[II-JCKAP5-2-4] Echocardiographic Parameters and Reverse Remodeling After Pediatric Pulsatile Left Ventricular Assist Device Implantation
Keywords:ventricular assist devices, pediatric, reverse myocardial remodeling
BackgroundLeft ventricular unloading via the implantation of left ventricular assist devices (LVADs) is renowned to promote reverse remodeling of the heart, which has potential to lead to myocardial recovery and device explantation. Nevertheless, there is a lack of data in pediatric patients.MethodsA retrospective analysis of medical records was conducted on pediatric patients who underwent implantation of paracorporeal pulsatile ventricular assist devices at a single center between November 2017 and October 2023. ResultsThirteen patients were enrolled in the study, with ten in the partial or non-recovery group and three in the complete recovery group. All patients experienced an improvement in LVEF. Importantly, LVEF continued to improve for three to four months before reaching a plateau. LVEF measurements showed a large variation in the early stages of treatment, with a significant reduction in LVEDD observed within the first month. NT-proBNP levels reduced abruptly within two weeks, while the cardiothoracic ratio decreased after two months. Compared to the partial or non-recovery group, the complete recovery group showed lower z-scores for LVEDD, LV end-systolic dimension (LVESD), and LV mass index. ConclusionThe changes in echocardiographic, serologic, and radiographic parameters suggest reverse myocardial remodeling after implantation of a pulsatile LVAD in children. Further investigation with a larger sample size and longer follow-up period is necessary to identify possible factors.