Key result
VAD implantation in pediatric dilated cardiomyopathy yielded >90% positive outcomes across all weights, though stroke was higher in smaller children (17% in <8kg vs 4% in >40kg, p=0.01).
Why the study?
Ventricular assist device options vary for children across weight groups, prompting an evaluation of contemporary device usage and outcomes based on weight.
Does weight impact ventricular assist device outcomes and adverse events in pediatric patients with dilated cardiomyopathy?
Cohort (n=222)
Yes
Does weight impact ventricular assist device outcomes and adverse events in pediatric patients with dilated cardiomyopathy?
VAD implantation in pediatric DCM patients yields >90% positive outcomes across all weight groups, though stroke risk is significantly higher in smaller children (<20 kg).
Answers are grounded in this paper and cite their sources.
Supports VAD use across pediatric DCM weights; leaves open targeted stroke prevention in infants.
Ventricular assist device (VAD) options vary for children in different weight groups. This study evaluates contemporary device usage and outcomes for children based on weight. Data from the Advanced Cardiac Therapies Improving Outcomes Network (ACTION) registry were examined for patients with dilated cardiomyopathy (DCM) in 4 weight cohorts: <8 kg, 8-20 kg, 21-40 kg, and >40 kg, for devices implanted 3/2013-10/2020. Adverse event rates and ultimate outcome (deceased, alive on device, transplanted, or ventricular recovery) were analyzed. 222 DCM patients were identified with 24% in cohort 1, 23% in cohort 2, 15% in cohort 3, and 38% in cohort 4. Of 272 total implants, paracorporeal pulsatile devices were most common (95%) in cohorts 1 and 2 and intracorporeal continuous devices (81%) in cohorts 3 and 4. Stroke was noted in 17%, 12%, 6%, and 4% of cohorts, respectively (Cohort 1 vs. 4 and 2 vs. 4 - p = 0.01; other comparisons - not significant). Incidences of major bleeding, device malfunction, and infection was not different. All cohorts had >90% positive outcomes. Stroke incidence was higher in smaller cohorts, but other outcomes were similar. Positive outcomes were attained in over 90% across all weight groups, demonstrating excellent outcomes using current VADs in this DCM population.
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Kwiatkowski et al. (2023) conducted a cohort in Dilated cardiomyopathy (n=222). Lower weight (<8 kg or 8-20 kg) vs. Higher weight (>40 kg) was evaluated on Stroke incidence (p=0.01). VAD implantation in pediatric dilated cardiomyopathy yielded >90% positive outcomes across all weights, though stroke was higher in smaller children (17% in <8kg vs 4% in >40kg, p=0.01).
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