Matthew J O'Connor1, Angela Lorts2, Ryan R Davies3, Francis Fynn-Thompson4, Anna Joong5, Katsuhide Maeda6, Christopher E Mascio7, Patrick I McConnell8, Michael C Mongé9, Deipanjan Nandi10, David M Peng11, David N Rosenthal12, Ming-Sing Si13, David L Sutcliffe14, Christina J VanderPluym15, Melita Viegas16, Farhan Zafar2, Matthew Zinn17, David L S Morales2. 1. Division of Cardiology, Department of Pediatrics, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania. Electronic address: oconnorm@email.chop.edu. 2. Cincinnati Children's Hospital Medical Center, Heart Institute, Cincinnati, Ohio. 3. Department of Cardiovascular and Thoracic Surgery, UT Southwestern Medical Center and Children's Health, Dallas, Texas. 4. Department of Cardiovascular Surgery, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts. 5. Division of Pediatric Cardiology, Ann & Robert H. Lurie Children's Hospital, Chicago, Illinois. 6. Departments of Cardiothoracic Surgery and Pediatrics, Lucile Packard Children's Hospital Stanford, Palo Alto, California. 7. Division of Pediatric Cardiothoracic Surgery, Department of Surgery, Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania. 8. Department of Cardiothoracic Surgery, Nationwide Children's Hospital, Columbus, Ohio. 9. Division of Cardiovascular-Thoracic Surgery, Ann & Robert H. Lurie Children's Hospital, Chicago, Illinois. 10. Division of Cardiology, Department of Pediatrics, Nationwide Children's Hospital, Columbus, Ohio. 11. Department of Pediatrics, Division of Pediatric Cardiology, University of Michigan, Ann Arbor, Michigan. 12. Division of Pediatric Cardiology, Lucile Packard Children's Hospital Stanford, Palo Alto, California. 13. Department of Cardiac Surgery, Division of Pediatric Cardiovascular Surgery, University of Michigan, Ann Arbor, Michigan. 14. Department of Pediatrics, UT Southwestern Medical Center and Children's Medical Center, Dallas, Texas. 15. Department of Cardiology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts. 16. Division of Pediatric Cardiothoracic Surgery, Department of Surgery, Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania. 17. Division of Cardiology, Department of Pediatrics, Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
Abstract
BACKGROUND: The HeartMate 3 ventricular assist device (VAD) is a newer centrifugal continuous-flow VAD used for bridge-to-transplant and destination therapy in adults. However, there is limited experience regarding its use in children and adults with complex congenital heart disease (CHD). METHODS: The Advanced Cardiac Therapies Improving Outcomes Network (ACTION) is a multicenter learning network comprised of pediatric hospitals implanting VADs in children and adults with complex CHD. We examined the outcomes of patients undergoing HeartMate 3 implantation at an ACTION center between December 2017 and September 2019. RESULTS: The HeartMate 3 was implanted in 35 patients at 9 ACTION centers, with a median age of 15.7 (8.8-47.3) years, median weight of 65.7 (19.1-114.1) kg, and median body surface area (BSA) of 1.74 (0.78-2.36) m2. Of the cohort, 14 patients (40%) weighed <60 kg. Diagnoses included dilated cardiomyopathy (63%), dilated cardiomyopathy in neuromuscular disease (20%), and CHD (17%). Of those with CHD, most had a Fontan circulation. With a median 78 days of follow-up, there was 1 death on device (97% survival); 20 out of 35 (57%) underwent transplantation with no post-transplantation mortality. There were no episodes of stroke or pump thrombosis. CONCLUSIONS: Use of the HeartMate 3 in ACTION centers was associated with a low incidence of mortality and adverse events. Patients as small as 19 kg (BSA 0.78 m2) were successfully implanted and supported, indicating that this device may be appropriate for older children and small adults.
BACKGROUND: The HeartMate 3 ventricular assist device (VAD) is a newer centrifugal continuous-flow VAD used for bridge-to-transplant and destination therapy in adults. However, there is limited experience regarding its use in children and adults with complex congenital heart disease (CHD). METHODS: The Advanced Cardiac Therapies Improving Outcomes Network (ACTION) is a multicenter learning network comprised of pediatric hospitals implanting VADs in children and adults with complex CHD. We examined the outcomes of patients undergoing HeartMate 3 implantation at an ACTION center between December 2017 and September 2019. RESULTS: The HeartMate 3 was implanted in 35 patients at 9 ACTION centers, with a median age of 15.7 (8.8-47.3) years, median weight of 65.7 (19.1-114.1) kg, and median body surface area (BSA) of 1.74 (0.78-2.36) m2. Of the cohort, 14 patients (40%) weighed <60 kg. Diagnoses included dilated cardiomyopathy (63%), dilated cardiomyopathy in neuromuscular disease (20%), and CHD (17%). Of those with CHD, most had a Fontan circulation. With a median 78 days of follow-up, there was 1 death on device (97% survival); 20 out of 35 (57%) underwent transplantation with no post-transplantation mortality. There were no episodes of stroke or pump thrombosis. CONCLUSIONS: Use of the HeartMate 3 in ACTION centers was associated with a low incidence of mortality and adverse events. Patients as small as 19 kg (BSA 0.78 m2) were successfully implanted and supported, indicating that this device may be appropriate for older children and small adults.
Authors: Joshua M Friedland-Little; Anna Joong; Svetlana B Shugh; Matthew J O'Connor; Neha Bansal; Ryan R Davies; Michelle S Ploutz Journal: Pediatr Cardiol Date: 2022-03-24 Impact factor: 1.838
Authors: Awais Ashfaq; Geoffrey M Gray; Jennifer Carapellucci; Ernest K Amankwah; Luis M Ahumada; Mohamed Rehman; Michael Puchalski; Andrew Smith; James A Quintessenza; Alfred Asante-Korang Journal: Lancet Reg Health Am Date: 2021-08-31