VAD and Mortality Rates in CHD Patients Awaiting Heart Transplantation

The Berlin Heart EXCOR ventricular assist device (VAD) is associated with the lowest mortality rate among heart-supporting devices used in patients with congenital heart disease (CHD) who are awaiting heart transplantation, according to study results presented at the American College of Cardiology (ACC) 2023 conference, held from March 4 to 6, 2023, in New Orleans, Louisiana.

Researchers conducted a systematic review and meta-analysis in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement. They searched the PubMed, Cochrane, Google Scholar, and Scopus databases for relevant articles on use of VAD and extracorporeal membrane oxygenation (ECMO) as heart-supporting equipment in patients with CHD awaiting heart transplantation.

The main outcome was overall mortality, and a random-effects model of proportional meta-analysis was used to estimate the total proportion.

A total of 17 trials were included in the analysis, in which 834 patients received VAD and 1004 received ECMO as a stopgap measure before heart transplantation.

The Berlin Heart EXCOR VAD had the lowest mortality rate (30.4%; 95% CI, 22.7%-38.1%) vs the centrifugal Thoratec VAD (56.9%; 95% CI, 38.5%-75.4%) and ECMO (42.4%; 95% CI, 24.3%-60.4%).

“The Berlin Heart EXCOR VAD type is a preferable option to improve the survival rate of CHD patients awaiting heart transplantation,” the investigators wrote.