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Continuous-Flow Ventricular Assist Device Support in Adult Congenital Heart Disease: A 15-Year, Multicenter Experience of Temporary and Durable Support

Authors :
Broda, Christopher R.
Frankel, William C.
Nair, Ajith P.
Dreyer, W. Jeffrey
Tunuguntla, Hari P.
Frazier, O. Howard
Dolgner, Stephen J.
Anders, Marc M.
Tume, Sebastian C.
Qureshi, Athar M.
Parekh, Dhaval R.
Hickey, Edward J.
Adachi, Iki
Civitello, Andrew B.
Source :
ASAIO Journal: A Peer-Reviewed Journal of the American Society for Artificial Internal Organs; May 2023, Vol. 69 Issue: 5 p429-437, 9p
Publication Year :
2023

Abstract

Heart failure (HF) is common in adult congenital heart disease (ACHD) patients; however, use of continuous-flow ventricular assist devices (CF-VADs) remains rare. We reviewed outcomes of patients with congenital heart disease greater than or equal to 18 years of age at the time of CF-VAD implant at the affiliated pediatric and adult institutions between 2006 and 2020. In total, 18 ACHD patients (15 with great anatomical complexity) received 21 CF-VADs. Six patients (median age 34 years) received seven percutaneous CF-VADs with a median duration of support of 20 days (3–44 days) with all patients survived to hospital discharge and two patients were bridged to durable CF-VADs. Fourteen patients (median age 38 years) received durable CF-VADs. Thirteen patients (93%) survived to hospital discharge and the median duration of support was 25.8 months (6.4–52.1 months). Estimated survival on durable CF-VAD at 1, 3, and 5 years was 84%, 72%, and 36%, respectively. Three patients were successfully bridged to transplantation. Device-related complications include cerebrovascular accident (n = 5), driveline infection (n = 3), device infection requiring chronic antibiotic therapy (n = 4), gastrointestinal bleeding (n = 6), and presumed pump thrombosis (n = 5). These results show percutaneous and durable CF-VADs can support ACHD patients with advanced HF.

Details

Language :
English
ISSN :
10582916 and 1538943X
Volume :
69
Issue :
5
Database :
Supplemental Index
Journal :
ASAIO Journal: A Peer-Reviewed Journal of the American Society for Artificial Internal Organs
Publication Type :
Periodical
Accession number :
ejs62945080
Full Text :
https://doi.org/10.1097/MAT.0000000000001853