دورية أكاديمية
Rational Use of Mechanical Circulatory Support as a Bridge to Pediatric and Congenital Heart Transplantation.
| العنوان: | Rational Use of Mechanical Circulatory Support as a Bridge to Pediatric and Congenital Heart Transplantation. |
|---|---|
| المؤلفون: | Miana LA; Cardiovascular Surgery Division, Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (InCor-HCFMUSP), São Paulo, SP, Brazil., Silva GVRD; Cardiovascular Surgery Division, Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (InCor-HCFMUSP), São Paulo, SP, Brazil., Caneo LF; Cardiovascular Surgery Division, Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (InCor-HCFMUSP), São Paulo, SP, Brazil., Turquetto AL; Cardiovascular Surgery Division, Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (InCor-HCFMUSP), São Paulo, SP, Brazil., Tanamati C; Cardiovascular Surgery Division, Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (InCor-HCFMUSP), São Paulo, SP, Brazil., Foronda G; Cardiovascular Surgery Division, Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (InCor-HCFMUSP), São Paulo, SP, Brazil., Massoti MR; Cardiovascular Surgery Division, Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (InCor-HCFMUSP), São Paulo, SP, Brazil., Penha JG; Cardiovascular Surgery Division, Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (InCor-HCFMUSP), São Paulo, SP, Brazil., Azeka E; Cardiovascular Surgery Division, Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (InCor-HCFMUSP), São Paulo, SP, Brazil., Galas FRBG; Cardiovascular Surgery Division, Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (InCor-HCFMUSP), São Paulo, SP, Brazil., Jatene FB; Cardiovascular Surgery Division, Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (InCor-HCFMUSP), São Paulo, SP, Brazil., Jatene MB; Cardiovascular Surgery Division, Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (InCor-HCFMUSP), São Paulo, SP, Brazil. |
| المصدر: | Brazilian journal of cardiovascular surgery [Braz J Cardiovasc Surg] 2018 May-Jun; Vol. 33 (3), pp. 242-249. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Brazilian Society of Cardiovascular Surgery Country of Publication: Brazil NLM ID: 101677045 Publication Model: Print Cited Medium: Internet ISSN: 1678-9741 (Electronic) Linking ISSN: 01027638 NLM ISO Abbreviation: Braz J Cardiovasc Surg Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: São Paulo, SP, Brasil : Brazilian Society of Cardiovascular Surgery, [2015]- |
| مواضيع طبية MeSH: | Heart-Assist Devices*, Extracorporeal Membrane Oxygenation/*methods , Heart Defects, Congenital/*surgery , Heart Transplantation/*methods, Adolescent ; Child ; Child, Preschool ; Extracorporeal Membrane Oxygenation/mortality ; Female ; Heart Defects, Congenital/mortality ; Heart Transplantation/mortality ; Humans ; Infant ; Male ; Multivariate Analysis ; Retrospective Studies ; Risk Factors ; Statistics, Nonparametric ; Time Factors ; Treatment Outcome ; Waiting Lists ; Young Adult |
| مستخلص: | Introduction: Donor shortage and organ allocation is the main problem in pediatric heart transplant. Mechanical circulatory support is known to increase waiting list survival, but it is not routinely used in pediatric programs in Latin America. Methods: All patients listed for heart transplant and supported by a mechanical circulatory support between January 2012 and March 2016 were included in this retrospective single-center study. The endpoints were mechanical circulatory support time, complications, heart transplant survival and discharge from the hospital. Results: Twenty-nine patients from our waiting list were assessed. Twelve (45%) patients were initially supported by extracorporeal membrane oxygenation (ECMO) and a centrifugal pump was implanted in 17 (55%) patients. Five patients initially supported by ECMO were bridged to another device. One was bridged to a centrifugal pump and four were bridged to Berlin Heart Excor®. Among the 29 supported patients, 18 (62%) managed to have a heart transplant. Thirty-day survival period after heart transplant was 56% (10 patients). Median support duration was 12 days (interquartile range [IQR] 4 - 26 days) per run and the waiting time for heart transplant was 9.5 days (IQR 2.5-25 days). Acute kidney injury was identified as a mortality predictor (OR=22.6 [CI=1.04-494.6]; P=0.04). Conclusion: Mechanical circulatory support was able to bridge most INTERMACS 1 and 2 pediatric patients to transplant with an acceptable complication rate. Acute renal failure increased mortality after mechanical circulatory support in our experience. |
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| تواريخ الأحداث: | Date Created: 20180726 Date Completed: 20190115 Latest Revision: 20190115 |
| رمز التحديث: | 20240628 |
| مُعرف محوري في PubMed: | PMC6089136 |
| DOI: | 10.21470/1678-9741-2018-0081 |
| PMID: | 30043916 |
| قاعدة البيانات: | MEDLINE |
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