Trends in the Indications and Survival in Pediatric Heart Transplants: A 24-year Single- Center Experience in 307 Patients Rochus K. Voeller, MD, Deirdre.

Slides:

Advertisements

Similar presentations

Heart Transplant vs Left Ventricular Assist Device in Heart Transplant-Eligible Patients Matthew L. Williams, MD, Jaimin R. Trivedi, MD, MPH, Kelly C.

Advertisements

Photodynamic Laser Therapy for Lesions in the Airway

Results of Coronary Artery Endarterectomy and Coronary Artery Bypass Grafting for Diffuse Coronary Artery Disease Srikrishna Sirivella, MD, Isaac Gielchinsky,

Treating Constrictive Pericarditis in a Chinese Single-Center Study: A Five-Year Experience Yiyun Lin, MD, Mi Zhou, MMS, Jian Xiao, MD, Bin Wang, MD,

Coronary Artery Bypass for Heart Failure in Ischemic Cardiomyopathy: 17-Year Follow- Up Marco Pocar, MD, PhD, Andrea Moneta, MD, Adalberto Grossi, MD,

Survival on the Heart Transplant Waiting List: Impact of Continuous Flow Left Ventricular Assist Device as Bridge to Transplant Jaimin R. Trivedi, MD,

Late Vascular Complications After Extracorporeal Membrane Oxygenation Support Daniel Zimpfer, MD, Birgit Heinisch, MD, Martin Czerny, MD, Thomas Hoelzenbein,

Heart Transplantation in Children: Clinical Outcomes in a Single Center Yanto Sandy Tjang, MD, DSc, Ute Blanz, MD, Lech Hornik, MD, Gero Tenderich, MD,

Lisa M. Brown, MD, MAS, David T. Cooke, MD, Elizabeth A. David, MD

Vinod H. Thourani, MD, Paul M. Kirshbom, MD, Kirk R

Outcome of Extracorporeal Membrane Oxygenation as a Bridge to Lung Transplantation and Graft Recovery Hartmuth B. Bittner, MD, PhD, Sven Lehmann, MD,

Andreas Zierer, MD, Spencer J. Melby, MD, Rochus K

Video-Assisted Thoracoscopic Left Ventricular Pacing in Patients With and Without Previous Sternotomy Katharine E. Nelson, MBBS, MRCP, Matthew G.D. Bates,

Pacemaker Therapy After Tricuspid Valve Operations: Implications on Mortality, Morbidity, and Quality of Life Janne J. Jokinen, MD, Anu K. Turpeinen,

Heart Transplantation for the Failing Fontan

Dhaval Chauhan, MD, Alexis K

Predictors and Outcome of Extracorporeal Life Support After Pediatric Heart Transplantation Jacob Simmonds, MD, Troy Dominguez, MD, Joanna Longman, MBBS,

Continuous Flow Left Ventricular Assist Device Outcomes in Commercial Use Compared With the Prior Clinical Trial Ranjit John, MD, Yoshifumi Naka, MD,

Biventricular Conversion After Single Ventricle Palliation in Patients With Small Left Heart Structures: Short-Term Outcomes Brian T. Kalish, MD, Puja.

Jeffrey Phillip Jacobs, MD, Alfred Asante-Korang, MD, Sean M

Successful Bridge Through Transplantation With Berlin Heart Ventricular Assist Device in a Child With Failing Fontan David M. Hoganson, MD, Umar S. Boston,

Video-Assisted Thoracic Surgery Lobectomy: Experience With 1,100 Cases

Extracorporeal Membrane Oxygenation is Superior to Right Ventricular Assist Device for Acute Right Ventricular Failure After Heart Transplantation Shahrokh.

The Effect of Institutional Volume on Complications and Their Impact on Mortality After Pediatric Heart Transplantation Cecillia Lui, MD, Joshua C. Grimm,

Lymph Node Evaluation Achieved by Open Lobectomy Compared With Thoracoscopic Lobectomy for N0 Lung Cancer Robert E. Merritt, MD, Chuong D. Hoang, MD,

Hanan A. Tanash, PhD, Gerdt C. Riise, PhD, Magnus P

Surgical Ventricular Restoration for Advanced Congestive Heart Failure: Should Pulmonary Hypertension Be a Contraindication? Nishant D. Patel, BA, Jason.

Jennifer K. Peterson, MS, Lazaros K. Kochilas, MD, MSCR, Kirsti G

Venous Thromboembolic Complications of Lung Transplantation: A Contemporary Single-Institution Review Charles F. Evans, MD, Aldo T. Iacono, MD, Pablo.

Age-Related Outcomes of the Ross Procedure Over 20 Years

Improvement in Survival After Mechanical Circulatory Support With Pneumatic Pulsatile Ventricular Assist Devices in Pediatric Patients Roland Hetzer,

Outcome of Concomitant Cox-Maze III Procedure Using an Argon-Based Cryosurgical System: A Single-Center Experience With 250 Patients Bobby Yanagawa,

Reversible Pulmonary Hypertension in Heart Transplant Candidates: To Transplant or Not to Transplant Stefan Klotz, MD, Frauke Wenzelburger, MD, Joerg.

