| Autor: |
Rohde, Sofie, Puyvelde, Joeri van, Veen, Kevin M, Schweiger, Martin, Biermann, Daniel, Amodeo, Antonio, Martens, Thomas, Damman, Kevin, Gollmann-Tepeköylü, Can, Hulman, Michael, Iacovoni, Attilio, Krämer, Ulrike S, Loforte, Antonio, Napoleone, Carlo Pace, Nemec, Petr, Netuka, Ivan, Özbaran, Mustafa, Polo, Luz, Pya, Yuriy, Ramjankhan, Faiz |
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| Zdroj: |
European Journal of Cardio-Thoracic Surgery; Aug2024, Vol. 66 Issue 2, p1-12, 12p |
| Abstrakt: |
OBJECTIVES The use of ventricular assist devices (VADs) in children is increasing. However, absolute numbers in individual centres and countries remain small. Collaborative efforts such as the Paedi-European Registry for Patients with Mechanical Circulatory Support (EUROMACS) are therefore essential for combining international experience with paediatric VADs. Our goal was to present the results from the fourth Paedi-EUROMACS report. METHODS All paediatric (<19 years) patients from the EUROMACS database supported by a VAD were included. Patients were stratified into a congenital heart disease (CHD) group and a group with a non-congenital aetiology. End points included mortality, a transplant and recovery. Cox proportional hazard models were used to explore associated factors for mortality, cerebrovascular accident and pump thrombosis. RESULTS A total of 590 primary implants were included. The congenital group was significantly younger (2.5 vs 8.0 years, respectively, P < 0.001) and was more commonly supported by a pulsatile flow device (73.5% vs 59.9%, P < 0.001). Mortality was significantly higher in the congenital group (30.8% vs 20.4%, P = 0.009) than in the non-congenital group. However, in multivariable analyses, CHD was not significantly associated with mortality [hazard ratio (HR) 1.285; confidence interval (CI) 0.8111–2.036, P = 0.740]. Pump thrombosis was the most frequently reported adverse event (377 events in 132 patients; 0.925 events per patient-year) and was significantly associated with body surface area (HR 0.524, CI 0.333–0.823, P = 0.005), CHD (HR 1.641, CI 1.054–2.555, P = 0.028) and pulsatile flow support (HR 2.345, CI 1.406–3.910, P = 0.001) in multivariable analyses. CONCLUSIONS This fourth Paedi-EUROMACS report highlights the increasing use of paediatric VADs. The patient populations with congenital and non-congenital aetiologies exhibit distinct characteristics and clinical outcomes. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
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