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Bridge to Transplant with Ventricular Assist Device Support in Pediatric Patients with Single Ventricle Heart Disease
- Source :
- ASAIO Journal. 66:205-211
- Publication Year :
- 2020
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2020.
-
Abstract
- Ventricular assist device (VAD) support for children with single ventricle (SV) heart disease remains challenging. We performed a single-center retrospective review of SV patients on VAD support and examined survival to transplant using the Kaplan-Meier method. Patients transplanted were compared with those who died on support. Between 2009 and 2017, there were 14 SV patients with 1,112 patient-days of VAD support. Stages of palliation included pre-Glenn (n = 5), Glenn (n = 5), and Fontan (n = 4). Eight patients (57%) were successfully bridged to transplant at a median 107 days. Deaths occurred early (n = 6, median 16 days) and in smaller patients (10.1 vs. 28.3 kg, P = 0.04). All Fontan patients survived to transplant, whereas only 20% of Glenn patients survived to transplant. Adverse events occurred in 79% (n = 11). Five patients met hospital discharge criteria, with two patients (one pre-Glenn, one Glenn) discharged and transplanted after 219 and 174 days of VAD support. All transplanted patients were discharged at a median 21 days posttransplant. SV patients in various stages of palliation can be successfully bridged to transplant with VAD support. With use of intracorporeal continuous-flow devices, longer-term support and hospital discharge are possible.
- Subjects :
- Male
medicine.medical_specialty
Time Factors
Heart disease
medicine.medical_treatment
Biomedical Engineering
Biophysics
Bioengineering
030204 cardiovascular system & hematology
Univentricular Heart
Biomaterials
03 medical and health sciences
0302 clinical medicine
medicine
Hospital discharge
Humans
Child
Adverse effect
Retrospective Studies
Heart transplantation
Bridge to transplant
business.industry
Infant
Retrospective cohort study
General Medicine
medicine.disease
Surgery
Treatment Outcome
medicine.anatomical_structure
030228 respiratory system
Ventricle
Child, Preschool
Ventricular assist device
Heart Transplantation
Female
Heart-Assist Devices
business
Subjects
Details
- ISSN :
- 10582916
- Volume :
- 66
- Database :
- OpenAIRE
- Journal :
- ASAIO Journal
- Accession number :
- edsair.doi.dedup.....7a919a711c8304a6f8adc8ac74068ca9