Children who needed renal replacement therapy at the time of VAD implantation were rare, sicker, and had lower one-year survival than other VAD patients. But after accounting for other factors, the therapy itself was not independently linked to mortality.
Adolescents and young adults are increasingly discharged home on a ventricular assist device, but little is known about what that period is actually like. Seventeen young people interviewed across ACTION sites described worries centered on emergencies, infection, and bleeding, along with limits on friendships, sports, and freedom of movement.
About one in ten children supported by a ventricular assist device developed a device-associated infection, and one-year survival was no different for those who did. Drawing on 1,527 patients in the ACTION registry, the study found that implanted devices carried a proportionately higher infection rate than external ones.
Concerns about survival have made biventricular support less common in children. Drawing on 223 pediatric patients in the ACTION registry, this study asked whether the timing of RVAD placement matters. Patients who received both devices in a single operation had better one-year survival, despite being sicker going into surgery.
Does Earlier Right Ventricular Assist Device Implant Confer a Survival Advantage Read More »
This ACTION registry study of 812 children on paracorporeal VADs found that one-third experienced infectious adverse events, which were associated with worse survival. Overlapping device support and smaller body size emerged as independent risk factors for infection.
This ACTION registry analysis of 94 children with heart failure found no difference in 30-day readmission or mortality whether beta-blockers were started during an inpatient admission or in the outpatient setting. The findings suggest both approaches are safe, though larger datasets are needed to confirm them.
Safety of Inpatient and Outpatient Beta Blocker Initiation in Pediatric Heart Failure Read More »
This review outlines the physiologic principles, patient selection criteria, and specialized management strategies needed to safely use the adult-designed HeartMate 3 heart pump in children, small adults, and patients with congenital heart disease or muscular dystrophy.
ACTION is a multicenter learning health system spanning 52 sites and over 5,000 pediatric patients that combines standardized data collection, quality improvement, and research to drive measurable gains in outcomes for children with congenital heart disease-related heart failure.
A new multicenter study suggests SGLT2 inhibitors — a diabetes drug class — may offer a well-tolerated way to modestly improve heart function in kids with dystrophin-deficient cardiomyopathy.
In this ACTION registry analysis of pediatric VAD recipients, patients bridged to transplant candidacy (rather than already listed at implant) faced significantly higher rates of major adverse events, on-device mortality, and lower rates of successful transplantation compared to bridge-to-transplant patients.
