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Long-term follow-up of pediatric cardiac patients requiring mechanical circulatory support
- Source :
- The Annals of Thoracic Surgery. 69:186-192
- Publication Year :
- 2000
- Publisher :
- Elsevier BV, 2000.
-
Abstract
- Background . The present study examines the long-term outcome of pediatric patients with cardiac disease who required mechanical circulatory support with extracorporeal membrane oxygenation or ventricular assist devices. Methods . Telephone interviews and questionnaires were administered to parents and physicians of pediatric cardiac patients who were in-hospital survivors after requiring mechanical circulatory support, with either extracorporeal membrane oxygenation or ventricular assist devices. Data was collected regarding these patients' general health, cardiac status, and neurologic outcome, and compared between the two modes of support. Results . Follow-up was available for 26 patients supported with extracorporeal membrane oxygenation (25 survivors, 96%) and 11 patients supported with ventricular assist devices (10 survivors, 91%); median follow-up 42 months, 11 to 92 months). More than 80% of survivors were in New York Heart Association class I or II. Of 31 patients for whom neurologic assessment data was available, moderate to severe neurologic impairment was more common for extracorporeal membrane oxygenation supported patients [13 of 21, 59%) than for ventricular assist device supported patients (2 of 10, 20% p = 0.03). Neurologic impairment was associated with small patient size and the use of circulatory arrest during cardiac surgical repair, but was not associated with in-hospital neurologic complications, carotid cannulation, or presupport cardiac arrest. Conclusions . The long-term survival and cardiac functional status of pediatric cardiac patients requiring mechanical circulatory support is favorable. Extracorporeal membrane oxygenation supported patients demonstrate higher rates of neurologic impairment than patients supported with ventricular assist devices. Poor neurologic outcomes are associated with institution of support in younger patients with more complex congenital heart disease.
- Subjects :
- Adult
Heart Defects, Congenital
Pulmonary and Respiratory Medicine
Adolescent
Heart Diseases
Membrane oxygenator
Health Status
medicine.medical_treatment
law.invention
Interviews as Topic
Child Development
Extracorporeal Membrane Oxygenation
law
Surveys and Questionnaires
Artificial heart
Extracorporeal membrane oxygenation
Humans
Medicine
Longitudinal Studies
Child
New York Heart Association Class I
Neurologic Examination
Chi-Square Distribution
business.industry
Infant
Heart
Treatment Outcome
El Niño
Child, Preschool
Ventricular assist device
Anesthesia
Circulatory system
Heart Arrest, Induced
Body Constitution
Surgery
Heart-Assist Devices
Cardiology and Cardiovascular Medicine
business
Chi-squared distribution
Follow-Up Studies
Subjects
Details
- ISSN :
- 00034975
- Volume :
- 69
- Database :
- OpenAIRE
- Journal :
- The Annals of Thoracic Surgery
- Accession number :
- edsair.doi.dedup.....6b01cc46c5a3c030f24c99a5d2494c90