Interstage Survival for Patients with Hypoplastic Left Heart Syndrome After ECMO.
There is a reported 5-20 % incidence of extracorporeal membrane oxygenation (ECMO) following stage I palliation for hypoplastic left heart syndrome (HLHS). This study compares the interstage mortality of HLHS patients supported with ECMO (HLHS-ECMO) to those who were not supported with ECMO (HLHS-nECMO) using the National Pediatric Cardiology Quality Improvement Initiative database. Patients with HLHS who survived to hospital discharge after stage I palliation were analyzed. HLHS-ECMO patients were compared to HLHS-non-ECMO patients with respect to demographics, surgical variables, and interstage survival. A total of 931 patients were identified in the database. Sixty-six (7.1 %) patients were supported with ECMO during their stage I palliation admission. There were no statistically significant differences between the groups with respect to demographics or anatomic subtype. HLHS-ECMO patients were more likely to have a preoperative risk factor identified (62 vs. 48 %, p = 0.03) or require ECMO prior to stage I palliation (3 vs. 0.5 %, p = 0.03). HLHS-ECMO patients had a significantly higher incidence of death or transplant versus the HLHS-nECMO group (18 vs. 9 %, p = 0.03). Despite survival to discharge, patients with HLHS requiring ECMO after their palliation continue to have an increased risk of death/cardiac transplant versus patients that do not require ECMO. ECMO use is likely a marker for a high-risk patient group. These patients may benefit from closer follow-up during the interstage period.
The Heart Center, Nationwide Children's Hospital, 700 Chlidren's Drive, Columbus, OH, 43205, USA. Richard.Fernandez@NationwideChildrens.org.
Richard P
RP
Fernandez
University of Minnesota Masonic Children's Hospital, Minneapolis, MN, USA.
Brian F
BF
Joy
The Heart Center, Nationwide Children's Hospital, 700 Chlidren's Drive, Columbus, OH, 43205, USA.
Robin
R
Allen
The Heart Center, Nationwide Children's Hospital, 700 Chlidren's Drive, Columbus, OH, 43205, USA.
Jamie
J
Stewart
The Heart Center, Nationwide Children's Hospital, 700 Chlidren's Drive, Columbus, OH, 43205, USA.
Holly
H
Miller-Tate
The Heart Center, Nationwide Children's Hospital, 700 Chlidren's Drive, Columbus, OH, 43205, USA.
Yongjie
Y
Miao
The Heart Center, Nationwide Children's Hospital, 700 Chlidren's Drive, Columbus, OH, 43205, USA.
Lisa
L
Nicholson
The Heart Center, Nationwide Children's Hospital, 700 Chlidren's Drive, Columbus, OH, 43205, USA.
Clifford L
CL
Cua
D016208:Databases, Factual; D015199:Extracorporeal Membrane Oxygenation / Q000379:methods*; D005260:Female; D006801:Humans; D018636:Hypoplastic Left Heart Syndrome / Q000401:mortality* / Q000628:therapy; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D058327:Norwood Procedures / Q000009:adverse effects / Q000379:methods*; D010166:Palliative Care / Q000379:methods*; D010351:Patient Discharge; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D016896:Treatment Outcome
Extracorporeal membrane oxygenation; Hypoplastic left heart syndrome; Interstage