Evolution of pediatric ventricular assist devices and their neurologic and renal complications—A 24‐year single‐center experience

Autor: Warren A. Zuckerman, Teresa Lee, Marc E. Richmond, David Kalfa, Namrata Jain, Damien J. LaPar, Paul J. Chai, Linda J. Addonizio, Benjamin S. Mantell, Jennie McAllister, S. Law, Emile A. Bacha
Rok vydání: 2020
Předmět:
Male
medicine.medical_treatment
Medicine (miscellaneous)
02 engineering and technology
030204 cardiovascular system & hematology
Single Center
Postoperative Complications
0302 clinical medicine
Risk Factors
Medicine
Registries
Child
Stroke
Incidence
Incidence (epidemiology)
Acute kidney injury
General Medicine
Acute Kidney Injury
Treatment Outcome
Child
Preschool
Female
biological phenomena
cell phenomena
and immunity
medicine.medical_specialty
Adolescent
Waiting Lists
0206 medical engineering
Biomedical Engineering
Bioengineering
Biomaterials
Young Adult
03 medical and health sciences
parasitic diseases
Humans
cardiovascular diseases
Retrospective Studies
Heart Failure
business.industry
Body Weight
Infant
Newborn
Infant
Retrospective cohort study
medicine.disease
020601 biomedical engineering
Transplantation
Ventricular assist device
Heart failure
Emergency medicine
Heart Transplantation
Heart-Assist Devices
business
Zdroj: Artificial Organs. 44:987-994
ISSN: 1525-1594
0160-564X
Popis: Utilization of ventricular assist devices (VADs) in adult populations with severe heart failure as a bridge to transplant has become the standard of care over the past two decades. Analogously, the use of VADs in pediatric populations has become more commonplace as pediatric heart transplantation has become more prevalent. We still have much to learn, however, about the complications after VAD placement in pediatric patients, their impact on transplantation and, in particular, how outcomes have changed over time. The objectives of this study were to (a) review the experience of a single pediatric VAD center, (b) identify risk factors that could lead to poor outcomes in patients on the transplant waitlist after VAD implantation and (c) demonstrate changes in outcomes over time. A retrospective cohort analysis was performed comparing death as a primary outcome and stroke and acute kidney injury (AKI) as secondary outcomes, across the study period divided into three timed eras. We analyzed 88 patients supported by a VAD over a 24-year timeframe. The duration, age at implant and indication for VAD support did not change significantly across the eras. We found that the incidence of stroke decreased over the study period and, while the rates of AKI did not change over the study period, those who developed AKI, while supported on VAD, had an increased risk of death.
Databáze: OpenAIRE
Externí odkaz: