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

• Autoři: 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
• Rok publikování: 2024
• Druh: Článek v odborném periodiku
• Časopis / Zdroj: EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY
• Fakulta / Pracoviště MU: Lékařská fakulta
• www: https://academic.oup.com/ejcts/article/66/2/ezae276/7717352?login=true
• Doi: http://dx.doi.org/10.1093/ejcts/ezae276
• Klíčová slova: Mechanical circulatory support; Ventricular assist device; Paediatric; Transplantation; EUROMACS
• Popis: 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.