title: Outpatient management of intra-corporeal left ventricular assist device system in children: a multi-center experience.
abstract: Little is known about the outcomes of children supported on intracorporeal left ventricular assist device (HVAD), and the feasibility of outpatient management. All centers with pediatric patients discharged from the hospital on the device were identified using company database. A total of 14 centers were contacted, with 9 centers, contributing data retrospectively. From 2011 to 2013, 12 pediatric patients (7 females), mean aged 11.9 ± 2.3 years (range 8-15), mean weight 43 ± 19 kg (range 18-81), mean body surface area 1.3 ± 0.3 m(2) (range 0.76-1.96) were identified. Diagnosis included: dilated cardiomyopathy (CMP) (n = 5), noncompaction CMP (n = 4), toxic CMP (n = 2) and viral CMP (n = 1). Indications for support were permanent support (n = 1), bridge to recovery (n = 1) and bridge to transplantation (n = 10). Prior to HVAD implantation, all patients received intravenous inotropes and two patients were on temporary mechanical support. Overall mortality was 0%. Mean duration of inpatient and outpatient support were 56 (range: 19-95 days) and 290 days (range: 42-790), respectively. Mean readmission rate was 0.02 per patient month (2.1 per patient). No adverse events involving emergency department occurred. Eight children resumed local schooling. Home discharge of children supported on HVAD is feasible and safe. School integration can be achieved. There is wide center variability to discharge practice for children.
authors.affiliation: Department of Congenital Cardiovascular Surgery, Children's Hospital Zurich, Zurich, Switzerland.
authors.forename: M
authors.initials: M
authors.lastname: Schweiger
authors.forename: C
authors.initials: C
authors.lastname: Vanderpluym
authors.forename: A
authors.initials: A
authors.lastname: Jeewa
authors.forename: C E
authors.initials: CE
authors.lastname: Canter
authors.forename: P
authors.initials: P
authors.lastname: Jansz
authors.forename: P E
authors.initials: PE
authors.lastname: Parrino
authors.forename: O
authors.initials: O
authors.lastname: Miera
authors.forename: J
authors.initials: J
authors.lastname: Schmitto
authors.forename: M
authors.initials: M
authors.lastname: Mehegan
authors.forename: I
authors.initials: I
authors.lastname: Adachi
authors.forename: M
authors.initials: M
authors.lastname: Hübler
authors.forename: D
authors.initials: D
authors.lastname: Zimpfer
mesh_terms: D000293:Adolescent; D000553:Ambulatory Care; D009202:Cardiomyopathies / Q000401:mortality / Q000628:therapy*; D002648:Child; D019468:Disease Management; D005240:Feasibility Studies; D005260:Female; D016027:Heart Transplantation; D006353:Heart-Assist Devices; D006801:Humans; D008297:Male; D011788:Quality of Life; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome
keywords: artificial organs; education; health services and outcomes research; heart disease: congenital, outpatient care; heart transplantation/cardiology; quality of life (QOL); support devices: heart; ventricular assist devices