Background
This study aims to evaluate the clinical outcomes of mechanical circulatory support (MCS) using paracorporeal continuous flow (pCF) pumps in children.
Methods
This multicenter retrospective study used the Advanced Cardiac Therapies Improving Outcomes Network (ACTION) database (4/2018–7/2023). Children who were supported with a pCF pump were included. The primary outcome was survival to transplant, explant, or transition to a durable device. The secondary outcomes were adverse events. The outcomes were stratified between non-congenital heart disease (CHD) and CHD with single and biventricular physiology.
Results
Three hundred and sixty-seven patients (CHD, N = 204, non-CHD, N = 163) were supported with a median of 25 days of support (CHD: 33 vs non-CHD 19 days, p = 0.04). CHD included single ventricle (n = 135 [66.2%]) and biventricular physiology (n = 69 [33.8%]). Non-CHD included dilated cardiomyopathy (n = 130 [79.8%]), transplant graft dysfunction (n = 9 [5.5%]), and others (n = 18 [11%]). Patients with CHD were younger (0.55 vs 2.0 years, p ≤ 0.001) and smaller (body surface area 0.35 vs 0.52 m2, p ≤ 0.001, weight 6.7 vs 11.1 kg, p ≤ 0.001) than those without CHD.
Overall positive outcome was 77.9% (n = 286) [survival to transplant: 38.7% (n = 142), durable device: 22.9% (n = 84)], recovery: 16.3% (n = 60). Between CHD and non-CHD, CHD showed lower positive outcomes (73.0 vs 82.2%, p = 0.05) with higher mortality (24 vs 14.1%, p = 0.02). There were comparable positive outcomes between single and biventricular CHD (73.0%), with a lower recovery rate in single ventricles (8.9% vs 21.8%, p = 0.01).
Conclusion
Mechanical circulatory support using a pCF pump in children was associated with a positive outcome in 78% of patients in a contemporary cohort. However, patients with CHD patients fared worse than patients without CHD.
- Lawrence Greiten, MD
- Christina VanderPluym, MD
- David M. Peng, MD
- Arene Butto, MD, MSCR
- Ryan Butts, MD
- Scott R. Auerbach, MD
- Jennifer Su, MD
- Matthew Zinn, DO
- Sairah Khan, MD
- Jonathan Byrnes, MD
- Angela Lorts, MD, MBA
- Shahnawaz Amdani, MD
- Mohammed Absi, MD
- John Dykes, MD
- Anna Joong, MD
- David Bearl, MD
- Sabrina Law, MD
- Deipanjan Nandi, MD
- Sarah Wilkens, MD
- Kevin Engelhardt, MD
- Lindsay May, MD, FRCPC
- Gabrielle Vaughn, MD
- John Jerry Parent, MD
- Joshua Friedland-Little, MD
- Deepa Mokshagundam, MD
- Jennifer Conway, MD, FRCPC
- Joseph Spinner, MD
- Othman Aljohani, MD, MPH
- Mark Bleiweis, MD
- Muhammad Farrukh Shezad, MS
- Matthew J. O’Connor, MD
CITATION
Moon, Jiyong, et al. Contemporary outcomes of mechanical circulatory support using paracorporeal continuous flow pump in children: A report from the ACTION learning network. The Journal of Heart and Lung Transplantation, (2025) Volume 0, Issue 0. DOI:10.1016/j.healun.2025.06.018
