Article
Cardiac & Cardiovascular Systems
Iki Adachi, David M. Peng, Seth A. Hollander, Kathleen E. Simpson, Ryan R. Davies, Jeffrey P. Jacobs, Christina J. VanderPluym, Francis Fynn-Thompson, Dennis A. Wells, Sabrina P. Law, Shahnawaz Amdani, Ryan Cantor, Devin Koehl, James K. Kirklin, David L. S. Morales, Joseph W. Rossano
Summary: The Pediatric Interagency Registry for Mechanical Circulatory Support (Pedimacs) collected detailed information on 1355 ventricular assist devices (VADs) in 1109 pediatric patients (<19 years) from 42 North American Hospitals between September 19, 2012, and December 31, 2021. The most common underlying causes for VAD use were cardiomyopathy (59%), congenital heart disease (25%), and myocarditis (9%). Implantable continuous (IC) VADs were the most common device type (40%), followed by paracorporeal pulsatile (PP; 28%) and paracorporeal continuous (PC; 26%). At 6 months after VAD implantation, 84% of patients achieved a favorable outcome, with IC VADs having the highest success rate (92%) and PC VADs having the lowest (69%). Adverse events, such as nongastrointestinal bleeding and neurologic dysfunction, were not uncommon. Stroke and bleeding had negative impacts on overall survival. Rating: 8 out of 10
ANNALS OF THORACIC SURGERY
(2023)
Article
Cardiac & Cardiovascular Systems
Awais Ashfaq, Angela Lorts, David Rosenthal, Iki Adachi, Joseph Rossano, Ryan Davies, Kathleen E. Simpson, Katsuhide Maeda, Bethany Wisotzkey, Devin Koehl, Ryan S. Cantor, Jeffrey P. Jacobs, David Peng, James K. Kirklin, David L. S. Morales
Summary: This study analyzed the complete data from the Pedimacs database, and identified important factors affecting mortality in pediatric VAD patients. It found that the patient's illness at VAD implantation, diagnosis, and support strategy can affect survival, and the outcomes also differ by device type.
ANNALS OF THORACIC SURGERY
(2023)
Article
Cardiac & Cardiovascular Systems
Robert A. Niebler, Shahnawaz Amdani, Betsy Blume, Ryan S. Cantor, Luqin Deng, James K. Kirklin, Angela Lorts, David L. Morales, David N. Rosenthal, Nancy S. Ghanayem
Summary: This study investigated rates, risk factors, and outcomes of cerebralvascular accidents (CVA) in pediatric patients supported on ventricular assist devices (VADs). The analysis found that the overall percentage of CVA in pediatric VAD support is now under 11%, with factors such as higher patient profile groups, implants within small volume centers, and the occurrence of ascites being associated with CVA. Encouragingly, data from the most recent era show protective factors for CVA, but it remains significantly associated with mortality. Future efforts should focus on pre-implant and early support periods.
JOURNAL OF HEART AND LUNG TRANSPLANTATION
(2021)
Review
Cardiac & Cardiovascular Systems
Chiara Giorni, Alessandra Rizza, Isabella Favia, Antonio Amodeo, Fabrizio Chiusolo, Sergio G. Picardo, Matteo Luciani, Giovina Di Felice, Luca Di Chiara
Summary: Pediatric mechanical circulatory support is a strategy for managing heart failure, with a focus on minimizing complications. Anticoagulation therapy plays a crucial role in managing bleeding and thrombotic complications, with careful consideration for drug selection and dosing in pediatric patients.
FRONTIERS IN CARDIOVASCULAR MEDICINE
(2021)
Article
Cardiac & Cardiovascular Systems
Theo M. M. H. de By, Martin Schweiger, Hina Hussain, Antonio Amodeo, Thomas Martens, Ad J. J. C. Bogers, Kevin Damman, Can Gollmann-Tepekoeylue, Michael Hulman, Attilio Iacovoni, Ulrike Kramer, Antonio Loforte, Carlo Pace Napoleone, Petr Nemec, Ivan Netuka, Mustafa Ozbaran, Luz Polo, Yuri Pya, Faiz Ramjankhan, Eugen Sandica, Joanna Sliwka, Brigitte Stiller, Alexander Kadner, Alessio Franceschini, Timothy Thiruchelvam, Daniel Zimpfer, Bart Meyns, Felix Berger, Oliver Miera
Summary: The EUROMACS report presents the data on mechanical circulatory support in pediatric patients. The study shows that the most common cause of heart failure in this population is cardiomyopathy. The overall survival rate at 12 months is 79.2%.
EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY
(2022)
Article
Cardiac & Cardiovascular Systems
Theo M. M. H. de By, Felix Schoenrath, Kevin M. Veen, Paul Mohacsi, Julia Stein, Khalid M. M. Alkhamees, Kyriakos Anastasiadis, Alexander Berhnardt, Friedhelm Beyersdorf, Kadir Caliskan, David Reineke, Kevin Damman, Arnt Fiane, Angeliki Gkouziouta, Can Gollmann-Tepekoeylue, Gustafsson Finn, Michal Hulman, Attilio Iacovoni, Antonio Loforte, Bela Merkely, Francesco Musumeci, Petr Nemec, Ivan Netuka, Mustafa Ozbaran, Evgenij Potapov, Yuri Pya, Gregorio Rabago, Faiz Ramjankhan, Hermann Reichenspurner, Diyar Saeed, Elena Sandoval, Bernard Stockman, Marc Vanderheyden, Laurens Tops, Thorsten Wahlers, Michael Zembala, Daniel Zimpfer, Thierry Carrel, Jan Gummert, Bart Meyns
Summary: The study reviewed outcomes of patients receiving mechanical circulatory support in different implant eras, finding changes in patient characteristics and outcomes between periods. Overall, mortality, transplant rates, and probability of weaning at 5 years post-implant were 55%, 25%, and 2% respectively. Major infections mainly occurred in the early phase post-implant.
EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY
(2022)
Article
Cardiac & Cardiovascular Systems
Palak Shah, Melana Yuzefpolskaya, Gavin W. Hickey, Khadijah Breathett, Omar Wever-Pinzon, Van-Khue Ton, William Hiesinger, Devin Koehl, James K. Kirklin, Ryan S. Cantor, Jeffrey P. Jacobs, Robert H. Habib, Francis D. Pagani, Daniel J. Goldstein
Summary: The twelfth annual report from The Society of Thoracic Surgeons (STS) Interagency Registry for Mechanically Assisted Circulatory Support (Intermacs) provides an overview of outcomes for LVAD patients over the past decade, highlighting the impact of the COVID-19 pandemic on LVAD implant volumes and improvements in survival rates and patient adverse events. The report also emphasizes the importance of reducing readmissions after LVAD implantation in improving patient outcomes.
ANNALS OF THORACIC SURGERY
(2022)
Review
Medicine, General & Internal
Katherine Regling, Arun Saini, Katherine Cashen
Summary: This article summarizes the challenges in anticoagulation management in pediatric mechanical circulatory support and introduces the application of viscoelastic testing in evaluating hemostatic function. This assessment method provides a comprehensive qualitative evaluation of clot formation and dissolution processes, and has certain guiding significance for evaluating treatment outcomes and prognosis in ECMO and VAD patients.
FRONTIERS IN MEDICINE
(2022)
Article
Cardiac & Cardiovascular Systems
Ryan J. Tedford, Marzia Leacche, Angela Lorts, Stavros G. Drakos, Francis D. Pagani, Jennifer Cowger
Summary: Durable left ventricular assist device (dLVAD) support is an important treatment option for patients with advanced heart failure. Innovations in dLVAD technology have improved survival rates and reduced adverse events. However, there are challenges in promoting wider adoption of this therapy, including delayed patient referral, limited clinician knowledge, and deprioritization of patients waiting for heart transplantation. Novel devices with smaller size and less invasive implantation methods are being developed.
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
(2023)
Article
Engineering, Biomedical
Sadeer G. Al-Kindi, Rongbing Xie, James K. Kirklin, Jennifer Cowger, Guilherme H. Oliveira, Thomas Krabatsch, Takeshi Nakatani, Stephan Schueler, Angeline Leet, Daniel Golstein, Chantal A. Elamm
Summary: This study investigates the characteristics and outcomes of myocarditis patients who received durable mechanical circulatory support (MCS) and compares them to patients with nonischemic cardiomyopathy (NICM). The study finds that myocarditis patients who receive MCS have similar overall survival rates to NICM patients, despite being sicker preoperatively with higher needs for biventricular MCS.
Article
Cardiac & Cardiovascular Systems
Corinna N. Lang, Klaus Kaier, Viviane Zotzmann, Peter Stachon, Torben Pottgiesser, Constantin von Zur Muehlen, Manfred Zehender, Daniel Duerschmied, Bonaventura Schmid, Christoph Bode, Tobias Wengenmayer, Dawid L. Staudacher
Summary: A study in a German university hospital found that the incidence and use of MCS in treating cardiogenic shock patients have increased over the past decade, while hospital survival rates remain low. There are significant differences in in-hospital survival rates among different types of MCS devices.
