Left ventricular assist device support as a bridge to recovery in young children

Chelsea L. Ihnat, Hannah Zimmerman, Jack G. Copeland, F. John Meaney, Richard E Sobonya, Brandon T. Larsen, Brian Blair, Daniela Lax, Brent J. Barber

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Objective. Left ventricular assist device (LVAD) experience and follow-up data in children are limited. We report the deployment and successful weaning from LVAD in young children with severe heart failure (HF). Design. From 2004-2009, 13 children suffering from HF were placed on LVAD. All presented with a dilated left ventricle (LV) with severely reduced contractility, secondary to myocarditis, atrial arrhythmia or idiopathic HF. This study reports their outcomes and longitudinal follow-up. Results. Of 13 young children with HF (ages 1 month-6 years; mean 19.2 months) placed on LVAD: eight weaned to recovery and successful hospital discharge, one was transplanted and four died. Echo follow-up in the weaned patients (mean age 22.1 months) revealed significant improvements from pre-LVAD measurements: LV end-diastolic dimension (LVED) mean z-score decreased from +4.8 to +0.95 (P <.001); fractional shortening (FS %) improved from a mean of 9.3% to 33% (P <.001); and the degree of mitral regurgitation (MR) significantly improved (P <.05). Time to LVAD deployment from HF diagnosis was more likely to be less than 30 days in the successfully weaned patients (100%) than patients who died or were transplanted (20%); P=.007. Conclusions. LVAD support can be utilized as a bridge to recovery in young children with HF. Following LVAD weaning, children sustain improvements in LV size, function and degree of MR. LVAD deployment less than 30 days from HF diagnosis improves the likelihood of successful weaning and illustrates that children with acute etiologies of HF are more likely to achieve recovery.

Original languageEnglish (US)
Pages (from-to)234-240
Number of pages7
JournalCongenital Heart Disease
Volume6
Issue number3
DOIs
StatePublished - May 2011

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Heart-Assist Devices
Heart Failure
Weaning
Heart Ventricles
Mitral Valve Insufficiency
Myocarditis
Cardiac Arrhythmias

Keywords

  • Cardiomyopathy
  • Echocardiography
  • Pediatrics
  • Ventricular Assist Device

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Pediatrics, Perinatology, and Child Health
  • Surgery
  • Radiology Nuclear Medicine and imaging

Cite this

Ihnat, C. L., Zimmerman, H., Copeland, J. G., Meaney, F. J., Sobonya, R. E., Larsen, B. T., ... Barber, B. J. (2011). Left ventricular assist device support as a bridge to recovery in young children. Congenital Heart Disease, 6(3), 234-240. https://doi.org/10.1111/j.1747-0803.2011.00494.x

Left ventricular assist device support as a bridge to recovery in young children. / Ihnat, Chelsea L.; Zimmerman, Hannah; Copeland, Jack G.; Meaney, F. John; Sobonya, Richard E; Larsen, Brandon T.; Blair, Brian; Lax, Daniela; Barber, Brent J.

In: Congenital Heart Disease, Vol. 6, No. 3, 05.2011, p. 234-240.

