Outcomes of children supported with devices labeled as “temporary” or short term: A report from the Pediatric Interagency Registry for Mechanical Circulatory Support

摘要

Background Historically, the “temporary” or short-term ventricular assist device (VAD) was used only as a quick bridge to recovery for children with an acute process. In the current era, the devices that were originally used for temporary support are now being used to support children for longer durations and for a variety of indications. In this study we aimed to describe the overall use, patients’ characteristics and outcomes of “temporary” VAD use in children. Methods The Pediatric Interagency Registry for Mechanical Circulatory Support (PediMACS) is a National Institutes of Health–supported national registry for United States Food and Drug Administration–approved VADs in patients Results Temporary VADs were implanted in 63 patients at 20 centers, accounting for 19% of all pediatric VAD patients entered into PediMACS. The median age at implantation was 3.7 (range n = 22) of the cardiomyopathy patients and 60% ( n = 12) of the single-ventricle patients achieved a favorable outcome. Conclusion Devices historically classified as “temporary” pumps are being used not only as a short-term mechanical circulatory support strategy but also as a longer term support strategy. In this multi-institutional, high-acuity, complex patient cohort, the use of “temporary” VADs resulted in a positive outcome (bridge to transplant, recovery durable device or alive) in 71% of patients.