title: Outcomes of pediatric patients supported by the HeartMate II left ventricular assist device in the United States.
abstract: OBJECTIVE
  The HeartMate II (HMII; Thoratec, Pleasanton, CA) continuous-flow left ventricular assist device (LVAD) is an established treatment modality for advanced heart failure in adults. The objective of this study was to evaluate outcomes of pediatric patients supported by the HMII LVAD.
  
  
  METHODS
  This was a retrospective review of the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) of patients supported with a HMII from April 2008 to September 2011. The primary cohort comprised pediatric patients aged 11 to 18 years. Outcomes were compared with a group of young adults aged 19 to 39 years who underwent HMII implant during the same period. Ischemic etiologies for heart failure were excluded.
  
  
  RESULTS
  There were 28 pediatric patients, of whom 19 (68%) were males, 14 (46%) were African American, and 7 (25%) underwent device placement in a pediatric hospital. Competing outcomes analysis showed that at 6 months of follow-up, the composite of survival to transplantation, ongoing support, or recovery was 96% for the pediatric group, which was not significantly different from the young adult group (96%, p = 0.330). The 2 groups had similar INTERMACS profiles but differed in diagnosis, weight, and morbidities. Bleeding complications requiring surgical intervention were more common in the pediatric group.
  
  
  CONCLUSIONS
  Pediatric outcomes with a HMII LVAD are comparable to that of young adults. As we continue to monitor this growing group, more sophisticated characterization and comparisons will be possible. Also, as technology progress and second- and third-generation devices are introduced, the number of children who will benefit from mechanical support will continue to grow.
authors.affiliation: Texas Children's Hospital, Baylor College of Medicine, Houston, Texas. Electronic address: agcabrer@texaschildrenshospital.org.
authors.forename: Antonio G
authors.initials: AG
authors.lastname: Cabrera
authors.forename: Kartik S
authors.initials: KS
authors.lastname: Sundareswaran
authors.forename: Andres X
authors.initials: AX
authors.lastname: Samayoa
authors.forename: Aamir
authors.initials: A
authors.lastname: Jeewa
authors.forename: E Dean
authors.initials: ED
authors.lastname: McKenzie
authors.forename: Joseph W
authors.initials: JW
authors.lastname: Rossano
authors.forename: David J
authors.initials: DJ
authors.lastname: Farrar
authors.forename: O Howard
authors.initials: OH
authors.lastname: Frazier
authors.forename: David L
authors.initials: DL
authors.lastname: Morales
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002648:Child; D015331:Cohort Studies; D005260:Female; D006333:Heart Failure / Q000453:epidemiology* / Q000628:therapy*; D006353:Heart-Assist Devices / Q000145:classification*; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care; D012042:Registries; D012189:Retrospective Studies; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: HeartMate II; outcomes; pediatric; small adults; ventricular assist device