Publications by authors named "Devilliers Jonker"

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Paracorporeal Support in Pediatric Patients: The Role of the Patient-Device Interaction.

Ann Thorac Surg 2021 Jul 28. Epub 2021 Jul 28.

Department of Pediatric Cardiology University of Alberta, Edmonton AB, Canada; Division of Pediatric Cardiology, Stollery Children's Hospital, Edmonton AB, Canada. Electronic address:

Background: Ventricular assist devices (VADs) are important in the treatment of pediatric heart failure. While paracorporeal pulsatile (PP) devices have historically been used, there has been increased use of paracorporeal continuous (PC) devices. We sought to compare the outcomes of children supported with a PP, PC, or combination of devices.

Methods: Retrospective review (2005-19) of patients <19 years of age from a single center, who received a PC, PP or combination of devices. Patient characteristics were compared between device strategies and Kaplan-Meier survival analysis was performed.

Results: Sixty-six patients were included (62% male, 62% non-congenital heart disease, median age 0.9 years (IQR 0.2, 4.9), median weight 8.5 kg (IQR 4.3, 17.7). PC devices were used in 45% of patients, PP in 35% and a combination in 20%. Patients on PC devices had a lower median weight (p=.02), a higher proportion of CHD (p=.02) and more patients requiring pre-VAD dialysis (p=.01). There was no difference in pre-VAD ECMO (p=.15) use. There was a difference in survival between the three device strategies (p=.02) CONCLUSIONS: Differences in survival was evident, with those on PC support having worse outcomes. Transition from PC to a PP devices was associated with a survival advantage. These findings may be driven by differences in patient characteristics across device strategies. Further studies are required to confirm these findings and to better understand the interaction between patient characteristics and device options.
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http://dx.doi.org/10.1016/j.athoracsur.2021.06.062DOI Listing
July 2021
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