Ventricular assist device as a bridge to heart transplantation in children
Katarzyna Januszewska 1*,
Edward Malec 1,
Julia Birnbaum 1,
Markus Loeff 1,
Ralf Sodian 1,
Christoph Schmitz 1,
Heinrich Netz 1,
Bruno Reichart 1
1 Ludwig Maximilians University, Munich, Germany
* To whom correspondence should be addressed. E-mail: mijanusz{at}cyf-kr.edu.pl.
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Abstract |
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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 awaiting 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. Keywords: Ventricular assist device; Pediatric heart transplantation; End-organ function
