We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
273 MECHANICAL CIRCULATORY SUPPORT IN THE DUTCH NATIONAL PAEDIATRIC HEART TRANSPLANTATION PROGRAM.
- Authors
Van Der Meulen, M.; Dalinghaus, M.; Maat, A.; Van De Woestijne, P.; Van Osch, L.; De Hoog, M.; Kraemer, U.; Bogers, A.J.J.C.
- Abstract
Objectives: Mechanical circulatory support (MCS) as a bridge to heart transplantation (HTx) or recovery may improve outcome in children with terminal heart failure. Here, we report our experience with the Berlin Heart Ventricular Assist Device (VAD) in children eligible for HTx and its effect on waiting-list mortality.Methods: A retrospective single-centre cohort study, national paediatric HTx program including all children eligible for HTx, from introduction of MCS-VAD in 2006.Results: A total of 41 patients were eligible for HTx, median age 10.6 years (IQR 2.9–14.4). Sixteen patients (40%) underwent MCS, 9 (56%) survived to HTx or recovery. Techniques and devices used were LVAD (n = 14, 88%), in 5 cases preceded by extracorporeal membrane oxygenation (ECMO) and BiVAD (n = 2, 13%), both preceded by ECMO. The main causes of death on MCS were neurological injury (n = 4, 25%) and systemic thromboembolic events (n = 2, 13%). In the MCS group, median time to death was 18 days (IQR 7–75), median time to HTx 124 days (IQR 52–300). Important complications requiring pump replacement included clot formation in the device [10 patients (63%), median 1 pump replacement/patient] and infections (n = 1, 6%). Compared to the era before MCS (1998–2006), waiting-list mortality decreased from 50% to 21% and was mainly related to complications of MCS (Fig. 1).Conclusion: Since the introduction of MCS, waiting-list mortality halved and more children with end-stage heart failure survived to HTx, thus improving outcome. Although there is substantial mortality and morbidity, overall mortality decreases making MCS an essential therapeutic tool. The need for donor organs remains critically urgent.
- Publication
Interactive Cardiovascular & Thoracic Surgery, 2014, Vol 19, Issue suppl_1, pS82
- ISSN
1569-9293
- Publication type
Article
- DOI
10.1093/icvts/ivu276.273