(389) Impact of Heartware Vad Discontinuation on the Pediatric Population-An Advanced Heart Failure Improving Outcomes (ACTION) Registry Analysis

• Published in: The Journal of heart and lung transplantation Vol. 42; no. 4; p. S184
• Main Authors: Niebler, R., Lorts, A., O'Connor, M., Shezad, M., Rosenthal, D.
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 01.04.2023
• ISSN: 1053-2498; 1557-3117
• DOI: 10.1016/j.healun.2023.02.1693

The HeartWare VAD (HVAD) was abruptly removed from the market in July 2021. The relative size of the HVAD made it desirable in the pediatric population. It is unclear of the impact the loss of the HVAD has had on device placement in pediatrics and what was the outcome of pediatric patients supported with a HVAD at the time of the discontinuation. The ACTION registry was queried to determine the impact of the loss of the HVAD had on the pediatric population with the focus on patients with a body surface area (BSA) of 0.7 to 1.4 m2. Patients less than 0.7 m2 are generally too small for the HVAD and those over 1.4 m2 would fit all devices. The rates of use of all devices and complications of patients were compared from before and after July 1, 2021. The outcomes of all patients within the registry actively supported with the HVAD at the time of its discontinuation is also reported. Since July 2021 the HeartMate 3 primarily replaced the HVAD in patients 0.7-1.4 m2 with a small increase in Berlin Heart EXCOR (EXCOR). The rate of complications implanted with the HeartMate 3 and the EXCOR are seen in Table 1 with comparison to baseline data with the HVAD. 19 patients were actively supported by HVAD on July 1, 2021. 7 patients have been transplanted, 3 have died, and 9 remain on device. The HeartMate 3 primarily replaced the HVAD after July 2021 with a small increase in the use of the EXCOR. The observed changes of complication rates are mixed with HeartMate 3 but higher than those observed in EXCOR patients of similar size or historically compared to the HVAD.