为患有恶性心律失常的儿科患者进行心脏移植:适应症和结果。

IF 8.3 2区 材料科学 Q1 MATERIALS SCIENCE, MULTIDISCIPLINARY ACS Applied Materials & Interfaces Pub Date : 2024-10-09 DOI:10.1016/j.hrthm.2024.09.066
Joseph Atallah, Simon Urschel, James K Kirklin, Ryan Cantor, Hong Zhao, Jillian Motiuk, Timothy M Hoffman, Molly Weisert, Irene D Lytrivi, Nikki M Singh, Estela Azeka, Carol A Wittlieb-Weber
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引用次数: 0

摘要

背景:心律失常可导致心脏骤停(CA)和心力衰竭。当病情难以控制时,心脏移植(HTX)可能是唯一可行的治疗方法。这一罕见的高危人群尚未作为一个独特的群体进行报道:描述以恶性心律失常(MA)为主要适应症、被列入心脏移植名单的儿科患者的治疗效果:通过小儿心脏移植协会的前瞻性登记,我们确定了所有患者的结果:在4630名列入名单的患者和3317名接受移植的患者中,分别有63人(1.4%)和49人(1.5%)的适应症为恶性心律失常。其中,11 例 MA 患者属于 PT,4 例属于 IA,6 例属于 CHD,42 例属于 CM。与非 MA 患者队列相比,MA 患者的年龄更大(平均(标清)年龄为 10.6 (6.2) 岁 vs. 6.1 (6.2) 岁,p 结论:马氏综合征患者在儿童期因高热惊厥入院的患者中只占一小部分。CM是最常见的类型,而IA和PT则很少见。他们的候诊死亡率和移植后的预后与非MA队列相当。
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Heart transplantation for pediatric patients with malignant arrhythmias: Indications and Outcomes.

Background: Arrhythmias can lead to cardiac arrest and heart failure. When intractable, heart transplantation (HTX) can become the only viable treatment. This rare high-risk cohort has not been reported as a distinct group.

Objective: The purpose of this study was to characterize the outcomes of pediatric patients listed for HTX with the primary indication being malignant arrhythmia (MA).

Methods: Using the Pediatric Heart Transplant Society prospective registry, we identified all patients younger than 18 years listed between 2014 and 2022. MA as the listing indication was categorized into primary tachyarrhythmia (PT), inherited arrhythmia (IA), congenital heart disease, and cardiomyopathy (CM) with secondary arrhythmia. Demographic, listing, and transplant data were analyzed.

Results: Among 4630 patients listed and 3317 transplanted, MA was the indication in 63 (1.4%) and 49 (1.5%), respectively. Patients with MA were categorized as PT in 11 (17%), IA in 4 (6%), congenital heart disease in 6 (10%), and CM in 42 (67%). Compared with the non-MA cohort, patients listed for MA were older (mean age 10.6 ± 6.2 years vs 6.1 ± 6.2 years; P < .01), more likely to present with cardiac arrest (43% vs 11%; P < .01), and less likely to be in the intensive care unit (40% vs 58%; P < .01) or on inotropes (30% vs 60%; P < .01) at the time of listing. Outcomes including waitlist mortality, transplantation, posttransplant survival, and freedom from rejection were comparable to those of the non-MA cohort.

Conclusion: Patients with MA constitute a small proportion of those listed for HTX in childhood. CM was the most common category, while IA and PT were rare. Their waitlist mortality and posttransplant outcomes were comparable to those of the non-MA cohort.

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来源期刊
ACS Applied Materials & Interfaces
ACS Applied Materials & Interfaces 工程技术-材料科学:综合
CiteScore
16.00
自引率
6.30%
发文量
4978
审稿时长
1.8 months
期刊介绍: ACS Applied Materials & Interfaces is a leading interdisciplinary journal that brings together chemists, engineers, physicists, and biologists to explore the development and utilization of newly-discovered materials and interfacial processes for specific applications. Our journal has experienced remarkable growth since its establishment in 2009, both in terms of the number of articles published and the impact of the research showcased. We are proud to foster a truly global community, with the majority of published articles originating from outside the United States, reflecting the rapid growth of applied research worldwide.
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