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. 2025 Jun 30:S1053-2498(25)02054-6.
doi: 10.1016/j.healun.2025.06.018. Online ahead of print.

Contemporary outcomes of mechanical circulatory support using paracorporeal continuous flow pump in children: A report from the ACTION learning network

Jiyong Moon  1 , Lawrence Greiten  2 , Christina VanderPluym  3 , David M Peng  4 , Arene Butto  5 , Ryan Butts  6 , Scott R Auerbach  7 , Jennifer Su  8 , Matthew Zinn  9 , Sairah Khan  10 , Jonathan Byrnes  11 , Angela Lorts  12 , Shahnawaz Amdani  13 , Mohammed Absi  14 , John Dykes  15 , Anna Joong  16 , David Bearl  17 , Sabrina Law  18 , Deipanjan Nandi  19 , Sarah Wilkens  20 , Kevin Engelhardt  21 , Lindsay May  22 , Gabrielle Vaughn  23 , John Jerry Parent  24 , Joshua Friedland-Little  25 , Deepa Mokshagundam  26 , Jennifer Conway  27 , Joseph Spinner  28 , Othman Aljohani  29 , Mark Bleiweis  30 , Muhammad Farrukh Shezad  12 , Matthew J O'Connor  31
Affiliations

Contemporary outcomes of mechanical circulatory support using paracorporeal continuous flow pump in children: A report from the ACTION learning network

Jiyong Moon et al. J Heart Lung Transplant. .

Abstract

Background: This study aims to evaluate the clinical outcomes of mechanical circulatory support (MCS) using paracorporeal continuous flow (pCF) pumps in children.

Methods: This multicenter retrospective study used the Advanced Cardiac Therapies Improving Outcomes Network (ACTION) database (4/2018-7/2023). Children who were supported with a pCF pump were included. The primary outcome was survival to transplant, explant, or transition to a durable device. The secondary outcomes were adverse events. The outcomes were stratified between non-congenital heart disease (CHD) and CHD with single and biventricular physiology.

Results: Three hundred and sixty-seven patients (CHD, N = 204, non-CHD, N = 163) were supported with a median of 25 days of support (CHD: 33 vs non-CHD 19 days, p = 0.04). CHD included single ventricle (n = 135 [66.2%]) and biventricular physiology (n = 69 [33.8%]). Non-CHD included dilated cardiomyopathy (n = 130 [79.8%]), transplant graft dysfunction (n = 9 [5.5%]), and others (n = 18 [11%]). Patients with CHD were younger (0.55 vs 2.0 years, p ≤ 0.001) and smaller (body surface area 0.35 vs 0.52 m2, p ≤ 0.001, weight 6.7 vs 11.1 kg, p ≤ 0.001) than those without CHD. Overall positive outcome was 77.9% (n = 286) [survival to transplant: 38.7% (n = 142), durable device: 22.9% (n = 84)], recovery: 16.3% (n = 60). Between CHD and non-CHD, CHD showed lower positive outcomes (73.0 vs 82.2%, p = 0.05) with higher mortality (24 vs 14.1%, p = 0.02). There were comparable positive outcomes between single and biventricular CHD (73.0%), with a lower recovery rate in single ventricles (8.9% vs 21.8%, p = 0.01).

Conclusion: Mechanical circulatory support using a pCF pump in children was associated with a positive outcome in 78% of patients in a contemporary cohort. However, patients with CHD patients fared worse than patients without CHD.

Keywords: congenital heart disease; mechanical circulatory support; paracorporeal continuous flow pump; pediatric; ventricular assist device.

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