Interstage Survival for Patients with Hypoplastic Left Heart Syndrome After ECMO

Richard P. Fernandez, Brian F. Joy, Robin Allen, Jamie Stewart, Holly Miller-Tate, Yongjie Miao, Lisa Nicholson, Clifford L. Cua

Research output: Contribution to journalArticlepeer-review

5 Scopus citations

Abstract

There is a reported 5–20 % incidence of extracorporeal membrane oxygenation (ECMO) following stage I palliation for hypoplastic left heart syndrome (HLHS). This study compares the interstage mortality of HLHS patients supported with ECMO (HLHS-ECMO) to those who were not supported with ECMO (HLHS-nECMO) using the National Pediatric Cardiology Quality Improvement Initiative database. Patients with HLHS who survived to hospital discharge after stage I palliation were analyzed. HLHS-ECMO patients were compared to HLHS-non-ECMO patients with respect to demographics, surgical variables, and interstage survival. A total of 931 patients were identified in the database. Sixty-six (7.1 %) patients were supported with ECMO during their stage I palliation admission. There were no statistically significant differences between the groups with respect to demographics or anatomic subtype. HLHS-ECMO patients were more likely to have a preoperative risk factor identified (62 vs. 48 %, p = 0.03) or require ECMO prior to stage I palliation (3 vs. 0.5 %, p = 0.03). HLHS-ECMO patients had a significantly higher incidence of death or transplant versus the HLHS-nECMO group (18 vs. 9 %, p = 0.03). Despite survival to discharge, patients with HLHS requiring ECMO after their palliation continue to have an increased risk of death/cardiac transplant versus patients that do not require ECMO. ECMO use is likely a marker for a high-risk patient group. These patients may benefit from closer follow-up during the interstage period.

Original languageEnglish (US)
Pages (from-to)50-55
Number of pages6
JournalPediatric Cardiology
Volume38
Issue number1
DOIs
StatePublished - Jan 1 2017

Bibliographical note

Funding Information:
The NPCQIC is supported by participation fees from centers, a gift from the Children?s Heart Association of Cincinnati and from the pediatric Center for Education and Research on Therapeutics, supported by Cooperative Agreement No. U19HS021114 from the Agency for Healthcare Research and Quality.

Funding Information:
Acknowledgments The NPCQIC is supported by participation fees from centers, a gift from the Children’s Heart Association of Cincinnati and from the pediatric Center for Education and Research on Therapeutics, supported by Cooperative Agreement No. U19HS021114 from the Agency for Healthcare Research and Quality.

Publisher Copyright:
© 2016, Springer Science+Business Media New York.

Keywords

  • Extracorporeal membrane oxygenation
  • Hypoplastic left heart syndrome
  • Interstage

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