Publication details

The European Registry for Patients with Mechanical Circulatory Support (EUROMACS): fourth Paediatric EUROMACS (Paedi-EUROMACS) report

Authors	ROHDE Sofie JOERI van Puyvelde VEEN Kevin M SCHWEIGER Martin BIERMANN Daniel AMODEO Antonio MARTENS Thomas DAMMAN Kevin GOLLMANN-TEPEKOYLU Can HULMAN Michael IACOVONI Attilio KRAMER Ulrike S LOFORTE Antonio CARLO Pace Napoleone NĚMEC Petr NETUKA Ivan OZBARAN Mustafa POLO Luz PYA Yuriy RAMJANKHAN Faiz SANDICA Eugen SLIWKA Joanna STILLER Brigitte KADNER Alexander FRANCESCHINI Alessio THIRUCHELVAM Timothy ZIMPFER Daniel BERGER Felix DAVIES Ben DASHKEVICH Alexey STARK Christoffer MEYNS Bart DE BY Theo M M H MIERA Oliver
Year of publication	2024
Type	Article in Periodical
Magazine / Source	EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY
MU Faculty or unit	Faculty of Medicine
Citation
Web	https://academic.oup.com/ejcts/article/66/2/ezae276/7717352?login=true
Doi	http://dx.doi.org/10.1093/ejcts/ezae276
Keywords	Mechanical circulatory support; Ventricular assist device; Paediatric; Transplantation; EUROMACS
Description	OBJECTIVES: The use of ventricular assist devices (VADs) in children is increasing. However, absolute numbers in individual centres and countries remain small. Collaborative efforts such as the Paedi-European Registry for Patients with Mechanical Circulatory Support (EUROMACS) are therefore essential for combining international experience with paediatric VADs. Our goal was to present the results from the fourth Paedi-EUROMACS report. METHODS: All paediatric (<19 years) patients from the EUROMACS database supported by a VAD were included. Patients were stratified into a congenital heart disease (CHD) group and a group with a non-congenital aetiology. End points included mortality, a transplant and recovery. Cox proportional hazard models were used to explore associated factors for mortality, cerebrovascular accident and pump thrombosis. RESULTS: A total of 590 primary implants were included. The congenital group was significantly younger (2.5 vs 8.0 years, respectively, P < 0.001) and was more commonly supported by a pulsatile flow device (73.5% vs 59.9%, P < 0.001). Mortality was significantly higher in the congenital group (30.8% vs 20.4%, P = 0.009) than in the non-congenital group. However, in multivariable analyses, CHD was not significantly associated with mortality [hazard ratio (HR) 1.285; confidence interval (CI) 0.8111-2.036, P = 0.740]. Pump thrombosis was the most frequently reported adverse event (377 events in 132 patients; 0.925 events per patient-year) and was significantly associated with body surface area (HR 0.524, CI 0.333-0.823, P = 0.005), CHD (HR 1.641, CI 1.054-2.555, P = 0.028) and pulsatile flow support (HR 2.345, CI 1.406-3.910, P = 0.001) in multivariable analyses. CONCLUSIONS: This fourth Paedi-EUROMACS report highlights the increasing use of paediatric VADs. The patient populations with congenital and non-congenital aetiologies exhibit distinct characteristics and clinical outcomes.