TY - JOUR
T1 - Sixth Annual Pediatric Interagency Registry for Mechanical Circulatory Support (Pedimacs) Report
T2 - The Society Of Thoracic Surgeons Pedimacs Annual Report
AU - Pedimacs Investigators
AU - Adachi, Iki
AU - Peng, David M.
AU - Hollander, Seth A.
AU - Simpson, Kathleen E.
AU - Davies, Ryan R.
AU - Jacobs, Jeffrey P.
AU - VanderPluym, Christina J.
AU - Fynn-Thompson, Francis
AU - Wells, Dennis A.
AU - Law, Sabrina P.
AU - Amdani, Shahnawaz
AU - Cantor, Ryan
AU - Koehl, Devin
AU - Kirklin, James K.
AU - Morales, David L.S.
AU - Rossano, Joseph W.
N1 - Publisher Copyright:
© 2023 The Society of Thoracic Surgeons
PY - 2023/5
Y1 - 2023/5
N2 - Background: The Pediatric Interagency Registry for Mechanical Circulatory Support (Pedimacs), supported by The Society of Thoracic Surgeons, provides detailed information on pediatric patients supported with ventricular assist devices (VADs). Methods: From September 19, 2012, to December 31, 2021, there were 1355 devices in 1109 patients (<19 years) from 42 North American Hospitals. Results: Cardiomyopathy was the most common underlying cause (59%), followed by congenital heart disease (25%) and myocarditis (9%). Regarding device type, implantable continuous (IC) VADs were most common at 40%, followed by paracorporeal pulsatile (PP; 28%) and paracorporeal continuous (PC; 26%). Baseline demographics differed, with the PC cohort being younger, smaller, more complex (ie, congenital heart disease), and sicker at implantation (P < .0001). At 6 months after VAD implantation, a favorable outcome (transplantation, recovery, or alive on device) was achieved in 84% of patients, which was greatest among those on IC VADs (92%) and least for PC VADs (69%). Adverse events were not uncommon, with nongastrointestinal bleeding (incidence of 14%) and neurologic dysfunction (11% [stroke, 4%]), within 2 weeks after implantation being the most prevalent. Stroke and bleeding had negative impacts on overall survival (P = .002 and P < .001, respectively). Conclusions: This Sixth Pedimacs Report demonstrates the continued evolution of the pediatric field. The complexity of cardiac physiologies and anatomic constraint mandates the need for multiple types of devices used (PC, PP, IC). Detailed analyses of each device type in this report provide valuable information to further advance the care of this challenging and vulnerable population.
AB - Background: The Pediatric Interagency Registry for Mechanical Circulatory Support (Pedimacs), supported by The Society of Thoracic Surgeons, provides detailed information on pediatric patients supported with ventricular assist devices (VADs). Methods: From September 19, 2012, to December 31, 2021, there were 1355 devices in 1109 patients (<19 years) from 42 North American Hospitals. Results: Cardiomyopathy was the most common underlying cause (59%), followed by congenital heart disease (25%) and myocarditis (9%). Regarding device type, implantable continuous (IC) VADs were most common at 40%, followed by paracorporeal pulsatile (PP; 28%) and paracorporeal continuous (PC; 26%). Baseline demographics differed, with the PC cohort being younger, smaller, more complex (ie, congenital heart disease), and sicker at implantation (P < .0001). At 6 months after VAD implantation, a favorable outcome (transplantation, recovery, or alive on device) was achieved in 84% of patients, which was greatest among those on IC VADs (92%) and least for PC VADs (69%). Adverse events were not uncommon, with nongastrointestinal bleeding (incidence of 14%) and neurologic dysfunction (11% [stroke, 4%]), within 2 weeks after implantation being the most prevalent. Stroke and bleeding had negative impacts on overall survival (P = .002 and P < .001, respectively). Conclusions: This Sixth Pedimacs Report demonstrates the continued evolution of the pediatric field. The complexity of cardiac physiologies and anatomic constraint mandates the need for multiple types of devices used (PC, PP, IC). Detailed analyses of each device type in this report provide valuable information to further advance the care of this challenging and vulnerable population.
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U2 - 10.1016/j.athoracsur.2022.10.042
DO - 10.1016/j.athoracsur.2022.10.042
M3 - Article
C2 - 36402175
AN - SCOPUS:85145331593
SN - 0003-4975
VL - 115
SP - 1098
EP - 1108
JO - Annals of Thoracic Surgery
JF - Annals of Thoracic Surgery
IS - 5
ER -