Evolution of pediatric ventricular assist devices and their neurologic and renal complications-A 24-year single-center experience.
Acute Kidney Injury
/ epidemiology
Adolescent
Body Weight
Child
Child, Preschool
Female
Heart Failure
/ mortality
Heart Transplantation
Heart-Assist Devices
/ adverse effects
Humans
Incidence
Infant
Infant, Newborn
Male
Postoperative Complications
/ epidemiology
Registries
/ statistics & numerical data
Retrospective Studies
Risk Factors
Stroke
/ epidemiology
Treatment Outcome
Waiting Lists
/ mortality
Young Adult
acute kidney injury
death
heart transplant
pediatrics
stroke
ventricular assist device
Journal
Artificial organs
ISSN: 1525-1594
Titre abrégé: Artif Organs
Pays: United States
ID NLM: 7802778
Informations de publication
Date de publication:
Sep 2020
Sep 2020
Historique:
received:
29
11
2019
revised:
27
01
2020
accepted:
19
02
2020
pubmed:
13
4
2020
medline:
10
8
2021
entrez:
13
4
2020
Statut:
ppublish
Résumé
Utilization of ventricular assist devices (VADs) in adult populations with severe heart failure as a bridge to transplant has become the standard of care over the past two decades. Analogously, the use of VADs in pediatric populations has become more commonplace as pediatric heart transplantation has become more prevalent. We still have much to learn, however, about the complications after VAD placement in pediatric patients, their impact on transplantation and, in particular, how outcomes have changed over time. The objectives of this study were to (a) review the experience of a single pediatric VAD center, (b) identify risk factors that could lead to poor outcomes in patients on the transplant waitlist after VAD implantation and (c) demonstrate changes in outcomes over time. A retrospective cohort analysis was performed comparing death as a primary outcome and stroke and acute kidney injury (AKI) as secondary outcomes, across the study period divided into three timed eras. We analyzed 88 patients supported by a VAD over a 24-year timeframe. The duration, age at implant and indication for VAD support did not change significantly across the eras. We found that the incidence of stroke decreased over the study period and, while the rates of AKI did not change over the study period, those who developed AKI, while supported on VAD, had an increased risk of death.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
987-994Informations de copyright
© 2020 International Center for Artificial Organs and Transplantation and Wiley Periodicals LLC.
Références
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