Research output: Contribution to journalArticle

Ihnat, CL, Zimmerman, H, Copeland, JG, Meaney, FJ, Sobonya, RE, Larsen, BT, Blair, B, Lax, D & Barber, BJ 2011, 'Left ventricular assist device support as a bridge to recovery in young children', Congenital Heart Disease, vol. 6, no. 3, pp. 234-240. https://doi.org/10.1111/j.1747-0803.2011.00494.x
Ihnat, Chelsea L. ; Zimmerman, Hannah ; Copeland, Jack G. ; Meaney, F. John ; Sobonya, Richard E ; Larsen, Brandon T. ; Blair, Brian ; Lax, Daniela ; Barber, Brent J. / Left ventricular assist device support as a bridge to recovery in young children. In: Congenital Heart Disease. 2011 ; Vol. 6, No. 3. pp. 234-240.
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abstract = "Objective. Left ventricular assist device (LVAD) experience and follow-up data in children are limited. We report the deployment and successful weaning from LVAD in young children with severe heart failure (HF). Design. From 2004-2009, 13 children suffering from HF were placed on LVAD. All presented with a dilated left ventricle (LV) with severely reduced contractility, secondary to myocarditis, atrial arrhythmia or idiopathic HF. This study reports their outcomes and longitudinal follow-up. Results. Of 13 young children with HF (ages 1 month-6 years; mean 19.2 months) placed on LVAD: eight weaned to recovery and successful hospital discharge, one was transplanted and four died. Echo follow-up in the weaned patients (mean age 22.1 months) revealed significant improvements from pre-LVAD measurements: LV end-diastolic dimension (LVED) mean z-score decreased from +4.8 to +0.95 (P <.001); fractional shortening (FS {\%}) improved from a mean of 9.3{\%} to 33{\%} (P <.001); and the degree of mitral regurgitation (MR) significantly improved (P <.05). Time to LVAD deployment from HF diagnosis was more likely to be less than 30 days in the successfully weaned patients (100{\%}) than patients who died or were transplanted (20{\%}); P=.007. Conclusions. LVAD support can be utilized as a bridge to recovery in young children with HF. Following LVAD weaning, children sustain improvements in LV size, function and degree of MR. LVAD deployment less than 30 days from HF diagnosis improves the likelihood of successful weaning and illustrates that children with acute etiologies of HF are more likely to achieve recovery.",
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AU - Blair, Brian

AU - Lax, Daniela

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N2 - Objective. Left ventricular assist device (LVAD) experience and follow-up data in children are limited. We report the deployment and successful weaning from LVAD in young children with severe heart failure (HF). Design. From 2004-2009, 13 children suffering from HF were placed on LVAD. All presented with a dilated left ventricle (LV) with severely reduced contractility, secondary to myocarditis, atrial arrhythmia or idiopathic HF. This study reports their outcomes and longitudinal follow-up. Results. Of 13 young children with HF (ages 1 month-6 years; mean 19.2 months) placed on LVAD: eight weaned to recovery and successful hospital discharge, one was transplanted and four died. Echo follow-up in the weaned patients (mean age 22.1 months) revealed significant improvements from pre-LVAD measurements: LV end-diastolic dimension (LVED) mean z-score decreased from +4.8 to +0.95 (P <.001); fractional shortening (FS %) improved from a mean of 9.3% to 33% (P <.001); and the degree of mitral regurgitation (MR) significantly improved (P <.05). Time to LVAD deployment from HF diagnosis was more likely to be less than 30 days in the successfully weaned patients (100%) than patients who died or were transplanted (20%); P=.007. Conclusions. LVAD support can be utilized as a bridge to recovery in young children with HF. Following LVAD weaning, children sustain improvements in LV size, function and degree of MR. LVAD deployment less than 30 days from HF diagnosis improves the likelihood of successful weaning and illustrates that children with acute etiologies of HF are more likely to achieve recovery.

AB - Objective. Left ventricular assist device (LVAD) experience and follow-up data in children are limited. We report the deployment and successful weaning from LVAD in young children with severe heart failure (HF). Design. From 2004-2009, 13 children suffering from HF were placed on LVAD. All presented with a dilated left ventricle (LV) with severely reduced contractility, secondary to myocarditis, atrial arrhythmia or idiopathic HF. This study reports their outcomes and longitudinal follow-up. Results. Of 13 young children with HF (ages 1 month-6 years; mean 19.2 months) placed on LVAD: eight weaned to recovery and successful hospital discharge, one was transplanted and four died. Echo follow-up in the weaned patients (mean age 22.1 months) revealed significant improvements from pre-LVAD measurements: LV end-diastolic dimension (LVED) mean z-score decreased from +4.8 to +0.95 (P <.001); fractional shortening (FS %) improved from a mean of 9.3% to 33% (P <.001); and the degree of mitral regurgitation (MR) significantly improved (P <.05). Time to LVAD deployment from HF diagnosis was more likely to be less than 30 days in the successfully weaned patients (100%) than patients who died or were transplanted (20%); P=.007. Conclusions. LVAD support can be utilized as a bridge to recovery in young children with HF. Following LVAD weaning, children sustain improvements in LV size, function and degree of MR. LVAD deployment less than 30 days from HF diagnosis improves the likelihood of successful weaning and illustrates that children with acute etiologies of HF are more likely to achieve recovery.

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