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

被引:0
作者
Rohde, Sofie [1 ]
van Puyvelde, Joeri [2 ]
Veen, Kevin M. [1 ,8 ]
Schweiger, Martin [3 ]
Biermann, Daniel [4 ]
Amodeo, Antonio [5 ,6 ]
Martens, Thomas [7 ]
Damman, Kevin
Gollmann-Tepekoylu, Can [9 ]
Hulman, Michael [10 ]
Iacovoni, Attilio [11 ]
Kramer, Ulrike S. [12 ]
Loforte, Antonio [13 ,14 ]
Pace Napoleone, Carlo [15 ]
Nemec, Petr [16 ,17 ]
Netuka, Ivan [18 ]
Ozbaran, Mustafa [19 ]
Polo, Luz [20 ]
Pya, Yuriy [21 ]
Ramjankhan, Faiz [22 ]
Sandica, Eugen [23 ]
Sliwka, Joanna [24 ]
Stiller, Brigitte [25 ]
Kadner, Alexander [26 ]
Franceschini, Alessio [27 ]
Thiruchelvam, Timothy [28 ]
Zimpfer, Daniel [29 ]
Berger, Felix [30 ]
Davies, Ben [31 ]
Dashkevich, Alexey [32 ]
Stark, Christoffer [33 ]
Meyns, Bart
de By, Theo M. M. H. [34 ]
Miera, Oliver [30 ]
机构
[1] Erasmus Univ, Med Ctr, Dept Cardiothorac Surg, Dr Molewaterpl 40, NL-3015 GD Rotterdam, Netherlands
[2] Katholieke Univ Leuven, Dept Cardiac Surg, Louvain, Belgium
[3] Childrens Hosp, Dept Congenital Pediat Surg, Zurich, Switzerland
[4] Univ Heart & Vasc Ctr Hamburg, Dept Congenital & Pediat Heart Surg, Childrens Heart Clin, Hamburg, Germany
[5] Univ Cattolica Sacro Cuore, Dept Cardiovasc & Pneumol Sci, Rome, Italy
[6] IRCCS, Bambino Gesu Childrens Hosp, Dept Cardiovasc & Pneumol Sci, Rome, Italy
[7] Ghent Univ Hosp, Dept Cardiac Surg, Ghent, Belgium
[8] Univ Groningen, Univ Med Ctr Groningen, Dept Cardiol, Groningen, Netherlands
[9] Med Univ Innsbruck, Dept Cardiac Surg, Innsbruck, Austria
[10] Comenius Univ, Klinika Kardiochirurg NUSCH, Fac Med, Bratislava, Slovakia
[11] Osped Papa Giovanni XIII, Cardiovasc Dept, Bergamo, Italy
[12] Erasmus MC, Dept Pediat & Neonatal Intens Care, Div Pediat Intens Care, Sophia Childrens Hosp, Rotterdam, Netherlands
[13] IRCCS Bologna, St Orsola Univ Hosp, Dept Cardiac Surg, Bologna, Italy
[14] Univ Turin, Dept Surg Sci, Turin, Italy
[15] Regina Margher Childrens Hosp, Pediat & Congenital Cardiac Surg, Turin, Italy
[16] Ctr Cardiovasc Surg & Transplantat, Brno, Czech Republic
[17] Masaryk Univ, Fac Med, Dept Cardiac Surg & Transplantat Brno, Brno, Czech Republic
[18] Inst Clin & Expt Med IKEM, Dept Cardiovasc Surg, Prague, Czech Republic
[19] Ege Univ Hosp, Dept Cardiovasc Surg, Izmir, Turkiye
[20] La Paz Univ Hosp, Dept Congenital Cardiac Surg, Madrid, Spain
[21] Natl Res Cardiac Surg Ctr, Dept Cardiac Surg, Astana, Kazakhstan
[22] Univ Utrecht, Dept Thorac Surg, Med Ctr, Utrecht, Netherlands
[23] Heart & Diabet Ctr North Rhine Westphalia, Dept Surg Congenital Heart Defects, Clin Pediat Cardiac Surg & Congenital Heart Defect, Bad Oeynhausen, Germany
[24] Med Univ Siles, Silesian Ctr Heart Dis, Dept Cardiac Surg Transplantol & Vasc Surg, Zabrze, Poland
[25] Univ Freiburg, Univ Heart Ctr Freiburg Bad Krozingen, Dept Congenital Heart Defects & Pediat Cardiol, Freiburg, Germany
[26] Univ Bern, Bern Univ Hosp, Ctr Congenital Heart Dis, Dept Cardiac Surg,Inselspital, Bern, Switzerland
[27] Bambino Gesu Pediat Hosp, Div Heart Failure Cardiothorac Transplantat & Mech, Rome, Italy
[28] Great Ormond St Hosp Sick Children, Heart & Lung Directorate, London, England
[29] Vienna Med Univ, Dept Cardiac Surg, Vienna, Austria
[30] Charite Univ med Berlin, Dept Congenital Heart Dis Pediat Cardiol, Deutsch Herzzentrum Charite, Berlin, Germany
[31] Royal Childrens Hosp, Pediat Cardiac Surg Dept, Melbourne, Australia
[32] Univ Leipzig, Dept Cardiac Surg, Heart Ctr Leipzig, Leipzig, Germany
[33] Helsinki Univ Hosp, Dept Cardiac Surg, Helsinki, Finland
[34] EUROMACS, EACTS House, Windsor, England
关键词
Mechanical circulatory support; Ventricular assist device; Paediatric; Transplantation; EUROMACS; INTERAGENCY REGISTRY;
D O I
10.1093/ejcts/ezae276
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
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.
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