to generate improvements in patients' quality of life and rationalisation of health resources.…”

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confidence: 99%

Paediatric cardiomyopathies: echocardiographic diagnosis, clinical profile, and demographic characteristics: the experience of a tertiary referral centre for Latin American paediatric cardiology

et al. 2020

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Background:Although multiple studies have been conducted in the adult population, there is a vast knowledge gap regarding the epidemiologic characteristics of cardiomyopathies in the paediatric population. This issue is even more crucial when the precarious situation of medical research in Latin America is considered. Given the potential impact that these disorders could have on Latin American health systems, a comprehensive epidemiologic study regarding the clinical profile and sociodemographic characteristics of these patients will influence the way we approach paediatric cardiomyopathies.Methods:An observational retrospective study was conducted at a tertiary referral centre for Colombian and Latin American paediatric cardiology. We analysed all cases of primary cardiomyopathies in children younger than 18 years of age who presented at our institution between 2010 and 2016. Cases of cardiomyopathies were classified according to World Health Organization guidelines.Results:From a total of 29,533 children who attended our institution during the study period, 89 new cases of primary cardiomyopathies were identified. The median age at diagnosis was 11 years (interquartile range 4–9). Dilated cardiomyopathy accounted for 57.3% (n = 51) of cases; hypertrophic cardiomyopathy, 12.3% (n = 11); restrictive cardiomyopathy, 8.9% (n = 8); non-compacted cardiomyopathy, 7.8% (n = 7); arrhythmogenic ventricular cardiomyopathy, 6.7% (n = 6); and unspecified cardiomyopathy, 6.7% (n = 6). Heart failure was observed in 53.93% of the patients. The overall mortality was 12.36% (n = 11), which included two of eight patients who underwent cardiac transplantation.

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Pediatric Ventricular Assist Device (VAD) as Successful Bridge to Heart Transplantation

Carvalho

Vieira

Bertollo

et al. 2018

Cardiovascular Surgery

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Pediatric Mechanical Circulatory Support Systems in Latin America

Cited by 8 publications

References 12 publications

Rational Use of Mechanical Circulatory Support as a Bridge to Pediatric and Congenital Heart Transplantation

Rational Use of Mechanical Circulatory Support as a Bridge to Pediatric and Congenital Heart Transplantation

Paediatric cardiomyopathies: echocardiographic diagnosis, clinical profile, and demographic characteristics: the experience of a tertiary referral centre for Latin American paediatric cardiology

Pediatric Ventricular Assist Device (VAD) as Successful Bridge to Heart Transplantation

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