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Mechanical circulatory support in patients with congenital heart disease: a European Registry for Patients with Mechanical Circulatory Support (EUROMACS) study.
Ardissino, Maddalena; Morley, Alec P; Lewis, Clive; Bhagra, Catriona; Stoll, Victoria; Popatov, Evegnij; Schoenrath, Felix; Gummert, Jan; Przybylowski, Piotr; Sliwka, Joanna; Meyns, Bart; de By, Theo M M H; Jones, Nicola; Tsui, Steven.
Afiliación
  • Ardissino M; Department of Critical Care, Royal Papworth Hospital, Royal Papworth Hospital NHS Trust, Cambridge, UK.
  • Morley AP; British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.
  • Lewis C; National Heart and Lung Research Institute, Imperial College London, London, UK.
  • Bhagra C; Medical Research Council Laboratory of Medical Sciences, Imperial College London, London, UK.
  • Stoll V; Department of Cardiology, Royal Papworth Hospital, Royal Papworth Hospital NHS Trust, Cambridge, UK.
  • Popatov E; Department of Medicine, School of Clinical Medicine, University of Cambridge, Cambridge, UK.
  • Schoenrath F; Gonville and Caius College, University of Cambridge, Cambridge, UK.
  • Gummert J; Department of Cardiology, Royal Papworth Hospital, Royal Papworth Hospital NHS Trust, Cambridge, UK.
  • Przybylowski P; Department of Cardiology, Royal Papworth Hospital, Royal Papworth Hospital NHS Trust, Cambridge, UK.
  • Sliwka J; Department of Cardiology, Addenbrooke's Hospital, Cambridge University Hospitals NHS Trust, Cambridge, UK.
  • Meyns B; Department of Cardiology, Royal Papworth Hospital, Royal Papworth Hospital NHS Trust, Cambridge, UK.
  • de By TMMH; Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum der Charité (DHZC), Berlin, Germany.
  • Jones N; Department of Cardiac Surgery, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin und Humboldt-Universität zu Berlin, Berlin, Germany.
  • Tsui S; Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum der Charité (DHZC), Berlin, Germany.
Eur J Cardiothorac Surg ; 65(6)2024 Jun 03.
Article en En | MEDLINE | ID: mdl-38781499
ABSTRACT

OBJECTIVES:

This study aims to explore characteristics and clinical outcomes of patients with congenital heart disease (CHD) in the European Registry for Patients with Mechanical Circulatory Support (EUROMACS).

METHODS:

This is a retrospective study of EUROMACS participants receiving MCS as bridge-to-transplant, possible bridge-to-transplant, or rescue therapy/bridge-to-recovery from 2011 to 2023 (n = 5340). Adult and paediatric cohorts were analysed separately. The primary outcome was mortality on MCS; secondary outcomes included recovery, transplant and complications including bleeding, cerebrovascular events, and sepsis.

RESULTS:

Among adult patients, mortality at 1-year was 33.3% among the CHD cohort vs 22.1% in the non-CHD cohort. Adult CHD patients had higher hazards of mortality within the first year after MCS implantation [hazard ratios 1.98, 95% confidence interval (CI) 1.35-2.91, P < 0.001] and bleeding events (subdistribution hazard ratios 2.10, 95% CI 1.40-3.16, P < 0.001) compared with non-CHD patients. Both associations remained significant after accounting for multiple mediators. Among paediatric patients, mortality at 1 year was 22.1% in the CHD cohort vs 17.3% in the non-CHD cohort (hazard ratios 1.39, 95% CI 0.83-2.32, P = 0.213).

CONCLUSIONS:

Adult and paediatric patients with CHD on MCS have higher adverse event risk compared with non-CHD MCS patients, though children did not have greater risk of mortality. As the number of CHD patients requiring advanced heart failure management continues to grow, these findings can enhance informed decision-making. CLINICAL TRIAL REGISTRATION NUMBER Registry name EUROMACS.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Sistema de Registros / Corazón Auxiliar / Cardiopatías Congénitas Límite: Adolescent / Adult / Child / Child, preschool / Female / Humans / Infant / Male / Middle aged País/Región como asunto: Europa Idioma: En Revista: Eur J Cardiothorac Surg Asunto de la revista: CARDIOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Reino Unido Pais de publicación: Alemania
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Sistema de Registros / Corazón Auxiliar / Cardiopatías Congénitas Límite: Adolescent / Adult / Child / Child, preschool / Female / Humans / Infant / Male / Middle aged País/Región como asunto: Europa Idioma: En Revista: Eur J Cardiothorac Surg Asunto de la revista: CARDIOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Reino Unido Pais de publicación: Alemania