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 »
A multi-center ACTION registry study found that while VAD removal following heart recovery is rare in children (about 3%), nearly three-quarters of those who underwent explantation remained alive without needing a transplant or new device at two-year follow-up.
This multicenter analysis shows bivalirudin is an effective alternative to heparin for anticoagulation in pediatric mechanical circulatory support, with comparable bleeding and stroke outcomes.
Following a 2024 expert convening, a comprehensive clinical protocol was created to support VAD and transplant candidacy in Duchenne muscular dystrophy, translating consensus into real-world implementation.
In this multicenter retrospective study of 150 pediatric patients supported with the Impella device, 89.3% achieved positive clinical outcomes despite a 28% adverse event rate. Findings suggest a potential role for Impella in managing refractory advanced heart failure in children, particularly those with cardiomyopathy, transplant graft dysfunction, or congenital heart disease.
Through the collection and use of real-world data, the field has gained greater understanding of best practices in care of these patients, as well as improved access to devices with pediatric labeling of devices previously approved only for adults. Recent and current work across the network’s major focus areas (VAD, heart failure, muscular dystrophy, and Fontan) are highlighted.
Innovation in pediatric medical devices is limited by financial and regulatory barriers due to the small and heterogenous target population. Intentional design of the ACTION registry has mitigated regulatory and financial barriers to pediatric VAD innovation through the use of real-world evidence gathered through a learning network.
An expert opinion statement, addressing a critical gap in cardiac care for Duchenne muscular dystrophy – providing thorough recommendations for the initiation and titration of cardiac medications based on disease progression and patient response.
CHD patients are more likely in extremis at VAD implantation and experience higher rates of adverse events and worse survival compared to those with non-CHD. Timely referral for patients with CHD experiencing worsening heart failure and a proactive approach to VAD implantation has the potential to improve outcomes for this vulnerable cohort.
