Severe heart failure and the need for mechanical circulatory support and heart transplantation in pediatric patients with myocarditis: Results from the prospective multicenter registry "MYKKE".
MCS
myocarditis
pediatric
transplantation
Journal
Pediatric transplantation
ISSN: 1399-3046
Titre abrégé: Pediatr Transplant
Pays: Denmark
ID NLM: 9802574
Informations de publication
Date de publication:
11 2019
11 2019
Historique:
received:
10
03
2019
revised:
16
06
2019
accepted:
22
06
2019
pubmed:
13
7
2019
medline:
26
8
2020
entrez:
13
7
2019
Statut:
ppublish
Résumé
Myocarditis represents an important cause for acute heart failure. MYKKE, a prospective multicenter registry of pediatric patients with myocarditis, aims to gain knowledge on courses, diagnostics, and therapy of pediatric myocarditis. The role of mechanical circulatory support (MCS) in children with severe heart failure and myocarditis is unclear. The aim of this study was to determine characteristics and outcome of patients with severe heart failure requiring MCS and/or heart transplantation. The MYKKE cohort between September 2013 and 2016 was analyzed. A total of 195 patients were prospectively enrolled by 17 German hospitals. Twenty-eight patients (14%) received MCS (median 1.5 years), more frequently in the youngest age group (0-2 years) than in the older groups (P < 0.001; 2-12 and 13-18 years). In the MCS group, 50% received a VAD, 36% ECMO, and 14% both, with a survival rate of 79%. The weaning rate was 43% (12/28). Nine (32%) patients were transplanted, one had ongoing support, and six (21%) died. Histology was positive for myocarditis in 63% of the MCS group. Patients within the whole cohort with age <2 years and/or ejection fraction <30% had a significantly worse survival with high risk for MCS, transplantation, and death (P < 0.001). Myocarditis represents a life-threatening disease with an overall mortality of 4.6% in this cohort. The fulminant form more often affected the youngest, leading to significantly higher rate of MCS, transplantation, and mortality. MCS represents an important and life-saving therapeutic option in children with myocarditis with a weaning rate of 43%.
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
e13548Investigateurs
Felix Berger
(F)
Guido Haverkämper
(G)
Sabine Klaassen
(S)
Anca Racolta
(A)
Deniz Kececioglu
(D)
Trong Phi Lê
(T)
Sven Dittrich
(S)
Julia Halbfaß
(J)
Brigitte Stiller
(B)
Janina Kaufmann
(J)
Jürgen Bauer
(J)
Heiner Latus
(H)
Christian Jux
(C)
Dietmar Schranz
(D)
Rainer Kozlik-Feldmann
(R)
Thomas Mir
(T)
Claudia Schlesner
(C)
Florian Schmidt
(F)
Thomas Jack
(T)
Philipp Beerbaum
(P)
Axel Rentzsch
(A)
Sandra Pontius
(S)
Hashim Abdul-Khaliq
(H)
Konrad Brockmeier
(K)
Ingo Dähnert
(I)
Jacqueline Richter
(J)
Andrea Engelhardt
(A)
Peter Ewert
(P)
Anselm Uebing
(A)
Michael Hofbeck
(M)
André Jakob
(A)
Nikolaus Haas
(N)
Micheal Kaestner
(M)
Christian Apitz
(C)
Hans-Heiner Kramer
(HH)
Gunther Fischer
(G)
Thomas Paul
(T)
Michael Steinmetz
(M)
Noa Freudenthal
(N)
Caroline von dem Busche
(C)
Johannes Breuer
(J)
Ulrike Bauer
(U)
Mohammed Dakna
(M)
Tim Friede
(T)
Anne Wölffel-Gale
(A)
Julia Stein
(J)
Informations de copyright
© 2019 Wiley Periodicals, Inc.
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