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Ventricular assist device as a bridge to heart transplantation in children

^a Department of Cardiac Surgery, Klinikum Grosshadern, Ludwig Maximilians University, Marchioninistr. 15, 81377 Munich, Germany
^b Department of Paediatric Cardiology, Klinikum Grosshadern, Ludwig Maximilians University, Munich, Germany

*Corresponding author. Tel.: +49 89 7095 2357; fax: +49 89 7095 8873.

E-mail address: mijanusz{at}cyf-kr.edu.pl (K. Januszewska).

The ventricular assist device (VAD) is a life-saving option for patients in heart failure refractory for conventional therapy. The aim of study was to assess the influence of VAD on heart transplantation (HT) outcome in children <16 years. Between October 1988 and August 2008, 73 children underwent HT: Group 1 (n=9) who received VAD as bridge to HT (left ventricular – 4, biventricular – 5), and Group 2 (n=64), without previous VAD. Diagnoses included cardiomyopathy (n=50 (68.5%)) and congenital heart defects (n=23 (31.5%)). Retrospective analysis of perioperative and long-term follow-up data was performed. The mean follow-up was 7.22±4.7 years. The diagnosis of cardiomyopathy appeared more often in Group 1 (P=0.074), but the difference was not significant. The two groups did not differ with respect to age (P=0.123) and weight (P=0.183). Mortality in long follow-up was: 11.1% (n=1) in Group 1 and 14.1% (n=9) in Group 2 (P=0.782). Analysis of preoperative end-organs function did not reveal significant differences between groups. There was also no significant differences with respect to waiting time for transplant (P=0.948), postoperative ventilatory support time (P=0.677), duration of hospital stay (P=0.711) and incidence of acute rejection episodes (P=0.156). VAD used as a bridge for HT in children does not negatively influence the outcome.

Key Words: Ventricular assist device; Pediatric heart transplantation; End-organ function