Outcomes in Patients Bridged With Univentricular and Biventricular Devices in the Modern Era of Heart Transplantation Joshua C. Grimm, MD, Christopher.

Radial Artery Grafts in Women: Utilization and Results

Allen Cheng, MD, Erin M. Schumer, MD, MPH, Jaimin R

Outcomes and Costs for Major Lung Resection in the United States: Which Patients Benefit Most From High-Volume Referral? Elliot Wakeam, MD, MPH, Joseph.

Should Patients 60 Years and Older Undergo Bridge to Transplantation With Continuous-Flow Left Ventricular Assist Devices? Jeremiah G. Allen, MD, Arman.

J. Westley Ohman, MD, Chandu Vemuri, MD, Sunil Prasad, MD, Scott C

Lung Function and ECMO After Lung Transplantation

Low-Dose Prophylactic Intravenous Immunoglobulin Does Not Prevent HLA Sensitization in Left Ventricular Assist Device Recipients Stavros G. Drakos, MD,

Michiaki Imamura, MD, PhD, Amy M

John M. Stulak, MD, Joseph A. Dearani, MD, Harold M

Arman Kilic, MD, Eric S. Weiss, MD, MPH, Jeremiah G

Posttransplant Outcomes Among Septuagenarians Bridged to Transplantation With Continuous-Flow Left Ventricular Assist Devices Shinichi Fukuhara, MD,

Mechanical Circulatory Support Pathways That Maximize Post-Heart Transplant Survival Tara Karamlou, MD, MS, Jill Gelow, MD, Brian S. Diggs, PhD, Frederick.

Mohammad A. Zafar, MBBS, Emily A

William M. Whited, MD, Paul Henley, BS, Erin M

Absent Long-Term Benefit of Patch Versus Linear Reconstruction in Left Ventricular Aneurysm Surgery Ruediger Lange, MD, Thomas Guenther, MD, Norbert.

Cardiac Transplantation in Pediatric Patients: Fifteen-Year Experience of a Single Center Jan Groetzner, MD, Bruno Reichart, MD, Ulrich Roemer, MD, Stefanie.

Early Outcomes With Marginal Donor Hearts Compared With Left Ventricular Assist Device Support in Patients With Advanced Heart Failure Erin M. Schumer,

Single Versus Double Lung Retransplantation Does Not Affect Survival Based on Previous Transplant Type Erin M. Schumer, MD, MPH, Jonathan D. Rice, MD,

Results of Thoracic Endovascular Aortic Repair 6 Years After United States Food and Drug Administration Approval Asad A. Shah, MD, Michael E. Barfield,

Survival After Isolated Coronary Artery Bypass Grafting in Patients With Severe Left Ventricular Dysfunction Waleed A. Ahmed, MD, Phillip J. Tully, BHSc(Hons),

Cardiac Surgery in Select Nonagenarians: Should We or Shouldn’t We?

Trends in Patient Characteristics and Outcomes of Coronary Artery Bypass Grafting in the 2000 to 2012 Medicare Population Christian McNeely, MD, Stephen.

Preoperative Performance Status Impacts Perioperative Morbidity and Mortality After Lung Transplantation Joshua C. Grimm, MD, Vicente Valero, MD, Arman.

The Impact of Volume Reduction on Early and Long-Term Outcomes in Surgical Ventricular Restoration for Severe Heart Failure Nathan Wm. Skelley, BS, Jeremiah.

Left-Sided Reoperations After Arterial Switch Operation: A European Multicenter Study Vladimiro L. Vida, MD, PhD, Lorenza Zanotto, MD, Lucia Zanotto,

Iki Adachi, MD, Muhammad S. Khan, MD, Francisco A

Non-Fontan Adult Congenital Heart Disease Transplantation Survival Is Equivalent to Acquired Heart Disease Transplantation Survival Josef Besik, MD,

Late Aortic Insufficiency Related to Poor Prognosis During Left Ventricular Assist Device Support Koichi Toda, MD, PhD, Tomoyuki Fujita, MD, Keitaro.

Long-term follow-up of pediatric cardiac patients requiring mechanical circulatory support Andra E Ibrahim, MD, Brian W Duncan, MD, Elizabeth D Blume,

Creation of a Quantitative Score to Predict the Need for Mechanical Support in Children Awaiting Heart Transplant Ryan R. Davies, MD, Shylah Haldeman,

Use of Ventricular Assist Devices in Children Across the United States: Analysis of 7.5 Million Pediatric Hospitalizations David L.S. Morales, MD, Farhan.

