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Cerebrovascular accidents in paediatric patients supported by the Berlin Heart EXCOR.
Rohde, Sofie; Sandica, Eugen; Veen, Kevin; Miera, Oliver; Amodeo, Antonio; Napoleone, Carlo Pace; Özbaran, Mustafa; Sliwka, Joanna; Thiruchelvam, Timothy; Zimpfer, Daniel; Schubert, Stephan; Bogers, Ad J J C; de By, Theo M M H.
Afiliación
  • Rohde S; Department of Cardio-thoracic surgery, Erasmus University Medical Center, Rotterdam, the Netherlands.
  • Sandica E; Clinic for Pediatric Cardiac Surgery and Congenital Heart Defects, Heart and Diabetes Centre North Rhine-Westphalia, Ruhr-University of Bochum, Bad Oeynhausen, Germany.
  • Veen K; Department of Cardio-thoracic surgery, Erasmus University Medical Center, Rotterdam, the Netherlands.
  • Miera O; Department of Congenital Heart Disease and Pediatric Cardiology, Deutsches Herzzentrum Berlin, Berlin, Germany.
  • Amodeo A; Ospedale Bambino Gesù, Rome, Italy.
  • Napoleone CP; Pediatric Cardiac Surgery Department, Regina Margherita Children's Hospital, Torino, Italy.
  • Özbaran M; Ege University Hospital, Izmir, Turkey.
  • Sliwka J; Department of Cardiac Surgery, Transplantology and Vascular Surgery, Silesian Center for Heart Diseases, Zabrze, Poland.
  • Thiruchelvam T; Great Ormond Street Hospital, London, United Kingdom.
  • Zimpfer D; Vienna Medical University, Vienna, Austria.
  • Schubert S; Center of Congenital Heart Disease/Pediatric Cardiology, Heart and Diabetes Center North Rhine Westfalia, Ruhr-University of Bochum, Bad Oeynhausen, Germany.
  • Bogers AJJC; Department of Cardio-thoracic surgery, Erasmus University Medical Center, Rotterdam, the Netherlands.
  • de By TMMH; EUROMACS, EACTS House, Windsor, United Kingdom.
Eur J Cardiothorac Surg ; 62(3)2022 08 03.
Article en En | MEDLINE | ID: mdl-35849328
OBJECTIVES: Ventricular assist device support as a bridge to transplant or recovery is a well-established therapy in children on the cardiac transplant waiting list. The goal of this study was to investigate the incidence of and the associated factors for cerebrovascular accidents in paediatric patients supported by a Berlin Heart EXCOR. METHODS: All patients <19 years of age supported by a Berlin Heart EXCOR between January 2011 and January 2021 from the European Registry for Patients with Mechanical Circulatory Support were included. RESULTS: In total, 230 patients were included. A total of 140 (60.9%) patients had a diagnosis of dilated cardiomyopathy. 46 patients (20.0%) sustained 55 cerebrovascular accidents, with 70.9% of the episodes within 90 days after the ventricular assist device was implanted. The event rate of cerebrovascular accidents was highest in the first era (0.75). Pump thrombosis and secondary need for a right ventricular assist device were found to be associated with a cerebrovascular accident (hazard ratio 1.998, P = 0.040; hazard ratio 11.300, P = 0.037). At the 1-year follow-up, 44.4% of the patients had received a transplant, 13.1% were weaned after recovery and 24.5% had died. Event rates for mortality showed a significantly decreasing trend. CONCLUSIONS: Paediatric ventricular assist device support is associated with important adverse events, especially in the early phase after the device is implanted. Pump thrombosis and the need for a secondary right ventricular assist device are associated with cerebrovascular accidents. Furthermore, an encouragingly high rate of recovery in this patient population was shown, and death rates declined. More complete input of data into the registry, especially concerning anticoagulation protocols, would improve the data.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Corazón Auxiliar / Trasplante de Corazón / Accidente Cerebrovascular / Insuficiencia Cardíaca Tipo de estudio: Etiology_studies / Guideline / Incidence_studies / Prognostic_studies Límite: Child / Humans Idioma: En Revista: Eur J Cardiothorac Surg Asunto de la revista: CARDIOLOGIA Año: 2022 Tipo del documento: Article País de afiliación: Países Bajos Pais de publicación: Alemania
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Corazón Auxiliar / Trasplante de Corazón / Accidente Cerebrovascular / Insuficiencia Cardíaca Tipo de estudio: Etiology_studies / Guideline / Incidence_studies / Prognostic_studies Límite: Child / Humans Idioma: En Revista: Eur J Cardiothorac Surg Asunto de la revista: CARDIOLOGIA Año: 2022 Tipo del documento: Article País de afiliación: Países Bajos Pais de publicación: Alemania