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.
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.
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.
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.
This multicenter analysis shows bivalirudin is an effective alternative to heparin for anticoagulation in pediatric mechanical circulatory support, with comparable bleeding and stroke outcomes.
This study evaluates the progression of the distal aorta in patients with acute type A aortic dissection complicated by malperfusion syndrome who were treated with endovascular fenestration/stenting followed by delayed open aortic repair, finding that although these patients had faster distal aortic growth, their long-term survival and reoperation rates were similar to those without malperfusion syndrome.
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.
