The european registry for patients with mechanical circulatory support (EUROMACS): fourth paediatric EUROMACS (Paedi-EUROMACS) report
Makaleler > Tam Makale · 2024
Yazarlar: Sofie Rohde, Joeri van Puyvelde, Kevin M Veen, Martin Schweiger, Daniel Biermann, Antonio Amodeo, Thomas Martens, Kevin Damman, Can Gollmann-Tepeköylü, Michael Hulman, Attilio Iacovoni, Ulrike S Krämer, Antonio Loforte, Carlo Pace Napoleone, Petr Nemec, Ivan Netuka, Mustafa ÖZBARAN, Luz Polo, Yuri Pya, Faiz Ramjankhan, Eugen Sandica, Joanna Sliwka, Brigitte Stiller, Alexander Kadner, Alessio Franceschini, Timothy Thiruchelvam, Daniel Zimpfer, Felix Berger, Ben Davies, Alexey Dashkevich, Christoffer Stark, Bart Meyns, Theo M M H de By, Olivier Miera
European Journal of Cardio-Thoracic Surgery, Uluslararası, Wos, 2024, cilt 66
Özet
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.