open access

Vol 68, No 6 (2010)
Original articles
Published online: 2010-06-17
Submitted: 2012-12-28
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Paediatric heart transplantation - the impact of a ventricular assist device on operative outcomes

Katarzyna Januszewska, Edward Malec, Julia Birnbaum, Markus Loeff, Ralf Sodian, Christoph Schmitz, Heinrich Netz, Bruno Reichart
Kardiol Pol 2010;68(6):669-674.

open access

Vol 68, No 6 (2010)
Original articles
Published online: 2010-06-17
Submitted: 2012-12-28

Abstract

Background: The use of a ventricular assist device (VAD) is a life-saving option for patients with heart failure refractory to conventional therapy.
Aim: To assess the effect of VAD on outcomes of heart transplantation in children.
Methods: Between October 1988 and June 2009, a consecutive series of 95 children (mean age 8.6 ± 6.7 years, range 5 days–17.9 years) underwent heart transplantation: patients in group 1 (n = 11) received VAD as a bridge to cardiac transplantation (left ventricular VAD in 4, biventricular VAD in 7), and patients in group 2 (n = 84) underwent heart transplantation without previous cardiac support using VAD. The indication for heart transplantation was cardiomyopathy/myocarditis in 66 (69.5%) of children and congenital heart disease in 29 (30.5%) patients.
Results: Congenital heart disease was diagnosed more often in group 2 than in group 1 (p = 0.047). The two groups did not differ significantly with respect to age, weight and parameters of preoperative liver and kidney function (except for aspartate aminotransferase activity, p = 0.020). The mean waiting time for transplantation was 64.2 ± 87.4 days (range 1–443 days) and did not differ between the groups. The mean follow-up was 6.8 ± 5.4 years (range 1 day–17.6 years). Mortality during long-term follow-up was 9.1% (n = 1) in group 1 and 20.2% (n=17) in group 2 (p = 0.632). We found no significant differences in postoperative ventilatory support time (p = 0.773), duration of hospital stay (p = 0.853), and incidence of acute rejection episodes (p = 0.575).
Conclusions: The use of VAD as a bridge to heart transplantation in children with severe heart failure had no negative effect on treatment outcomes.
Kardiol Pol 2010; 68, 6: 664-669

Abstract

Background: The use of a ventricular assist device (VAD) is a life-saving option for patients with heart failure refractory to conventional therapy.
Aim: To assess the effect of VAD on outcomes of heart transplantation in children.
Methods: Between October 1988 and June 2009, a consecutive series of 95 children (mean age 8.6 ± 6.7 years, range 5 days–17.9 years) underwent heart transplantation: patients in group 1 (n = 11) received VAD as a bridge to cardiac transplantation (left ventricular VAD in 4, biventricular VAD in 7), and patients in group 2 (n = 84) underwent heart transplantation without previous cardiac support using VAD. The indication for heart transplantation was cardiomyopathy/myocarditis in 66 (69.5%) of children and congenital heart disease in 29 (30.5%) patients.
Results: Congenital heart disease was diagnosed more often in group 2 than in group 1 (p = 0.047). The two groups did not differ significantly with respect to age, weight and parameters of preoperative liver and kidney function (except for aspartate aminotransferase activity, p = 0.020). The mean waiting time for transplantation was 64.2 ± 87.4 days (range 1–443 days) and did not differ between the groups. The mean follow-up was 6.8 ± 5.4 years (range 1 day–17.6 years). Mortality during long-term follow-up was 9.1% (n = 1) in group 1 and 20.2% (n=17) in group 2 (p = 0.632). We found no significant differences in postoperative ventilatory support time (p = 0.773), duration of hospital stay (p = 0.853), and incidence of acute rejection episodes (p = 0.575).
Conclusions: The use of VAD as a bridge to heart transplantation in children with severe heart failure had no negative effect on treatment outcomes.
Kardiol Pol 2010; 68, 6: 664-669
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Keywords

ventricular assist device; paediatric heart transplantation

About this article
Title

Paediatric heart transplantation - the impact of a ventricular assist device on operative outcomes

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Vol 68, No 6 (2010)

Pages

669-674

Published online

2010-06-17

Bibliographic record

Kardiol Pol 2010;68(6):669-674.

Keywords

ventricular assist device
paediatric heart transplantation

Authors

Katarzyna Januszewska
Edward Malec
Julia Birnbaum
Markus Loeff
Ralf Sodian
Christoph Schmitz
Heinrich Netz
Bruno Reichart

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