Outcomes following implantation of mechanical circulatory support in adults with congenital heart disease: An analysis of the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS)

VanderPluym, Christina; Cedars, Ari; Eghtesady, Pirooz; Maxwell, Bryan G.; Gelow, Jill M.; Burchill, Luke J.; Maltais, Simon; Koehl, Devin; Cantor, Ryan S.; Blume, Elizabeth D.

doi:10.1016/j.healun.2017.03.005

Cited by 110 publications

(110 citation statements)

References 34 publications

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“…Vanderpluym and colleagues used the INTERMACS registry to evaluate outcomes of circulatory support device use in patients ACHD patients. Over 10 years, there were 126 ACHD patients who received mechanical circulatory support out of 16,182 patients (43). Forty-five of the 126 patients had a systemic morphologic right ventricle.…”

Section: Waiting List and Mechanical Circulatory Support As A Bridgementioning

confidence: 99%

Overview of adult congenital heart transplants

Bryant¹,

Morales²

2018

Ann. Cardiothorac. Surg.

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Transplantation for adult patients with congenital heart disease (ACHD) is a growing clinical endeavor in the transplant community. Understanding the results and defining potential high-risk patient subsets will allow optimization of patient outcomes. This review summarizes the scope of ACHD transplantation, the mechanisms of late ventricular dysfunction, the ACHD population at risk of developing heart failure, ranges between 14% and 39%. The majority of early mortality occurs in ACHD patients with univentricular congenital heart disease. However, there has been improvement in operative survival in more contemporary studies. In conclusion, the experience with cardiac transplantation for ACHD patients with end-stage heart failure is growing, and high-risk patient subsets have been defined. Significant strides have been made in developing evidence-based guidelines of indications for transplant, and the intraoperative management of complex reconstruction has evolved. With proper patient selection, more aggressive use of mechanical circulatory support, and earlier referral of patients with failing Fontan physiology, outcomes should continue to improve.

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Section: Waiting List and Mechanical Circulatory Support As A Bridgementioning

confidence: 99%

Overview of adult congenital heart transplants

Bryant¹,

Morales²

2018

Ann. Cardiothorac. Surg.

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“…Currently, VAD use remains limited in ACHD patients, despite favorable outcomes in a recent INTERMACS analysis . In this study, while survival was similar between ACHD and non‐ACHD patients, ACHD patients were three times more likely to undergo a biventricular assist device or total artificial heart.…”

Section: Commentmentioning

confidence: 72%

Pulmonary hypertension: Barrier or just a bump in the road in transplanting adults with congenital heart disease

Menachem

Birati

Zamani

et al. 2018

Congenital Heart Disease

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“…Recent data from the Interagency Registry for Mechanically Assisted Circulatory Support registry have shown similar outcomes between non-CHD patients and patients with CHD with a biventricular circulation requiring LVAD, independent of systemic ventricular morphology. Options for patients with biventricular failure are limited 23. The only Food and Drug Administration-approved total artificial heart is a pneumatically driven device for temporary use (bridge to transplant) based on technology that is more than three decades old.…”

Section: Discussionmentioning

confidence: 99%

“…The only Food and Drug Administration-approved total artificial heart is a pneumatically driven device for temporary use (bridge to transplant) based on technology that is more than three decades old. Additionally, the mortality is higher in patients with CHD requiring biventricular assist devices 23. Finally, novel forms of mechanical support need to be developed for patients with univentricular circulations.…”

Section: Discussionmentioning

confidence: 99%

Heart or heart-lung transplantation for patients with congenital heart disease in England

Dimopoulos

Muthiah

Alonso‐Gonzalez

et al. 2019

Heart

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BackgroundIncreased longevity in patients with congenital heart disease (CHD) is associated with late complications, mainly heart failure, which may not be amenable to redo surgery and become refractory to medical therapy and so, trigger referral for transplantation. We assessed the current role and future prospects of heart and heart-lung transplantation for patients with CHD in England.MethodsWe performed a retrospective analysis of hospital episodes for England for 1997–2015, identifying patients with a CHD code (ICD-10 ‘Q2xx.x’), who underwent heart or heart-lung transplantation.ResultsIn total, 469 transplants (82.2% heart and 17.8% heart-lung) were performed in 444 patients. Half of patients transplanted had mild or moderate CHD complexity, this percentage increased with time (p=0.001). While overall, more transplantations were performed over the years, the proportion of heart-lung transplants declined (p<0.0001), whereas the proportion of transplants performed in adults remained static. Mortality was high during the first year, especially after heart-lung transplantation, but remained relatively low thereafter. Older age and heart-lung transplantation were strong predictors of death. While an increase in CHD transplants is anticipated, actual numbers in England seem to lag behind the increase in CHD patients with advanced heart failure.ConclusionsThe current and future predicted increase in the numbers of CHD transplants does not appear to parallel the expansion of the CHD population, especially in adults. Further investment and changes in policy should be made to enhance the number of donors and increase CHD transplant capacity to address the increasing numbers of potential CHD recipients and optimise transplantation outcomes in this growing population.

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Outcomes following implantation of mechanical circulatory support in adults with congenital heart disease: An analysis of the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS)

Cited by 110 publications

References 34 publications

Overview of adult congenital heart transplants

Overview of adult congenital heart transplants

Pulmonary hypertension: Barrier or just a bump in the road in transplanting adults with congenital heart disease

Heart or heart-lung transplantation for patients with congenital heart disease in England

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