Marginal Donor Use in Patients Undergoing Heart Transplantation With Left Ventricular Assist Device Explantation Marat Fudim, MD, Mary E. Davis, MS,

Long-Term Survival After Bovine Pericardial Versus Porcine Stented Bioprosthetic Aortic Valve Replacement: Does Valve Choice Matter? Asvin M. Ganapathi,

Significance of Postoperative Acute Renal Failure After Continuous-Flow Left Ventricular Assist Device Implantation Jamil Borgi, MD, Athanasios Tsiouris,

Pediatric Heart Transplantation for Congenital and Restrictive Cardiomyopathy Bari Murtuza, MD, PhD, Matthew Fenton, MD, Michael Burch, MD, Arun Gupta,

Kathleen E. Simpson, MD, Elizabeth Pruitt, MSPH, James K

Presentation transcript:

Trends in the Indications and Survival in Pediatric Heart Transplants: A 24-year Single- Center Experience in 307 Patients Rochus K. Voeller, MD, Deirdre J. Epstein, RN, Tracey J. Guthrie, RN, Sanjiv K. Gandhi, MD, Charles E. Canter, MD, Charles B. Huddleston, MD The Annals of Thoracic Surgery Volume 94, Issue 3, Pages 807-816 (September 2012) DOI: 10.1016/j.athoracsur.2012.02.052 Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Indications for transplant annually are broken down into the percentage of cardiomyopathy (CM, black bar), congenital heart disease (CHD, vertical line), and retransplants (RETX, slanted line). In recent years, the percentage of CM as an indication has become more prevalent at our center. The Annals of Thoracic Surgery 2012 94, 807-816DOI: (10.1016/j.athoracsur.2012.02.052) Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 An analysis of age groups at transplant annually shows recipients aged > 10 years (hashed bars) have become more prevalent in recent years in our series than those aged <1 year (slanted bars) and those aged 1 to 10 years (black bars). The Annals of Thoracic Surgery 2012 94, 807-816DOI: (10.1016/j.athoracsur.2012.02.052) Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 The overall breakdown for indications by percentage for transplantation is shown by (left) cardiomyopathy (CM, black), congenital heart disease (CHD, grey), and retransplantation (white) in all patients and (right) in patients with CHD by subgroups of single-ventricle and no palliation (black), single-ventricle after (s/p) a palliation procedure (gray), and in patients with other (white) types of CHD. The Annals of Thoracic Surgery 2012 94, 807-816DOI: (10.1016/j.athoracsur.2012.02.052) Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 The data were divided into three consecutive intervals by 8-year increments: (A) 1986 to 1993; (B) 1994 to 2001; and (C) 2002 to 2009. This revealed an overall decline in congenital heart disease (gray) as an indication for transplant, an increase in cardiomyopathy (black) as an indication for transplant, and retransplant rates (white) have remained relatively stable. The Annals of Thoracic Surgery 2012 94, 807-816DOI: (10.1016/j.athoracsur.2012.02.052) Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions

Fig 5 In our series, there was a significant increase in the percentage of patients who received allografts for single-ventricle (SV) with failed palliative operations (gray), particularly Fontan procedures, compared with SV with no palliation (black) and patients with other congenital heart disease (white) over the years. (A) 1984 to 1993; (B) 1994 to 2001; (C) 2002 to 2009. The Annals of Thoracic Surgery 2012 94, 807-816DOI: (10.1016/j.athoracsur.2012.02.052) Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions

Fig 6 (A) This Kaplan-Meier survival curve is for all patients (black), the cardiomyopathy group (dark gray), the congenital heart disease group (light gray), and those who received pretransplant support with extracorporeal membrane oxygenation or a ventricular assist device (dotted line). Patients who received mechanical support are a subgroup of the cardiomyopathy group; none of the congenital group had mechanical support pretransplant. (B) The survival curves for the single-ventricle (SV) groups (dark dotted line for SV without palliation; light dotted line for SV with palliation, dash-dot line for failed Fontan) are shown with the main diagnostic groups (cardiomyopathy, dark gray line; congenital, light gray line) for contrast. In particular, SV patients without palliation had a comparable survival to the cardiomyopathy group. (C) Survival curves for the SV patients (without palliation, dash-dot line; with palliation, black line) only, based on the pretransplant interventions (failed Fontan, dashed line) as well as the basic anatomy (double-ventricle, gray line), show the SV patients had the best overall survival. (VAD = ventricular assist device.) The Annals of Thoracic Surgery 2012 94, 807-816DOI: (10.1016/j.athoracsur.2012.02.052) Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions

Fig 6 (A) This Kaplan-Meier survival curve is for all patients (black), the cardiomyopathy group (dark gray), the congenital heart disease group (light gray), and those who received pretransplant support with extracorporeal membrane oxygenation or a ventricular assist device (dotted line). Patients who received mechanical support are a subgroup of the cardiomyopathy group; none of the congenital group had mechanical support pretransplant. (B) The survival curves for the single-ventricle (SV) groups (dark dotted line for SV without palliation; light dotted line for SV with palliation, dash-dot line for failed Fontan) are shown with the main diagnostic groups (cardiomyopathy, dark gray line; congenital, light gray line) for contrast. In particular, SV patients without palliation had a comparable survival to the cardiomyopathy group. (C) Survival curves for the SV patients (without palliation, dash-dot line; with palliation, black line) only, based on the pretransplant interventions (failed Fontan, dashed line) as well as the basic anatomy (double-ventricle, gray line), show the SV patients had the best overall survival. (VAD = ventricular assist device.) The Annals of Thoracic Surgery 2012 94, 807-816DOI: (10.1016/j.athoracsur.2012.02.052) Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions