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 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 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.
This study surveyed pediatric heart failure practitioners across ACTION centers to understand thromboprophylaxis practices in children with cardiomyopathy. The survey explored decision-making factors and medication choices using three clinical vignettes: dilated cardiomyopathy (DCM), left ventricular non-compaction (LVNC), and restrictive cardiomyopathy (RCM).
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.
The HeartWare ventricular assist device (HVAD) was discontinued in July 2021. The study aims to describe the impact the discontinuation the HVAD had on pediatric ventricular assist device (VAD) utilization and outcomes.
ACTION set forth to report current outcomes in patients supported with the HeartMate 3 ventricular assist device in a multicenter learning network.
Expanding Use of the HeartMate 3 VAD in Pediatric and Adult Patients within ACTION Read More »
