Short-term outcomes of EXCOR Paediatric implantation

Komori, Motoki; Hoashi, Takaya; Sakaguchi, Heima; Imai, Kenta; Okuda, Naoki; Fukushima, Norihide; Kurosaki, Kenichi; Ichikawa, Hajime

doi:10.1093/icvts/ivac051

Cited by 3 publications

(2 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Regarding VAD development in terms of extracorporeal systems, the use of "BIOFLOAT NCVC" (Nipro Corporation, Osaka, Japan), an extracorporeal continuous-flow VAD system, has increased in recent years. 25,26 However, in light of the increasing use of the EXCOR Pediatric VAD (Berlin Heart, Berlin, Germany) with a pulsatile flow pump 27 and the fact that J-MACS data on extracorporeal VAD-only enrollment ended on December 31, 2018, the present study provides the only valuable data on long-term QoL with pulsatile flow extracorporeal VAD implantation. Therefore, our findings may be useful for managing patients with EXCOR and for comparison with findings on the use of newly approved extracorporeal centrifugal VADs (BIOFLOAT NCVC).…”

Section: Discussionmentioning

confidence: 95%

Impact of Different Therapeutic Strategies With Left Ventricular Assist Devices on Health-Related Quality of Life During Prolonged Device-Based Support

et al. 2023

Self Cite

View full text Add to dashboard Cite

Background: Left ventricular assist device (LVAD) implantation improves survival and health-related quality of life (HRQoL) of patients with heart failure. However, the impact of LVADs or different LVAD-based therapeutic strategies on long-term HRQoL has not been investigated. We evaluated the long-term HRQoL of Japanese patients who were treated with different LVAD-based therapeutic strategies. Methods and Results:Patients whose data were recorded in the Japanese Registry for Mechanical Assisted Circulatory Support between January 2010 and December 2018 were divided into 3 groups: primary implantable LVAD (G-iLVAD; n=483), primary paracorporeal LVAD (n=33), and bridge-to-bridge from paracorporeal to implantable LVAD (n=65). HRQoL was evaluated using the EuroQoL 5-dimension 3-level (EQ-5D-3L) before and 3 and 12 months after LVAD implantation; the mean EQ-5D-3L visual analog scale (VAS) score in the G-iLVAD group at these time points was 47.4, 71.1, and 72.9, respectively (where scores of 0 and 100 indicate worst and best imaginable health state, respectively). Changes in the least squares means of the VAS scores at 3 and 12 months after implantation differed significantly among the 3 groups. Social function, disability, and physical and mental problems were significantly lower in the G-iLVAD than other groups. Conclusions:HRQoL improved significantly at 3 and 12 months after LVAD implantation in all groups. Physical function showed a stronger improvement than did social function, disability, and mental function.

show abstract

Section: Discussionmentioning

confidence: 95%

Impact of Different Therapeutic Strategies With Left Ventricular Assist Devices on Health-Related Quality of Life During Prolonged Device-Based Support

et al. 2023

Self Cite

View full text Add to dashboard Cite

show abstract

“…Some of our included studies seem to reflect this too. For example, some studies with older patients show lower recovery rates [ 15 , 16 , 21 , 25 ], whereas others with younger children show higher recovery rates [ 22 , 35 ].…”

Section: Discussionmentioning

confidence: 99%

Myocardial recovery in children supported with a durable ventricular assist device—a systematic review

Rohde

Bogers

et al. 2023

European Journal of Cardio-Thoracic Surgery

View full text Add to dashboard Cite

Introduction A small percentage of paediatric patients supported with a ventricular assist device (VAD) can have their device explanted following myocardial recovery. The aim of this systematic review is to summarize current literature on clinical course in these children after weaning. Methods A systematic literature search was performed on 27th of May, 2022 using Embase, Medline ALL, Web of Science Core Collection, Cochrane Central Register of Controlled Trials, and Google Scholar to include all literature on paediatric patients supported by a durable VAD of the last decade. Overlapping study cohorts and registry-based studies were filtered out. Results Thirty-seven articles were included. Eighteen of them reported on incidence of recovery in cohort studies, with an overall incidence rate of 8.7% (81/928). Twenty-two of the included articles reported on clinical outcomes after VAD explantation (83 patients). Aetiology varied widely and was not limited to diseases with a natural transient course like myocarditis. Most of the patients in the included studies (70; 84.3%) were supported by a Berlin Heart EXCOR™, and in 66.3% (55/83) only the left ventricle had to be supported. The longest follow-up was 19.1 years and multiple studies reported on long-term myocardial recovery. Less than half of the reported deaths had a cardiac cause. Conclusions Myocardial recovery during VAD support is dependent on various contributing components. The interaction between patient-, device-, time-, and hospital-related factors is complex and not yet fully understood. Long-term recovery after VAD support is achievable, even after a long duration of VAD support, and even in patients with aetiology different than myocarditis or post-cardiotomy heart failure. More research is needed on this favourable outcome after VAD support.

show abstract

Cardiomyocyte deoxyribonucleic acid damage and cardiac recovery in paediatric dilated cardiomyopathy

Tominaga

Taira

Watanabe

et al. 2023

European Journal of Cardio-Thoracic Surgery

View full text Add to dashboard Cite

Objectives This study aimed to identify the clinical significance of the deoxyribonucleic acid damage response marker, phosphorylated H2A histone variant X, on the bridge to recovery in low-weight pediatric patients with dilated cardiomyopathy post-Berlin Heart EXCOR implantation. Methods Consecutive pediatric patients with dilated cardiomyopathy who underwent EXCOR implantation for dilated cardiomyopathy at our hospital between 2013 and 2021 were reviewed. Patients were classified into two groups according to the degree of deoxyribonucleic acid damage in left ventricular cardiomyocytes—low deoxyribonucleic acid damage group and high deoxyribonucleic acid damage group—using the median value as the threshold. We examined and compared the preoperative factors and histological findings associated with cardiac functional recovery following explantation in the two groups. Results Competing outcome analysis of 18 patients (median body weight, 6.1 kg) showed that the incidence of EXCOR explantation was 40% at 1 year after implantation. Serial echocardiography revealed significant left ventricular functional recovery in the low deoxyribonucleic acid damage group 3 months after implantation. The univariable Cox proportional-hazards model revealed that the percentage phosphorylated H2A histone variant X positive cardiomyocyte was the significant factor associated with cardiac recovery and EXCOR explantation (hazard ratio, 0.16; 95% confidence interval, 0.027–0.51; P = 0.0096). Conclusions The degree of deoxyribonucleic acid damage response at EXCOR implantation may aid in predicting the bridge to recovery with EXCOR among low-weight pediatric patients with dilated cardiomyopathy.

show abstract

Short-term outcomes of EXCOR Paediatric implantation

Cited by 3 publications

References 27 publications

Impact of Different Therapeutic Strategies With Left Ventricular Assist Devices on Health-Related Quality of Life During Prolonged Device-Based Support

Impact of Different Therapeutic Strategies With Left Ventricular Assist Devices on Health-Related Quality of Life During Prolonged Device-Based Support

Myocardial recovery in children supported with a durable ventricular assist device—a systematic review

Cardiomyocyte deoxyribonucleic acid damage and cardiac recovery in paediatric dilated cardiomyopathy

Contact Info

Product

Resources

About