The European Registry for Patients with Mechanical Circulatory Support (EUROMACS): third Paediatric (Paedi-EUROMACS) report

de By T.M.M.H. Schweiger M. Hussain H. Amodeo A. Martens T. Bogers A.J.J.C. Damman K. Gollmann-Tepeköylü C. Hulman M. Iacovoni A. Krämer U. Loforte A. Napoleone C.P. Němec P. Netuka I. Özbaran M. Polo L. Pya Y. Ramjankhan F. Sandica E. Sliwka J. Stiller B. Kadner A. Franceschini A. Thiruchelvam T. Zimpfer D. Meyns B. Berger F. Miera O.
1 August 2022 European Association for Cardio-Thoracic Surgery

European Journal of Cardio-thoracic Surgery
2022 #62 Issue 2

OBJECTIVES: A third paediatric report has been generated from the European Registry for Patients with Mechanical Circulatory Support (EUROMACS). The purpose of EUROMACS, which is operated by the European Association for Cardio-Thoracic Surgery, is to gather data related to durable mechanical circulatory support for scientific purposes and to publish reports with respect to the course of mechanical circulatory support therapy. Since the first report issued, efforts to increase compliance and participation have been extended. Additionally, the data provided the opportunity to analyse patients of younger age and lower weight. METHODS: Participating hospitals contributed pre-, peri- and long-term postoperative data on mechanical circulatory support implants to the registry. Data for all implants in paediatric patients (<19 years of age) performed from 1 January 2000 to 31 December 2020 were analysed. This report includes updates of patient characteristics, implant frequency, outcome (including mortality rates, transplants and recovery rates) as well as adverse events including neurological dysfunction, device malfunction, major infection and bleeding. RESULTS: Twenty-five hospitals contributed 537 registered implants in 480 patients. The most frequent aetiology of heart failure was any form of cardiomyopathy (59%), followed by congenital heart disease and myocarditis (15% and 14%, respectively). Competing outcomes analysis revealed that a total of 86% survived to transplant or recovery or are ongoing; at the 2-year follow-up examination, 21.9% died while on support. At 12 months, 45.1% received transplants, 7.5% were weaned from their device and 20.8% died. The 3-month adverse events rate was 1.59 per patient-year for device malfunction including pump exchange, 0.7 for major bleeding, 0.78 for major infection and 0.71 for neurological events. CONCLUSIONS: The overall survival rate was 79.2% at 12 months following ventricular assist device implant. The comparison of survival rates of the early and later eras shows no significant difference. A focus on specific subgroups showed that survival was less in patients of younger age (<1 year of age; P = 0.01) and lower weight (<20 kg; P = 0.015). Transplant rates at 6 months continue to be low (33.2%).

Congenital heart disease , End-stage heart failure , Mechanical circulatory support , Paediatric patients , Registry , Ventricular assist device

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EUROMACS, EACTS House, Windsor, United Kingdom
Department of Congenital Pediatric Surgery, Children’s Hospital Zürich, Zürich, Switzerland
Quality and Outcomes Research Unit, University Hospital Birmingham, Birmingham, United Kingdom
Ospedale Bambino Gesù, Rome, Italy
Universitair Ziekenhuis Gent, Gent, Belgium
Department of Cardio-Thoracic Surgery, Erasmus MC, Rotterdam, Netherlands
University of Groningen, University Medical Center Groningen, Groningen, Netherlands
Department of Cardiac Surgery, Innsbruck, Austria
Klinika Kardiochirurgie NUSCH, Bratislava, Slovakia
Ospedale Papa Giovanni XIII, Bergamo, Italy
Department of Pediatric Intensive Care, Erasmus MC, Rotterdam, Netherlands
San Orsola Hospital, Bologna, Italy
Pediatric Cardiac Surgery Department, Regina Margherita Children’s Hospital, Torino, Italy
Center for Cardiovascular and Transplant Surgery, Brno, Czech Republic
Institute for Clinical and Experimental Medicine (IKEM), Prague, Czech Republic
Ege University Hospital, Izmir, Turkey
La Paz University Hospital, Madrid, Spain
National Research Cardiac Surgery Center, Astana, Kazakhstan
Utrecht University Medical Center, Utrecht, Netherlands
Clinic for Pediatric Cardiac Surgery and Congenital Heart Defects, Heart and Diabetes Centre North Rhine-Westphalia, Bad Oeynhausen, Germany
Department of Cardiac Surgery, Transplantology and Vascular Surgery, Silesian Center for Heart Diseases, Zabrze, Poland
Department of Congenital Heart Defects and Pediatric Cardiology, University Heart Center Freiburg-Bad Krozingen, University of Freiburg, Germany
Department of Herz- und Gefässchirurgie, University Hospital Bern, Switzerland
Great Ormond Street Hospital, London, United Kingdom
Vienna Medical University, Vienna, Austria
Katholieke Universiteit Leuven, Leuven, Belgium
Department of Congenital Heart Disease and Pediatric Cardiology, Deutsches Herzzentrum Berlin, Berlin, Germany

EUROMACS
Department of Congenital Pediatric Surgery
Quality and Outcomes Research Unit
Ospedale Bambino Gesù
Universitair Ziekenhuis Gent
Department of Cardio-Thoracic Surgery
University of Groningen
Department of Cardiac Surgery
Klinika Kardiochirurgie NUSCH
Ospedale Papa Giovanni XIII
Department of Pediatric Intensive Care
San Orsola Hospital
Pediatric Cardiac Surgery Department
Center for Cardiovascular and Transplant Surgery
Institute for Clinical and Experimental Medicine (IKEM)
Ege University Hospital
La Paz University Hospital
National Research Cardiac Surgery Center
Utrecht University Medical Center
Clinic for Pediatric Cardiac Surgery and Congenital Heart Defects
Department of Cardiac Surgery
Department of Congenital Heart Defects and Pediatric Cardiology
Department of Herz- und Gefässchirurgie
Great Ormond Street Hospital
Vienna Medical University
Katholieke Universiteit Leuven
Department of Congenital Heart Disease and Pediatric Cardiology

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