Continuous-Flow Ventricular Assist Device Support in Adult Congenital Heart Disease: A 15-Year, Multicenter Experience of Temporary and Durable Support

被引:8
作者
Broda, Christopher R. [1 ,2 ]
Frankel, William C. [3 ]
Nair, Ajith P. [4 ,5 ]
Dreyer, W. Jeffrey [2 ,6 ]
Tunuguntla, Hari P. [2 ,6 ]
Frazier, O. Howard [4 ,5 ]
Dolgner, Stephen J. [1 ]
Anders, Marc M. [2 ,7 ]
Tume, Sebastian C. [2 ,7 ]
Qureshi, Athar M. [2 ,6 ]
Parekh, Dhaval R. [1 ,2 ,6 ]
Hickey, Edward J. [2 ,8 ]
Adachi, Iki [2 ,8 ,10 ]
Civitello, Andrew B. [4 ,5 ,9 ]
机构
[1] Baylor Coll Med, Dept Pediat, Sect Pediat & Adult Congenital Cardiol, Houston, TX USA
[2] Texas Childrens Hosp, Houston, TX USA
[3] Heart Vasc & Thorac Inst, Dept Thorac & Cardiovasc Surg, Cleveland Clin, Cleveland, OH USA
[4] Baylor Coll Med, Michael E DeBakey Dept Surg, Div Cardiothorac Transplantat & Circulatory Suppor, Houston, TX USA
[5] Texas Heart Inst, Dept Cardiopulm Transplantat, Houston, TX USA
[6] Baylor Coll Med, Dept Pediat, Lillie Frank Abercrombie Sect Cardiol, Houston, TX USA
[7] Baylor Coll Med, Dept Pediat, Sect Crit Care Med, Houston, TX USA
[8] Baylor Coll Med, Michael E DeBakey Dept Surg, Div Congenital Heart Surg, Houston, TX USA
[9] Baylor Coll Med, Adv Heart Failure Ctr Excellence, 6770 Bertner Ave, Suite 350, Houston, TX 77030 USA
[10] Texas Childrens Hosp, Michael E DeBakey Dept Surg, Div Congenital Heart Surg, 6651 Main St, Houston, TX 77030 USA
关键词
adult congenital heart disease; left ventricular assist device; Fontan circulation; mechanical circulatory support; heart failure; MECHANICAL CIRCULATORY SUPPORT; TOTAL ARTIFICIAL-HEART; INTERAGENCY REGISTRY; RISK-FACTORS; TRANSPLANTATION; IMPLANTATION; MORTALITY; OUTCOMES; HOSPITALIZATION; DYSFUNCTION;
D O I
10.1097/MAT.0000000000001853
中图分类号
R318 [生物医学工程];
学科分类号
0831 ;
摘要
Heart failure (HF) is common in adult congenital heart disease (ACHD) patients; however, use of continuous-flow ventricular assist devices (CF-VADs) remains rare. We reviewed outcomes of patients with congenital heart disease greater than or equal to 18 years of age at the time of CF-VAD implant at the affiliated pediatric and adult institutions between 2006 and 2020. In total, 18 ACHD patients (15 with great anatomical complexity) received 21 CF-VADs. Six patients (median age 34 years) received seven percutaneous CF-VADs with a median duration of support of 20 days (3-44 days) with all patients survived to hospital discharge and two patients were bridged to durable CF-VADs. Fourteen patients (median age 38 years) received durable CF-VADs. Thirteen patients (93%) survived to hospital discharge and the median duration of support was 25.8 months (6.4-52.1 months). Estimated survival on durable CF-VAD at 1, 3, and 5 years was 84%, 72%, and 36%, respectively. Three patients were successfully bridged to transplantation. Device-related complications include cerebrovascular accident (n = 5), driveline infection (n = 3), device infection requiring chronic antibiotic therapy (n = 4), gastrointestinal bleeding (n = 6), and presumed pump thrombosis (n = 5). These results show percutaneous and durable CF-VADs can support ACHD patients with advanced HF.
引用
收藏
页码:429 / 437
页数:9
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