Acute cardiac care & resuscitationCohort study
Outcomes for Children With Congenital Heart Disease Undergoing Ventricular Assist Device Implantation
- Retrospective cohort study
- multicentre
- registry (ACTION)
Authors' conclusion
CHD patients are more likely in extremis at VAD implantation and experience higher rates of adverse events and worse survival compared to those with non-CHD.
Study context
- Population
- Children undergoing ventricular assist device (VAD) implantation in the ACTION network, April 2018 to February 2023
- Participants
- 966 children
- Exposure
- CHD vs non-CHD; univentricular vs biventricular CHD
- CHDn = 352
- Univentricular CHDn = 230
- Outcome
- Postimplantation survival and adverse events
Main finding
Adjusted survival
Hazard ratio
2.05
95% CI 1.39–3.02
P < 0.001
CHD vs Non-CHD
HR 2.05 (95% CI 1.39–3.02); P < 0.001
As reported in the abstract
Observational data: associations, not effects.
Further findings
| Outcome | CHD | Non-CHD | Univentricular CHD | Biventricular CHD |
|---|---|---|---|---|
| Preimplantation characteristics, CHD vs non-CHD | ||||
| Median age | 1.2 years | 9.4 years | Not reported in the abstract | Not reported in the abstract |
| INTERMACS 1 | 36.1% | 28.7% | Not reported in the abstract | Not reported in the abstract |
| Mechanical ventilation | 67.0% | 44.1% | Not reported in the abstract | Not reported in the abstract |
| Total parenteral nutrition | 63.6% | 45.1% | Not reported in the abstract | Not reported in the abstract |
| ECMO preimplantation | 33.2% | 20.5% | Not reported in the abstract | Not reported in the abstract |
| eGFR, univentricular vs biventricular CHD | Not reported in the abstract | Not reported in the abstract | median 47.3 mL/min/1.73 m² | median 59.9 mL/min/1.73 m² |
- Preimplantation characteristics, CHD vs non-CHD: P < 0.05 for all
eGFR, univentricular vs biventricular CHD
- No other significant differences in clinical characteristics
Safety
Major adverse events (stroke, bleeding, infection, respiratory failure, renal and hepatic dysfunction)
- More likely with CHD than non-CHD
Original publication
Outcomes for Children With Congenital Heart Disease Undergoing Ventricular Assist Device Implantation. J Am Coll Cardiol. Published 8 January 2025. doi:10.1016/j.jacc.2024.10.083
Summarised from the published abstract; every number is checked against it