Related Experiment Video
Updated: Oct 1, 2025
Implantation of Electroencephalogram and Electrocardiogram Telemetry Devices in Neonatal Rabbit Kits
Published on: February 28, 2025
Short-term outcomes of EXCOR Paediatric implantation
Motoki Komori1, Takaya Hoashi1, Heima Sakaguchi2
1Department of Pediatric Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Osaka, Japan.
Insights
EXCOR Paediatric support showed good survival rates for children needing heart transplants, but complications increased over time, particularly in smaller children. Careful consideration is needed for pediatric mechanical circulatory support.
Area of Science:
- Pediatric Cardiology
- Mechanical Circulatory Support
- Cardiothoracic Surgery
Background:
- Pediatric heart failure requires advanced treatment options.
- Mechanical circulatory support (MCS) devices like EXCOR Paediatric offer a bridge to transplantation.
- Single-institution reviews are crucial for understanding real-world outcomes of novel therapies.
Purpose of the Study:
- To review a single institution's experience with EXCOR Paediatric implantation in children.
- To evaluate the outcomes and complications associated with EXCOR Paediatric support.
- To identify risk factors for adverse events in pediatric patients receiving EXCOR support.
Main Methods:
- Retrospective review of pediatric patients (<15 years) implanted with EXCOR Paediatric between 2015-2021.
- Patients received support as a bridge to heart transplantation.
- Major adverse events were defined as death, cerebrovascular events, major infections, or device malfunction.
Main Results:
- Twenty children (median age 10.8 months, median weight 6.3 kg) received EXCOR support.
- Major complication-free survival at 18 months was 38.6%.
- Low body weight (<5 kg) at implantation was a significant risk factor for decreased major complication-free survival.
Conclusions:
- EXCOR Paediatric provides good survival for pediatric patients awaiting heart transplantation.
- The incidence of major complications increases with support duration and is higher in smaller children.
- Prolonged support may increase transplant wait times, necessitating careful patient selection and management.
Objectives:
The aim of this study was to review a single institution's experience with EXCOR Paediatric implantation.
Methods:
Patients <15 years old who underwent EXCOR implantation as a bridge to transplantation between 2015 and 2021 were enrolled. Major adverse events included death, cerebrovascular event resulting in sequelae, major infection (sepsis or surgical site infection requiring open sternal irrigation or device removal) and device malfunction requiring surgical treatment.
Results:
Overall median age and weight for all 20 children at implantation were 10.8 (interquartile range, 7.9-33.2) months and 6.3 (4.6-10.2) kg. Ten patients (50%) weighed <5 kg. Primary diagnoses were dilated cardiomyopathy in 13 patients, fulminant myocarditis in 3, restrictive cardiomyopathy in 2 and congenital heart disease in 2. Two patients required biventricular assist support. The median support time was 365 (241-636) days. Six patients (30%) were supported for >20 months. One patient died. Seven patients underwent heart transplant. Heart transplant has not been performed in the last 1.5 years. Five patients were weaned from EXCOR support after native myocardial recovery, including a patient with dilated cardiomyopathy who recovered after 24 months of EXCOR support. Major complication-free survival at 6, 12 and 18 months were 79.3%, 49.6% and 38.6%, respectively. Body weight <5 kg at implantation was a risk factor for decreased major complication-free survival.
Conclusions:
Survival during EXCOR Paediatric support was good, but it prolonged the wait time for a heart transplant. The number of major complications increased over time and was not negligible, especially in small children.
More Related Videos
08:42The DREAM Implant: A Lightweight, Modular, and Cost-Effective Implant System for Chronic Electrophysiology in Head-Fixed and Freely Behaving Mice
Published on: July 26, 2024
04:35Author Spotlight: Innovative Methodology for Implanting and Securing Neural Probes in the Rodent Spinal Cord
Published on: July 12, 2024