We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Contemporary outcomes of durable ventricular assist devices in adults with congenital heart disease as a bridge to heart transplantation.
- Authors
Das, Bibhuti B.; Kogon, Brian; Deshpande, Shriprasad R.; Slaughter, Mark S.; Trivedi, Jaimin R.
- Abstract
Objectives: This study aimed to compare the clinical characteristics, risk factors, and overall survival outcomes in adults with congenital heart disease (ACHD) bridged to transplantation with a ventricular assist device (VAD) versus no‐VAD. Methods: The study included 894 ACHD patients aged ≥18 years listed for primary heart transplantation between 2010 and 2019 from the United Network for Organ Sharing database. Primary outcomes were waitlist and 1‐year post‐transplant mortality between VAD and no‐VAD ACHD patients. Results: Of 894 ACHD patients included in the study, 91(10.1%) had VAD support at the time of listing. Patients who needed VAD support were mostly males, heavier, and had higher pulmonary artery pressure than the no‐VAD group at the listing. The overall waitlist mortality was 38% in the VAD group than 17% in the no‐VAD group (p < 0.01). ECMO use was associated with significantly higher mortality than either group. There was no significant difference in 1‐year post‐transplant mortality between VAD versus no‐VAD at the time of transplant (15% vs. 17%; p = 0.66). Multivariate regression analysis found that BMI <20 kg/m2 (hazard ratio (HR) 1.1; p = 0.01), bilirubin >2 mg/dl (HR 1.1; p = 0.03), creatinine >2 mg/dl (HR 1.3; p = 0.04) and ECMO at transplant (HR 1.4; p = 0.03) increased early post‐transplant mortality. Conclusions: The one‐year post‐transplant mortality rate was no different for ACHD patients that received VAD versus no‐VAD. These findings suggest that a VAD should be considered an option to support ACHD patients as a bridge to heart transplantation.
- Subjects
HEART assist devices; HEART; HEART transplantation; CONGENITAL heart disease; HEART transplant recipients; SURVIVAL rate; ADULTS
- Publication
Artificial Organs, 2022, Vol 46, Issue 4, p697
- ISSN
0160-564X
- Publication type
Article
- DOI
10.1111/aor.14092