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Lack of Bridge to Recovery in Pediatric Dilated Cardiomyopathy With Left Ventricular Noncompaction

Moyu Hasegawa1, Masaki Taira1, Yuji Tominaga1

  • 1Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine, Yamadaoka, Osaka, Japan.

Annals of Thoracic Surgery Short Reports
|March 18, 2025
PubMed

Insights

Pediatric patients with dilated cardiomyopathy and left ventricular noncompaction had lower recovery rates using the Berlin Heart EXCOR device. Myocardial fibrosis was higher, and cardiac function did not improve in this group.

Area of Science:

  • Pediatric Cardiology
  • Cardiovascular Surgery
  • Histopathology

Background:

  • Assessing the Berlin Heart EXCOR as a bridge to recovery in pediatric dilated cardiomyopathy.
  • Investigating the impact of left ventricular noncompaction phenotype on recovery.
  • Examining histologic characteristics in affected children.

Purpose of the Study:

  • To evaluate the efficacy of the Berlin Heart EXCOR in pediatric patients with dilated cardiomyopathy.
  • To determine if the presence of left ventricular noncompaction affects cardiac recovery.
  • To compare histologic features and left ventricular function between patient groups.

Main Methods:

  • Retrospective analysis of 17 pediatric patients with dilated cardiomyopathy treated with Berlin Heart EXCOR (2013-2020).
  • Classification into dilated cardiomyopathy (DCM) group and DCM with left ventricular noncompaction (DCM-LVNC) phenotype group.
  • Histologic examination of myocardium and comparison of left ventricular function pre- and post-implantation.

Main Results:

  • No cardiac recovery observed in the DCM-LVNC group.
  • 55% of patients in the DCM group achieved recovery and device explantation.
  • Significantly higher myocardial fibrosis in the DCM-LVNC group (P < .05).
  • Significant improvement in ejection fraction and end-diastolic diameter in the DCM group (P < .001), but not in the DCM-LVNC group.

Conclusions:

  • The left ventricular noncompaction phenotype may hinder cardiac recovery in pediatric patients with dilated cardiomyopathy supported by the Berlin Heart EXCOR.
  • Histologic differences, specifically increased fibrosis, may contribute to poorer outcomes in the DCM-LVNC group.
Abstract

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