Background: The use of a ventricular assist device (VAD) is a life-saving option for patients with heart failure refractory to conventional therapy.
Aim: To assess the effect of VAD on outcomes of heart transplantation in children.
Methods: Between October 1988 and June 2009, a consecutive series of 95 children (mean age 8.6 ± 6.7 years, range 5 days–17.9 years) underwent heart transplantation: patients in group 1 (n = 11) received VAD as a bridge to cardiac transplantation (left ventricular VAD in 4, biventricular VAD in 7), and patients in group 2 (n = 84) underwent heart transplantation without previous cardiac support using VAD. The indication for heart transplantation was cardiomyopathy/myocarditis in 66 (69.5%) of children and congenital heart disease in 29 (30.5%) patients.
Results: Congenital heart disease was diagnosed more often in group 2 than in group 1 (p = 0.047). The two groups did not differ significantly with respect to age, weight and parameters of preoperative liver and kidney function (except for aspartate aminotransferase activity, p = 0.020). The mean waiting time for transplantation was 64.2 ± 87.4 days (range 1–443 days) and did not differ between the groups. The mean follow-up was 6.8 ± 5.4 years (range 1 day–17.6 years). Mortality during long-term follow-up was 9.1% (n = 1) in group 1 and 20.2% (n=17) in group 2 (p = 0.632). We found no significant differences in postoperative ventilatory support time (p = 0.773), duration of hospital stay (p = 0.853), and incidence of acute rejection episodes (p = 0.575).
Conclusions: The use of VAD as a bridge to heart transplantation in children with severe heart failure had no negative effect on treatment outcomes.
Kardiol Pol 2010; 68, 6: 664-669