CLINICAL RESEARCH IN CARDIOLOGY
(2021)
Review
Pediatrics
Alexandra Idrovo, Natasha Afonso, Jack Price, Sebastian Tume, Ayse Akcan-Arikan
Summary: The use of mechanical circulatory support (MCS) in children with medically refractory cardiac failure has increased, presenting unique challenges for pediatric nephrologists when acute kidney injury (AKI) develops. This review aims to introduce current MCS technologies, selection approaches, interactions with KRT circuits, and focus on the growing trend of using continuous-flow ventricular assist devices.
PEDIATRIC NEPHROLOGY
(2021)
Article
Cardiac & Cardiovascular Systems
Katia Orvin, Leor Perl, Uri Landes, Danny Dvir, John George Webb, Marie-Elisabeth Stelzmueller, Wilfried Wisser, Tamim Michael Nazif, Isaac George, Mizuki Miura, Maurizio Taramasso, Thomas Pilgrim, Monika Fuerholz, Jan-Malte Sinning, Georg Nickenig, Chris Rumer, Giuseppe Tarantini, Giulia Masiero, Matjas Bunc, Peter Radsel, Azeem Latib, Faraj Kargoli, Alfonso Ielasi, Massimo Medda, Luis Nombela-Franco, Hana Vaknin-Assa, Ran Kornowski
Summary: The study showed that prophylactic or rescue use of pMCS during high-risk TAVI procedures can improve clinical outcomes. Despite higher mortality rates, pMCS-related complications were infrequent, supporting the use of pMCS in high-risk cases or in acute life-threatening situations during TAVI.
CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS
(2021)
Article
Cardiac & Cardiovascular Systems
Chi Zhou
Summary: This article reports a case of myocarditis in a 42-year-old woman. The patient presented with fever, chest pain, and cardiogenic shock. Through a series of examinations, the diagnosis of fulminant myocarditis was confirmed. Early diagnosis and treatment are crucial for the long-term prognosis of the patient.
FRONTIERS IN CARDIOVASCULAR MEDICINE
(2023)
Review
Cardiac & Cardiovascular Systems
Guido Tavazzi, Valentino Dammassa, Costanza Natalia Julia Colombo, Eloisa Arbustini, Thomas Castelein, Martin Balik, Christophe Vandenbriele
Summary: In atrial and ventricular tachyarrhythmias, reduced cardiac output can lead to cardiogenic shock. This can also occur during catheter ablation procedures and is associated with increased mortality. Managing cardiogenic shock and tachyarrhythmias is challenging.
FRONTIERS IN CARDIOVASCULAR MEDICINE
(2022)
Article
Cardiac & Cardiovascular Systems
Iki Adachi, David M. Peng, Seth A. Hollander, Kathleen E. Simpson, Ryan R. Davies, Jeffrey P. Jacobs, Christina J. VanderPluym, Francis Fynn-Thompson, Dennis A. Wells, Sabrina P. Law, Shahnawaz Amdani, Ryan Cantor, Devin Koehl, James K. Kirklin, David L. S. Morales, Joseph W. Rossano
Summary: The Pediatric Interagency Registry for Mechanical Circulatory Support (Pedimacs) collected detailed information on 1355 ventricular assist devices (VADs) in 1109 pediatric patients (<19 years) from 42 North American Hospitals between September 19, 2012, and December 31, 2021. The most common underlying causes for VAD use were cardiomyopathy (59%), congenital heart disease (25%), and myocarditis (9%). Implantable continuous (IC) VADs were the most common device type (40%), followed by paracorporeal pulsatile (PP; 28%) and paracorporeal continuous (PC; 26%). At 6 months after VAD implantation, 84% of patients achieved a favorable outcome, with IC VADs having the highest success rate (92%) and PC VADs having the lowest (69%). Adverse events, such as nongastrointestinal bleeding and neurologic dysfunction, were not uncommon. Stroke and bleeding had negative impacts on overall survival. Rating: 8 out of 10
ANNALS OF THORACIC SURGERY
(2023)
Article
Health Care Sciences & Services
Seth A. Hollander, Kari Wujcik, Julie Schmidt, Esther Liu, Aileen Lin, John Dykes, Julie Good, Michelle Brown, David Rosenthal
Summary: This study retrospectively analyzed the use of milrinone in children with end-stage heart failure receiving hospice care. The results showed that combining milrinone with oral diuretics effectively controlled symptoms in these patients, and in most cases, there was no need for opioids, benzodiazepines, or supplemental oxygen.
