TY - JOUR
T1 - The European Registry for Patients with Mechanical Circulatory Support (EUROMACS)
T2 - fourth Paediatric EUROMACS (Paedi-EUROMACS) report
AU - Rohde, Sofie
AU - van Puyvelde, Joeri
AU - Veen, Kevin M.
AU - Schweiger, Martin
AU - Biermann, Daniel
AU - Amodeo, Antonio
AU - Martens, Thomas
AU - Damman, Kevin
AU - Gollmann-Tepeköylü, Can
AU - Hulman, Michael
AU - Iacovoni, Attilio
AU - Krämer, Ulrike S.
AU - Loforte, Antonio
AU - Pace Napoleone, Carlo
AU - Nemec, Petr
AU - Netuka, Ivan
AU - Özbaran, Mustafa
AU - Polo, Luz
AU - Pya, Yuriy
AU - Ramjankhan, Faiz
AU - Sandica, Eugen
AU - Sliwka, Joanna
AU - Stiller, Brigitte
AU - Kadner, Alexander
AU - Franceschini, Alessio
AU - Thiruchelvam, Timothy
AU - Zimpfer, Daniel
AU - Berger, Felix
AU - Davies, Ben
AU - Dashkevich, Alexey
AU - Stark, Christoffer
AU - Meyns, Bart
AU - de By, Theo M.M.H.
AU - Miera, Oliver
N1 - Publisher Copyright:
© The Author(s) 2024. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.
PY - 2024/8/2
Y1 - 2024/8/2
N2 - 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.
AB - 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.
KW - EUROMACS
KW - Mechanical circulatory support
KW - Paediatric
KW - Transplantation
KW - Ventricular assist device
UR - https://www.scopus.com/pages/publications/85201988370
U2 - 10.1093/ejcts/ezae276
DO - 10.1093/ejcts/ezae276
M3 - Article
C2 - 39029919
AN - SCOPUS:85201988370
SN - 1010-7940
VL - 66
JO - European Journal of Cardio-thoracic Surgery
JF - European Journal of Cardio-thoracic Surgery
IS - 2
M1 - ezae276
ER -