Abstract 10088: Outcomes of Children Implanted with Ventricular Assist Devices in the United States: Analysis of the Interagency Registry for Mechanical Circulatory Support (INTERMACS)
INTRODUCTION: Pediatric mechanical circulatory support (MCS) has gained increasing attention as a strategy to decrease mortality in those awaiting transplant. Pediatric specific ventricular assist devices (VADs) are likely to soon become FDA approved; prior to this, a nationwide account of current FDA-approved device usage in pediatrics is essential.
METHODS: INTERMACS, a federally-supported registry for FDA-approved durable VADs, records data prior to and during VAD therapy. Analysis was performed for all patients < 21 years old, enrolled between June 23, 2006 and December 31, 2010.
RESULTS: Seventy four pediatric patients underwent VAD implantation at 42 institutions. Pre-implant characteristics are in Table 1. Implanted devices include LVADs alone in 51 (69%), BiVADs in 21 (28%), and total artificial hearts in 2 (3%). Half (n=37) were continuous flow. Among those with a continuous flow device, 62% were 18-20 years of age, compared to 41% with a pulsatile device. Overall, at 6 months after implant, 55% were transplanted, 37% were alive on support, and 8% had died (Figure 1). There were 291 adverse events, including infection (n=82), major bleeding (n=72), neurologic events (n=10), and device malfunction (n=20). Causes of death were CNS (4), infection (1), RV failure (1), hemorrhage (1), and other (3).
CONCLUSIONS: Ventricular assist devices may be successfully applied to adolescents awaiting heart transplant, and their outcomes compare favorably with current 6-month survival rates of adults with VADs. Annual comparative INTERMACS analyses of smaller children supported with emerging pediatric-specific VADs will be possible as novel VADs become FDA-approved.
- Ventricular assist devices
- Pediatric cardiac intensive care
- Heart failure
- Pediatric cardiology
- © 2011 by American Heart Association, Inc.