JOURNAL OF PAIN AND SYMPTOM MANAGEMENT
(2023)
Article
Critical Care Medicine
Seth A. A. Hollander, Kimberly A. A. Pyke-Grimm, Muhammad F. F. Shezad, Farhan Zafar, Melissa K. K. Cousino, Chris Feudtner, Danton S. S. Char
Summary: This retrospective study analyzed the death outcomes of 117 pediatric patients on VAD support and found that 16% died while on VAD. The most common causes of death were multiple organ failure and infection. Most patients received invasive interventions at the end of life, and 10% died at home. These findings can inform clinical decision-making to reduce suffering at end-of-life.
PEDIATRIC CRITICAL CARE MEDICINE
(2023)
Article
Pediatrics
Rachel K. Hopper, Oscar van der Have, Seth A. Hollander, Anne I. Dipchand, Valeria Perez de Sa, Jeffrey A. Feinstein, Karin Tran-Lundmark
Summary: This study surveyed physicians at pediatric heart transplant centers and found significant variability in the management of elevated pulmonary vascular resistance in children awaiting heart transplant, highlighting the need for evidence-based guidelines.
PEDIATRIC TRANSPLANTATION
(2023)
Article
Engineering, Biomedical
David M. Kwiatkowski, Muhammad P. Shezad, Aliessa P. S. Barnes, Michelle S. P. Ploutz, Sabrina P. Law, Farhan Zafar, David L. S. J. Morales, Matthew J. O'Connor
Summary: This study evaluates the usage and outcomes of ventricular assist devices (VADs) for children based on their weight. The findings show that current VADs have excellent outcomes in children with dilated cardiomyopathy (DCM) across different weight groups, with low mortality rates and most children surviving or successfully undergoing transplantation.
Review
Cardiac & Cardiovascular Systems
Adam M. Lubert, Ari Cedars, Christopher S. Almond, Shahnawaz Amdani, Jennifer Conway, Joshua M. Friedland-Little, Robert J. Gajarski, Steven J. Kindel, Angela Lorts, David L. S. Morales, Matthew J. O'Connor, David M. Peng, David N. Rosenthal, Lauren Smyth, David L. Sutcliffe, Kurt R. Schumacher
Summary: Referral indications for advanced heart failure care vary between centers, leading to late consideration for therapy or lack of specialist consultation for Fontan circulation-related complications. Guidelines are needed to direct appropriately timed referral. The ACTION Fontan Committee has developed recommended thresholds for advanced heart failure referral to guide primary cardiologists.
CIRCULATION-HEART FAILURE
(2023)
Article
Cardiac & Cardiovascular Systems
Awais Ashfaq, Angela Lorts, David Rosenthal, Iki Adachi, Joseph Rossano, Ryan Davies, Kathleen E. Simpson, Katsuhide Maeda, Bethany Wisotzkey, Devin Koehl, Ryan S. Cantor, Jeffrey P. Jacobs, David Peng, James K. Kirklin, David L. S. Morales
Summary: This study analyzed the complete data from the Pedimacs database, and identified important factors affecting mortality in pediatric VAD patients. It found that the patient's illness at VAD implantation, diagnosis, and support strategy can affect survival, and the outcomes also differ by device type.
ANNALS OF THORACIC SURGERY
(2023)
Article
Cardiac & Cardiovascular Systems
Neha Bansal, Nikita D'Souza, Bethany L. Wisotzkey, Erin Albers, Renata Shih, Vernat Exil, Melissa McQueen, Joseph P. Hillenburg, Estela Azeka, Sabrina Law, David M. Peng, Matthew O'Connor, Robert Gajarski, Christina Vanderpluym, Angela Lorts, Aliessa Barnes, Melanie Sojka, Maria Bano, Megan Keating, David N. Rosenthal, Jennifer Conway, Katie Schroeder, Deipanjan Nandi
Summary: The working group of ACTION and PHTS developed an algorithm to determine appropriateness and educational handouts for telehealth. They found that telehealth is a viable modality for delivering healthcare to pediatric heart failure and transplant patients, with potential applications in follow-up, medication titration, and patient education/counselling.
