Severe heart failure and the need for mechanical circulatory support and heart transplantation in pediatric patients with myocarditis: Results from the prospective multicenter registry "MYKKE". (11th July 2019)

• Record Type: Journal Article
• Authors: Schubert, Stephan; Opgen‐Rhein, Bernd; Boehne, Martin; Weigelt, Annika; Wagner, Robert; Müller, Götz; Rentzsch, Axel; zu Knyphausen, Edzard; Fischer, Marcus; Papakostas, Konstantin; Wiegand, Gesa; Ruf, Bettina; Hannes, Tobias; Reineker, Katja; Kiski, Daniela; Khalil, Markus; Steinmetz, Michael; Fischer, Gunther; Pickardt, Thomas; Klingel, Karin; Messroghli, Daniel R.; Degener, Franziska
• Other Names: Berger Felix investigator.; Haverkämper Guido investigator.; Klaassen Sabine investigator.; Racolta Anca investigator.; Kececioglu Deniz investigator.; Phi Lê Trong investigator.; Dittrich Sven investigator.; Halbfaß Julia investigator.; Stiller Brigitte investigator.; Kaufmann Janina investigator.; Bauer Jürgen investigator.; Latus Heiner investigator.; Jux Christian investigator.; Schranz Dietmar investigator.; Kozlik‐Feldmann Rainer investigator.; Mir Thomas investigator.; Schlesner Claudia investigator.; Schmidt Florian investigator.; Jack Thomas investigator.; Beerbaum Philipp investigator.; Rentzsch Axel investigator.; Pontius Sandra investigator.; Abdul‐Khaliq Hashim investigator.; Brockmeier Konrad investigator.; Dähnert Ingo investigator.; Richter Jacqueline investigator.; Engelhardt Andrea investigator.; Ewert Peter investigator.; Uebing Anselm investigator.; Hofbeck Michael investigator.; Jakob André investigator.; Haas Nikolaus investigator.; Kaestner Micheal investigator.; Apitz Christian investigator.; Kramer Hans‐Heiner investigator.; Fischer Gunther investigator.; Paul Thomas investigator.; Steinmetz Michael investigator.; Freudenthal Noa investigator.; von dem Busche Caroline investigator.; Breuer Johannes investigator.; Bauer Ulrike investigator.; Dakna Mohammed investigator.; Friede Tim investigator.; Wölffel‐Gale Anne investigator.; Stein Julia investigator.;
• Is Part Of: Pediatric transplantation. Volume 23:Number 7(2019)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2019-07-11
• Subjects: MCS -- myocarditis -- pediatric -- transplantation; Transplantation of organs, tissues, etc. in children -- Periodicals; 617.95408305
• DOI: 10.1111/petr.13548
• Languages: English
• ISSNs: 1397-3142

Abstract

Abstract: Myocarditis represents an important cause for acute heart failure. MYKKE, a prospective multicenter registry of pediatric patients with myocarditis, aims to gain knowledge on courses, diagnostics, and therapy of pediatric myocarditis. The role of mechanical circulatory support (MCS) in children with severe heart failure and myocarditis is unclear. The aim of this study was to determine characteristics and outcome of patients with severe heart failure requiring MCS and/or heart transplantation. The MYKKE cohort between September 2013 and 2016 was analyzed. A total of 195 patients were prospectively enrolled by 17 German hospitals. Twenty‐eight patients (14%) received MCS (median 1.5 years), more frequently in the youngest age group (0‐2 years) than in the older groups ( P < 0.001; 2‐12 and 13‐18 years). In the MCS group, 50% received a VAD, 36% ECMO, and 14% both, with a survival rate of 79%. The weaning rate was 43% (12/28). Nine (32%) patients were transplanted, one had ongoing support, and six (21%) died. Histology was positive for myocarditis in 63% of the MCS group. Patients within the whole cohort with age <2 years and/or ejection fraction <30% had a significantly worse survival with high risk for MCS, transplantation, and death ( P < 0.001). Myocarditis represents a life‐threatening disease with an overall mortality of 4.6% in this cohort. The fulminant form more often affected the youngest, leading to significantly higher rate of MCS, transplantation, and mortality. MCS represents an important and life‐saving therapeutic option in children with myocarditis with a weaning rate of 43%.