LAUSR

OBJECTIVES We reviewed outcomes in 82 consecutive children supported with the Berlin Heart pulsatile ventricular assist device (VAD), comparing those with functionally univentricular circulation (n=34) to those with biventricular circulation (N=48). METHODS The primary outcome was mortality. Kaplan-Meier methods and log-rank tests were used to assess group differences in long-term survival. T-tests using KM-estimated survival proportions and standard errors were used to compare groups at specific time points. RESULTS 48 biventricular patients were supported (Age: median=1.4 years, range=17 days-17.7 years; Weight [kilograms]: median=9.4, range=3.1-112), including 43 BiVAD, 4 LVAD only, and 1 LVAD converted to BiVAD. In biventricular patients, duration of VAD support [days]: median=97, range=4-315. Of 48 biventricular patients, 35 underwent heart transplantation, 7 died on VAD, 5 weaned off VAD (1 of whom underwent heart transplantation 334 days after weaning), and 1 is still on VAD. 34 univentricular patients were supported with single VAD (sVAD) (Age: median=38.5 days, range=4 days-13.3 years; Weight [kilograms]: median=3.98, range=2.4-32.6). In univentricular patients, duration of VAD support [days]: median=138, range=4-554. Of 34 univentricular patients, 22 underwent transplantation, 11 died on VAD, and 1 is still on VAD. One-year survival was 82.7% (95% CI=72.4%-94.4%) in biventricular patients and 59.7% (95% CI=44.9%-79.5%) in univentricular patients, P=0.026. Five-year survival was 79.7% (95% CI=68.6%-92.6%) in biventricular patients and 50.5% (95% CI=35.0%-73.0%) in univentricular patients, P=0.010. CONCLUSION Pulsatile VAD facilitates bridge to transplantation in neonates, infants, and children with functionally univentricular circulation; however, survival is less than that observed in patients with biventricular circulation.