CARDIOLOGY IN THE YOUNG
(2023)
Article
Cardiac & Cardiovascular Systems
Rabia S. Khan, Philip R. Khoury, Farhan Zafar, David L. Morales, Clifford Chin, David M. Peng, Christopher S. Almond, Danielle S. Burstein, Folasade Odeniyi, Samuel G. Wittekind
Summary: This study aimed to investigate the association of functional status with waitlist and post-transplant outcomes in pediatric heart transplantation. The study found that functional status at listing was associated with negative waitlist outcomes, while functional status at transplant was associated with 1-year post-transplant survival. Interventions targeting functional impairment may improve outcomes in pediatric heart transplantation.
JOURNAL OF HEART AND LUNG TRANSPLANTATION
(2023)
Article
Cardiac & Cardiovascular Systems
Matthew J. O'Connor, Muhammad Shezad, Humera Ahmed, Shahnawaz Amdani, Scott R. Auerbach, David W. Bearl, Arene Butto, Jonathan W. Byrnes, Jennifer Conway, John C. Dykes, Lauren Glass, Jodie Lantz, Sabrina Law, Michael C. Monge, David L. S. Morales, John J. Parent, David M. Peng, Michelle S. Ploutz, Kriti Puri, Svetlana Shugh, Natalie S. Shwaish, Christina J. Vanderpluym, Sarah Wilkens, Lydia Wright, Matthew D. Zinn, Angela Lorts
Summary: Patients supported with the HeartMate 3 ventricular assist device in a multicenter learning network showed excellent outcomes with mortality on device less than 8%. Adverse events including stroke, infection, and renal dysfunction were more commonly seen in smaller patients, highlighting opportunities for improvements in care.
JOURNAL OF HEART AND LUNG TRANSPLANTATION
(2023)
Article
Cardiac & Cardiovascular Systems
Anusha Konduri, Caroline West, Ray Lowery, Tiffany Hunter, Audrey Jarosz, Sunkyung Yu, Heang M. Lim, Amanda D. Mccormick, Kurt R. Schumacher, David M. Peng
Summary: This study retrospectively analyzed the early experience of using SGLT2i in patients with single ventricle congenital heart disease palliated to the Fontan circulation. The results showed that SGLT2i had no significant adverse effects in these patients, and there was some evidence suggesting potential efficacy in improving vascular function and reducing peptide levels.
PEDIATRIC CARDIOLOGY
(2023)
Article
Pediatrics
Daniel H. H. Mai, Scott Sutherland, Joshua Blinder, Seth A. A. Hollander
Summary: This study compares the predictive ability of the KDIGO AKI-6 scoring system and traditional AKI staging for clinical and renal outcomes in pediatric heart transplant recipients. The results suggest that the AKI-6 scoring system provides better prognostic utility for survival and renal dysfunction in these patients.
PEDIATRIC TRANSPLANTATION
(2023)
Article
Pediatrics
Nina Zook, Lisa Schultz, Sandra Rizzuto, Amanda Aufdermauer, Amanda M. Hollander, Christopher S. Almond, Seth A. Hollander
Summary: This retrospective study analyzed data of pediatric heart transplant recipients from 2014 to 2021, revealing that tube feeding for malnourishment is common in these patients, and a significant proportion remain malnourished at the time of transplantation and 1 year later. Feeding disorders mainly occur at the time of transplantation but generally resolve within 1 year post-transplant.
PEDIATRIC TRANSPLANTATION
(2023)
Article
Pediatrics
Alexandra Idrovo, Seth A. Hollander, Tara M. Neumayr, Cynthia Bell, Genevieve Munoz, Swati Choudhry, Jack Price, Iki Adachi, Poyyapakkam Srivaths, Scott Sutherland, Ayse Akcan-Arikan
Summary: This study investigated kidney outcomes in pediatric patients with long-term CF-VAD support. The results showed that CKD was common during CF-VAD support, and in some patients, CKD worsened. Preexisting CKD and peri-implantation AKI were common risk factors. Therefore, proactive kidney function monitoring and targeted follow-up are important for optimizing outcomes.
PEDIATRIC NEPHROLOGY
(2023)
Article
Pediatrics
Neha Bansal, Aamir Jeewa, Kae Watanabe, Marc E. Richmond, Anaam Alzubi, Nikita D'Souza, Maria Bano, Angela Lorts, David N. Rosenthal, Katie Taylor, Catherine O'Shea, Lauren Smyth, Devin Koehl, Hong Zhao, Seth A. Hollander
Summary: Pediatric heart transplant centers have a high rejection rate for donor hearts, highlighting the importance of a multi-institutional donor decision discussion to reduce practice variation.
PEDIATRIC TRANSPLANTATION
(2023)
