Ventricular assist device implantation in children with a mechanical valve: An ACTION registry analysis
Background: Patients with congenital heart disease (CHD) frequently have had valve interventions, including replacement with a mechanical valve (mechV). The impact of a mechV on clinical outcomes in patients undergoing ventricular assist device (VAD) implantation is not well characterized. Objective...
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Elsevier
2025-02-01
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| author | Sabena F. Hussain, MD, MSc Elyse Miller, MD Othman Aljohani, MBBS, MPH Scott Auerbach, MD David Bearl, MD Victor Benvenuto, MD Erica Bonura, MD Richard L. Crawford Anna Joong, MD Jameson Dyal, MD Christina Hartje-Dunn, MD Sujit Jana, MD Sonia Kaushal, MD Melanie Lynn, MD Joseph Spinner, MD Laura Radel, MD Alexander Raskin, MD Diana Torpoco-Rivera, MD Sarah J. Wilkens, MD, MPH Chet R. Villa, MD |
| author_facet | Sabena F. Hussain, MD, MSc Elyse Miller, MD Othman Aljohani, MBBS, MPH Scott Auerbach, MD David Bearl, MD Victor Benvenuto, MD Erica Bonura, MD Richard L. Crawford Anna Joong, MD Jameson Dyal, MD Christina Hartje-Dunn, MD Sujit Jana, MD Sonia Kaushal, MD Melanie Lynn, MD Joseph Spinner, MD Laura Radel, MD Alexander Raskin, MD Diana Torpoco-Rivera, MD Sarah J. Wilkens, MD, MPH Chet R. Villa, MD |
| author_sort | Sabena F. Hussain, MD, MSc |
| collection | DOAJ |
| description | Background: Patients with congenital heart disease (CHD) frequently have had valve interventions, including replacement with a mechanical valve (mechV). The impact of a mechV on clinical outcomes in patients undergoing ventricular assist device (VAD) implantation is not well characterized. Objectives: This study assessed VAD outcomes in patients with CHD and a mechV. Methods: All patients with a history of CHD (n = 433) in the Advanced Cardiac Therapies Improving Outcomes Network database were included in the study (January 2012-January 2023). Patient characteristics and outcomes were assessed among patients with a mechV and without a mechV. Results: Twenty-seven (6%) patients with CHD had a mechV at VAD implantation. Fourteen (52%) of the patients with mechV had univentricular anatomy and 13 (48%) had biventricular anatomy. Patients with mechV were older (4.9 vs 1.9 years, p = 0.02), smaller (14.9 vs 10.6 kg, p = 0.02), and had a higher interagency registry for mechanically assisted circulatory support profile (p = 0.01). Three (11%) patients with mechV experienced a valve-related complication. There was no difference in survival (p = 0.4) or ischemic stroke frequency (11% vs 13%, p = 1) between patients with mechV and non-mechV. Patients with mechV had higher frequency of hemorrhagic stroke (18% vs 4.7%, p = 0.01) and major bleeding (44% vs 26%, p = 0.04). Conclusions: Patients with CHD with a mechV have similar survival to patients with non-mechV; however, there is higher risk of bleeding including hemorrhagic stroke. |
| format | Article |
| id | doaj-art-2ad87f7c76c94551b69207b486dde571 |
| institution | Kabale University |
| issn | 2950-1334 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Elsevier |
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| series | JHLT Open |
| spelling | doaj-art-2ad87f7c76c94551b69207b486dde5712025-02-09T05:02:00ZengElsevierJHLT Open2950-13342025-02-017100198Ventricular assist device implantation in children with a mechanical valve: An ACTION registry analysisSabena F. Hussain, MD, MSc0Elyse Miller, MD1Othman Aljohani, MBBS, MPH2Scott Auerbach, MD3David Bearl, MD4Victor Benvenuto, MD5Erica Bonura, MD6Richard L. Crawford7Anna Joong, MD8Jameson Dyal, MD9Christina Hartje-Dunn, MD10Sujit Jana, MD11Sonia Kaushal, MD12Melanie Lynn, MD13Joseph Spinner, MD14Laura Radel, MD15Alexander Raskin, MD16Diana Torpoco-Rivera, MD17Sarah J. Wilkens, MD, MPH18Chet R. Villa, MD19Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OhioCincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OhioBenioff Children's Hospitals, San Francisco, CaliforniaUniversity of Colorado, Denver, ColoradoMonroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, TennesseeBoston Children's