Continuous-Flow Ventricular Assist Device Support in Adult Congenital Heart Disease: A 15-Year, Multicenter Experience of Temporary and Durable Support. Issue 5 (10th November 2022)

• Record Type: Journal Article
• Authors: Broda, Christopher R.; Frankel, William C.; Nair, Ajith P.; Dreyer, W. Jeffrey; Tunuguntla, Hari P.; Frazier, O. Howard; Dolgner, Stephen J.; Anders, Marc M.; Tume, Sebastian C.; Qureshi, Athar M.; Parekh, Dhaval R.; Hickey, Edward J.; Adachi, Iki; Civitello, Andrew B.
• Is Part Of: ASAIO journal. Volume 69:Issue 5(2023)
• Page Start: 429
• Page End: 437
• Publication Date: 2022-11-10
• Subjects: adult congenital heart disease -- left ventricular assist device -- Fontan circulation -- mechanical circulatory support -- heart failure; Artificial organs -- Periodicals; 617
• DOI: 10.1097/MAT.0000000000001853
• Languages: English
• ISSNs: 1058-2916

Abstract

Abstract : Heart failure (HF) is common in adult congenital heart disease (ACHD) patients; however, use of continuous-flow ventricular assist devices (CF-VADs) remains rare. We reviewed outcomes of patients with congenital heart disease greater than or equal to 18 years of age at the time of CF-VAD implant at the affiliated pediatric and adult institutions between 2006 and 2020. In total, 18 ACHD patients (15 with great anatomical complexity) received 21 CF-VADs. Six patients (median age 34 years) received seven percutaneous CF-VADs with a median duration of support of 20 days (3–44 days) with all patients survived to hospital discharge and two patients were bridged to durable CF-VADs. Fourteen patients (median age 38 years) received durable CF-VADs. Thirteen patients (93%) survived to hospital discharge and the median duration of support was 25.8 months (6.4–52.1 months). Estimated survival on durable CF-VAD at 1, 3, and 5 years was 84%, 72%, and 36%, respectively. Three patients were successfully bridged to transplantation. Device-related complications include cerebrovascular accident (n = 5), driveline infection (n = 3), device infection requiring chronic antibiotic therapy (n = 4), gastrointestinal bleeding (n = 6), and presumed pump thrombosis (n = 5). These results show percutaneous and durable CF-VADs can support ACHD patients with advanced HF.