Stroke in pediatric ventricular assist device patients—a pedimacs registry analysis
Section snippets
Methods
Pedimacs is a North American registry of mechanical circulatory support in the pediatric population supported initially by the National Heart, Lung, and Blood Institute (NHLBI), and later assumed by the Society of Thoracic Surgeons. Supplementary Appendix 1 displays the enrollment of devices, patients, and hospitals over time. Pedimacs includes data on patients younger than 19 years age at the time of initiation of circulatory support. As the Berlin Heart EXCOR is the only FDA approved
Discussion
The use of VAD to support end-stage heart failure in pediatric patients has continued to expand, resulting in a reduction in transplant waitlist mortality by 50%.17 The risks of neurologic injury (specifically, CVA) have tempered enthusiasm for these devices, though. As a result, many practitioners postpone placement of a VAD until risk of death is imminent, or only when they feel a VAD's potential benefits outweigh the significant risk of CVA. This has led to delayed implant in patients
Disclosure statement
Dr. R.A.N. reports personal fees from Abbott and Berlin Heart for travel funds to attend learning network and educational conferences; not related to the submitted work. Dr. J.K.K. reports salary support from the Society of Thoracic Surgeons as the database coordinator. Dr. A.L. reports grants and personal fees from Abbott, personal fees from Abiomed, grants from Syncardia, grants from Berlin Heart, and grants and personal fees from Medtronic; not related to the submitted work. Dr. D.L.M.
Acknowledgement
The authors thank the tireless effort of multiple investigators who contributed to the data within the Pedimacs registry. The data for this research were provided by the Society of Thoracic Surgeons’ National Database Access and Publications Research Program. This analysis would not be possible without the collaboration from all institutions and individuals.
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