Ventricular Assist Device Outcomes in Infants and Children With Stage 1 Single Ventricle Palliation

Anna Joong; Katsuhide Maeda; David M. Peng; Mohammed Absi; Blake P.N. Armstrong; Neha Bansal; David W. Bearl; Mark S. Bleiweis; Molly Brickler; Holger Buchholz; Sharon Chen; Jennifer Conway; Nhue L. Do; Paul Esteso; Joshua Friedland-Little; Eric R. Griffiths; Daphne T. Hsu; Steven J. Kindel; Angela Lorts; Hugo R. Martinez; David Michael Mcmullan; Mary Mehegan; Deepa Mokshagundam; David L.S. Morales; Joseph Philip; Michelle Ploutz; David N. Rosenthal; Muhammad F. Shezad; Joshua Sparks; Courtney Ventresco; Chet Villa; Sarah Wilkens; Farhan Zafar

doi:10.1097/MAT.0000000000001817

Ventricular Assist Device Outcomes in Infants and Children With Stage 1 Single Ventricle Palliation

Anna Joong, Katsuhide Maeda, David M. Peng, Mohammed Absi, Blake P.N. Armstrong, Neha Bansal, David W. Bearl, Mark S. Bleiweis, Molly Brickler, Holger Buchholz, Sharon Chen, Jennifer Conway, Nhue L. Do, Paul Esteso, Joshua Friedland-Little, Eric R. Griffiths, Daphne T. Hsu, Steven J. Kindel, Angela Lorts, Hugo R. MartinezDavid Michael Mcmullan, Mary Mehegan, Deepa Mokshagundam, David L.S. Morales, Joseph Philip, Michelle Ploutz, David N. Rosenthal, Muhammad F. Shezad, Joshua Sparks, Courtney Ventresco, Chet Villa, Sarah Wilkens, Farhan Zafar

Pediatrics

Research output: Contribution to journal › Article › peer-review

2 Scopus citations

Abstract

Data on ventricular assist device (VAD) outcomes in infants with stage 1 single ventricle (SV) palliation are limited. We examined the Advanced Cardiac Therapies Improving Outcomes Network (ACTION) registry for outcomes of pre/poststage 1 SV patients undergoing VAD implantation between March 2018 and October 2020. Data are collected from 32 centers and major adverse events undergo central adjudication. During the study period, 30 stage 1 SV patients underwent VAD implant with median age of 0.9 months (range 0.1-25) and weight 3.7 kg (2.4-17). Preimplant illness severity was high: ventilator support (90%), ECMO (30%), prior cerebral vascular accident (CVA, 23%), and dialysis (13%). Devices used included paracorporeal pulsatile (50%), paracorporeal continuous-flow (37%), and multiple devices (13%). Median support duration was 56 days (range 3-246). A positive clinical outcome (transplanted or weaned) was attained in 63% (63% transplanted, 37% mortality, 0% weaned). VAD adverse events included: major infection (43%), neurologic dysfunction (any = 30%; CVA = 20%), major bleeding (17%), renal dysfunction (13%), and device malfunction (3%). In conclusion, stage 1 SV patients undergoing VAD support have high preimplant illness severity and complexity, as well as significant morbidity and mortality postimplant. A variety of devices and strategies are employed by centers to support this challenging population.

Original language	English (US)
Pages (from-to)	E188-E195
Journal	ASAIO Journal
Volume	68
Issue number	11
DOIs	https://doi.org/10.1097/MAT.0000000000001817
State	Published - Nov 1 2022

Keywords

congenital heart disease
mechanical circulatory support
pediatrics
single ventricle
ventricular assist device

ASJC Scopus subject areas

Biophysics
Bioengineering
Biomaterials
Biomedical Engineering

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10.1097/MAT.0000000000001817

