TY - JOUR
T1 - Continuous flow device support in children using the HeartWare HVAD
T2 - 1,000 days of lessons learned from a single center experience
AU - Sparks, Joshua
AU - Epstein, Deirdre
AU - Baltagi, Sirine
AU - Mehegan, Mary E.
AU - Simpson, Kathleen E.
AU - Canter, Charles E.
AU - Silvestry, Scott
AU - Eghtesady, Pirooz
AU - Boston, Umar S.
N1 - Publisher Copyright:
© 2015 by the American Society for Artificial Internal Organs.
PY - 2015/10/1
Y1 - 2015/10/1
N2 - The purpose of this study is to provide a single center experience with a continuous flow device in adolescents with end-stage heart failure. A retrospective single center analysis of patients aged 18 years or younger implanted with HVAD (HeartWare Inc, Framingham, MA) between October 2012 and March 2014 was performed. Demographics, preimplant and postimplant clinical data, survival, and adverse events (AEs) were recorded. A matched group of adults based on diagnosis, body surface area (BSA), and time period were used for outcome comparisons. Six adolescents with dilated cardiomyopathy were implanted with the HVAD. Median age and BSA were 13.4 years and 1.45 m2, respectively. All were Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) profile-1 or profile-2. Median days on device were 108 with total patient-days on device of 1,017. Four adolescents were discharged home on device all in New York Heart Association 1. Five underwent transplantation with 100% survival. There were 18 AEs with one AE per 170 days on device. Compared with the adult cohort (n = 5), there was no difference in 1 year survival (p = 0.32). HVAD support in adolescents is highly successful as a bridge to transplantation. It provides early rehabilitation and improvement in quality of life. Morbidity is not negligible but appears comparable with that seen in adults.
AB - The purpose of this study is to provide a single center experience with a continuous flow device in adolescents with end-stage heart failure. A retrospective single center analysis of patients aged 18 years or younger implanted with HVAD (HeartWare Inc, Framingham, MA) between October 2012 and March 2014 was performed. Demographics, preimplant and postimplant clinical data, survival, and adverse events (AEs) were recorded. A matched group of adults based on diagnosis, body surface area (BSA), and time period were used for outcome comparisons. Six adolescents with dilated cardiomyopathy were implanted with the HVAD. Median age and BSA were 13.4 years and 1.45 m2, respectively. All were Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) profile-1 or profile-2. Median days on device were 108 with total patient-days on device of 1,017. Four adolescents were discharged home on device all in New York Heart Association 1. Five underwent transplantation with 100% survival. There were 18 AEs with one AE per 170 days on device. Compared with the adult cohort (n = 5), there was no difference in 1 year survival (p = 0.32). HVAD support in adolescents is highly successful as a bridge to transplantation. It provides early rehabilitation and improvement in quality of life. Morbidity is not negligible but appears comparable with that seen in adults.
KW - HeartWare
KW - adolescents
KW - bride-to-transplantation
KW - continuous flow device
KW - durable mechanical support
UR - http://www.scopus.com/inward/record.url?scp=84946830927&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84946830927&partnerID=8YFLogxK
U2 - 10.1097/MAT.0000000000000253
DO - 10.1097/MAT.0000000000000253
M3 - Article
C2 - 25967955
AN - SCOPUS:84946830927
SN - 1058-2916
VL - 61
SP - 569
EP - 573
JO - ASAIO Journal
JF - ASAIO Journal
IS - 5
ER -