Institutional report - Assisted circulation Ventricular assist device as a bridge to heart transplantation in children
msra(2009)
Abstract
The ventricular assist device (VAD ) is a life-saving option for patients in heart failure refractory for conventional therapy. The aim of study was to assess the influence of VAD on heart transplantation (HT) outcome in children -16 years. Between October 1988 and August 2008, 73 children underwent HT: Group 1 (ns9) who received VAD as bridge to HT (left ventricular - 4, biventricular - 5), and Group 2 (ns64), without previous VAD. Diagnoses included cardiomyopathy (ns50 (68.5%)) and congenital heart defects (ns23 (31.5%)). Retrospective analysis of perioperative and long-term follow-up data was performed. The mean follow-up was 7.22"4.7 years. The diagnosis of cardiomyopathy appeared more often in Group 1 (Ps0.074), but the difference was not significant. The two groups did not differ with respect to age (Ps0.123) and weight (Ps0.183). Mortality in long follow-up was: 11.1% (ns1) in Group 1 and 14.1% (ns9) in Group 2 (Ps0.782). Analysis of preoperative end-organs function did not reveal significant differences between groups. There was also no significant differences with respect to waiting time for transplant (Ps0.948), postoperative ventilatory support time (Ps0.677), duration of hospital stay (Ps0.711) and incidence of acute rejection episodes (Ps0.156). VAD used as a bridge for HT in children does not negatively influence the outcome. 2009 Published by European Association for Cardio-Thoracic Surgery. All rights reserved.
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Key words
ventricular assist device,end-organ function,pediatric heart transplantation
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