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Joong, A., Maeda, K., Peng, D. M., Absi, M., Armstrong, B. P. N., Bansal, N., Bearl, D. W., Bleiweis, M. S., Brickler, M., Buchholz, H., Chen, S., Conway, J., Do, N. L., Esteso, P., Friedland-Little, J., Griffiths, E. R., Hsu, D. T., Kindel, S. J., Lorts, A., ... Zafar, F. (2022). Ventricular Assist Device Outcomes in Infants and Children With Stage 1 Single Ventricle Palliation. ASAIO Journal, 68(11), E188-E195. https://doi.org/10.1097/MAT.0000000000001817

Joong, A, Maeda, K, Peng, DM, Absi, M, Armstrong, BPN, Bansal, N, Bearl, DW, Bleiweis, MS, Brickler, M, Buchholz, H, Chen, S, Conway, J, Do, NL, Esteso, P, Friedland-Little, J, Griffiths, ER, Hsu, DT, Kindel, SJ, Lorts, A, Martinez, HR, Michael Mcmullan, D, Mehegan, M, Mokshagundam, D, Morales, DLS, Philip, J, Ploutz, M, Rosenthal, DN, Shezad, MF, Sparks, J, Ventresco, C, Villa, C, Wilkens, S & Zafar, F 2022, 'Ventricular Assist Device Outcomes in Infants and Children With Stage 1 Single Ventricle Palliation', ASAIO Journal, vol. 68, no. 11, pp. E188-E195. https://doi.org/10.1097/MAT.0000000000001817

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title = "Ventricular Assist Device Outcomes in Infants and Children With Stage 1 Single Ventricle Palliation",

abstract = "Data on ventricular assist device (VAD) outcomes in infants with stage 1 single ventricle (SV) palliation are limited. We examined the Advanced Cardiac Therapies Improving Outcomes Network (ACTION) registry for outcomes of pre/poststage 1 SV patients undergoing VAD implantation between March 2018 and October 2020. Data are collected from 32 centers and major adverse events undergo central adjudication. During the study period, 30 stage 1 SV patients underwent VAD implant with median age of 0.9 months (range 0.1-25) and weight 3.7 kg (2.4-17). Preimplant illness severity was high: ventilator support (90%), ECMO (30%), prior cerebral vascular accident (CVA, 23%), and dialysis (13%). Devices used included paracorporeal pulsatile (50%), paracorporeal continuous-flow (37%), and multiple devices (13%). Median support duration was 56 days (range 3-246). A positive clinical outcome (transplanted or weaned) was attained in 63% (63% transplanted, 37% mortality, 0% weaned). VAD adverse events included: major infection (43%), neurologic dysfunction (any = 30%; CVA = 20%), major bleeding (17%), renal dysfunction (13%), and device malfunction (3%). In conclusion, stage 1 SV patients undergoing VAD support have high preimplant illness severity and complexity, as well as significant morbidity and mortality postimplant. A variety of devices and strategies are employed by centers to support this challenging population.",

keywords = "congenital heart disease, mechanical circulatory support, pediatrics, single ventricle, ventricular assist device",

author = "Anna Joong and Katsuhide Maeda and Peng, {David M.} and Mohammed Absi and Armstrong, {Blake P.N.} and Neha Bansal and Bearl, {David W.} and Bleiweis, {Mark S.} and Molly Brickler and Holger Buchholz and Sharon Chen and Jennifer Conway and Do, {Nhue L.} and Paul Esteso and Joshua Friedland-Little and Griffiths, {Eric R.} and Hsu, {Daphne T.} and Kindel, {Steven J.} and Angela Lorts and Martinez, {Hugo R.} and {Michael Mcmullan}, David and Mary Mehegan and Deepa Mokshagundam and Morales, {David L.S.} and Joseph Philip and Michelle Ploutz and Rosenthal, {David N.} and Shezad, {Muhammad F.} and Joshua Sparks and Courtney Ventresco and Chet Villa and Sarah Wilkens and Farhan Zafar",

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T1 - Ventricular Assist Device Outcomes in Infants and Children With Stage 1 Single Ventricle Palliation

AU - Joong, Anna

AU - Maeda, Katsuhide

AU - Peng, David M.

AU - Absi, Mohammed

AU - Armstrong, Blake P.N.

AU - Bansal, Neha

AU - Bearl, David W.

AU - Bleiweis, Mark S.

AU - Brickler, Molly

AU - Buchholz, Holger

AU - Chen, Sharon

AU - Conway, Jennifer

AU - Do, Nhue L.

AU - Esteso, Paul

AU - Friedland-Little, Joshua

AU - Griffiths, Eric R.

AU - Hsu, Daphne T.

AU - Kindel, Steven J.

AU - Lorts, Angela

AU - Martinez, Hugo R.

AU - Michael Mcmullan, David

AU - Mehegan, Mary

AU - Mokshagundam, Deepa

AU - Morales, David L.S.

AU - Philip, Joseph

AU - Ploutz, Michelle

AU - Rosenthal, David N.

AU - Shezad, Muhammad F.

AU - Sparks, Joshua

AU - Ventresco, Courtney

AU - Villa, Chet

AU - Wilkens, Sarah

AU - Zafar, Farhan

PY - 2022/11/1

Y1 - 2022/11/1

N2 - Data on ventricular assist device (VAD) outcomes in infants with stage 1 single ventricle (SV) palliation are limited. We examined the Advanced Cardiac Therapies Improving Outcomes Network (ACTION) registry for outcomes of pre/poststage 1 SV patients undergoing VAD implantation between March 2018 and October 2020. Data are collected from 32 centers and major adverse events undergo central adjudication. During the study period, 30 stage 1 SV patients underwent VAD implant with median age of 0.9 months (range 0.1-25) and weight 3.7 kg (2.4-17). Preimplant illness severity was high: ventilator support (90%), ECMO (30%), prior cerebral vascular accident (CVA, 23%), and dialysis (13%). Devices used included paracorporeal pulsatile (50%), paracorporeal continuous-flow (37%), and multiple devices (13%). Median support duration was 56 days (range 3-246). A positive clinical outcome (transplanted or weaned) was attained in 63% (63% transplanted, 37% mortality, 0% weaned). VAD adverse events included: major infection (43%), neurologic dysfunction (any = 30%; CVA = 20%), major bleeding (17%), renal dysfunction (13%), and device malfunction (3%). In conclusion, stage 1 SV patients undergoing VAD support have high preimplant illness severity and complexity, as well as significant morbidity and mortality postimplant. A variety of devices and strategies are employed by centers to support this challenging population.

AB - Data on ventricular assist device (VAD) outcomes in infants with stage 1 single ventricle (SV) palliation are limited. We examined the Advanced Cardiac Therapies Improving Outcomes Network (ACTION) registry for outcomes of pre/poststage 1 SV patients undergoing VAD implantation between March 2018 and October 2020. Data are collected from 32 centers and major adverse events undergo central adjudication. During the study period, 30 stage 1 SV patients underwent VAD implant with median age of 0.9 months (range 0.1-25) and weight 3.7 kg (2.4-17). Preimplant illness severity was high: ventilator support (90%), ECMO (30%), prior cerebral vascular accident (CVA, 23%), and dialysis (13%). Devices used included paracorporeal pulsatile (50%), paracorporeal continuous-flow (37%), and multiple devices (13%). Median support duration was 56 days (range 3-246). A positive clinical outcome (transplanted or weaned) was attained in 63% (63% transplanted, 37% mortality, 0% weaned). VAD adverse events included: major infection (43%), neurologic dysfunction (any = 30%; CVA = 20%), major bleeding (17%), renal dysfunction (13%), and device malfunction (3%). In conclusion, stage 1 SV patients undergoing VAD support have high preimplant illness severity and complexity, as well as significant morbidity and mortality postimplant. A variety of devices and strategies are employed by centers to support this challenging population.

KW - congenital heart disease

KW - mechanical circulatory support

KW - pediatrics

KW - single ventricle

KW - ventricular assist device

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Ventricular Assist Device Outcomes in Infants and Children With Stage 1 Single Ventricle Palliation

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