Hospital, Boston, MassachusettsSt. Louis Children's Hospital, Saint Louis, MissouriAnn & Robert H. Lurie Children's Hospital of Chicago, Chicago, IllinoisAnn & Robert H. Lurie Children's Hospital of Chicago, Chicago, IllinoisChildren's Healthcare of Atlanta, Atlanta, GeorgiaBoston Children’s Hospital, Boston, MassachusettsStollery Children's Hospital, Edmonton, Alberta, CanadaTexas Children's Hospital, Houston, TexasTexas Children's Hospital, Houston, TexasTexas Children's Hospital, Houston, TexasChildren's Medical Center of Dallas, Dallas, TexasChildren's Wisconsin, Brookfield, WisconsinLucille Packard Children's Hospital, Palo Alto, CaliforniaNorton Children's Hospital, Louisville, KentuckyCincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio; Corresponding author: Chet R. Villa, MD, 3333 Burnet Ave, MLC 2003, Cincinnati, OH 45229.Background: Patients with congenital heart disease (CHD) frequently have had valve interventions, including replacement with a mechanical valve (mechV). The impact of a mechV on clinical outcomes in patients undergoing ventricular assist device (VAD) implantation is not well characterized. Objectives: This study assessed VAD outcomes in patients with CHD and a mechV. Methods: All patients with a history of CHD (n = 433) in the Advanced Cardiac Therapies Improving Outcomes Network database were included in the study (January 2012-January 2023). Patient characteristics and outcomes were assessed among patients with a mechV and without a mechV. Results: Twenty-seven (6%) patients with CHD had a mechV at VAD implantation. Fourteen (52%) of the patients with mechV had univentricular anatomy and 13 (48%) had biventricular anatomy. Patients with mechV were older (4.9 vs 1.9 years, p = 0.02), smaller (14.9 vs 10.6 kg, p = 0.02), and had a higher interagency registry for mechanically assisted circulatory support profile (p = 0.01). Three (11%) patients with mechV experienced a valve-related complication. There was no difference in survival (p = 0.4) or ischemic stroke frequency (11% vs 13%, p = 1) between patients with mechV and non-mechV. Patients with mechV had higher frequency of hemorrhagic stroke (18% vs 4.7%, p = 0.01) and major bleeding (44% vs 26%, p = 0.04). Conclusions: Patients with CHD with a mechV have similar survival to patients with non-mechV; however, there is higher risk of bleeding including hemorrhagic stroke.http://www.sciencedirect.com/science/article/pii/S2950133424001484ACTION learning networkpediatricsventricular assist devicemechanical valvecongenital heart disease |
| spellingShingle | Sabena F. Hussain, MD, MSc Elyse Miller, MD Othman Aljohani, MBBS, MPH Scott Auerbach, MD David Bearl, MD Victor Benvenuto, MD Erica Bonura, MD Richard L. Crawford Anna Joong, MD Jameson Dyal, MD Christina Hartje-Dunn, MD Sujit Jana, MD Sonia Kaushal, MD Melanie Lynn, MD Joseph Spinner, MD Laura Radel, MD Alexander Raskin, MD Diana Torpoco-Rivera, MD Sarah J. Wilkens, MD, MPH Chet R. Villa, MD Ventricular assist device implantation in children with a mechanical valve: An ACTION registry analysis JHLT Open ACTION learning network pediatrics ventricular assist device mechanical valve congenital heart disease |
| title | Ventricular assist device implantation in children with a mechanical valve: An ACTION registry analysis |
| title_full | Ventricular assist device implantation in children with a mechanical valve: An ACTION registry analysis |
| title_fullStr | Ventricular assist device implantation in children with a mechanical valve: An ACTION registry analysis |
| title_full_unstemmed | Ventricular assist device implantation in children with a mechanical valve: An ACTION registry analysis |
| title_short | Ventricular assist device implantation in children with a mechanical valve: An ACTION registry analysis |
| title_sort | ventricular assist device implantation in children with a mechanical valve an action registry analysis |
| topic | ACTION learning network pediatrics ventricular assist device mechanical valve congenital heart disease |
| url | http://www.sciencedirect.com/science/article/pii/S2950133424001484 |
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