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Myocardial recovery in children supported with a durable ventricular assist device-a systematic review

Sofie Rohde1, Theo M M H de By2, Ad J J C Bogers1

  • 1Department of Cardio-thoracic surgery, Erasmus University Medical Center, Rotterdam, Netherlands.

European Journal of Cardio-Thoracic Surgery : Official Journal of the European Association for Cardio-Thoracic Surgery
|July 27, 2023
PubMed

Insights

Pediatric patients with ventricular assist devices (VADs) can achieve myocardial recovery and device explantation. Long-term recovery is possible even after prolonged VAD support and in various underlying conditions.

Area of Science:

  • Pediatric cardiology
  • Cardiovascular surgery
  • Regenerative medicine

Background:

  • A small percentage of pediatric patients with ventricular assist devices (VADs) experience myocardial recovery, allowing for device explantation.
  • Understanding the clinical course and long-term outcomes after VAD weaning in these children is crucial.

Approach:

  • A systematic literature search was conducted across multiple databases (Embase, Medline ALL, Web of Science, Cochrane, Google Scholar) for studies published in the last decade.
  • Included studies focused on pediatric patients with durable VADs, excluding overlapping cohorts and registry-based studies.

Key Points:

  • The incidence of myocardial recovery in pediatric VAD patients was 8.7% (81/928).
  • Eighty-three patients underwent VAD explantation due to recovery, with diverse etiologies beyond myocarditis.
  • The Berlin Heart EXCOR was the most common VAD used, with a longest follow-up of 19.1 years.

Conclusions:

  • Myocardial recovery during VAD support is influenced by complex patient-, device-, time-, and hospital-related factors.
  • Long-term recovery after VAD support is achievable, regardless of VAD duration or etiology.
  • Further research is warranted to fully understand this favorable outcome.
Abstract

Keywords:
RecoveryVAD explantationpaediatricventricular assist deviceweaning

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